Sexual sensation seeking has been correlated with STI-related risk factors in numerous cross sectional studies. However, no current studies have examined whether sexual sensation seeking is longitudinally related to a broad spectrum of STI-related factors such as consistent condom use, number of sexual partners, frequency of partner sexual communication, self-efficacy to refuse sex, and fear of condom negotiation. We explored these relationships over a 12-month period among a sample of 715 African American females attending three STI clinics in Georgia that were recruited into a larger randomized clinic intervention study. Utilizing A-CASI technology to assess all self-reported measures and employing general estimation equations while controlling for age, peer norms, school enrollment and employment, major results indicated that higher sexual sensation seeking predicted lower percent of condom use in the last 14 and 60 days, lower consistent condom use and a higher number of lifetime sexual partners. Additionally, higher sexual sensation seeking predicted lower partner sexual communication, diminished self-efficacy to refuse sex, and a higher fear of condom negotiation. Findings suggest that STI/HIV prevention/intervention programs should assess for and target sexual sensation seeking behaviors in such efforts.