Health Survey

2005- 2006 Interactive Survey

Please take FIVE minutes of your time to participate in our ON-LINE survey Your responses are completely anonymous and do not require your name. Please answer all questions to the best of your ability. After completing the survey, click the SUBMIT button.

The purpose of this survey will allow Lifeguard:

1) to estimate the prevalence and distribution of selected diseases/conditions,

2) to view prevalence and distribution of risk behaviors and protective factors,

3) make comparisons of sexaul behaviors to estimated HIV risk, and

4) the ability to monitor trends in Atlanta, Georgia.

AGE
Last Grade Completed
Ethnicity
The Atlanta Bar you frequent the most:
My friends/lovers always use condoms during anal intercourse.
For HIV/AIDS risk, my friends/lovers are best described as:
On the following scale, where do you consider yourself?	1 (Exclusively Homosexual/Gay)
	2 (Gay)
	3 (Less Gay)
	4 (Lesser Gay)
	5 (Bisexual)
	6 (Lesser Straight)
	7 (Less Straight)
	8 (Straight? Hmmmm...)
	9 Exclusively Heterosexual/Straight)
How many different guys have you had sex with over the past 2 months?
How many different women have you had sex with over the past 2 months?
How often do you use condoms?
How many times in a year do you get tested for HIV?
Based on your sexual behavior over the past 2 months, please estimate your risk for getting HIV. (choose one)	Not at all
	Slight
	Some
	A lot

All information on Lifeguard's website is not designed to replace your relationship with your doctor, and is intended soley for educational or research purposes. Any and all personal information you may provide us with is never released to anyone at any time. Your privacy and trust is extremely important to us.