HPTN 075 was an observational cohort study that aimed to determine the feasibility of recruiting and retaining men who have sex with men (MSM) in a multi-country prospective cohort study in preparation for human immunodeficiency virus (HIV) prevention studies in sub-Saharan Africa. Participants included those identified at birth as male, regardless of HIV infection status, aged 18-44 years who reported anal sex with a man in the past three months. Transgender women and gender diverse individuals were not specifically recruited but were not excluded from recruitment for the study. The study was conducted between July 2015 and August 2017. A total of 401 participants, regardless of HIV infection status, were enrolled at four sites in Kenya, Malawi and South Africa. Each participant was followed for 12 months, during which five study visits were conducted. These visits included interviewing participants about behaviors that may put them at risk for HIV infection, medical examinations and collection of blood samples. Of the 401 enrolled, 329 were HIV-negative at the time of enrollment. By the end of the study, 21 of them had become infected with HIV. Incidence rates differed substantially by study site.