The issues that have taken shape around the need to prevent the spread of HIV/Aids, and to manage the risks of an epidemic, throw light on the pressing contradictions within Chinese society. They offer a very relevant approach for analysis of current changes in the field of sexuality and to understand the variety of its discourses and practices. The theoretical perspective of this article will be informed by a constructivist approach, since such approaches have radically altered our understanding of sexuality by raising questions about the social and historical contexts that surround it. In China, the history of sexually transmitted disease (STD) epidemics shows that the ways in which sexuality is managed have a greater impact than disease control measures or health education. Nonetheless, despite the political efforts on the part of official agencies, combined with the dominant pressures of family values and of “revitalised” cultural features inherited from the past, individuals are subjected to the multiple influences associated with globalisation and China's transformation into a consumer society. Recent studies have revealed marked shifts in the expression of sexuality. This article has three sections. The first gives an analytical overview of current scientific literature, and of the available data concerning sexual behaviour and its representation. The second deals with governmental action and pronouncements in relation to the dynamics of the Aids epidemic and the risks of sexual transmission. Finally, the third section provides a diachronic analysis of the state's management of sexual issues.