14.1 Blood type:
14.2 Are you currently on any contraceptives?
14.2.2 Yes; (specify what)
14.3 Do you currently have any allergies?
14.3.2 Yes; (specify what)
14.4 Do you use prescription drugs?
14.4.2 Yes; (specify what)
14.5 Do you use non-prescription drugs?
14.5.2 Yes;(specify what)
14.6 Do you use any recreational drugs (Marijuana, cocaine, ecstasy, Valium, etc.)?
14.6.2 Yes; (specify what)
14.7 In the past 5 years, have you had sexual contact with anyone in high-risk groups for HIV/ AIDS? These include intravenous drug users, recipients of blood products, transfusions, and sexually active persons with multiple partners?
14.7.2 Yes; (specify what)
14.8 Are you at risk for HIV/AIDS?
14.8.2 Yes; (specify what)
14.9 To your knowledge, have any of your sexual partners in the last 5 years been sexually active with anyone in the high- risk group for HIV/AIDS?
14.9.2 Yes; (specify what)
14.10 Do you currently have any medical problems or conditions?
14.10.2 Yes; (specify what)