Despite decreasing trends in the rest of the country, certain low-income neighborhoods and disenfranchised African-American communities continue to face a higher burden of syphilis. Correct and consistent condom use decreases the risk of sexually transmitted diseases (STDs), and is a key behavioral intervention in STD prevention and control programs. Sexual practices of individuals, including condom use, in the last sexual encounter reduces recall bias at time of measurement and is considered a reasonable indicator for sexual behavior. This study uses data from three cross-sectional surveys conducted annually from 1998 through 2000 in two low-income inner city neighborhoods undergoing gentrification, populated predominantly by African-Americans, and a high prevalence of STDs in Houston, Texas as part of a CDC-funded syphilis prevention program. A sample of 2408 residents, 18 years or older, were interviewed using a street-intercept methodology. The surveys revealed that 3 out of 5 respondents had not used condoms in the most recent sexual encounter. Those reporting a new partner in the last sexual encounter were more likely to use condoms (53%; p<0.01) than respondents whose partners were not new (37%). Those who lived with a sex partner at the time of interview were significantly less likely (20%; p<0.01) to use a condom in the last sex act compared with the ones that did not live with a partner (51%). The intent to test for syphilis or HIV in the month following the interview was not associated with condom use. A logistic regression model revealed that condom use at last sexual encounter was significantly associated with the following: if the last sex act involved a new partner (adjusted odds ratio: 1.57; 95% confidence interval: 1.24-1.99), if the respondent lived with a sex partner (0.28; 0.22-0.34), place where last sexual encounter occurred (1.2; 1.1-1.3), and age of the respondent (0.69; 0.56-0.86). Although, the 40% condom use in the last sex act found in these high-prevalence communities was higher than 21% in the general population reported in a national survey published in 1996, syphilis and other STD burdens continue to persist in these communities. Further exploration of particular high-risk sub-groups and the role of fundamental social factors in the spread of STDs is required in order to attain the Healthy People 2010 goals for improving sexual health in disadvantaged communities.Keyword(s): community-based programs, disease prevention, health promotion