Since 1990 have you ...

• Had unprotected vaginal, oral, or anal sexual activity or intercourse?
   
• Had unprotected sex with a man who has had sex with another man or men?
   
• Had unprotected sex with someone who has HIV or AIDS, or who you think might have been infected?
   
• Had unprotected sex with someone you believe has injected drugs (someone who "shoots up")?
   
• Not properly and carefully used latex condoms with people who might have had HIV?
   

 Have you ever ...

• Injected drugs, steroids, or vitamins, or had a sexual partner who did or does so?
   
• Shared needles and/or the same cooker, cotton, rinse water, or other possibly contaminated materials?
   
• Had multiple sexual partners?
   
• Given or gotten money or drugs in exchange for sex?
   
• Had a sexually transmitted disease (STD), such as gonorrhea, syphilis, chlamydia, genital herpes or warts, or had a sexual partner with an STD?
   
• Received transfusions of blood or blood components between early 1978 and mid-1985, or had a sexual partner who had?
   
• Had sexual partners who have had other sexual partners who did any of the above?