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Background: Sexual orientation disclosure has been reported to promote good peer support, improve psychological health, as well as access to STIs and HIV prevention services. Hence, this study sought to assess the level of disclosure sexual orientation and its predictors among HIV-positive men who have sex with men (MSM) in Plateau state Nigeria. Methods: This was a cross-sectional study design conducted between October 2018 and December 2019 among 114 HIV-infected MSM through respondent driven sampling technique. Epi Info version 7 was used for the data analysis with adjusted odds ratio and 95% confidence interval (CI) used as point and interval estimates on the logistic regression model and P < 0.05 considered statistically significant. Results: The mean age of the respondents was 26.0 ± 5.4 years with disclosure of sexual orientation to nonpartner being reported by 45 (39.5%). Positive family history of same sex practice was found to significantly predict self disclosure of sexual orientation (adjusted odds ratio: 3.30; 95% CI: 1.2356–8.8038; P = 0.017). Conclusions: This study has revealed a low level of disclosure of sexual orientation among HIV-positive MSM in Plateau state with a positive family history of same sex involvement as its predictor.