POZ232_December

Time After Time
Taking every dose of your HIV meds exactly as prescribed by your health care provider, is essential to halt HIV replication and keep your viral load suppressed. POZ wants to know about your drug adherence and what you do to make sure you take your medications on time.
1) Are you currently taking antiretroviral meds for HIV?

YesNo
2) In the past month, did you miss any doses of your HIV medications? If so, how many?

123 or moreI did not miss a dose.
3) Have you ever missed several doses in a row?

YesNo
4) Do you tell your doctor or health care provider if you miss a dose?

YesNoSometimes
5) If you miss a dose, what do you do?

Take the meds as soon as I rememberWait until my next scheduled dose to take the medsDepends on how long it's been since I missed the dose
6) Have you ever taken a double dose by mistake?

YesNo
7) Are you resistant to any class of drugs?

YesNoI don't know
8) Is your viral load undetectable?

YesNoI don't know
9) Have you ever switched meds to improve adherence?

YesNo
10) Do you need to take your HIV meds with food?

YesNo
11) When do you take your HIV medications? (Check all that apply.)

In the morningIn the afternoonIn the evening
12) Do you use any reminders to take your HIV meds?

YesNo
13) Do you carry or store your HIV meds in a special case?

YesNo
14) Have you ever run out of your HIV meds?

YesNo
15) Other than simply forgetting, what reasons have you had for missing a dose? (Check all that apply.)

Didn't carry HIV meds when travelingDrug or alcohol useNot feeling wellFell asleepRan out of HIV medsUnable to afford HIV medsOther
16) Where do you get your HIV medications?

Local pharmacyMail-order pharmacyPrison or other correctional institutionOther
17) What year were you born?
18) What is your gender?

MaleFemaleTransgenderOther
19) What is your sexual orientation?

StraightGay/LesbianBisexualOther
20) 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
21) What is your zip code?
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Time After Time