HIV-related stigma and discrimination are major barriers to the successful control of HIV. Stigma is associated with the disease as well as the behaviors that lead to infection. A qualitative study was conducted to identify the reasons, sources, and types of HIV-related stigma prevalent in rural China. Eighty in-depth interviews were conducted with people living with HIV/AIDS, their family members, health care providers, and uninfected villagers. Stigmatizing behaviors were primarily associated with fear of HIV rather than with the route of infection. Uninfected villagers were the main source of discrimination, with health workers and family members also holding some stigmatizing attitudes. A primary concern for HIV-positive villagers was protecting their families, especially their children, from discrimination. Secondary stigma also extended to uninfected members of the same village. The results have been used to develop an intervention to reduce fear of casual transmission and stigma in these communities.