This study is based on a large-scale household survey and in-depth interviews of key informants that were conducted in villages in three counties of two provinces in China. We assess the new decentralized service provision system for people living with HIV/AIDS in rural populations in China. Since 2003, new social assistance schemes and, more importantly, decentralization of routine treatment and care to community health stations, were progressively implemented in rural areas most affected by the HIV/AIDS epidemic. Though some problems remain, such as persistent discrimination towards infected patients and lack of sufficient training for medical personnel, the new decentralized pattern of service provision has lowered barriers to health access and alleviated economic pressure on affected households.