[p.227]
National Health Interview Survey: AIDS knowledge and Attitudes
Segment ____
Serial ____
2[] p.m
6. Number of family members 18+ years old
[] Interview (complete Item 63, page 18)
2[] Partial interview (some but not all appropriate questions completed) Explain _______
4[] SP temporarily absent
5[] SP mentally or physically incapable
8[] Other- explain ________
1[] a.m
2[] p.m
2[] Telephone
11. Interviewer identification
Code ________
Transcription From completed HIS-1
12. Sex of SP (page 2 or 51, question 3)
2[] F
13. Education of SP (page 42 or 43, question 2a)
[] Elem
[] 2
[] 3
[] 4
[] 5
[] 6
[] 7
[] 8
[] 10
[] 11
[] 12
[] 2
[] 3
[] 4
[] 5
[] 6+
1[] Yes
2[] No
14. Main race of SP (page 42 or 43, question 3a/b)
[] 2
[] 3
[] 4
[] 5 (Specify) ________
15. Martial status (Page 46 or 47, question 7)
2[] Married - spouse not in HH
3[] Widowed
4[] Divorced
5[] Separated
6[] Never married
16. Family income (Page 46, question 8b)
01[] B
02[] C
03[] D
04[] E
05[] F
06[] G
07[] H
08[] I
09[] J
10[] K
11[] L
12[] M
13[] N
14[] O
15[] P
16[] Q
17[] R
18[] S
19[] T
20[] U
21[] V
22[] W
23[] X
24[] Y
25[] Z
26[] ZZ
(Transcribe from 8a if 8b blank)
27[] $20,000 or more
28[] Less than $20,000
17. Sample person number ________
18. Sample person Age ________
[p.228]
Introduction: These next questions are to determine what people know about AIDS, also called Acquired Immunodeficiency Syndrome.
1. In the PAST MONTH, have you ...
a. seen any Public Service Announcements about AIDS on television>
2[] No
9[] DK
b. heard any public service announcements about AIDS on the radio?
2[] No
9[] DK
Check Item 1
[] "Yes" in 1a and/or 1b (2)
[] Other (3)
2. Were any of those public service announcements called "America Responds to AIDS"?
2[] No
9[] DK
3. In the PAST MONTH, have you read any brochures or pamphlets about AIDS? Do not include articles in magazines or newspapers.
2[] No
9[] DK
4. Have you EVER read any brochures or pamphlets about AIDS? Again, do not include articles in magazines or newspapers.
2[] No (Check item 2)
9[] DK (Check item 2)
[p.229]
5. Where did you get the pamphlets or brochures? Anywhere else? (Mark all that apply)
1[] Doctor's office/HMO
1[] Drug store
1[] Public health department
1[] Received it in the mail without asking for it.
1[] Red cross/with red cross blood donation
1[] With other blood donation
1[] School
1[] Sent/phoned for it myself, requested it
1[] " The Government" - federal, state, or local
1[] Work, other than clinic or nurse
1[] Work, nurse of clinic
1[] Other (Specify) ________
[] May, June, July 1988 (6)
[] Other (17)
6. The Government is mailing a brochure with basic information about AIDS to each household in the country. Hold copy up. The brochure looked this this. The brochure is 81/2 by 11 inches, white with blue and black printing, and has a picture of DR. C Everett Koop, the Surgeon General of the United States on the cover, with the title, "Understanding AIDS" printed at the top.
Was this brochure received at this household?
2[] No (17)
9[] Don't know (17)
7. How much of the brochure did you read; would you say all or almost all of it, about half, less than half, or none of it?
2[] About half
3[] Less than half
4[] None
9[] DK
[p.230]
8. When you read it, did you read it carefully or did you just skim through it?
2[] Skimmed through
8[] Other (specify) ________
9[] DK
9. Did the brochure give you any new information or answer any questions you had about AIDS?
2[] No
(If one-person household, mark box 3 and skip to Q.11)
10. Did you discuss the brochure with anyone else in the family?
2[] No
3[] One-person
11. Do you have any children aged 10 through 17?
2[] No (21)
12. How many do you have? ________
13. Did [this child/any of your children aged 10 through 17] read the brochure?
2[] No
9[] DK
14. Was the brochure discussed with [this child/any of your children aged 10 through 17]?
2[] No.
9[] DK
15. Have you ever discussed AIDS with [this child/any of your children aged 10 through 17]?
2[] No
16. [Has this child/have any or all of your children aged 10 through 17] had instruction at school about AIDS?
2[] No (21)
9[] DK (21)
17. Do you have any children aged 10 through 17?
2[] No (21)
18. How many do you have? __________
[p.231]
19.Have you ever discussed AIDS with [this child/any of your children aged 10 through 17]?
2[] No
20. [Has this child/have any or all of your children aged 10 through 17] had instruction at school about AIDS?
2[] No
9[] DK
21. How much would you say you know about AIDS --- a lot, some, a little, or nothing?
2[] Some
3[] A little
4[] Nothing
22. To the best of your knowledge, is there a difference between having the AIDS virus and having the disease AIDS?
2[] No
8[] Other (specify) ________
9[] DK
HAND CARD A
(card A not found)
23. After I read each statement, tell me whether you think the statement is definitely true, probably true, probably false, definitely false, or you don't know if it is true or false.
a. AIDS can reduce the body's natural protection against disease.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
b. AIDS is especially common in older people.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
c. AIDS can damage the brain.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
d. AIDS usually leads to heart disease.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
e. AIDS is an infectious disease caused by a virus.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
f. Teenagers cannot get AIDS.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
g. AIDS leads to death.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
23. (continued)
Tell me whether you think each of these statements is definitely true, probably true, probably false, definitely false, or you don't know if it is true or false.
h. A person can be infected with the AIDS virus and not have the disease AIDS.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
i. Looking at a person is enough to tell if he or she has the AIDS virus.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
j. ANY person with the AIDS virus can pass it on to someone else through sexual intercourse.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
k. A person who has the AIDS virus can look and feel well and healthy.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
l. A pregnant woman who has the AIDS virus can give the AIDS virus to her baby.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
m. There is a vaccine available to the public that protects a person from getting the AIDS virus.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
n. There is no cure for AIDS at present.
2[] Prob. true
3[] Prob. False
4[] Def. False
9[] DK
HAND CARD B
(Card B not found)
24. After I read each statement, tell me if you think it is very likely, somewhat likely, somewhat unlikely, very unlikely, definitely not possible, or if you don't know how likely it is that a person will get AIDS or the AIDS virus inflection that way.
How likely do you think it is that a person will get AIDS or the AIDS virus infection from ---
a. Living near a home or hospital for AIDS patients
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
b. Working near someone with the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
c. Eating in a restaurant where the cook has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
d. Kissing - with exchange of saliva - a person who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
e. Shaking hands, touching, or kissing on the cheek someone who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
f. Sharing plates, forks, or glasses with someone who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
g. using public toilets.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
h. sharing needles for drug use with someone who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
i. Being coughed on or sneezed on by someone who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
j. Attending school with a child who has the AIDS virus.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
k. Mosquitoes or other insects.
2[] Somewhat likely
3[] Somewhat unlikely
4[] Very unlikely
5[] Definitely not possible
9[] DK
25. Have you ever donated blood?
2[] No (27)
9[] DK (27)
a. Since March, 1985
2[] No (27)
9[] DK (27)
b. In the past 12 months?
2[] No (27)
9[] DK (27)
27. Have you ever heard of a blood test that can detect the AIDS virus infection?
2[] No (44a, page 12)
9[] DK (44a, page 12)
The Next questions are about the blood test for the AIDS virus infection. No question will ask what the results are of any tests you may have had.
28. To the best of your knowledge, are blood donations routinely tested now for the AIDS virus infection?
2[] No
9[] DK
29a. Have you ever received counseling or had a talk with a health professional about taking the AIDS virus test?
2[] [No (31)
9[] DK (31)
1. with a private doctor?
2[] No
9[] DK
2. at a family planning clinic?
2[] No
9[] DK
3. on an AIDS hotline?
2[] No
9[] DK
4. at a prenatal clinic?
2[] No
9[] DK
5. at an STD or sexually transmitted disease clinic?
2[] No
9[] DK
6. at an AIDS/HIV counseling and testing site?
2[] No
9[] DK
7. with some other health professional?
2[] No
9[] DK
8. with some other counselor?
2[] No
9[] DK
30. During that discussion, did you receive information about how to avoid getting or passing on the AIDS virus?
2[] No
9[] DK
31. Have you ever been advised by a health professional NOT to have the blood test for the AIDS virus infection?
2[] No
9[] DK
32. Have you ever been advised by friends or relatives NOT to have the blood test for the AIDS virus infection?
2[] No
9[] DK
33. Have you had your blood tested for the AIDS virus infection?
2[] No (41)
9[] DK (41)
34a. Have you had your blood tested for the AIDS virus infection more than once?
2[] No
9[] DK
34b. Was your blood tested in the past twelve months?
2[] No (36)
9[] DK (36)
35a. How many times have you had your blood tested for the AIDS virus infection?
XXXX[] One time
02[] Two times
03[] Three times
04[] Four times
05[] Five times
06[] Six times
07[] Seven times
08[] Eight times
09[] Nine times
10[] Ten times
11[] Eleven times
12[] Twelve times
13[] More than twelve times
99[] DK
35b. How many times in the past 12 months have you had your blood tested for the AIDS virus infection?
01[] One time
02[] Two times
03[] Three times
04[] Four times
05[] Five times
06[] Six times
07[] Seven times
08[] Eight times
09[] Nine times
10[] Ten times
11[] Eleven times
12[] Twelve times
13[] More than twelve times
99[] DK
[p.236]
36. Was the test ----/ were any of the blood tests, including those you had before the past twelve months ---.
a. part of a blood donation?
2[] No
b. part of a blood transfusion?
2[] No
c. Voluntarily sought from a source such as your doctor, clinic, or HMO?
2[] No
d. Part of some other activity that requires a blood sample and includes automatic AIDS testing, such as testing for the military or immigration?
2[] No
Check item 3:
[] "Yes" in Q. 36d (37)
[] Other (38)
37. Where did you have your blood tested for AIDS virus infection? Anywhere else? (Mark all that apply).
1[] Family planning clinic
1[] Prenatal clinic
1[] Drug treatment facility
1[] Tuberculosis clinic
1[] Work clinic/ health station
1[] AIDS counseling/testing site
1[] Military induction
1[] Immigration site
1[] Other (specify) ________
1[] DK
38. Did you get the results of your test?/any of your tests?
2[] No (40)
9[] DK (40)
39. When you received your test results, did your receive counseling or talk with a health professional about how to lower your chances of becoming infected with the AIDS virus or how to avoid passing it to another person?
2[] No
9[] DK
[p.237]
40. Were you referred to a health professional to get counseling about the AIDS virus infection?
2[] No
9[] DK
41. Do you expect to have a blood test for the AIDS virus infection in the next 12 months?
2[] No (44)
9[] DK (44)
42. Will you have the blood test--
a. as part of a blood donation?
2[] No
9[] DK
b. voluntarily from a source such as your doctor, clinic, or HMO?
2[] No
9[] DK
c. as part of some other activity that requires a blood sample and includes automatic AIDS testing, such as testing for the military or immigration?
2[] No
9[] DK
Check Item 4:
[] "Yes" In question 42b (43)
[] Other (44)
43. Where would you go to have a blood test for the AIDS virus infection? (Mark first mention)
01[] AIDS clinic
02[] Company or industry clinic
03[] Doctor/HMO
04[] Hospital/emergency room/OP clinic
05[] Other clinic
06[] Public Health Department
07[] Red cross/Blook bank
88[] Other (Specify) ________
99[] DK
[p.238]
44a. Did you have a blood transfusion at any time between 1977 and 1985?
2[] No
9[] DK
44b. Do you think that present supply of blood is safe for transfusions?
2[] No
9[] DK
HAND CARD C
(Card C not found)
45. Here are some methods people use to keep from getting the AIDS virus through sexual activity.
After I read each one, tell me whether you think it is very effective, somewhat effective, not at all effective, or if you don't know how effective it is in preventing getting the AIDS virus through sexual activity. How effective is ---
a. using a diaphragm?
2[] Somewhat effective
3[] Not at all effective
4[] DK how effective
9[] DK method
b. Using a condom?
2[] Somewhat effective
3[] Not at all effective
4[] DK how effective
9[] DK method
c. Using a spermicidal jelly, foam or cream?
2[] Somewhat effective
3[] Not at all effective
4[] DK how effective
9[] DK method
d. Having a vasectomy?
2[] Somewhat effective
3[] Not at all effective
4[] DK how effective
9[] DK method
e. Two people who do not have the AIDS virus having sex only with each other?
2[] Somewhat effective
3[] Not at all effective
4[] DK how effective
9[] DK method
46. What are your chances of having the AIDS virus; would you say high, medium, low, or none?
2[] Medium
3[] Low
4[] None
7[] Refused
9[] DK
[p.239]
47. What are your chances of getting the AIDS virus; would you say high, medium, low, or none?
2[] Medium
3[] Low
4[] None
7[] Refused (Check item 6)
9[] DK
48. People have different meanings when they say a "high", "medium", or "low" chance.
If "no chance" is zero-out-of- one hundred, what would you say High/Medium/Low is? What number of times-out-of-one hundred?
____ out of a 100
999[] DK
[] "High" or "medium" in Q. 47 (49)
[] Other (check item 6)
49. Do you say your chance of getting AIDS is (high/medium) because you --
a. have had a blood transfusion?
2[] No
b. Have had sexual contact with someone who might have the virus?
2[] No
c. Some other reason? (specify) __________
2[] No
[p. 240]
Check item 6:
[] Female 18-45 (50 Intro, then 50 a)
[] Other (50 Intro, then 50c)
50. In the past twelve months, have you received services or care at ---
a. a prenatal health clinic?
2[] No
9[] DK
b. a maternal and infant health clinic?
2[] No
9[] DK
c. a family planning clinic?
2[] No
9[] DK
d. a hospital, as an in patient?
2[] No
9[] DK
e. a hospital emergency room?
2[] No
9[] DK
f. a tuberculosis clinic?
2[] No
9[] DK
g. a drug treatment facility or clinic?
2[] No
9[] DK
h. an STD (sexually transmitted disease) clinic?
2[] No
9[] DK
i. an alcohol treatment facility or clinic?
2[] No
9[] DK
j. an AIDS counseling and testing clinic?
2[] No
9[] DK
k. a community health clinic?
2[] No
9[] DK
l. a public health clinic?
2[] No
9[] DK
51. In the past twelve months, have you ---
a. been in the job corps?
2[] No
9[] DK
b. had a physical examination to join the military?
2[] No
9[] DK
c. been in prison?
2[] No
9[] DK
52. Have you ever discussed AIDS with a friend or relative?
2[] No (54)
9[] DK (54)
[p. 241]
53. When was the last time you discussed AIDS with a friend or relative?
Number _______
3[] Weeks ago
4[] Months ago
5[] Years ago
54. Have you ever personally known anyone with AIDS or the AIDS virus?
2[] No (57)
9[] DK if someone has/had AIDS, AIDS virus (57)
(If more than one person volunteered in Q. 54, Ask Q. 55 and Q. 56 about the person known best)
55. How long has it been since you say this person?
2[] Two weeks to less than one month
3[] One month to less than 3 months
4[] 3 months to less than 6 months
5[] 6 months or more
9[] DK
56. How well do you know this person? Would you say ---
2[] Fairly well, but it is not a close relationship?
3[] Not very well, it is only an acquaintance or casual relationship? OR
4[] You don't really know them personally, such as a friend of a friend?
8[] Other (SPECIFY) ________
[p.242]
HAND CARD D
(Card D not found)
57. (I am going to read a list of statements. After I have read them all) Please tell me if any of these statements is true for you. Do not tell me which statement or statements are true for you, just if any of them are.
a. You have hemophilia and have received clotting factor concentrates since 1977.
b. You are a native of Haiti, Central or East Africa who has entered the United States Since 1977.
c. You are a man who has had sex with another man at some time since 1977, even one time.
d. You have taken illegal drugs by needle at any time since 1977.
e. Since 1977, you are or have been the sex partner of any person who would answer "Yes" to any of the items (I have read/above on this card)
f. You have had sex for money or drugs at any time since 1977
2[] No to all statements
58. The US Public Health Service has said that AIDS is one of the major health problems in the country but exactly how many people it affects is not known. The Surgeon General has proposed that a study be conducted and blood samples be taken to help find out how widespread the problem is.
If you were selected in this national sample of people to have their blood tested with assurances of privacy of test results, would you have the test?
2[] No
8[] Other response (specify) __________
9[] DK
[p.243]
59. Why wouldn't you take part in the test? Any other reason? (Mark all that apply)
1[] Don't want any counseling about AIDS (60b)
1[] Fear I'll get AIDS (61)
1[] Don't like to give blood (61)
1[] Don't trust government programs (61)
1[] It is a waste of money (61)
1[] Don't believe AIDS can really be cured anyway (61)
1[] Other (specify) (61)
1[] DK (61)
60a. If it were not possible to provide you with the results of the test, would you still take part in the study?
2[] No (61)
9[] DK (61)
60b. If the results of the test were not provided to you, then would you take part in the study?
2[] No
9[] DK
61. When Federal Public Health officials give information about AIDS, do you believe what they say or are you doubtful about the information they give?
2[] Doubtful
9[] DK
62. When they give advice about how to help keep from getting AIDS, do you believe their advice or are you doubtful about what they say?
2[] Doubtful
9[] DK
[p.244]
63. Date AIDS supplement final status ____/____/19___
Interviewer transcription from HIS-1
64. Hispanic Origin (item 4a/b, page 41, HIS-1)
2[] No
HIS-1 item 4b
2[] Cuban
3[] Mexican/Mexicano
4[] Mexican American
5[] Chicano
6[] Other Latin American
7[] Other Spanish
66. Exact Address (Item 6a, Cover Page, HIS-1)
State ________
County ________
ZIP code ________
67. Mailing address (Item 6b, Cover page, HIS-1)
City ________
State ________
County ________
ZIP code ________
68. Telephone Number (item 11, Cover page, HIS-1)
2[] No telephone
3[] Phone, but no number listed or number refused
9[] DK or refused
A.C ____/Exch ____/Number ____