This study examined the effectiveness of video-based patient education interventions on promoting condom use among men and women seeking services at a large public STD clinic in New York City. Culturally sensitive video-based interventions designed to promote safer sex behaviors were evaluated in a randomized study of black and Hispanic male and female STD clinic patients. Subjects (n = 1,653) were randomly assigned to one of three groups: 1) control, 2) video viewing, and 3) video viewing followed by participation in an interactive group session led by a trained facilitator. The authors examined 1) the effectiveness of interventions in increasing STD and condom-related knowledge, positive attitudes about condoms, human immunodeficiency virus/STD risk perceptions, and self-efficacy and 2) the relationships among these variables, level of intervention, and condom acquisition, a behavioral measure of condom use. Compared with a control group, subjects assigned to video viewing demonstrated greater knowledge about condoms and STDs, more positive attitudes about condom use, increased human immunodeficiency virus/STD risk perceptions, greater self-efficacy, and higher rates of condom acquisition. Subjects assigned to video viewing followed by interactive sessions demonstrated still further increases in risk perceptions, self-efficacy, and condom acquisition, but not in knowledge or condom attitudes. A significant proportion of the association between the behavioral outcome of condom acquisition and level of intervention is attributable to the impact of interventions on risk perception and self-efficacy. Based on extensive formative research that identified barriers to safer sex behaviors, video-based interventions were developed to promote condom use among black and Hispanic men and women attending STD clinics. Designed to be integrated into clinic services, these interventions help improve knowledge, promote positive attitudes about condoms, and increase condom acquisition among individuals at high risk of acquiring and transmitting human immunodeficiency virus infection and other STDs.