POZ232_December

Sex Talk
Sexual health is a crucial aspect of one’s overall health and well-being. A positive and holistic approach to sexuality respects individual rights, helps foster healthy relationships and contributes to one’s quality of life. Please take our confidential survey and let POZ know about your sexual health.
1) How would you rate your overall sexual health?

ExcellentGoodFairPoor
2 How frequently do you engage in any type of sexual activity?

At least once a weekA few times a monthA few times a yearI don’t engage in any sexual activities.
3) How comfortable are you discussing sexual health topics with your sexual partners?

Very comfortableSomewhat comfortableNot at all comfortable
4) How comfortable are you discussing sexual health topics with your health care provider?

Very comfortableSomewhat comfortableNot at all comfortable
5) Have you ever had a health care provider who was uncomfortable discussing sexual health topics with you or made you feel uncomfortable?

YesNo
6) Are you aware that taking HIV medication to treat HIV can eliminate the risk of sexually transmitting the virus? (This is known as U=U.)

YesNo
7) Have you ever experienced any pain or discomfort during sexual activity?

YesNo
8) Have you ever experienced any type of sexual abuse or trauma?

YesNo
9) Do you use any methods to prevent sexually transmitted infections ?

YesNo
10) Which of the following do you do to improve your sexual health? (Check all that apply.)

Eat healthyExerciseManage stressUse lubricantAvoid recreational drugs and alcoholNone of the above
11) What year were you born?
12) What is your gender?

MaleFemaleTransgenderOther
13) What is your sexual orientation?

StraightGay/LesbianBisexualOther
14) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
15) What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
16) What is your annual household income?

Less than $15,000$15,000–$34,999$35,000–$49,999$50,000–$74,999$75,000–$99,999$100,000 or more
17) What is your zip code?
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Sex Talk