We report on two waves of bio-behavioral surveillance of MSM in Jinan, Shandong Province, China. HIV prevalence rose from 0.05% in 2007 to 3.1% in 2008. Differences in the two waves of surveys were noted, particularly with respect to marital status, requiring stratified analysis. In multivariable analysis, unmarried, homosexually identified MSM who do not have female sex partners have a greater than sixfold greater chance of being infected with HIV compared to married, non-homosexually identified MSM who do have female partners. Carefully targeted and population-specific messages will be needed for homosexually identified and non-identified MSM in China.