AIDS Awareness and Advocacy survey
Required Required Question(s)
Required 1.

What is your gender?

 
Male
Female
Other  
Required 2.

What is your age group?
Under 18yrs
18-25yrs
26-35yrs
36-45yrs
46-64yrs
65 and above
Required 3.

What is your Ethncity/Race?
African American, Black
American Indian, Native American
Asian
Hispanic,Latino
White
Other
Required 4.

What is your Marital Status?
Married
Single
Widowed
Divorced
Required 5.

Do you know anyone who has tested HIV/AIDS positive?
Yes
No
Required 6.

If you learned that someone in your churh had AIDS would you feel comfortable around them?
Yes
No
Required 7.

Have you taken an HIV/AIDS test?
Yes
No
Required 8.

Do you feel safe disclosing your HIV/AIDS status?
Yes
No
Required 9.

Have you lost a friend, famiy member, or loved one to HIV/AIDS?
Yes
No
Required 10.

Do you know anyone living with HIV/AIDS?
Yes
No