POZ232_December

State of Wellness
Wellness is defined as the quality or state of being healthy in both body and mind, especially as the result of deliberate effort. POZ wants to know about wellness in your life.
1) Do you have relationships with people who make you feel good about yourself?

YesNo
2) Do you have people in your life who support you?

YesNo
3) Do your romantic or sexual relationships fulfill your wants and needs?

YesNo
4) How often do you exercise for 30 minutes or more?

Once a weekSeveral times a weekEvery dayI don’t exercise regularly.
5) Do you maintain a healthy and balanced diet?

YesNo
6) Do you get enough sleep each night?

YesNo
7) Do you smoke or vape cigarettes?

YesNo
8) How often do you drink alcohol?

Once a weekSeveral times a weekEvery dayI don’t drink alcohol.
9) Do you wear a face mask to protect yourself and others from COVID-19?

AlwaysSometimesNever
10) Are you mindful of others and your environment?

YesNo
11) How often do you feel stressed?

All the timeFairly oftenNot very oftenNever
12) Do you use any of these methods to help manage your stress? (Check all that apply.)

Deep breathingExerciseListen to musicMeditateTake a bathWrite/journalYogaNone of the above
13) Do you take time to unwind and relax on your own?

YesNo
14) How easily do you adapt to change?

Very easilySomewhat easilyNot easily
15) Do you seek out new learning opportunities and stimulating mental activities?

YesNo
16) Do you participate in a variety of social activities and find ways to form new relationships?

YesNo
17) Do you feel like your life has meaning and purpose?

YesNo
18) How long have you been living with HIV?

Less than one year1–5 years5–10 years10–15 years15–20 years20 years or moreI’m not HIV positive.
19) What year were you born?
20) What is your gender?

MaleFemaleTransgenderOther
21) What is your sexual orientation?

StraightGay/LesbianBisexualOther
22) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
23) What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor’s degree or higher
24) What is your zip code?
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State of Wellness