PrEP Questionaire

How do you consider yourself? (Gay, Straight, Bi etc)
   What race/ethnicity to you most closely identify with?

In the last 72-hours, have you been exposed to the semen or blood of someone you know to be HIV positive?

Have you ever been diagnosed with HIV?

Have you ever taken or are you currently taking prep?
Who are you normally having sex with?
In the last 6 months, how many sexual partners have you had?
What type of sex do you normally have?
In the last 6 months, have any of your sexual partners been HIV positive?
In the next 6 months, do you plan to have any of the following unprotected sex or unprotected sex with someone who you know is HIV positive?
Have you been diagnoses with any of the following in the last 6 months?
Have you ever been diagnosed with Syphilis (in your lifetime)?
Have you ever been diagnosed with any of these conditions?
Are you currently taking any medications, herbal treatments like St. John’s Wort or nutritional supplements such as creatinine?
Do you have drug allergies?