Objective To evaluate a four-hour life-skills-based HIV/AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province.Methods The study included two stages.Stage one (September 2006-May 2007) was a pre-post-quasi experimental design;a total of 2 413 students aged 9 to 14 years from fifth grade classes of nine primary schools completed a baseline survey (1 720 students were in the intervention group,693 in the control group),and over 98% of them took part in a short survey.The experimental curriculum was provided to the intervention group.At stage two (September 2008),a cross-sectional questionnaire was administered to 6 923 students in 7th grade classes of eight middle schools in the same study sites.There were 1 437 students in the intervention group when the curriculum was conducted.Results Students tended to score higher in areas of HIV/AIDS related knowledge and attitudes,if they were younger than average,lived in the county seat,had access to the internet,and their parents had completed higher levels of education.Path analysis showed that,after controlling for characteristics such as family and community factors,the total effects of curriculum on knowledge in the short-term model increased remarkably compared with the baseline,and maintained major contributions to knowledge in the mid-term model.The positive effect of knowledge on attitudes was significantly improved in the short-term model as well.Conclusion A life-skills based curriculum can improve HIV/AIDS related knowledge and self-perceived level of life-skills among primary school students in rural areas in a short time,and these positive effects can still be observed at least 2 years post participation in the curriculum. Objective To evaluate a four-hour life-skills-based HIV / AIDS prevention curriculum among 5th grade students in rural primary schools of Hainan province. Methods The study included two stages. Stage one (September 2006-May 2007) was a pre-post -quasi experimental design; a total of 2 413 students aged 9 to 14 years from fifth grade classes of nine primary schools completed a baseline survey (1 720 students were in the intervention group, 693 in the control group), and over 98% of they took part in a short survey. The experimental curriculum was provided to the intervention group. At stage two (September 2008), a cross-sectional questionnaire was administered to 6 923 students in 7th grade classes of eight middle schools in the same study sites . There were 1 437 students in the intervention group when the curriculum was conducted. Results students tended to score higher in areas of HIV / AIDS related knowledge and attitudes, if they were younger than average, lived in the county seat, had access to theinternet, and their parents had completed higher levels of education. Path analysis showed that, after controlling for characteristics such as family and community factors, the total effects of curriculum on knowledge in the short-term model increased remarkably compared with the baseline, and maintained major contributions to knowledge in the mid-term model. The positive effect of knowledge on attitudes was significantly improved in the short-term model as well. Confluence A life-skills based curriculum can improve HIV / AIDS related knowledge and self-perceived level of life-skills among primary school students in rural areas in a short time, and positive results can still be observed at least 2 years post participation in the curriculum.