POZ Basics: How Am I Aging? Survey

How Am I Aging?

HIV & Aging Survey
We want to hear from you! After completing the “How Am I Aging?” module, please take the following survey. We appreciate your feedback.
1) Are you living with HIV?

YesI'm not sure.NoNo, but someone close to me is.
2) Please rate the overall quality of this eLearning module:

ExcellentGoodFairPoor
3) After completing the “How Am I Aging?” module, do you better understand where you can find support, how to adjust to living with HIV and how your life will be different?

YesNo
4) What is the core advice for aging well with HIV? (Check all that apply.)

Maintain a partnership with a care provider you see regularlyEngage in work or activities that give you pleasureEat a healthy dietGet regular exerciseOther
5) What did you learn that was the most useful to you?
6) What would have made this module more useful to you? (Check all that apply.)

More quizzesAdditional scenariosLinks to more informationMore in-depth informationOther
7) What other topics should be covered in future modules? (Check all that apply.)

Adherence and ResistanceHIV and HCVHIV and the BrainPaying for Care and TreatmentStarting TreatmentOther
8) What year were you born?
9) What is your gender?

MaleFemaleTransgenderOther
10) What is your sexual orientation?

StraightGay/lesbianBisexualOther
11) What is your yearly personal income?

Less than $15,000$15,000–$34,999$35,000–$49,999$50,000–$74,999$75,000–$99,999$100,000 or more
12) What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
13) What is your ZIP code?
Enter the message as it's shown*
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