Appendix A. Online Risk Assessment Tool - AHRQ National ...

Infectious disease (continued)# Question Prereq Sub-Question Options Script(s)Do you have a tattoo orbody piercing that yougot in your home or1hsomeone else's home? Yes Hep C (at risk)1h Do you have a tattoo or body piercing that you got in your home or someone else's home?No2Has a doctor or nurseever told you that youhave any of the following?Select all that apply.2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.Syphilis2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.Gonorrhea2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.HIV2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.2 Has a doctor or nurse ever told you that you have any of the following? Select all that apply.33When you went to seeyour doctor or nurse inthe past, he or she mayhave tested you for asexually transmittedinfection, or STI. Haveyou ever been tested foran STI? This wouldinclude Chlamydia,Syphillis, HIV and others."Yes" toQuestion1 HealthPromotionWhen you went to see your doctor or nurse in the past, he or she may have tested you for a sexually transmittedNoinfection, or STI. Have you ever been tested for an STI? This would include Chlamydia, Syphillis, HIV and others. "Yes" to Question 1 Health PromotionChlamydia ChlamydiaSyphilisHIVGenitalHerpesHepatitisCTuberculosis(TB)None ofthe aboveYesGonorrhea, Atrisk for STIHSVHepC (hasinfection)TB (hasinfection)Not tested foran STI and issexually activeProgrammingNotesPlug in "becauseyou have a tattoo orpiercing that wasdone at home"Also, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptAlso, if yes to anyand girl has not hadhepatitis B vaccinethen use "Hep B atrisk" scriptContinue 3a-3dbelowonly use if notreceiving "at risk forSTI" script. Skip3a-3d15