The first patient with acquired immunodeficiency syndrome (AIDS) was identified in 1985; since then, as of October 31, 2010, a total accumulative number of 370,000 patients with human immunodeficiency virus (HIV)/AIDS have been reported. The estimated number of patients living with HIV (PLHIV) in China was 740,000 in 2009. Although China is still a low-HIV prevalence region (rate of 0.057%), the epidemic has spread more widely from the high-risk groups to the general population. This paper covers five topics of importance, i.e., current trends of the HIV epidemic; HIV-1 subtype diversity; emergence of HIV drug resistance; the country’s response to the disease; and future challenges and additional actions needed. This paper emphasizes sexual transmission as the predominant route of transmission and it being spread more frequently among men who have sex with men; the epidemic being concentrated over particular areas in China. We also discuss the fact that diverse HIV-1 subtypes have been found throughout the entire country and that recombinant subtypes became predominant. We also explore other topics such as the possibility of HIV drug resistance (HIVDR), including primary and secondary resistance, with the use of free high activity antiretroviral therapy (HAART); the integrated strategy of HIVDR surveillance and individual clinical HIVDR testing as a new attempt in China. For many years both policy-makers and professionals (including non-governmental organizations) have expressed strong commitment to prevention, control, and care of HIV/ sexual transmission infection (STI), promoted the research and conducted different actions to slow the rising trend of the HIV epidemics. Although China is facing many challenges, its citizens need to be persistent on continuing the campaign of the State Council titled “Information of Strengthening Work on Prevention and Control of AIDS”.