POZ Focus: Shopping for HIV Coverage

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POZ Focus: Shopping for HIV Coverage

We want to hear from you! Please fill out the following survey. We appreciate your feedback
 
1. After reading this POZ Focus, has your understanding of your health care options…
Increased greatly
Increased slightly
Stayed the same
 
2. After reading this POZ Focus, has your understanding of the Affordable Care Act and how it affects people living with HIV…
Increased greatly
Increased slightly
Stayed the same
 
3. Which of the following is important to you when considering brand-name versus generic drugs?
How they affect me
Drug quality
Convenience
Cost
All of the above
 
4. How do you currently pay for your HIV care and treatment? (Check all that apply.)
Employer-based insurance
Private insurance
Medicaid
Medicare
AIDS Drug Assistance Program (ADAP)
Pharmaceutical Assistance Program (PAP)
 
5. After reading this Focus, do you plan on exploring other health care options?
Yes
No
Not sure
 
6. Please rate the overall quality of this POZ Focus:
Excellent
Good
Fair
Poor
 
7. I was diagnosed with HIV…
In the past year
In the past two to five years
Six to 10 years ago
More than 10 years ago
 
8. What year were you born?
 
9. What is your gender?
Male
Female
Transgender
Other
 
10. What is your sexual orientation?
Straight
Gay/Lesbian
Bisexual
Other
 
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 Native
Arab or Middle Eastern
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other: (please specify): 
 
13. What is your zip code?



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