Objective  To explore the influence of health education on knowledge, attitude and practice (KAP) about AIDS among freshmen in colleges and universities in Shanxi province.

  Methods  We conducted on-site anonymous questionnaire surveys on AIDS-related KAP before and after lectures on AIDS prevention and control from August to December 2018 among 3 960 freshmen recruited in 33 colleges and universities in Shanxi province. Variations in AIDS-related KAP among the participants were analyzed.

  Results  Totally 3 879 freshman (49.1% males and 51.9% females with the mean age of 20.71 ± 1.28) completed the surveys. After receiving the lectures, significantly increased awareness rates were observed among the participants for AIDS-related knowledge (mean latent period, window period, transmission route, infection risk for multiple sexual partners, condom use when having sex) and prevention policies (free treatment for AIDS patients with economic difficulties, free voluntary consultation and screening test, free detection and medication in pregnancies with AIDS for preventing mother to child transmission, tuition-free for children with AIDS, and providing daily life support to AIDS patients with poor economic conditions), attitudes and practice about AIDS patients (having a class together with AIDS patients, disclosure of AIDS status for others and self, condom usage, and seeking medical service when having a suspected infection) (P < 0.01 for all).

  Conclusion  Special lectures on AIDS prevention and control could improve AIDS-related knowledge, attitude and practice among college freshmen.