Real Health Summer 2012: How do you feel about HIV/AIDS?

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Real Health Survey

Real Health Summer 2012: How do you feel about HIV/AIDS?

Although studies show African Americans have a high level of concern and awareness about HIV/AIDS, findings also suggest these feelings are slowly being replaced by apathy and complacency about the virus. We want to know how you feel about HIV/AIDS. Tell us by filling out the following survey.
 
1. Do you think you are personally at risk of contracting HIV?
Yes
No
Unsure
 
2. Do you think only certain people are at risk of contracting HIV?
Yes
No
Unsure
 
3. Do you think living with HIV is no big deal?
Yes
No
Unsure
 
4. Do you view HIV/AIDS as a big problem in the black community?
Yes
No
Unsure
 
5. Do you know all the ways HIV can be transmitted?
Yes
No
Unsure
 
6. Despite your relationship status (single, married, divorced or widowed), do you routinely practice safer sex?
Yes
No
Unsure
 
7. Do you think the government is doing enough to address the HIV/AIDS epidemic in the black community?
Yes
No
Unsure
 
8. Do you think HIV/AIDS testing should be mandatory for everyone?
Yes
No
Unsure
 
9. Name:
 
10. Organization (if you represent one):
 
11. Street address:
 
12. City & state:
 
13. Zip code:
 
14. Email:
 
15. Phone:
 
16. What year were you born? (e.g., 1975)
 
17. What is your gender?
Female
Male
Transgender
Other
 
18. What is your household income?
Under $15,000
$15,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 and over
 
19. What is the highest level of education attained?
Some high school
High school graduate
Some college
Bachelor's degree or higher
 
20. What is your ethnicity
American Indian or Alaska Native
Arab or Middle Eastern
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other
 
21. Where do you get Real Health?
I'm a subscriber
My doctor's office
My church
A community or college organization
It was mailed to me
Other: 
 
22. Do you have Internet access?
Yes
No


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