E. HIV Risk Behavior Questionnaire

Would you please take a few minutes to answer the questions below. Your answers will help us to educate the community more effectively to avoid this disease.

Which of the following increases a person’s chances of getting AIDS?

PLEASE CHECK EACH CORRECT ANSWER.

(Associated with sex)

a)Having sexual intercourse with someone who was exposed to HIV 5 years ago, but who looks and feels healthy and has never shown any sign of the illness
b)Having sexual intercourse with someone who has HIV
c)Massaging someone who has HIV or AIDS
d)Hugging someone who has HIV or AIDS
e)Kissing someone who has HIV or AIDS
f)Properly using latex condoms with spermicide
g)Using a condom with oil or Vaseline instead of a water-based lubricant
h)Using the same condom twice
i)Unprotected oral sex
j)Unprotected vaginal sex
k)Unprotrected anal sex
l)Having many sexual partners

(Associated with drugs and use of needles)

m)Using alcohol, crack, marijuana, or other drugs that affect good judgment
n)Sharing needles for injecting drugs
o)Sharing needles for injecting steroids or vitamins or for ear or body piercing or tattooing
p)Sharing a needle that has been cleaned with water
q)Sharing a needle that has been properly cleaned with bleach or alcohol

(Associated with other modes of transmission)

r)Receiving a blood transfusion today
s)Being born to or breastfed by an infected mother
t)Being born to a mother whose husband was exposed to HIV 5 years ago, but who looks and feels healthy and has never shown any sign of the illness

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