Perceptions regarding sex and condom use among Chinese college students were examined within a framework provided by protection motivation theory. Data from semistructured individual interviews indicate that Chinese students generally perceive a low level of vulnerability to HIV and sexually transmitted disease (STD) infection and a minimum exposure from family to drugs and risky sexual behaviors. While only a small proportion of students reported being sexually experienced, the majority of them expressed tolerance toward premarital sex and a high level of perceived intrinsic rewards from sexual experience. Students view condoms to be efficacious in preventing pregnancy or HIV/STD, but they also perceive a high level of response cost for use of condoms. The findings suggest that efforts to adapt HIV/STD prevention programs targeting Chinese adolescents and young adults need to consider cultural aspects of perceptions regarding sex and condoms among Chinese students and to address the conflict between traditional Chinese cultural values and modern influences.