CFAR Engaged Community Questionnaire

This is your opportunity to share with us your knowledge of HIV/AIDS in hopes to help improve services in your community. These questions relate to HIV/AIDS, sexual behavior and your knowledge about them.Your responses to this survey are very important and anonymous.Your answers will not be associated with you. If you are uncomfortable with specific questions and do not wish to answer, you may check "prefer not to answer." This survey will take approximately 5-10 minutes.


1. What is the name of the county in Alabama where you currently live?

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2. What is your Zipcode?

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3. How do you identify yourself?








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4. Have you ever had an HIV test?




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5. If you have never had an HIV/AIDS test, why not? (Check all that apply)










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6. What kind of services related to HIV/AIDS education and prevention are provided where you live? (check all that apply)







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7. How much do you know about HIV/AIDS?





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8. Please check the ways HIV/AIDS can be transmitted (check all that apply)
















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9. Please check the ways that HIV/AIDS can be prevented (check all that apply)














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10. If you needed condoms where would you go? (check all that apply)









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11. How do you get information about HIV/AIDS? (check all that apply)



















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What other resources do you think your community needs?

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Are there any additional HIV/AIDS related comments that you would like to add?

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If you are interested in participating in community efforts around HIV please provide your name

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If you are interested in participating in community efforts around HIV please provide your email address

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