-HIV/AIDS Med Adherence Survey-

1. Are you HIV positive (or have AIDS)?
   Yes
   Recently tested negative
   Tested negative year or more ago
   No (not sure)
   
   
2. Are you using HIV medications or AIDS treatments?
   Yes
   No
   I recently stopped
   
   
3. Do you take your medications daily and regular times?
   I take all meds on time all the time
   I might miss a day every week
   I might miss a day a month
   I miss dosing often
   I'm not using HIV/AIDS meds
   
   
4. Are you resistant to any HIV or AIDS medications?
   Yes
   No
   Haven't tested (don't know)
   
   
5. How often do you visit your HIV/AIDS doctor/specialist?
   Every month
   Every 3 months
   Every 6 months
   Only when there's an issue
   Never
   
   
6. Do you drink alcohol or abuse other drugs?
   Daily
   Weekends
   Occasionally
   Never
   
   

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