Expression of Interest for people to be video interviewed on sex, HIV and HIV prevention

HIV Online Learning Australia (HOLA) are looking for people who would be comfortable to talk about their experiences with sex, HIV and HIV prevention on camera. These videos will be used as part of online learning for people who work in the community HIV workforce.

We are looking for diverse group of people including across a range of sexualities, genders, cultural backgrounds and experiences with HIV.

Registering your details below is providing an expression of interest only, and depending on the level of interest may not guarantee participation. After you have submitted this form, we may be in contact to check if you are still interested and organise a brief video call to get to know better and to organise a date for filming.

The filming will run over a two-hour period and you will be compensated for your time with a $50 gift voucher.

If you would like to chat to us before completing this form, please email us at hola@afao.org.au

Please fill in the answers below to submit your expression of interest to participate in the filming:

Personal Details:

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* Name:

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* Pronouns (select all that apply):

They/them/theirs

She/her/hers

Him/him/his

I don't use pronouns

Other (please write)

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* Phone Number:

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* Email:

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* Occupation:

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* If you have a photo of yourself to include, you can upload it here

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

More information:

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* What year were you born?

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* What country were you born in?

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* What is your cultural background?

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* Do you speak another language other than English? (if yes, please explain)

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* How would you describe your gender identity? (select all that apply)

Man or Male

Woman or Female

Non-Binary or Gender Diverse

Different identity

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* What sex were you recorded at birth? (i.e. what sex was specified on your original birth certificate)

Male

Female

Neither male nor female

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* How would you describe your sexual orientation? (select all that apply)

Gay or Lesbian

Bisexual or multi gender attracted

Asexual

Queer

Straight (heterosexual)

I use a different term

I don't know my sexual orientation

Prefer not to answer

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* Do you identify as (select all that apply)?

Person living with HIV

Person with a disability

Aboriginal or Torres Strait Islander

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* If you are a person living with HIV, when were you diagnosed?

Less than 12 months

1-2 years

2-5 years

5-10 years

10+ years

Expression of Interest for people to be video interviewed on sex, HIV and HIV prevention

Question Title

* Name:

Question Title

* Pronouns (select all that apply):

Question Title

* Phone Number:

Question Title

* Email:

Question Title

* Occupation:

Question Title

* If you have a photo of yourself to include, you can upload it here

Question Title

* What year were you born?

Question Title

* What country were you born in?

Question Title

* What is your cultural background?

Question Title

* Do you speak another language other than English? (if yes, please explain)

Question Title

* How would you describe your gender identity? (select all that apply)

Question Title

* What sex were you recorded at birth? (i.e. what sex was specified on your original birth certificate)

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* How would you describe your sexual orientation? (select all that apply)

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* Do you identify as (select all that apply)?

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* If you are a person living with HIV, when were you diagnosed?

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* Is there anything else that you would like to share about yourself and/or identity?