April/May 2014: Mind Matters

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April/May 2014: Mind Matters

Studies show that people living with HIV may be more likely than the general population to develop mental disorders like depression or anxiety. POZ wants to know about your mental health issues.
 
1. How would you rate your overall mental health?
Excellent
Good
Fair
Poor
 
2. Did you have a history of mental health issues before your HIV diagnosis?
Yes
No
 
3. Have you experienced any mental health issues after your HIV diagnosis?
Yes
No
 
4. Have you been diagnosed with any of the following depressive disorders? (Check all that apply.)
Major depressive disorder
Bipolar disorder
Dysthymia
Postpartum depression
Seasonal affective disorder (SAD)
 
5. Have you been diagnosed with any of the following anxiety disorders?(Check all that apply.)
Generalized anxiety disorder
Panic disorder
Agoraphobia or social anxiety disorder
Obsessive compulsive disorder
Post-traumatic stress disorder
Separation anxiety disorder
 
6. Have you received treatment for your mental health issues?
Yes
No
 
7. If yes, what type of treatment have you received? (Check all that apply.)
Counseling
Prescription medication
Nonprescription medication
Other (please specify): 
 
8. Have your mental health issues interfered with your HIV care and treatment?
Yes
No
 
9. Have your mental health issues caused you to miss and/or forget to take your HIV medication?
Yes
No
 
10. Have you ever experienced stigma in regards to your mental health?
Yes
No
 
11. To whom have you disclosed your mental health issues? (Check all that apply.)
Spouse/partner
Family
Friends
Co-workers
Health care provider
None of the above
 
12. What year were you born?
 
13. What is your gender?
Male
Female
Transgender
Other
 
14. What is your sexual orientation?
Straight
Gay/Lesbian
Bisexual
Other
 
15. 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): 
 
16. What is your zip code?



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