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

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?

Did you take or go back for the result?

Did your partner get the result?

Do you know if your partner has already taken the HIV test?

Have you suffered any permanent disability or health problem as a result of an accident, injury or violence?

Have you suffered any permanent disability or health problems as a result of an accident, injury or violence?

The last time you sought healthcare services, what was the principal reason that led you to seek medical attention?