Risk Assessment Tool

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Read Me* This field is required.By checking this box below you agree to the privacy policies of this site. Data collected only be used to guide our recommendations for you, to give you the best possible clinic options and to understand overall reach of this system online.
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What is your date of birth? 📆
Date
Year
Month
Day
3
When was your last HIV test? 💉
Within the past 3 months
Between 3 to 6 months ago
More than 6 months ago
Never
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What is your HIV status?
HIV Negative
HIV Positive
Not Sure
5
PrEP is a once daily pill that can prevent HIV. Are you taking PrEP? 💊
I take PrEP everyday
I take PrEP when I need it
I do not take PrEP
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How often are you taking treatment? 💊
Everyday
Some days
No longer taking treatment
Did not start taking treatment
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Risk Assessment Result 1
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Which of the following apply to you?
I meet regularly with my doctor to for PrEP care (STI testing and lab tests)
I am not meeting with a doctor to help manage my PrEP use
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Which of the following apply to you?
My viral load is suppressed or undetectable (as told by my doctor or lab test)
I have been taking my HIV treatment every day for the last 6 months or more
Not there yet
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How do you identify your gender today?
Male
Female
Transgender
Rather not say
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What was your sex assigned at birth? 👶
Male
Female
Rather not say
12
What was your sex assigned at birth? 👶
Male
Female
Rather not say
13
What was your sex assigned at birth? 👶
Male
Female
Rather not say
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Who do you have sex with? 💕
Men
Women
Both
Not having sex yet
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Who do you have sex with? 💕
Men
Women
Both
Not having sex yet
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Have you experienced any of the following since your last HIV test?
Sex without a condom or condom broke
I shared a needle with someone else
None of these
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Have you experienced any of the following since your last HIV test?
Sex without a condom or condom broke
I shared a needle with someone else
None of these
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Have you experienced any of the following since your last HIV test?
Sex without a condom or condom broke
I shared a needle with someone else
None of these
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When you had sex without a condom recently, were you…?
Top
Bottom
Both
Other
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When you had sex without a condom recently, were you…?
Top
Bottom
Both
Other
21
When you had sex without a condom recently, were you…?
Top
Bottom
Both
Other
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Risk Assessment Result 2
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Have you experienced any of the following in the last 6 months?
Injected drugs not from a medical doctor
I received money or goods in for sex
Multiple sex partners
Sex without my consent
Had an STI or STI symptoms
Alcohol or drugs before sex
High fun or chem sex
Joined a sex party
I paid for sex
Emotional or physical abuse or violence from a sexual partner
None of these
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Are you on oral substitution therapy (OST) now?
Yes
No
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Risk Assessment Result 3
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Risk Assessment Result - Final
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You’re doing great!

Keep taking your HIV treatment medications every day. To stay healthy and achieve suppression, it is important to get a regular viral load test.
28

Get back on track!

Recommendation:

You might have been exposed to other STIs! To stay healthy, it is important to get an STI test and treatment.
29

Get back on track!

Recommendation:

You are close to a suppressed viral load. To help you maintain a healthy life and eliminate the risk of transmitting HIV, take your HIV treatment medications every day and get a regular viral load test.
30
Get back on track!

Recommendation:

You are close to a suppressed viral load. To help you maintain a healthy life and eliminate the risk of transmitting HIV, take your HIV treatment medications every day and get a regular viral load test.

Other things to do:

You may have been exposed to an STI so make a booking for STI testing below.

You may have exposed others to HIV so confidentially refer your partners for HIV testing below.
31
Get back on track!

Recommendation:

Taking your HIV treatment medications (ART) every day keeps you healthy and allows you to get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission.

Other things to do:

Use a condom each time you have sex to avoid transmitting HIV to others.
32
Get back on track!

Recommendation:

Taking your HIV treatment medications every day keeps you healthy and allows you to get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission.

Other things to do:

You may have been exposed to an STI so make a booking for STI testing today.

You also may have exposed others to HIV so confidentially refer your partners for HIV testing.
33

Get back on track!

Recommendation:

Taking your HIV treatment medications (ART) every day keeps you healthy and allows you to get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission. If you’re having trouble taking your HIV treatment medications every day, make an appointment with your doctor for ART services.
34
Get back on track!

Recommendation:

Taking your HIV treatment medications (ART) every day keeps you healthy and allows you to get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission. If you’re having trouble taking your HIV treatment medications every day, make an appointment with your doctor for ART services.

Other things to do:

You may have been exposed to an STI so make a booking for STI testing below.

You may have exposed others to HIV so confidentially refer your partners for HIV testing below.

Use a condom each time you have sex to avoid transmitting HIV to others.
35
Time to Act!

Recommendation:

Start taking HIV treatment medications (ART) every day to stay healthy and get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission.

Other things to do:

Use a condom each time you have sex to avoid transmitting HIV to others.
36
Time to Act!

Recommendation:

Start taking HIV treatment medications (ART) every day to stay healthy and get on with your life. After taking ART every day for 6 months, you can suppress the virus and eliminate the risk of transmission.

Other things to do:

You may have been exposed to an STI so make a booking for STI testing below.

You may have exposed others to HIV so confidentially refer your partners for HIV testing below.

Use a condom each time you have sex to avoid transmitting HIV to others.
37

You’re doing great!

Recommendation:

You reported no potential exposure to HIV or STIs and you are taking PrEP to reduce your future HIV risk.
38
Time to act!

Recommendation:

You might have been exposed to other STIs! To stay healthy, it is important to get an STI test and treatment. Make an appointment for STI screening.

Other things to do:

Use a condom each time you have sex to avoid STIs.

Continue taking PrEP to prevent HIV infection.
39

Get back on track!

Recommendation:

You can get more out of your PrEP use with routine engagement from a PrEP doctor who can help you better manage your PrEP use, side effects, and run quarterly screenings.
40
Time to act!

Recommendation:

You might have been exposed to other STIs! To stay healthy, it is important to get an STI test and treatment.

Other things to do:

Use a condom each time you have sex to avoid STIs.

Continue taking PrEP to prevent HIV infection and enroll with a PrEP doctor to help manage your PrEP use, side effects, and run quarterly screenings.
41

You’re doing great!

Recommendation:

You reported no potential exposure to HIV or STIs.
42
Time to act!

Recommendation:

You might have been exposed to HIV and other STIs! To stay healthy, it is important to get tested.

Other things to do:

Use a condom each time you have sex to avoid STIs and prevent HIV.

If you test HIV negative, you can also protect yourself from HIV with a daily pill called PrEP.

If you are diagnosed with HIV, you can live a healthy long life with daily HIV medicine (ART).
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Time to act!

Recommendation:

You reported no possible exposures to HIV or other common STIs, but if you are experiencing any STI symptoms you should book an appointment for STI screening and treatment services.
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Name or NicknameWe will use your name or nickname to identify your appointment. You can use a name you are most comfortable with sharing.
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Phone NumberYour phone number will not be shared with anyone. If you provide a number, we will be able to follow up with you a day before your appointment.
Area Code
Phone Number
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