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Thank you for your interest in being part of the Ask Me About PrEP programme.
✔ Please ensure you’ve read the
information page
before enrolling
✔ You must be currently
living in Wales and aged 18 or older
to take part
✔
Only enrol if you are certain
you want to take part – if you’re uncertain but still have questions please email
[email protected]
and we’ll arrange a chat
Please answer these quick questions – they help to ensure that we get a good mix of people taking part in the project. ** A reminder: please don’t use the mobiliser events as a way of getting generic PrEP training for you or your staff team – this isn’t the right training for you! **
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Where do you currently live?
*
Wales
What part of England do you currently live in:
*
East England
East England
East Midlands
London
North East
North West
South East
South West
West Midlands
Yorkshire and the Humber
I don't know
I don’t want to share this information
What part of Wales do you currently live in:
*
Bridgend and Neath Port Talbot
Bridgend and Neath Port Talbot
Cardiff and Vale of Glamorgan
Central Valleys
Conwy and Denbighshire
Flintshire and Wrexham
Gwent Valleys
Gwynedd
Isle of Anglesey
Monmouthshire and Newport
Powys
South West Wales
Swansea
I don't know
I don’t want to share this information
Don’t know? What is the closest town or city to you?
*
What is your age?
Skip if you don’t want to share this information
If you’re willing, please tell us about your own PrEP use.
*
I‘ve used PrEP in the last six months
I’ve previously used PrEP but not in the last six months
I’ve never used PrEP
I don’t want to share this information
The project is recruiting people who see themselves as the peers of people who could most benefit from PrEP. If you’re willing, briefly tell us how you see yourself as a peer of people who could most benefit from PrEP.
The project will ask people – once they’ve attended a mobiliser event – to talk to their peers about PrEP. In a few sentences, tell us how you think you might go about doing this. It’s OK if you currently aren’t sure!
Tell us when you’d prefer your mobiliser event to be (we’ll do our best to match with your preference):
*
At the weekend
During weekday evening
During the weekday day time
Tell us what language you’d prefer your mobiliser event to be held in (we’ll do our best to match with your preference):
English
Portuguese
Spanish
I’ll need Welsh translation during my mobiliser event
*
Yes
No
Do you currently work or volunteer in a sexual health or PrEP related project?
*
Yes
No
If you answered yes to the above, please tell us the name of the organisation you work or volunteer for
*
Do you have anything further you want to tell us?
Please tell us your name
*
First
Last
Please provide an email address. We’ll use this address to contact you about the next steps on this project
*
Please confirm that you are happy for the project team to contact you via email
*
Yes
No
GDPR Agreement
*
I consent to having this website store my submitted information so they can respond to my inquiry.
We won’t share any of this information with anyone else. Information will be stored on password protected systems and will be deleted as soon as you are enrolled onto a mobiliser event. If you do not attend an event, your information will be deleted. We won’t add you to mailing lists unless you ask.
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