• Home
  • PrEP Screening Tool Too

PrEP Navigation Screening Tool

PrEP Survey Header

PrEP Screening Tool

Answer these six questions to help determine if Pre-Exposure Prophylaxis (PrEP) is a good option for you.  

This questionnaire is designed for masculine spectrum people who have sex with masculine spectrum people (MSM) and is based on health related studies developed by the CDC.

To learn more about the MSM Risk Index: click here.

From the Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014 Clinical Providers’ Supplement Page 21 of 43

1. How old are you today?

Under 18 years
18 -28 years
29 - 40 years
41-48 years
49 years or more

2. In the last 6 months, how many men have you had sex with?

More than 10 male partners
6 - 10 male partners
0 - 5 male partners

3. In the last 6 months, how many times did you have receptive anal sex (you were the bottom) with a man without a condom?

1 or more times
0 times

4. In the last 6 months, how many of your male sex parters were HIV positive?

  More than 1 positive partners
1 positive partner
No positive partners

5. In the last 6 months, did you have insertive anal sex 5 or more times (you were the top) without a condom with a man who was HIV positive?


6. In the last 6 months, have you used methamphetamines such as crystal or speed?


How many eyes does a typical person have (e.g: 4)?