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Background  Given the widespread use of the Internet among men who have sex with men (MSM) and high risk of Internet-facilitated sexual behaviors, Internet-based interventions to reduce sexual risk are urgently needed.    Methods  We recruited 1,100 participants from online and randomly assigned to two groups. One group received online HIV intervention services. Online HIV intervention was developed through mix-method formative research, measures included scenarios experiencing intervention and HIV information dissemination. Self-reported condomless anal sex with a male in the past three months was measured to evaluate the intervention effect.    Result  Of the 1,100 participants, the majority were aged between 21 and 30 years old (62%), had a college degree or higher (80%), were single (88%), and self-identified as homosexual (78%). The estimated risk difference of condomless sex with a male in the past three months between groups was 9.3% (95% confidence interval (CI): 1.1, 17.5%). Using multiple imputations intention-to-treat, the estimated risk difference was 8.9% (95%CI: 1.2, 16.6%). Modification effects were found between intervention and characteristics including: educational attainment ( p  = 0.012), marital status ( p  = 0.005) and awareness of AIDS-related knowledge ( p  = 0.010).    Conclusion  Internet appears to be a promising approach to disseminate HIV prevention amongst MSM. Interactive online intervention appeals to MSM and poses a great potential for reducing HIV risky behavior.    Trial registration   ChiCTR1800014260  (retrospectively registered 2 Jan, 2018).    Electronic supplementary material  The online version of this article (10.1186/s12879-019-4251-5) contains supplementary material, which is available to authorized users.

Online HIV prevention intervention on condomless sex among men who have sex with men: a web-based randomized controlled trial