OBJECTIVE: To assess the quality of life (QOL) and hostile mentality trend (HMT) of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in China, and to identify their major concerns. STUDY DESIGN AND METHODS: Short Form-36 (SF-36) was used to assess QOL, and seven items were developed to assess the HMT. In-depth interviews were conducted with patients and health workers. RESULTS: SF-36 had moderate reliability, with Cronbach's alpha coefficients ranging from 0.75 to 0.90 and test-retest correlation coefficients ranging from 0.54 to 0.80 for the eight domains. The item-subscale correlation coefficients ranged from 0.46 to 0.97. The QOL of patients with HIV/AIDS was significantly lower than the average QOL of the general population (P<0.01). Hostile mentality of patients was significant (mean scores of the seven items ranged from 2.87 to 4.32, and the mean sum of scores was 3.45 from a range of 1-5). Cronbach's alpha coefficient of HMT items was 0.75 and the test-retest correlation coefficient was 0.80. The major concerns of patients with HIV/AIDS were financial insecurity and family responsibilities, followed by the fear of death and no cure for HIV/AIDS. CONCLUSION: SF-36 is a reliable instrument for the assessment of QOL of patients with HIV/AIDS. The QOL of patients with HIV/AIDS in China is poor. The HMT is a valuable indicator to monitor the outcomes of care for patients with HIV/AIDS.