In this paper, we report on the results of what we believe to be the first population-based, random-digit telephone AIDS survey conducted in Russia. Recent and rapidly increasing STD and HIV rates show the extremely urgent need for HIV prevention programmes in Russia. HIV sexual risk behaviour, knowledge, attitudes, and personal concern characteristics were assessed in a sample of men and women aged 15-55 years living in 435 St Petersburg households. Many factors related to high HIV risk were found in this study. Only 6% of respondents reported consistent condom use, and 78% reported that they never or seldom used condoms. At the same time, over 13% had 3 and more sexual partners during the last year and 12% had 10 and more lifetime partners. Occasional or frequent anal sex was reported by 13% of those surveyed. Two-thirds of respondents acknowledged personal risk for getting HIV but fewer than 25% indicated that they had taken steps to reduce the risks. One-third of respondents believed that condoms are not an effective protection against HIV. Forty-eight per cent of respondents believed that HIV could be transmitted through kissing, 56% through mosquito bites, and 29.2% through sharing cigarettes. HIV/AIDS prevention efforts for the general public and also targeted campaigns directed toward high-risk communities must be quickly undertaken in Russia.