POZ227_APRIL_MAY_2018

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Antiretroviral medications are recommended for all people living with HIV to reduce the risk of both AIDS- and non-AIDS-related illnesses as well as to prevent transmitting HIV. POZ wants to know about the HIV medications you are taking.
1) How soon after your diagnosis did you begin taking HIV medications?

Within one year1–3 years3–5 yearsMore than five yearsI haven’t started taking HIV meds.
2) Which factors did you consider when choosing your current HIV regimen? (Check all that apply.)

ConvenienceCostFood restrictionsOther health conditionsPossible side effectsPotential drug interactionsResults of drug-resistance testsNone of the above
3) How often do you take your HIV medications?

Once a dayMore than once a day
4) Are you on a one-pill, once-daily HIV regimen?

YesNo
5) Do you take your HIV medication with food?

YesNo
6) Are you taking any generic versions of your HIV medications?

YesNo
7) Have you ever switched your HIV regimen?

YesNo
8) Do you experience any side effects from your current HIV medications?

YesNo
9) Are you resistant to any HIV medications?

YesNoI don’t know.
10) How comfortable are you talking to your health care provider about your HIV treatment options?

Very comfortableSomewhat comfortableNot at all comfortable
11) Are you taking medication for any other health condition?

YesNo
12) Do you use a pillbox or other sorting device to organize your medications?

YesNo
13) Do you use an alarm or other type of reminder to take your medications?

YesNo
14) What year were you born?
15) What is your gender?

MaleFemaleTransgenderOther
16) What is your sexual orientation?

StraightGay/LesbianBisexualOther
17) 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
18) What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor's degree or higher
19) What is your zip code?
Enter the message as it's shown*
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