11% of survey complete.

West Hollywood is committed to ending stigma and HIV. Help us get there by taking the survey and enter to WIN an AMEX $100 gift card.

1. How do you describe your gender identity?
(SELECT ONE)

2. What best describes your sexual identity?
(SELECT ONE)

3. What is your HIV status

4. What is your age?

5. Select the race/ethnic group(s) that best describe(s) you?

6. Is your Doctor/Health Provider located in the City of West Hollywood?

7. Do you live, work, own property, spend a significant amount of time, or are homeless in West Hollywood?

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