POZ Focus Managing Your HIV 2016 Survey

POZ FOCUS-MANAGING YOUR HIV
We want to hear from you! Please fill out the following survey. We appreciate your feedback.
1) How long have you been living with HIV?

Less than one yearOne to five yearsFive to ten years10 to 15 yearsMore than 15 years
2) How comfortable are you talking to your health care provider about your treatment options for HIV?

Very comfortableSomewhat comfortableNot very comfortable
3) Which topics do you discuss with your HIV doctor? (Check all that apply.)

When I should start/switch treatmentHow well my current treatment is workingShort- and long-term side effects of HIV medsInteractions between HIV meds and other drugsStrategies for my long-term healthScreenings that are needed for other diseases and health conditions
4) Do you have any issues with adherence?

YesNo
5) Are you concerned about drug resistance?

YesNo
6) How would you rate your current support network?

ExcellentGoodFairPoor
7) After reading this POZ Focus, do you better understand the importance of caring for your overall health?

YesNo
8) Please rate the overall quality of this issue of this POZ Focus.

ExcellentGoodFairPoor
9) What year were you born?
10) What is your gender?

MaleFemaleTransgenderOther
11) What is your sexual orientation?

StraightGay/lesbianBisexualOther
12) What is your yearly personal income?

Less than $15,000$15,000–$34,999$35,000–$49,999$50,000–$74,999$75,000–$99,999$100,000 or more
13) 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
14) What is your zip code?
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POZ FOCUS-MANAGING YOUR HIV