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Dramatic political, economic, and social changes in China over the past several decades have been accompanied by much discussion in popular media and among academics of a fundamental transformation in Chinese sexual behavior. Several studies have examined current Chinese sexual behavior but have been limited to particular provinces or cities and have been based on non-random samples. The potential threat of a generalized HIV epidemic in China highlights the dearth of population-based information on current patterns of sexual behavior that could help design better intervention strategies and prevent misguided ones. This article uses data from the first national probability survey of adult sexual behavior in China completed during 1999–2000, along with a historical and literature review, to address three key questions: 1) Has there been a revolution in sexual behavior in China? 2) Is China unique compared to other countries in these transformations? 3) What are the implications of these findings for China's risk of a generalized HIV epidemic?