Upper Hill, Nairobi. Kenya
Level of Education: Less than K.C.S.EK.C.S.ECollege
Race: AfricanAsian / IndianCaucasianOrientalMixture
Tested positive for any of the following (if ‘YES’ when?Year)
Chlamydia? YESNO
Gonorrhea? YESNO
Have you ever been tested for HIV? YESNO
Syphilis? YESNO
Trichomonas? YESNO
Genital Warts? YESNO
Hepatitis? YESNO
Herpes? YESNO
Do you suffer from any of these diseases?
AsthmaAutismDown syndromeEpilepsyDrug abuseDepressionSchizophreniaManic depressive psychosisBipolar disorderAlcoholismOther (specify below)
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