Have you ever been told by a health worker that you had a sexually transmitted disease?

Have you ever experienced sexual dysfunction, such as a loss of desire or trouble with sexual performance?

When was the last time you were tested for HIV?

How many times have you had an ulcer on your penis or genitals?

How many times have you had an abnormal discharge from your penis?

Has your partner been tested for HIV/AIDS?

Did you take or go back for the result?

Did you seek treatment for this problem?

Did your partner get the result?

Did your partner take or go back for the result?