Academic Research Survey on Sexual Health

An anonymous academic survey that collects demographic and behavioral data to study risk factors associated with sexually transmitted infections.

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What is your gender?

Female Male Non-binary Prefer not to say

What is your age range?

18-24 25-34 35-44 45-54 55 and older

Do you have any children?

Yes No

What is your annual income range?

Under 20,000 20,000-40,000 40,000-60,000 Over 60,000 Prefer not to say

Do you have a history of any medical condition?

Yes No Not sure

If the answer to the previous question is yes, which medical conditions?

Not likely

1 2 3 4 5 6 7 8 9 10

Very likely

Previous experience of consensual sexual intercourse

Yes No Prefer not to say

Number of sexual partners in the last 60 days

None One Two to three Four or more

Frequency of condom use with main partner

Always Often Sometimes Rarely Never

Frequency of condom use with casual partner

Always Often Sometimes Rarely Never

Have you ever contracted an STI?

Yes No Not sure

Rate from 1 to 5

★ 1 star ★ 2 stars ★ 3 stars ★ 4 stars ★ 5 stars

Have you ever traded sex for money, drugs, food, or shelter?

Yes No Prefer not to say

Reasons why you have never been tested for HIV/STIs

Fear of the result Lack of access Cost Stigma Lack of time

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