POZ - January/February 2011: Support Services

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January/February 2011: Support Services

AIDS service organizations (ASOs) provide a variety of services to people living with-and affected by-HIV/AIDS. From support groups to case management, ASOs are often a great resource and a lifeline to the people they help. POZ wants to hear about your local ASO and the type of assistance it provides.
 
1. How often do you visit your local ASO?
Weekly
Monthly
Every couple of months
Yearly
Never (skip to question 10)
 
2. What distance do you travel to your ASO?
Less than 1 mile
1-5 miles
6-10 miles
11-20 miles
More than 20 miles
 
3. How did you find your local ASO?
Referred by a doctor
Referred by a family member/friend
Referred by another HIV-positive person
Through the Health Services Directory on POZ.com
Through another online resource
The phone book
Other: 
 
4. What types of services does your ASO provide? (Check all that apply.)
Adult education
Day care services
Dental services
Financial assistance
Hep C prevention
Hep C testing/counseling
Hep C treatment education
Housing services
Mental health counseling
HIV case management
HIV prevention
HIV testing/counseling
HIV treatment education
Holistic treatments
Immigration support
Insurance assistance
Legal assistance
Medical treatment
Nutritional assistance
Peer/group support
Senior programs
Substance abuse counseling or treatment
Transportation assistance
Youth programs
Family planning
 
5. What types of services do you use at your ASO? (Check all that apply.)
Adult education
Day care services
Dental services
Financial assistance
Hep C prevention
Hep C testing/counseling
Hep C treatment education
Housing services
Mental Health counseling
HIV case management
HIV prevention
HIV testing/counseling
HIV treatment education
Holistic treatments
Immigration support
Insurance assistance
Legal assistance
Medical treatment
Nutritional assistance
Peer/group support
Senior programs
Substance abuse counseling or treatment
Transportation assistance
Youth programs
Family planning
 
6. Are there any services not available at your local ASO that you would like it to offer?
Yes
No
Other: (if yes, please specify): 
 
7. How would you rate the services at your local ASO?
Excellent
Good
Fair
Poor
 
8. How would you rate the staff at your local ASO?
Excellent
Good
Fair
Poor
 
9. Do you feel your ASO is up-to-date on the latest HIV treatment news?
Yes
No
 
10. What is your gender?
Male
Female
Transgender
Other
 
11. What is your sexual orientation?
Straight
Gay/Lesbian
Bisexual
Other
 
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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