PrEP in Black America
This PrEP Assessment is to help broaden the conversation around PrEP (Pre-Exposure Prophylaxis) in the Black Community. The lack of access in Biomedical HIV Prevention within Blacks are low while our numbers among HIV Acquisition are higher than any other race. This tool is to help the Black Treatment Advocacy Network assess the barriers/challenges of PrEP Navigation.
What is your race? *
What is your age? *
Your answer
What is your zip code? *
Your answer
What is your current gender identity? *
What is your sexual orientation? *
What is your HIV status? *
Do you engage in condomless anal/vaginal sex? *
Are you aware there is a medication that can help stop the transmission of HIV? *
Have you ever taken PrEP (Truvada) before? *
Are you currently on PrEP (Truvada)? *
Who is your current PrEP Provider? *
Your answer
Do you know how to access PrEP via your medical network? *
What are some barriers/challenges with accessing PrEP (Truvada)? *
Would you like to be apart of a PrEP Focus Group? (The group will allow us to concentrate of the raw data around PrEP Education and Access in the community) *
Add email address *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Unified. Report Abuse - Terms of Service