Survey Text

1999
1998
1997
top
1999
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance 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. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

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ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________

top
1998
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance 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. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________

top
1997
Survey form view entire document:  text  image

ADS.065

FR: SHOW CARD A18

[If ADS.020 = (1) read:]
Not including your blood donations, which of these would you say were the reasons for your last AIDS test?

[Else read:]
Which of these would you say were the reasons for your last AIDS test?
Card A18
1. Just to find out/Worried that you are infected
2. Because a doctor asked you to
3. Because the Health Department asked you to
4. Because sex partner asked you to
5. For hospitalization or surgical procedure
6. To apply for health insurance 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. Because of pregnancy
12. For some other reason (Specify)
REATOT
(1) Just to find out/Worried that you are infected (ADS.070)
(2) Because a doctor asked you to (ADS.070)
(3) Because the Health Department asked you to (ADS.070)
(4) Because sex partner asked you to (ADS.070)
(5) For hospitalization or surgical procedure (ADS.070)
(6) To apply for health insurance or life insurance (ADS.070)
(7) To comply with guidelines for health workers (ADS.070)
(8) To apply for a new job (ADS.070)
(9) For military induction, separation, or during military service (ADS.070)
(10) For immigration (ADS.070)
(11) Because of pregnancy (ADS.070)
(12) Other reason - specify (ADS.067)
(13) Other reason - specify (ADS.068)
(97) Refused (ADS.070)
(99) Don't Know(ADS.070)

[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

ADS.067

Specify the additional reason for the last AIDS test.
REASPEC1 First reason: _______________

ADS.068

Specify the additional reason for the last AIDS test.
REASPEC2 Second reason: _______________