The HIV epidemic is a global health problem that has now shown an increasing case in men who have sex with men (MSM). This study aims to identify the relationship between drug use, HIV disclosure and interpersonal communication patterns towards sexual risk behavior in HIV-positive MSM. This study used a cross sectional design with purposive sampling technique on respondents who visited the VCT clinic in Budi Kemulian Hospital Batam and snow ball sampling technique on  respondents in the work area of ​​the Lubuk Baja Health Center in Batam City involving 126 HIV positive MSM. The results showed that there was a significant relationship between HIV disclosure and sexual risk behavior (p = 0.019; α = 0.05; OR = 2,530) and a significant relationship between interpersonal communication patterns and sexual risk behavior (p = 0.016; α = 0.05; OR = 2,589). In multiple logistic regression analysis, it was found that education was the factor that most influenced the sexual risk behavior of HIV positive MSM (p = 0.027; α = 0.05; OR = 2,807; 95% CI = 1,125-7,006). HIV disclosure and interpersonal communication patterns have a significant negative relationship with sexual risk behavior of HIV-positive MSM, so nurses need to improve comprehensive assessment and personal counseling and education in reducing behaviors that are at risk of HIV transmission and improve disease management for HIV-positive MSM.