The present formative study sought to describe issues relevant to HIV prevention among men who have sex with men (MSM) in South India by surveying 62 MSM outreach workers from three non governmental organizations in Chennai. Although 92% reported having sex with men, only 74% identified as gay and 27% were married. Only half of these men reported having been tested for HIV. More than half of the sample reported that they would rather not know they had HIV until they were sick, and almost half indicated that they would rather end their life than live with the disease. Eighty-five percent of the sample reported having experienced varying levels of harassment from police, and 86% reported varying levels of harassment from others. These data point to several important barriers to HIV prevention among MSM in South India and lay the groundwork for enhancing the use of outreach workers to play a role in HIV prevention in this population.