Risk Assessment
Demographics
Age
*
Please enter a valid age (1–120).
Gender
*
Select…
Male
Female
Other
Please select a gender.
Risk Questions
1. Do you have the habit of using/sharing injecting drugs?
*
Used
Shared
No
Refuse to Answer
Please answer this question.
2. What kind of sexual partner(s) you have?
*
Male
Female
TG
No Sexual partner
Refuse to Answer
Please answer this question.
3. Do you have any sexual relationship beyond your spouse/partner?
*
Yes
No
Refuse to Answer
Please answer this question.
4. Have you bought sex in the past from a man, woman or TG using money, goods, favours or benefits?
*
Yes
No
Refuse to Answer
Please answer this question.
5. Have you provided sex in the past in exchange for money, goods, favours or benefits?
*
Yes
No
Refuse to Answer
Please answer this question.
6. Have you been diagnosed or experienced any symptoms of any sexually transmitted infection in the past three months?
*
Yes
No
Maybe
Refuse to Answer
Please answer this question.
7. Is your spouse or partner a PLHIV?
*
Yes
No
Refuse to Answer
Please answer this question.
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Your age, gender, and anonymous responses are recorded to assess risk. Sharing your name or mobile number is optional and only needed if you’re identified as high risk. For assistance, call 1097.
