[p. 280]
ITEM V1
Refer to sample person selection label.
[] Y (End Interview)
Adult SP status.
Begin here on Section V callbacks.
[] Callback required (Item 16 on Household page of HIS-1)
[] Noninterview (Response status on Back Cover)
These next questions are asked to determine what people know about the disease AIDS.
1. How much would you say you know about AIDS -- a lot, some, a little, or nothing?
[] 2 Some
[] 3 A little
[] 4 Nothing
2. 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
c. received any brochures about AIDS from your workplace?
[] 2 No
[] 3 Not currently working
[] 4 Self employed
[] 9 DK
d. received any brochures about AIDS from a church or religious organization?
[] 2 No
[] 9 DK
e. received any information about AIDS form the American Red Cross?
[] 2 No
[] 9 DK
3. DO YOU THINK that doctors, nurses, dentists, and other health care workers should be allowed to REFUSE care to a person who has the AIDS virus?
[] 2 No
[] 3 It depends -- Specify -- ____
[] 9 DK
4. I'm going to read some statements about AIDS. After I read each one, tell me whether you think it is true or false or if you don't know.
a. The AIDS virus can be passed on through sexual intercourse between a man and a woman.
[] 2 False
[] 9 Don't know
b. A man with the AIDS virus can pass it on to another man through sexual intercourse.
[] 2 False
[] 9 Don't know
c. A pregnant woman who has the AIDS virus can give it to her baby.
[] 2 False
[] 9 Don't know
d. There is a vaccine available to the public that protects a person from getting the AIDS virus.
[] 2 False
[] 9 Don't know
e. A person who has the AIDS virus can look well and healthy.
[] 2 False
[] 9 Don't know
f. Oil-based lubricants, like vaseline, cause latex condoms to break.
[] 2 False
[] 9 Don't know
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
5. (For the next statements, 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 the AIDS virus infection that way.) (Now look at Card A1.) In general, how likely do you think it is that a person will get AIDS or the AIDS virus from --
HAND CARD A1. Read introduction if telephone interview.
CARD A1
2. Somewhat likely
3. Somewhat unlikely
4. Very unlikely
5. Definitely not possible
a. using public toilets?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
b. working near or with someone who has the AIDS virus?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
c. sharing plates, forks, or glasses with someone who has the AIDS virus?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
d. sharing needles for drug use with someone who has the AIDS virus?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
e. being coughed or sneezed on by someone who has the AIDS virus?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
f. attending school with a child who has the AIDS virus?
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Def. not possible
[] 9 Don't know
6. How effective do you think the proper use of a condom is to prevent getting the AIDS virus through sexual activity? Would you say very effective, somewhat effective, not at all effective, or you don't know how effective it is?
[] 2 Somewhat effective
[] 3 Not at all effective
[] 4 Don't know how effective
[] 9 Don't know method
7. Do you have any children aged 10 through 17?
[] 2 No (10)
8. Have you ever discussed AIDS with any of your children aged 10 through 17?
[] 2 No
9. Have any of your children aged 10 through 17 had instruction at school about AIDS?
[] 2 No
[] 9 DK
10a. Do you feel that information about AIDS should be taught in schools?
[] 2 No (11)
[] 9 DK (11)
b. At what grade in school should AIDS education start?
Probe for EXACT grade if necessary
Mark (x) only one.
Grade
02[] 2
03[] 3
04[] 4
05[] 5
06[] 6
07[] 7
08[] 8
09[] 9
10[] 10
11[] 11
12[] 12
97[] Refused
99[] DK
[p. 282]
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
11a. In the past 12 months, has your workplace offered an organized AIDS education program to its employees?
Do not include merely distributing brochures as an organized education program.
[] 2 No
[] 3 Not currently working
[] 4 Self employed
[] 7 Refused
[] 9 DK
b. In the past 12 months, have you attended an organized AIDS education program at any of these places?
HAND CARD A2. Read each category if telephone interview.
CARD A2
2. A family planning clinic or STD clinic
3. A hospital, HMO clinic or other health facility
4. A school
5. A social or civic club
6. Your workplace
7. Some other place (Specify)
8. Attended no programs
If "Yes," ask: Which?
Mark (X) each that applies.
[] 2 A family planning clinic or STD clinic
[] 3 A hospital, HMO clinic or other health facility
[] 4 A school
[] 5 A social or civic club
[] 6 Your workplace
[] 7 Some other place (Specify) ____
[] 8 Attended no programs
[] 9 DK
Now, I am going to ask some questions about giving blood donations to a blood bank, such as the American Red Cross. But this does NOT include blood drawn at a doctor's office for laboratory analysis.
12. Have you ever given a blood donation?
[] 2 No (13c)
[] 9 DK (13c)
13a. Have you given blood since March 1985?
[] 2 No (13c)
[] 9 DK (13c)
b. In what month and year did you last give blood?
Year 19____
c. Do you expect to donate blood in the next 12 months?
[] 2 No
[] 9 DK
14. In general, while GIVING A BLOOD DONATION to a blood bank, how likely is it that a person will get the AIDS virus?
HAND CARD A1. Read categories if telephone interview
CARD A1
2. Somewhat likely
3. Somewhat unlikely
4. Very unlikely
5. Definitely not possible
[] 2 Somewhat likely
[] 3 Somewhat unlikely
[] 4 Very unlikely
[] 5 Definitely not possible
[] 9 DK
The next questions are about the blood test for the AIDS virus infection. No questions will ask what the results are of any tests you may have had.
15a. (Except for tests you may have had as part of blood donations,) Have you ever had your blood tested for the AIDS virus infection?
[] 2 No (15b)
[] 9 DK (26)
b. Is there any particular reason why you have not been tested?
If "Yes," ask: What is the reason?
(Any other?)
Do not read list
Mark (X) each that applies.
[] 02 Don't consider myself at risk of AIDS (26)
[] 03 Doctor/HMO did not recommend it (26)
[] 04 Don't believe test results are accurate (26)
[] 05 Don't believe anything can be done if I am positive (26)
[] 06 Don't like needles (26)
[] 07 Don't trust results to be confidential (26)
[] 08 Afraid of losing job, insurance, housing, friends, family, if people knew I was positive for AIDS infection (26)
[] 09 Other (Specify) ____ (26)
[] 99 DK (26)
[p. 283]
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
16a. How many times, have you had your blood tested for the AIDS virus infection, (NOT including blood donations)?
Times ____ number (16c)
[] 99 DK (16c)
b. Was it in the past 12 months?
[] 2 No (17)
[] 9 DK (17)
c. In the past 12 months, how many times have you had your blood tested for the AIDS virus infection (NOT including blood donations)?
Times in past 12 months ____
[] 99 DK
17. In what month and year was your (last) blood test for the AIDS virus infection?
Year 19____
18. Which of these would you say were the reasons for your (last) AIDS blood test (NOT including blood donations)? (Just tell me the numbers of your answers.)
HAND CARD A3. Read categories if telephone interview.
CARD A3
2. Because a doctor asked you to
3. Because the Health Dept. asked you to
4. Because a sex partner asked you to
5. For hospitalization or a surgical procedure
6. To apply for health or life insurance
7. To comply with guidelines for health workers
8. To apply for a new job
9. For military induction, separation or during military service
10. For immigration
11. For some other reason (Please specify the other reason or reasons)
(Anything else?)
Mark (X) each that applies.
[] 02 Because a doctor asked you to
[] 03 Because the Health Department asked you to
[] 04 Because a sex partner asked you to
[] 05 For hospitalization or a surgical procedure
[] 06 To apply for health or life insurance
[] 07 To comply with guidelines for health workers
[] 08 To apply for a new job
[] 09 For military induction, separation or during military service
[] 10 For immigration
[] 11 For some other reason (Specify) ____
[] 97 Refused
[] 99 DK
19. (Not including a blood donation) Where did you have your (last) blood test for the AIDS virus?
Mark (X) only one.
If "Clinic", Probe: What kind of clinic is that?
[] 02 Community health clinic (20)
[] 03 Clinic run by employer (20)
[] 04 STD clinic (20)
[] 05 Family planning/parental clinic (20)
[] 06 Other clinic (20)
[] 07 Doctor/HMO (22)
[] 08 Hospital/emergency room/outpatient clinic (22)
[] 09 Military induction, separation or military service site (22)
[] 10 Immigration site (22)
[] 11 At home/home visit by nurse/health worker (22)
[] 12 Other location -- Specify -- ____ (20)
[] 97 Refused (20)
[] 99 DK (20)
20. When your blood was (last) tested for the AIDS virus, were you required to give your name?
[] 2 No
[] 7 Refused
21. (Again not including blood donations,) AT THE TIME they drew blood for your (last) test for the AIDS virus, did a health professional talk with you about the transmission, prevention or treatment of the AIDS or about the meaning of the test?
[] 2 No
[] 9 DK
22. Did you get the results of your (last) blood test?
[] 2 No (26)
[] 3 Only notified if there was a problem (26)
[] 9 DK (26)
[p. 284]
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
23. How long did you wait to get the results?
number
2[] Weeks
3[] Months
999[] DK
24a. Did a health professional talk with you about AIDS when you were GIVEN THE RESULTS of your (last) test?
[] 2 No (25)
[] 9 DK (25)
b. What kind of topics were covered in the discussion of AIDS? (Just tell me the numbers of your answers).
HAND CARD A4. Read categories if telephone interview.
CARD A4
2. How to prevent transmission
3. The correct use of condoms
4. Needle cleaning/using clean needles
5. Dangers of needle sharing
6. Abstinence from sex
7. Contraception
8. Safe sex practices
9. Other (Please specify what other topics)
(Anything else?)
Mark (X) each that applies.
[] 02 How to prevent transmission
[] 03 The correct use of condoms
[] 04 Needle cleaning/using clean needles
[] 05 Dangers of needle sharing
[] 06 Abstinence form sex
[] 07 Contraception
[] 08 Safe sex practices
[] 09 Other -- Specify -- ____
[] 99 DK/Don't remember
c. Did you ask questions about the information provided?
[] 2 No
d. Were you given any information that you did NOT understand?
[] 2 No
25. Were the results given to you in person, by telephone, by mail, or in some other way?
Mark (X) only one.
If more than one given, mark lowest numbered response.
[] 2 By telephone
[] 3 By mail
[] 4 In some other way
26. Do you expect to have (a/another) blood test for the AIDS virus infection in the next 12 months, not including through blood donation?
[] 2 No (29)
[] 9 DK (29)
27. (I'm going to read some reasons people might have the blood test for the AIDS virus infection.)
HAND CARD A5. Read intro and categories if telephone interview.
CARD A5
2. It will be part of hospitalization or surgery you expect to have
3. Because you expect to apply for life or health insurance
4. Because you expect to apply for a job
5. Because you expect to join the military
6. Because of guidelines for health care workers
7. Because it will be a required part of some other activity that includes automatic AIDS testing
8. Because it is required in your non-health care employment
9. Because you plan to have/begin a sexual relationship
10. Some other reason (Please specify what other reason or reasons)
Tell me which of these statements explain WHY YOU expect to have the blood test in the next 12 months. (Just tell me the numbers of your answers).
(Anything else?)
Mark (X) each that applies.
[] 02 Because it will be part of hospitalization or surgery you expect to have
[] 03 Because you expect to apply for life or health insurance
[] 04 Because you expect to apply for a job
[] 05 Because you expect to join the military
[] 06 Because of guidelines for health care workers
[] 07 Because it will be a required part of some other activity that includes automatic AIDS testing
[] 08 Because it is required in your non-health care employment
[] 09 Because you plan to have/begin a sexual relationship
[] 10 For some other reason -- Specify -- ____
[] 99 DK/Refused
28. Where will you have a blood test for the AIDS virus infection?
Mark (X) only one.
If "Clinic", Probe: "What kind of clinic is that?"
[] 02 Community Health Clinic
[] 03 Clinic run by employer
[] 04 STD clinic
[] 05 Family planning/parental clinic
[] 06 Other clinic
[] 07 Doctor/HMO
[] 08 Hospital/emergency room/outpatient clinic
[] 09 Military induction/separation or military service site
[] 10 Red Cross/blood blank/blood drive
[] 11 At home/in a visit by the nurse/health practitioner
[] 12 Other location -- Specify -- ____
[] 97 Refused
[] 99 DK
[p. 284]
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
29a. Have you ever known anyone personally who had AIDS or the AIDS virus?
[] 2 No (30)
[] 7 Refused (30)
[] 9 Don't know if has/had AIDS or the AIDS virus (30)
b. Who was that -- a friend, relative, co-worker, or someone else?
Mark (X) each that applies.
[] 2 Relative
[] 3 Co-worker
[] 4 Someone else -- Specify -- ____
[] 7 Refused
[] 9 DK
30. What are your chances of GETTING the AIDS virus; would you say high, medium, low, or none?
[] 2 Medium
[] 3 Low
[] 4 None
[] 5 Already have AIDS or AIDS virus
[] 7 Refused
[] 9 DK
31. (I'm going to read five statements. AFTER I have read them all,) 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.
HAND CARD A6. Read statements only if telephone interview.
CARD A6
b. You are a man who has had sex with another man at some time since 1980, even one time.
c. You have taken street drugs by needle at any time since 1980.
d. You have traded sex for money or drugs at any time since 1980.
e. Since 1980, you are or have been the sex partner of any person who would answer "Yes" to any of the items above on this card.
a. You have hemophilia and have received clotting factor concentrations.
b. You are a man who has had sex with another man at some time since 1980, even one time.
c. You have taken street drugs by needle at any time since 1980.
d. You have traded sex for money or drugs at any time since 1980.
e. Since 1980, you are or have been the sex partner of any person who would answer "Yes" to any of the items I have read.
[] 2 No to all statements
The next questions are about Tuberculosis, or TB.
32. Are you worried about catching TB?
[] 2 No (34)
[] 9 DK (34)
33. How worried are you about catching TB -- a lot, some, a little, or not at all?
[] 2 Some
[] 3 A little
[] 4 Not at all
[] 9 DK
34a. How much would you say you know about Tuberculosis -- a lot, some, a little, or nothing?
[] 2 Some (34b)
[] 3 A little (34b)
[] 4 Nothing (Check Item V3)
b. Do you know how TB is spread from one person to another?
[] 2 No (Check Item V3)
c. As you understand it, how is TB spread from one person to another?
HAND CARD A7. Read categories if telephone interview.
CARD A7
2. Through food and water
3. By sexual intercourse
4. It is inherited from parents
5. From mosquito or other insect bites
6. Other (Specify)
(Any other way?)
Mark (X) each that applies.
[] 2 Through food and water
[] 3 By sexual intercourse
[] 4 It is inherited form parents
[] 5 From mosquito or other insect bites
[] 6 Other -- Specify -- ____
[] 9 DK
[p. 286]
Section V -- AIDS KNOWLEDGE AND ATTITUDES -- Continued
[] 2 60+ (End Interview)
35. This card shows seven methods of birth control. Which of these do you think is the most effective for preventing pregnancy?
HAND CARD A8. If telephone interview, end interview.
CARD A8
1. Condom (rubber)
2. IUD (loop, coil)
3. Rhythm (safe period by calendar)
4. Foam
5. Pill
6. Withdrawal (pulling out)
Mark (X) only one.
[] 1 Condom (rubber)
[] 2 IUD (loop, coil)
[] 3 Rhythm (safe period by calendar)
[] 4 Foam
[] 5 Pill
[] 6 Withdrawal (pulling out)
[] 7 DK methods
[] 9 DK
36. Which of these do you think is the most effective for preventing sexually transmitted diseases such as syphilis, gonorrhea or AIDS?
Refer to Card A8.
CARD A8
1. Condom (rubber)
2. IUD (loop, coil)
3. Rhythm (safe period by calendar)
4. Foam
5. Pill
6. Withdrawal (pulling out)
Mark (X) only one.
[] 1 Condom (rubber)
[] 2 IUD (loop, coil)
[] 3 Rhythm (safe period by calendar)
[] 4 Foam
[] 5 Pill
[] 6 Withdrawal (pulling out)
[] 7 DK methods
[] 9 DK
RECORD FINAL STATUS ON BACK COVER.