Background and Objectives: 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. Study Design: Patients were asked to report sexual activity and condom use while STD symptoms were present. Medical records were abstracted for diagnoses. Results: 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.