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A cross-sectional survey of sexually transmitted disease (STD) patients assessed sexual activity and condom use during the time between STD symptom onset and clinic attendance.Patients were asked to report sexual activity and condom use while STD symptoms were present. Medical records were abstracted for diagnoses.The study population (n = 3025) was predominately African American (75.3%) and male (63.5%), with a mean age of 28.1 years. Sexual activity while experiencing STD symptoms was reported by 39.7% of 2,508 symptomatic patients, 17.2% of whom reported always using a condom. Logistic regression models identified the significant independent determinants of sexual intercourse while symptomatic were duration of symptoms before clinic visit [0-7 days versus 8 or more days, OR = 5.9]; race [African American versus other races (primarily Hispanics), OR = 2.1]; and gender [men versus women, OR = 1.5]. Older age [≥30 years versus 18-29 years, OR = 1.5] and higher education attainment [≥high school versus > high school, OR = 1.5] were the significant factors associated with reporting always using a condom.These data suggest patient groups with behaviors likely to enhance STD transmission could be targeted for educational messages.