Name *

First

Last

Email *

1) HIV and AIDS are the same *

• Yes
• No
• I don't know

2) There is a medicine to PREVENT the transmission of HIV *

• Yes
• No
• I don't know

3) A person living with HIV has a limited time to live *

• Yes
• No
• I don't know

4) A person who has HIV will have AIDS later *

• Yes
• No
• I don't know

5) Do you agree for HIV pre-testing before marriage? *

• Yes
• No
• I don't know

6) Are you aware of the EMERGENCY PILL? *

• Yes
• No
• I don't know

7) Do you know anyone living with HIV? *

• Yes
• No
• I don't know

8) Are you okay being friend with HIV positive person? *

• Yes
• No
• I don't know

9) Would you share food and drinks with HIV positive person? *

• Yes
• No
• I don't know

10) HIV can only be transmitted sexually *

• Yes
• No
• I don't know

11) Can a person get HIV from a mosquito bite? *

• Yes
• No
• I don't know

12) Is blood transfusion a significant source of HIV transmission? *

• Yes
• No
• I don't know

13) Are condom 100% effective in controlling of HIV? *

• Yes
• No
• I don't know

14) If a pregnant woman becomes infected with HIV, her child will also be born with HIV *

• Yes
• No
• I don't know

15) Can a person die with HIV/AIDS? *

• Yes
• No
• I don't know

16) Is there a cure for HIV/AIDS? *

• Yes
• No
• I don't know

17) Can a person with HIV look healthy? *

• Yes
• No
• I don't know

18) Have you ever heard about medicines for HIV/AIDS? *

• Yes
• No
• I don't know

19) Medicines can cure HIV/AIDS? *

• Yes
• No
• I don't know

20) Medicines can prolong the life of people infected with HIV/AIDS *

• Yes
• No
• I don't know

21) People with HIV should be ashamed of themselves *

• Yes
• No
• I don't know

22) People with HIV cannot have more than one partner *

• Yes
• No
• I don't know

23) I would feel ashamed if I were infected with HIV *

• Yes
• No
• I don't know

24) People with HIV should be expelled from their community *

• Yes
• No
• I don't know

25) Are you aware of any programs from the Indian Government that are intended to help prevent infection with HIV/AIDS? *

• Yes
• No
• I don't know

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