BACKGROUND: Acupuncture is in widespread use in China, a country where the prevalence of infection with hepatitis B (HBV) is high and that of other bloodborne viruses is growing. Policies to reduce iatrogenic transmission have so far focused on injections, overlooking the risks connected with acupuncture. OBJECTIVE: To assess knowledge, attitudes, and practice relevant to the potential iatrogenic transmission of bloodborne viruses in Guizhou province, southwest China. MATERIALS AND METHODS: Semi-structured interviews and focus groups were conducted (in 2005) with 80 health care workers, patients, and other key informants in health facilities at provincial, county, and village levels. RESULTS: In village clinics, reusable acupuncture needles were disinfected with alcohol rather than being sterilized, because of concerns that sterilization might blunt the needles. Sterilization of equipment by acupuncturists in the informal sector may be inadequate, but official monitoring of their practice appears not to be taking place. Acupuncturists working in hospitals are not included in formal training on bloodborne diseases and do not routinely receive HBV immunization. Some health workers lack clear understanding of asymptomatic infections. CONCLUSION: Policy on iatrogenic transmission of bloodborne viruses in China needs to place a greater emphasis on safe acupuncture, taking account of prevailing beliefs that may lead to hazardous practices, while enforcing safe procedures.