Yes
	No

	Yes
	No

	Once a month
	Four times a year
	Twice a year
	Once a year
	Every two years
	It's been awhile

	Primary care physician (if different from your HIV doctor)
	Dentist
	OB/GYN
	Therapist/psychiatrist

	Hospital affiliation
	Credentials/experience
	Geographical proximity
	That he/she is my race
	That he/she is my gender
	That he/she is my sexual orientation
	That he/she is HIV positive
	None of the above

	Yes
	No

	Yes
	No

	Referred by another HIV-positive person
	Referred by my family physician or nurse practitioner
	Through an AIDS service organization
	Through an online resource
	The phone book
	Other: (please specify)

	It is the closest place I can find treatment
	I worry about confidentiality in my hometown
	I moved/relocated and wanted to keep my old doctor
	My preferred doctor just happens to be far away

	Less than 10 minutes
	11–20 minutes
	21–30 minutes
	More than 30 minutes

	Very comfortable
	Somewhat comfortable
	Not at all comfortable

	Aging
	Drug/alcohol addiction
	Drug interactions
	Emotional issues
	Medication adherence
	Nutrition and exercise
	Other sexual health topics
	Pregnancy
	Preventing HIV transmission

	Every time I visit
	Whenever my regimen seems to be failing
	Whenever a new drug becomes available
	Whenever I have trouble with side effects
	Never
	Other: (please specify)

	Male
	Female
	Transgender
	Other

	Straight
	Gay/Lesbian
	Bisexual
	Other

	American Indian or Alaska Native
	Arab or Middle Easternn
	Asian
	Black or African American
	Hispanic or Latino
	Native Hawaiian or other Pacific Islander
	White
	Other: (please specify)