Instrument Variable Name: TST12M_M
QuestionText:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?/In
what month and year was your last test for HIV, (the virus that causes AIDS)?]
* Enter month of last HIV test.
* Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

UniverseText: Sample adults 18+ who have been tested for HIV/AIDS
SkipInstructions:

(R,96) [goto TIMETST]
(1-12,D) [goto TST12M_Y]

Instrument Variable Name: TST12M_Y
QuestionText:

2 of 2
* Enter year of last HIV test.

1985-2009 1985-2009
9996 Time period format
9997 Refused
9999 Don't know

UniverseText: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
SkipInstructions:

(1880-2030) [goto REATST]
(R,D)[goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name: TST12M_M
QuestionText:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?/In what month and year was your last test for HIV, (the virus that causes AIDS)?]
* Enter month of last HIV test.
* Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

UniverseText: Sample adults 18+ who have been tested for HIV/AIDS
SkipInstructions:

[R,96] [goto TIMETST]
[1-12,D] [goto TST12M_Y]

Instrument Variable Name: TST12M_Y
QuestionText:

2 of 2
* Enter year of last HIV test.

1985-2009 1985-2009
9996 Time period format
9997 Refused
9999 Don't know

UniverseText: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
SkipInstructions:

[1880-2030] [goto REATST]
[R,D] [goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name:TST12M_M
QuestionText:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?In what month and year was your last test for HIV, (the virus that causes AIDS)?]
* Enter month of last HIV test.
* Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

UniverseText:Sample adults 18+ who have been tested for HIV/AIDS
SkipInstructions:

(R,96) [goto TIMETST]
(1-12,D) [goto TST12M_Y]

Instrument Variable Name:TST12M_Y
QuestionText:

2 of 2
* Enter year of last HIV test.

1985-2009 1985-2009
9996 Time period format
9997 Refused
9999 Don't know

UniverseText:Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
SkipInstructions:

(1880-2030) [goto REATST]
(R,D) [goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name: TST12M M
Question Text:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?/In what month and year was your last test for HIV, (the virus that causes AIDS)?]
* Enter month of last HIV test.
* Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV/AIDS
Skip Instructions:

(R,96) [goto TIMETST]
(1-12,D) [goto TST12M Y]

Instrument Variable Name: TST12M Y
Question Text:

2 of 2
* Enter year of last HIV test.

1985-2008 1985-2008
9996 Time period format
9997 Refused
9999 Don't know

Universe Text: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
Skip Instructions:

(1880-2030) [goto REATST]
(R,D) [goto TIMETST]
[if TST12M M and TST12M Y = a future date] goto ERR1 TST12M Y
[if TST12M M and TST12M Y = a date prior to birth date] goto ERR2 TST12M Y

Instrument Variable Name: TIMETST
Question Text:

Was it:
* Read answer categories.

1 6 months or less
2 More than 6 months but not more than 1 year ago
3 More than 1 year, but not more than 2 years ago
4 More than 2 years, but not more than 5 years ago
5 More than 5 years ago
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV, who refused or requested the time period format at TEST12M M, or refused or don't know the year of their last HIV test.
Skip Instructions:

(1-5,R,D) [goto REATST]

Instrument Variable Name: TST12M_M
Qustion Text:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?/In what month and year was your last test for HIV, (the virus that causes AIDS)?]
*Enter month of last HIV test.
*Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV/AIDS
Skip Instructions:

(R,96) [goto TIMETST]
(1-12,D) [goto TST12M_Y]

Instrument Variable Name: TST12M_Y
Qustion Text:

2 of 2
*Enter year of last HIV test.

1985-2007 1985-2007
9996 Time period format
9997 Refused
9999 Don't know

Universe Text: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
Skip Instructions:

(1880-2030) [goto REATST]
(R,D) [goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name: TIMETST
Qustion Text:

Was it:
* Read answer categories.

1 6 months or less
2 More than 6 months but not more than 1 year ago
3 More than 1 year, but not more than 2 years ago
4 More than 2 years, but not more than 5 years ago
5 More than 5 years ago
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV, who refused or requested the time period format at TEST12M_M, or refused or don't know the year of their last HIV test.
Skip Instructions:

(1-5,R,D) [goto REATST]

Instrument Variable Name: AHCSY8_ 8
Question Text:

*Read Lead-in if Necessary.
DURING THE PAST 12 MONTHS, that is since {12 month ref.date}, have you seen or talked to any of the following health care providers about your own health?
...A medical doctor who specializes in a particular medical disease or problem (other than obstetrician/gynecologist, psychiatrist, or ophthalmologist).

1 Yes
2 No
7 Refused
9 Don't know

Universe Text: Sample adults 18+
Skip Instructions:

(1,2,R,D) [go to AHCSY8_ 9]

Instrument Variable Name: TST12M_Y
Question Text:

2 of 2
*Enter year of last HIV test.

1985-2006 1985-2006
9996 Time period format
9997 Refused
9999 Don't know

Universe Text: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
Skip Instructions:

(1880-2030) [goto REATST]
(R,D) [goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name: TST12M_M
Question Text:

1 of 2
[fill: Not including blood donations, in what month and year was your last test for HIV (the virus that causes AIDS)?/In what month and year was your last test for HIV, (the virus that causes AIDS)?]
*Enter month of last HIV test.
*Enter "96" to go to the time period format.

01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
96 Time period format
97 Refused
99 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV/AIDS
Skip Instructions:

(R,96) [goto TIMETST]
(1-12,D) [goto TST12M_Y]

Instrument Variable Name: TST12M_Y
Question Text:

2 of 2
*Enter year of last HIV test.

1985-2005 1985-2005
9996Time period format
9997 Refused
9999 Don't know

Universe Text: Sample adults 18+ who gave a month for their last HIV test or who didn't know the month
Skip Instructions:

(1880-2030) [goto REATST]
(R,D) [goto TIMETST]
[if TST12M_M and TST12M_Y = a future date] goto ERR1_TST12M_Y
[if TST12M_M and TST12M_Y = a date prior to birth date] goto ERR2_TST12M_Y

Instrument Variable Name: TIMETST
Question Text:

Was it:
*Read answer categories.

1 6 months or less
2 More than 6 months but not more than 1 year ago
3 More than 1 year, but not more than 2 years ago
4 More than 2 years, but not more than 5 years ago
5 More than 5 years ago
7 Refused
9 Don't know

Universe Text: Sample adults 18+ who have been tested for HIV who refused or or requested the time period format at TEST12M_M or refused or don't know the year of their last HIV test.
Skip Instructions:

(1-5,R,D) [goto REATST]

If ADS.020 equals (1) read:
Not including blood donations, in what month and year was your last test for HIV, (the virus that causes AIDS)?

Else read:
In what month and year was your last test for HIV, (the virus that causes AIDS)?

FR: Enter T for Time Period (ADS.061)

[ ] MONTH:

(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Refused (ADS.061)
(99) Don't know

[ ] YEAR:

(1880-2030) 1880-2030 (ADS.065)
(97) Refused (ADS.061)
(99) Don't know (ADS.061)

Was it:

(1) 6 months or less
(2) More than 6 months but not more than 1 year ago
(3) More than 1 year, but not more than 2 years ago
(4) More than 2 years, but not more than 5 years ago
(5) More than 5 years ago
(7) Refused
(9) Don't know

If ADS.020 equals (1) read:
Not including blood donations, in what month and year was your last test for HIV, (the virus that causes AIDS)?

Else read:
In what month and year was your last test for HIV, (the virus that causes AIDS)?

FR: Enter T for Time Period (ADS.061)

[ ] MONTH:

(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Refused (ADS.061)
(99) Don't know

[ ] YEAR:

(1880-2030) 1880-2030 (ADS.065)
(97) Refused (ADS.061)
(99) Don't know (ADS.061)

Was it:

(1) 6 months or less
(2) More than 6 months but not more than 1 year ago
(3) More than 1 year, but not more than 2 years ago
(4) More than 2 years, but not more than 5 years ago
(5) More than 5 years ago
(7) Refused
(9) Don't know

If ADS.020 equals (1) read:
Not including blood donations, in what month and year was your last test for HIV, (the virus that causes AIDS)?

Else read:
In what month and year was your last test for HIV, (the virus that causes AIDS)?

FR: Enter (T) for Time Period (ADS.061)

[ ] MONTH:
(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Refused (ADS.061)
(99) Don't know

[ ]YEAR:
(1880-2030) 1880-2030 (ADS.065)
(97) Refused (ADS.061)
(99) Don't know (ADS.061)

Was it:

(1) 6 months or less
(2) More than 6 months but not more than 1 year ago
(3) More than 1 year, but not more than 2 years ago
(4) More than 2 years, but not more than 5 years ago
(5) More than 5 years ago
(7) Refused
(9) Don't know

[If ADS.020 equals (1) read:]
Not including blood donations, in what month and year was your last test for HIV, (the virus that causes AIDS)?

[Else read:]
In what month and year was your last test for HIV, (the virus that causes AIDS)?

FR: Enter "T" for Time Period (ADS.061)

[ ] MONTH:

(01) January
(02) February
(03) March
(04) April
(05) May
(06) June
(07) July
(08) August
(09) September
(10) October
(11) November
(12) December
(97) Refused (ADS.060B)
(99) Don't know (ADS.060B)

[ ] YEAR:

(1880-2030) 1880-2030 (ADS.065)
(97) Refused (ADS.061)
(99) Don't know (ADS.061)

Was it:

(1) 6 months or less
(2) More than 6 months but not more than 1 year ago
(3) More than 1 year, but not more than 2 years
(4) More than 2 years, but not more than 5 years ago
(5) More than 5 years ago
(7) Refused
(9) Don't know

_____/19____
Month Year

_____/19____
Month Year

_____/19____
Month Year

Times ____
99[] DK

1[] "1 time" (21)
8[] Other (20)

Month ____
Year 19____
9999[] DK

Month ____
Year 19____
9999[] DK

Month ____
Year ____