October/November 2013: On Schedule

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October/November 2013: On Schedule

Taking your medications as scheduled is essential to treating your HIV. Missing doses can cause drug resistance and limit your future treatment options. POZ wants to know about your drug adherence and what you do to take your medications on time.
 
1. Are you currently taking antiretroviral meds for HIV?
Yes
No
 
2. In the past month, did you miss any doses of your HIV medications? If yes, how many?
No
1
2
3 or more
 
3. Have you ever missed several doses in a row?
Yes
No
 
4. Do you tell your doctor or health care provider if you miss a dose?
Yes
No
Sometimes
 
5. If you miss a dose, what do you do?
Take the meds as soon as I remember
Wait until my next scheduled dose to take the meds
It depends on how long it’s been since I missed the dose
 
6. Are you resistant to any class of drugs?
Yes
No
I don't know
 
7. Is your viral load undetectable?
Yes
No
I don't know
 
8. Have you ever switched meds to improve adherence?
Yes
No
 
9. Do you need to take your HIV meds with food?
Yes
No
 
10. When do you take your HIV medications? (Check all that apply.)
In the morning
In the afternoon
In the evening
 
11. Do you use any reminders to take your HIV meds?
Yes
No
 
12. Do you carry or store your HIV meds in a special case?
Yes
No
 
13. Have you ever taken a double dose by mistake?
Yes
No
 
14. Have you ever run out of your HIV meds?
Yes
No
 
15. Other than simply forgetting, what reasons have you had for missing a dose? (Check all that apply.)
Didn't carry HIV meds when traveling
Drug or alcohol use
Not feeling well
Fell asleep
Ran out of HIV meds
Unable to afford them
(please specify): 
 
16. Where do you get your HIV medications
Local pharmacy
Mail-order pharmacy
Prison or other correctional institution
(please specify): 
 
17. What year were you born?
 
18. What is your gender?
Male
Female
Transgender
Other
 
19. What is your sexual orientation?
Straight
Gay/Lesbian
Bisexual
Other
 
20. 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
(please specify): 
 
21. What is your zip code?



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