Sexual Health Risk Assessment
Sexual Health Risk Assessment Score --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)" memo="score"] There are options when it comes to protecting your sexual health. Finding ones that fit your needs and sexual behaviors can keep you healthy. This is why it is important to discuss these with your health care provider. Start by answering these questions openly and honestly as possible. Then you and your healthcare provider can work together to find prevention options that work best for you and your lifestyle. [select name="Q1" value="always=0|often=1|sometimes=2|never=3"] <-- #1 I have sex without condoms [select name="Q2" value="none=0|one=1|more than 1=2"] <-- #2 In the past three months, I had ______ sexual partner(s) [select name="Q3" value="no=0|yes =1"] <-- #3 Within the past three months, I participated in oral sex. [select name="Q4" value="no=0|yes=1"] <-- #4 Within the past three months, I had vaginal sex. [select name="Q5" value="no=0|yes=1"] <-- #5 Within the past three months, I had anal sex. [select name="Q6" value="never=0|over 6 months ago=1|within the last 6 months=2|currently have an STI=3"] <-- #6 I have ___________ had a sexually transmitted infection (STI) - STIs like syphillis, gonorrhea, chlamydia, or HPV [select name="Q7" value="does not apply=0|HIV=1|STI=1|both HIV and STI=2|I don't know either HIV or STI=3"] <-- #7 I know the _________ status of my past/present sexual partner(s). [select name="Q8" value="am not=0|am not sure=1|am=2"] <-- #8 I _________ having sex or considering having sex with someone who is HIV positive. [select name="Q9" value="very interested=1|intersted=1|not interested at all=2"] <-- #9 I am _____________ in learning more about ways to prevent HIV and other STIs. Score --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)" memo="score"] out of 17 points. Interpretation --> 8+ = Stongly consider PrEP and other STI prevention strategies 4+ = Consider PrEP and other STI prevention strategies 2+ = Discuss STI prevention strategies, including HIV risk reduction 1 = Revisit sexual risk at next visit or come in sooner if needed
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Sandbox Metrics: Structured Data Index 1, 11 form elements, 234 boilerplate words, 9 drop downs, 2 calculations, 9 total clicks
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