Objective  To describe change trends in AIDS-related knowledge, attitude and sexual behavior among high school students in urban Beijing and to explore main intervention measures in future.

  Methods  The data on a total of 17 624 urban senior high school and vocational and technical students were extracted from the dataset of three waves of Beijing Youth Health Hazard Behavior Survey conducted in 2005, 2008 and 2014. The trends in AIDS-related knowledge, attitude and sexual behavior were described and compared by gender, school type and grade. Chi-square and logistic regression were used to analyze the data.

  Results  The proportion of participants receiving AIDS-related health education increased during the period, with the ratios of 45.0%, 66.2%, and 73.8% for the boy students and 49.7%, 70.1%, and 77.4% for the girl students in 2005, 2008, and 2014, respectively. However, the knowledge level and the prevalence rate of positive attitude showed a decreasing trend after their initial increase. Lower ratios for correctly answering the question about the pathogen of AIDS were observed among vocational and technical school students (65.7%, 66.5%, and 42.7%) and senior high students of grade one (71.5%, 82.4%, and 54.6%) in the surveys conducted in 2005, 2008, and 2014. The vocational and technical school students reported the highest rates of sexual behavior (10.8%, 15.5%, and 11.2%) and forced sexual behavior (3.0%, 3.2%, and 4.4%) in the surveys conducted in 2005, 2008, and 2014. The sexual education from parents became one of the top three sources of AIDS-related knowledge among all the senior high school students of grade one and two in the survey conducted in 2014.

  Conclusion  AIDS-related health education programs should be developed according to characteristics and requirements of different groups among high school students for efficient intervention.