Although the South African government has increased the number of male condoms distributed free to the public, there is no understanding of whether these are being used effectively to prevent the spread of sexually transmitted diseases, including HIV infection. The study goal was to determine sexual behaviors and barriers to condom use among individuals procuring condoms distributed free to the public sector. In a prospective study, individuals who procured condoms from 12 public health facilities across South Africa were recruited and observed for the next 5 weeks. The 384 successfully observed subjects reported 3262 sexual contacts, of which 2637 (81%) involved protection with a condom. In multivariate analysis, alcohol consumption and use of other contraceptives were associated with unprotected sexual intercourse. The levels of condom use are relatively high in this population, but these data highlight several important barriers to condom use that may be targeted by future interventions.