Rapid HIV Testing_Screening Survey

 
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1. How did you hear about our study?
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2. Are you:
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3. How old were you on your last birthday? (Please only use whole numbers and exclude months. For example, you could answer "26").
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4. Do you consider yourself?
5. In the past year, how many male sexual partners have you had? You can approximate. (Please use whole numbers. Do not use fractions or decimal points.)
6. Currently, are you in a monogamous relationship?
7. Have you ever tested HIV positive?
8. On average, how many times per month (an approximate number) do you have receptive anal intercourse (bottom)?
9. Thinking of the last 10 times you bottomed, how many times would you say you used condoms?
10. If someone has receptive anal intercourse (that is, they bottom) without condoms, would you say that:
11. How many alcoholic drinks (an approximate number) do you have per week?
12. Do you smoke cigarettes?
13. How do you want to receive notification if you qualify for this study? Please include an email address or phone number.
14. What do you want to be called? Nicknames are acceptable. This study is completely anonymous.
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