Background: Inadequate knowledge, negative attitudes towards people living with HIV/AIDS and risky practices are related to the spread of HIV infection. This study aimed to explore and test associations between knowledge, attitude and AIDS prevention behavior among students in Kham Mouane Technical-Vocation College, Lao People’s Democratic Republic. Methods: A cross-sectional, self-report questionnaire study was conducted in May 2018. Pearson's Chi-squared test and binary logistic regression was used to test the association between variables. Results: Of 939 participants, it was found that: 61.6% were women; the mean age was 20.7 years (range 18-28 years); 40.2% lived in the college dormitory; >80% drank alcoholic beverages; 31.9% drank until slightly intoxicated; 13.7% drank until drunk; and the average drinking rate was 1-2 times a month (50%). Knowledge levels about the route of HIV transmission and how it can be controlled were poor. Misunderstood issues included: HIV transmission can be controlled by having a single partner and using condoms while having sex was correctly understood by only 22.8%; 72% incorrectly reported that HIV can be transmitted through a mosquito bite; and 48.2% believed incorrectly that drinking alcohol can disinfect HIV. Attitudes towards HIV were at a moderate level: the participants believed that infected persons should not reveal themselves in public, at work or college, and that requesting a boyfriend use a condom showed mistrust. HIV prevention practices were reported at a better level: reducing opportunity for sex by not cohabiting or staying privately with a lover and wearing condoms regularly during sexual intercourse, although more than 70% still drank alcohol when visiting nightclubs, associated with an increased likelihood of unprotected sex. Conclusions: Public and community stakeholders need to design HIV prevention classes suited to college environments to improve students’ knowledge, attitudes and risky behavior practices related to HIV.