A traditional society in change encounters HIV/AIDS: knowledge, attitudes, and risk behavior among students in northwestern China.

China has to date in general only been moderately affected by the global HIV epidemic, but there are cities, particularly in Yunnan, with a high prevalence. This situation seems to be changing, however, with the risk of a rapidly growing epidemic. Our aim was to investigate the level of knowledge about HIV and AIDS and risk behavior among young people at Xinjiang Medical University, Urumqi, China. Xinjiang has a population of mixed minority groups and Han Chinese. The largest minority group is the Uygur (8.82 million), who are Sunni Muslims and speak a Turkish language. Questionnaires were handed out to 400 students. Twenty open interviews were conducted after invitation to the students answering the questionnaires and their friends. All but one had heard about HIV/AIDS and approximately 95% knew the most common routes of transmission: sexual contact, mother to child, and sharing needles. Eighty percent also knew about transmission through breastfeeding. There were some knowledge gaps about how HIV is not transmitted. The questionnaires showed that only 5.7% of the undergraduate students admitted to being sexually active. Twenty-eight percent of the undergraduates and 17% of the postgraduates would not tell anyone if they were infected with HIV. In the interviews the students' knowledge of HIV/AIDS seems to be superficial. Although they did not display high sexual risk behavior during the time of our study, attitudes are changing, and becoming more liberal. We believe that extensive information about sex, infection, and protective measures is crucial to help China prevent an epidemic.