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HIV Risk Assessment Questionnaire
Health ServicesSexually Transmitted Infections > HIV Risk Assessment Questionnaire 


Please read the following information and answer the questions to help you determine your risk for HIV. Please feel free to ask a counselor any questions you may have.
  1. Have you or your sexual partner(s) had other sexual partners within the last year?
  2. Have you ever had a sexually transmitted infection (like gonorrhea, Chlamydia, warts, etc.)?
  3. Are you pregnant or considering becoming pregnant?
  4. Have you or your sexual partner(s) injected drugs or other substances and/or shared needles with another person?
  5. Have you ever had sex with a male partner who has had sex with another male?
     
  6. Have you ever had sex with a person who is HIV infected?
  7. Have you been paid for sex and/or had sex with a prostitute/sex worker?
  8. Have you engaged in behavior resulting in blood to blood contact (e.g., S&M, tattooing, piercing)?
  9. Have you or your sexual partner(s) received a blood transfusion or blood products transfusion before 1985?
  10. Have you been the victim of rape, date rape or sexual abuse?
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