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Sign up here!
Interested in finding a mentor? Please fill out this form and the one on the next page so that we can match you up with someone with the experience and skills you're looking for.
Interested in being a mentor? These
two sign-up page pages are for you, too.
Please be as honest and clear as you can,
and don't sell yourself short! You may not
feel like an expert, but the fact that you're
HIV positive and have some experience with
its challenges may qualify you for peer support.
Medical professionals do have a place in the mentoring loop, of course. POZ Mentor is only meant to complement, not substitute for, an HIV patient partnership with her or his doctor.
Want to be both? No problem. |
| Choose a username: |
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Choose a password: |
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| Re-type password: |
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| Your e-mail address: |
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I am a: |
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| I was born on |
month
day
year
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My ethnicity:
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I will tell you later
Hispanic/Latino
African American/Black
Middle Eastern
Asian
Native American
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South Asian
Pacific Islander
Caucasian/White
other
multiracial
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| I live in... City: |
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| US
State or Canadian Province: |
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| Zip or Postal Code: |
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| Country: |
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| Country of origin 1: |
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| Country of origin 2: |
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Languages I speak:
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Arabic
Chinese Mandarin
Chinese Cantonese
English
French
German
Hindi
Italian
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Japaneseés
Korean
Portuguese
Russian
Spanish
Tagalog
other
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| I just found out I'm HIV+: |
yes |
I have been positive since: |
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| My health status: |
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Are you or have you been on any of these HIV drugs?
(Some members are interested in sharing specific treatment experiences.)
Please check all that apply.
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Aptivus (tipranavir)
Atripla (efavirenz + tenofovir + emtricitabine)
Combivir (lamivudine/zidovudine)
Crixivan (indinavir sulfate)
Emtriva (emtricitabine or FTC)
Epivir (lamivudine or 3TC)
Epzicom (abacavir + lamivudine)
Fuzeon (enfuvirtide or T-20)
Intelence (etravirine)
Invirase (saquinavir mesylate)
Isentress (raltegravir)
Kaletra (lopinavir/ritonavir)
Lexiva (fosamprenavir)
Norvir (ritonavir)
Prezista (darunavir)
Selzentry (maraviroc)
Sustiva (efavirenz)
Rescriptor (delavirdine mesylate)
Retrovir (zidovudine)
Reyataz (atazanavir sulfate)
Trizivir (abacavir sulfate/lamivudine/zidovudine)
Truvada (tenofovir + emtricitabine)
Videx buffered tablets (didanosine or ddl)
Videx EC capsules (didanosine or ddl)
Viracept (nelfinavir mesylate)
Viramune (nevirapine)
Viread (tenofovir disoproxil fumarate)
Zerit (stavudine or d4T)
Ziagen (abacavir) |
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| Are you or have you been any of the following? |
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doctor
nurse
social worker
HIV counselor
AIDS service worker
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pharmacist
medical researcher
HIV buddy
HIV caregiver
treatment activist
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I would like to receive POZ.com's twice-a-week news Update: |
yes
no |
I would like to receive occasional emails about POZ Mentor: |
yes
no |
I would like to receive the weekly AIDSmeds.com newsletter: |
yes
no |
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