The objectives of this study are to assess the confidence in their ability to use condoms among at-risk women and identify predictors for the women's condom use self-efficacy. Structured interviews were conducted with 250 adult women in Atlanta, Georgia, between August 1997 and August 2000. Overall, the women reported feeling moderately to moderately-strongly confident in their ability to use condoms consistently. Multivariate analysis showed women with higher condom use self-efficacy were significantly younger, experienced childhood neglect, had higher self-esteem, communicated better with their sex partner, and had fewer drug problems. Findings suggest the importance of addressing condom use self-efficacy in HIV risk reduction programs with a specific focus on women and the need to be attuned to tailored needs for specific subgroups such as older women or women who encountered childhood neglect.