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Condoms are one of the most effective methods of birth control and sexually transmitted illness (STI) prevention. A great deal is known about condom knowledge, attitudes, and use in different countries in the current literature, but not much comparative data exist. This study seeks to explore the cross-cultural differences in condom knowledge, attitudes, and use, as well as the relationships among these variables, for young, educated women--an important yet often overlooked target audience for prevention campaigns. We surveyed approximately 300 18- to 30- year-old women each from China, India, the United Kingdom, and the United States (n = 1,099) using online survey services. Results showed that American and British women reported better condom knowledge and more favorable condom attitudes than Chinese and Indian women; however, Chinese women reported significantly higher condom use than others. Multi-group structural equation modeling (SEM) revealed that condom negotiation was the most important explanatory factor of condom attitudes among all four groups. Embarrassment during condom purchase and lack of accessibility for purchase were important in determining condom attitudes of Indian women. Moreover, condom use was more strongly associated with condom attitudes among Chinese and Indian women than American and British women. Condom knowledge was not positively associated with condom use in any of the groups. Theoretical contributions to the literature and practical implications for condom promotion, sex education, and health campaigns are presented. [ABSTRACT FROM AUTHOR]