Questionnaire No __________ Date: Day __ Month ___ Year ___

Country : ________ ________ ________ _____ Name: ________ ________ ________ ______ Sex:____ ________ ____ Place (Name of Mohallah or you mean House/Ba zar/street etc). : ________ ________ ________ ________ ________ ________ ________ ______

City/town: _____________________________ Union Council:_______________________

PLEASE READ THE FOLLOWING STATEMENT CAREFULLY BEFORE SIGNING OR COMPLETING THE QUESTIONNAIRE. The research project is conducting a survey to help us to improve provincial HIV/AIDS programme and to restrategize the advocacy for HIV AIDS awareness. Your participation on this survey is important to us and is completely voluntary. If you agree to complete the questionnaire, you will answer questions regarding yourself, your ideas, attitudes and behavior regarding different aspects of HIV/AIDS prevention. Your answers will be kept confidential and only the researchers and study personnel will have access to this information. Completing the questionnaire will take between 15 and 20 minutes; the completed questionnaires will be collected by the official representative of the Provincial HIV/AIDS programme and will be kept in such a manner as to guarantee your privacy. Please mark with an X if you agree or not to complete the questionnaire.
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I do not wish to complete the questionnaire ____ I agree to complete the questionnaire and do so in a completely voluntary manner. I understand that my responses will be kept confidential. ______ Name (optional) ________________________ Signature _____________________ Thumb Impression: (No need for these things as it un-necessarily over sensitize the respondents) _______________________________ Date _________________________

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How old are you? Are you Educated? If No, skip question no.3 What is the highest level of school you attended?

YEARS OLD DOES NOT KNOW NO YES NONE PRIMARY SECONDARY POST-SECONDARY OTHER, SPECIFY SINGLE MARRIED WIDOWED DIVORCED SEPARATED NO YES NO WHERE GOVERNMENT HEALTH CARE WORKER (DOCTOR /NURSE) PRIVATE HEALTH CARE WORKER (DOCTOR/NURSE ) COMMUNITY HEALTH WORKER/ Lady Health Worker Dispenser

98 0 1 0 1 2 3 97 0 1 2 3 4 0 1 0 1 2 3 4

What is your marital status now?

Have you ever heard of HIV /AIDS? 5 6. From where have you got this information?

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HUSBAND/WIFE (SPOUSE) 5 OTHER RELATIVES .6 FRIENDS 7 RADIO 8 TV 9 NEWSPAPERS/MAGAZINES 10 Bill Boards11 Neighbors 12 7.
How is HIV spread from one person to another?

Circle all the persons/places in the right column

Need explanation what it means where go to ask or find health in this specific question??Ignore ,just a mistake

Blood contact 1 Sharing Syringes..2 Piercing and tattooing3 Sharing Blades..4 Mother to Child..5 Husband to Wife.6 Wife to Husband7. Sex with multiple partners8 Saliva..9 Sharing Food & utensils..10 Hugging..11 Shaking hands12 Mosquito bite.13 Others.________________________97 NO WHERE 0 GOVERNMENT HEALTH CARE WORKER (DOCTOR /NURSE) 1 PRIVATE HEALTH CARE WORKER (DOCTOR/NURSE ) 2 COMMUNITY HEALTH WORKER/ 3 Lady Heath worker Dispenser 4 HUSBAND/WIFE (SPOUSE) 5 OTHER RELATIVES .6 FRIENDS 7 RADIO 8 TV 9 NEWSPAPERS/MAGAZINES 10 COMMUNITY OR PUBLIC MEETINGS 11 OTHER, SPECIFY_______________ 97 NO YES 0 1

If you have a question about HIV/AIDS, who do you ask or where do you go to get the information? Circle all the persons/places in the right column where you go to ask or find health information.

Do you know if there is anything a person can do to avoid getting AIDS?

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DONT KNOW 10 In your opinion what can a person do to avoid getting AIDS? Circle all the answers on the right column that you think would help a person to not get infected with AIDS. .

NOTHING 0 Not to get involved in Sexual relationship 1 USE CONDOMS 2 AVOID MULTIPLEPARTNERS 3 LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PART. 4 AVOID SEX WITH PROSTITUTE .5 AVOID SEX WITH HOMOSEX 6 AVOID BLOOD CONTACT. 7 AVOID INJECTIONS 8 AVOID KISSING 9 AVOID MOSQUITO BITES 10 SEEK PROTECTION FROM TRADITIONAL HEALER 11 OTHER (SPECIFY) Don't know 98 97

11

Is it possible for a healthy looking person to be infected with the AIDS virus

NO YES DONT KNOW NO YES

0 1 8 0 1

12

Do you know someone personally who has AIDS or the virus that causes AIDS or someone who died from AIDS?

No.0 13 Can AIDS be transmitted from an infected mother to a child during delivery? The question needs to be clarified if it focus on, as I assume, reproductive process is under consideration. If, it is concerned even about all sort of mother child relations, even than, there are other possible anwers i.e. No, sharing bed or food etc. otherwise the question if focus on reproduction be as Can HIV/AIDS infected Mothers transmit it to their children on delivery or in breast feeding? Yes...1

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The possible answers be given as No, Yes, the new born will automatically be infected child Yes, Breast feeding can transmit infection Yes, loving, kissing and hugging can transmit it to the child Etc. Corrected 14 Can AIDS be transmitted from an infected mother to a child through breast feeding? No0 Yes.. 1 NO YES NEVER MARRIED/ NO REGULAR PARTNER NO YES
DON,T KNOW

15 Have you ever talked about HIV or AIDS with your spouse or regular sex partner? 0 1 3 0 1
..8

16

Do you think people look down upon people infected with HIV AIDS

17

If Yes why

18

What are the cultural barriers which prevents the infected person with HIV to seek medical treatment The cultural barriers need to be specifically addressed. For example Do you think the concept of Honor or Ghairat, is a major hurdle not to seek medical treatment for HIV/AIDS? Or The concept of Badal revenge and strong family bonds is a major hurdle in declaring one self as HIV/AIDS infected or going public for treatment. Or The strong attachment of Hospitaltiy as ritual with Treatment/illness and stigma of sin attached with HIV/AIDS hinder us from not exposing oneself as HIV/AIDS Patient.

Do you think the concept of Honor or Ghairat, is a major hurdle not to seek medical treatment for HIV/AIDS?................................................1 Do you think The concept of Badal revenge and strong family bonds is a major hurdle in declaring one self as HIV/AIDS infected or going public for treatment2 DO you think The strong attachment of Hospitaltiy as ritual with Treatment/illness and stigma of sin attached with HIV/AIDS hinder us from not exposing oneself as HIV/AIDS Patient3 Others4

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Thanx for the suggestions

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If a person knows that he or she has AIDS or the virus that causes AIDS, do you think that he/she should keep it private or tell other people in the community?

SHOULD KEEP IT PRIVATE SHOULD TELL OTHERS OTHER, (SPECIFY) DONT KNOW / NOT SURE

1 2 3 98

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What do you suggest how to overcome these barriers.What do you suggest that govt should do to help to remove this stigma and motivate people for screening and getting treatment. Here too some concrete options be given to make a lay (wo)man understand what is basically asked for in the question. Is it clear now Please write in the column in the right what NOTHING things should be included in the plan to ABSTAIN FROM SEX avoid getting infected with the HIV/AIDS USE CONDOMS virus 0 1 2

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LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PART. 3 AVOID SEX WITH PROSTITUTE .4 AVOID SEX WITH HOMOSEX 5 AVOID BLOOD CONTACT. 6 AVOID INJECTIONS 7 AVOID KISSING 8 AVOID MOSQUITO BITES 9 SEEK PROTECTION FROM TRADITIONAL HEALER 10

OTHER (SPECIFY) Don't know

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97 98

THANK-YOU VERY MUCH FOR COMPLETING THIS QUESTIONNAIRE AND FOR HELPING US IMPROVE OUR PROGRAM.

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