DOESN'T USE CONDOMS A
HAS MORE THAN 1 SEXUAL PARTNER B
HUSBAND HAS SEVERAL SEXUAL PARTNERS C
HAS HOMOSEXUAL RELATIONSHIPS D
BLOOD TRANSFUSIONS E
HAS HAD USED INJECTIONS F
SEXUAL CONTACT WITH AN INFECTED PERSON G
OTHER (SPECIFY)____ X
DON'T KNOW Y

DO NOT USE CONDOMS A
MULTIPLE PARTNERS B
PARTNER HAS MANY PARTNERS C
HAD TRANSFUSION/INJECTIONS D
OTHER (SPECIFY) _____ E
DON'T KNOW X