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This survey is being conducted on behalf of The Eddystone Trust. The following questions are being asked to help The Eddystone Trust to understand knowledge, attitudes and behaviour surrounding HIV. Some questions may be personal and sensitive; you do not have to answer them if they make you feel uncomfortable, but if you do, we can assure you that your answers will be kept completely confidential.

Known As

Female
Male

Age:

Relationship Status:

Sexual Orientation:

Your Local Authority:

How would you describe your ethnicity?

Q1. Have you heard of HIV?

Yes
No

Q2. Have you heard of AIDS?

Yes
No

Q3. Can you cure HIV / AIDS?

Yes
No
I don't know

Q4. How can HIV be passed on? Tick as many as you want.

Sex without a condom
Blood transfusion
Dirty needles
Passed from mother to her baby
(in the womb, through childbirth or breastfeeding)
Bitten by a mosquito
Bitten by another insect (not a mosquito)
Sharing a meal with someone who has HIV
Sharing a cup with someone who has HIV
None of these
I don’t know

Q5. A person who looks strong and healthy can have HIV?

Strongly agree
Tend to agree
Neither agree nor disagree
Tend to disagree
Strongly disagree
No opinion

Q6. Would you do any of these? Tick as many as you want.

Remain friends with someone who has HIV
Care for a member of my family who has HIV
Buy food from a shopkeeper who has HIV
Receive treatment from a doctor who has HIV
None of these
I don’t know

Q7. A teacher has HIV. Should she/he be able to still teach in school?

Strongly agree
Tend to agree
Neither agree nor disagree
Tend to disagree
Strongly disagree
No opinion

Q8. If a member of my family had HIV, I would want it kept a secret.

Strongly agree
Tend to agree
Neither agree nor disagree
Tend to disagree
Strongly disagree
No opinion

Q9. Are you worried about getting HIV?

Worries me a great deal
Worries me a fair amount
Does not worry me very much
Does not worry me at all
I don’t know

Q10 . If you are worried, why?

Q11. Have you ever been told how to stop HIV infection?

Yes
No
I don't know

Q12. Was the information you received useful?

Yes
No
I don't know

Q13.Have you had, or would you have a test for HIV?

I would never have a HIV test
I would have a HIV test but haven’t yet
I have had one HIV test
I get tested often (e.g. once every year or so)
None of these
I don’t know

Q14. Using condoms. Tick as many as you want.

I can buy or get free condoms easily
If I was having sex I would always use a condom
I have had sex without using a condom
I have had sex using a condom
None of these
I don’t know
I do not need to use condoms

Q15. If you have ever had sex, did you use a condom …

Every time
Most of the time
Some of the time
None of the time
I have never had sex
I don’t know/I can’t remember
I do not need to use condoms





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