Objective To investigate the attitude on pre-exposure prophylaxis (PrEP) among drug users from high-risk population of AIDS in western China and its influencing factors. Methods A total of 190 drug users were recruited by snowball sampling from high-risk population of AIDS including those involved in mem having sex with men (MSM), female sex workers (FSW) and the spouse or sex partner (PAR) of HIV carrier in Chongqing, Sichuan, Guangxi and Xinjiang. Self-administered questionnaire survey was conducted with the assistance of investigators. Univariate and multivariate logistic regression was employed for statistical analysis. Results MSM, FSW and PAR accounted for 34.74%(66/190), 48.42%(92/190) and 16.84% (32/190) among the 190 drug users, respectively. The positive attitude rate for PrEP among drug users reached 70% in the premise of drug safety and effectiveness, which increased with favorable condition provided. The Results of multivariate logistic regression analysis indicated that the factors significantly associated with the positive attitude for PrEP included awareness of AIDS seriousness (OR: 2.66, 95% CI: 1.14-6.25, P=0.024 2), attitudes towards HIV patients(OR: 4.41, 95% CI: 1.68-11.58, P=0.002 6； OR: 2.99, 95% CI: 1.05-8.54, P=0.040 3) and virus detection of AIDS (OR: 1.94, 95% CI: 0.98-3.87, P=0.058 1). Conclusion The attitude for PrEP among drug users from AIDS high-risk population is mainly related to the attitude for AIDS, AIDS-related knowledge and behavior, and preventive measures for AIDS, indicating that PrEP should be implemented and promoted with a sound social background, and education on HIV/AIDS prevention should be reinforced. Positive attitude towards AIDS prevention need to be developed among drug users by various behavioral therapies, so as to improve the attitude for PrEP among drug users with high HIV risks.