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RANDOM INDIVIDUAL ID: ______________________

INDIVIDUAL SURVEY QUESTIONNAIRE

SOCIAL DIMENSIONS OF RESPONSE TO HIV AND AIDS: A SEMI-

LONGITUDINAL STUDY IN THREE NIGERIAN COMMUNITIES

TABLE OF CONTENTS

A. DEMOGRAPHIC AND SOCIO-ECONOMIC ASPECTS DEM

B. HIV/AIDS RELATED KNOWLEDGE AND AWARENESS HKL

C. SEX RELATED ATTITUDES SRA

D. HIV/AIDS TESTING AND ANTI-RETROVIRAL DRUGS HTA

E. HIV/AIDS RELATED BEHAVIOUR HRB

F. HIV/AIDS RELATED RISK BEHAVIOUR HRR

G. HIV/AIDS RISK PERCEPTION HRP

H. DOMESTIC AND SEXUAL VIOLENCE DSV

I. STIGMA AND DISCRIMINATION SDI

J. AWARENESS OF, AND ACCESS TO, HIV/AIDS PREVENTION SERVICES SER

K. POLICY AWARENESS QUESTIONS PAQ

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INTRODUCTION

Dear respondent,
We are research assistants working on a collaborative research study between the University of Ibadan, Nigeria and Northwestern
University, USA. We are studying a number of communities in Nigeria to learn about behaviours, perceptions, attitudes, and
knowledge about HIV/AIDS. To achieve this, we are conducting a community survey here in _____________ and in two other
communities. We hope to be able to use your responses to make recommendations to help improve HIV/AIDS prevention services. If
you agree to participate, I would like to read you/you to read this consent form.

[Interviewer: Please administer CONSENT FORM at this point].

This part should be filled out by the interviewer after the respondent as agreed to participate in the study.
Response Value

LOCAL GOVERNMENT AREA WHERE

INTERVIEW IS BEING CONDUCTED:
LOCATION: Urban 1
Rural 2
EA CODE:

QUESTIONNAIRE NUMBER:

HOUSEHOLD RANDOM ID:

RESPONDENT INDIVIDUAL RANDOM ID:

DATE OF INTERVIEW: __ __/ __ __/ __ __

DD MM YY
INTERVIEWER’S NAME:

TIME INTERVIEW STARTED:

NUMBER OF INTERVIEW SESSION:

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Section A: DEMOGRAPHIC AND SOCIO-ECONOMIC CHARACTERISTICS

INTERVIEWER: UNLESS YOU ARE INSTRUCTED TO DO SO, DO NOT READ ALOUD THE OPTIONS. ALLOW THE
RESPONDENT TO ANSWER AND FIND THE RESPONSE THAT CLOSELY MATCHES THE OPTIONS. PROBE, WHEN
TOLD TO DO SO, TO GET A RESPONSE THAT MATCHES THE OPTIONS.

Interviewer read: This first set of questions we will ask will help us learn about you and your household.

INTERVIEWER: Circle the value corresponding to the option mentioned by the respondent.

No Questions RESPONSE Value Skip to

MALE 1
DEM 1. Interviewer: Enter Respondent’s gender FEMALE 2
DEM 2. How old are you? AGE (in years) [ ]
DON’T KNOW 88
NO RESPONSE 99
YORUBA 1
DEM 3. What ethnic group do you belong to? YAKURR 2
IGBO 3
HAUSA 4
MIXED (more than one) 5
SPECIFY MIX: ______________
OTHER (SPECIFY) 77
……………………………………
NO RESPONSE 99
CATHOLIC 1
Which religious denomination do you belong to?
DEM 4. PENTECOSTAL 2
PROTESTANT 3
TRADITIONAL AFRICAN 4
RELIGION
ISLAM 5
OTHER 77
(SPECIFY)………………………
NO RESPONSE 99
DEM 5. Are you currently married? NO 0 DEM 7
YES 1
NO RESPONSE 99 DEM 7
DEM 6. If YES, what kind of marriage? MARRIED (MONOGAMOUS) 1 DEM8
MARRIED (POLYGYNOUS) 2 DEM8
NO RESPONSE 99 DEM8
1
NEVER BEEN MARRIED
DEM 7. If NO, Have/Are you…
SEPARATED 2
(PROBE) DIVORCED 3
WIDOWED 4
READ ALOUD THE OPTIONS OTHER (SPECIFY)…………….. 77
NO RESPONSE 99
NO FORMAL SCHOOL 0
DEM 8. What is the highest level of school you PRIMARY 1
completed: JUNIOR SECONDARY 2
SENIOR SECONDARY 3
(PROBE) POST-SECONDARY 4
(SPECIFY)......................................
READ ALOUD THE OPTIONS OTHER 77
(SPECIFY)………………………..
NO RESPONSE 99

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No Questions RESPONSE Value Skip to

DEM 9 What is your present occupation? FARMER 1
UNEMPLOYED 2
PETTY TRADING 3
GOVERNMENT WORKER 4
EMPLOYED IN PRIVATE 5
SECTOR
SELF-EMPLOYED 6
PROFESSIONAL
OTHER (_______________ ) 77
SPECIFY
DON’T KNOW 88
NO RESPONSE 99
DEM 10 Approximately how much income in cash do NONE/ NOT CURRENTLY 0
you earn from work each month? WORKING
LESS THAN N500 1
N500 - N1000 2
N1001 - N5000 3
N5001 - N10,000 4
N10,001 – N20,000 5
ABOVE N20,000 6
OTHER (SPECIFY) 77
……………………………
DON’T KNOW 88
NO RESPONSE 99
DEM 11 Have you ever lived outside this community? NO 0 DEM 13
YES 1
NO RESPONSE 99 DEM 13
DEM 12 Where? BIG CITY 1
TOWN 2
READ ALOUD THE OPTIONS TO THE VILLAGE 3
RESPONDENT NO RESPONSE 99
DEM 13 How long have you been living in this place LESS THAN 1 YEAR 1
continuously? 1 – 5 YEARS 2
6 – 10 YEARS 3
MORE THAN 10 YEARS 4
NO RESPONSE 99
DEM 14 How many nights were you away from your NUMBER OF NIGHTS [ ]
home in the past ONE month? DON’T REMEMBER 88
NO RESPONSE 99

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Section B: HIV/AIDS RELATED KNOWLEDGE

Interviewer read: Please, I will now like to ask you some questions about your knowledge of HIV/AIDS.

INTERVIEWER: Circle the value corresponding to the option mentioned by the respondent.
No Questions RESPONSE Value Skip to
HKL 15 Have you ever heard of AIDS or of HIV - NO 0 SRA 22
the Human Immunodeficiency Virus that YES 1
causes AIDS? NOT SURE 88 SRA 22
NO RESPONSE 99 SRA 22
If YES, through which source did you Yes No
hear about HIV or AIDS? a. RADIO 1 0
b. TELEVISION 1 0
c. BILLBOARD or HAND BILLS 1 0
NOTE: DO NOT PROMPT. ALLOW c. NEWSPAPER / MAGAZINE 1 0
RESPONDENT TO EXHAUST THE d. SPOUSE 1 0
SOURCES. THEN ASK ANYTHING e. OTHER SEXUAL PARTNER 1 0
ELSE. f. FAMILY MEMBER 1 0
g. DOCTORS OR NURSES 1 0
Anything else? h. INFECTED PERSONS 1 0
i. COMMUNITY LEADERS/MEETINGS 1 0
RECORD ALL MENTIONED.
j. SCHOOL 1 0
k. CHURCH / MOSQUE 1 0
CIRCLE 1 IN THE YES COLUMN
WHEN AN OPTION IS MENTIONED l. FRIENDS 1 0
BY RESPONDENT. m. OTHER (SPECIFY) …………… 1 0
n. DON’T KNOW 88
All without “1” will be coded as “0” o. NO RESPONSE 99
HKL 16 If you heard about HIV or AIDS from a a. PARENT 1
family member, who did you hear from? b. OTHER ADULT 2
c. CHILD 3
RECORD ALL MENTIONED. d. OTHER, SPECIFY: _______________ 77

No Questions RESPONSE Value Skip to

Yes No
HKL 17 Please tell me all the ways that a person a. ABSTAIN FROM SEX 1 0
can protect themselves from becoming b. USE CONDOMS 1 0
infected with HIV/AIDS? c. STAY FAITHFUL TO ONE PARTNER 1 0
d. LIMIT NUMBER OF SEXUAL 1 0
NOTE TO INTERVIEWER: DO NOT PARTNERS
PROMPT RESPONDENT. e. AVOID SEX WITH COMMERCIAL SEX 1 0
RECORD ALL MENTIONED. WORKERS
f. AVOID SEX WITH PERSONS WHO HAVE 1 0
CIRCLE 1 IN THE YES COLUMN MANY PARTNERS
WHEN RESPONDENT MENTIONS g. AVOID SEX WITH HOMOSEXUALS 1 0
AN OPTION. h. AVOID SEX WITH PERSONS WHO 1 0
INJECT ILLEGAL DRUGS
All options not coded as “1” will be INTRAVENOUSLY
coded automatically as “0”. i. AVOID TRANSFUSIONS WITH BLOOD 1 0
THAT HAS NOT BEEN TESTED FOR HIV
j. AVOID UNSTERILIZED NEEDLES AND 1 0
INJECTIONS
k. AVOID KISSING 1 0
l. AVOID MOSQUITO BITES 1 0
m. SEEK PROTECTION FROM 1 0
TRADITIONAL HEALER
n. AVOID SHARING RAZORS, BLADES OR 1 0
ANY SHARP OBJECT
o. REQUIRE PARTNER TO TAKE HIV TEST 1 0
p. OTHER (SPECIFY) 77
……………………………………………

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q. DON’T KNOW 88
r. NO RESPONSE 99

HKL 18 Can someone die from AIDS? NO 0

YES 1
DON’T KNOW 88
NO RESPONSE 99
HKL 19 Is there a cure for AIDS? NO 0
YES 1
DON’T KNOW 88
NO RESPONSE 99
HKL 20 Can a person infected with HIV look NO 0
healthy? YES 1
DON’T KNOW 88
NO RESPONSE 99
Yes No
HKL 21 Please tell me all the ways that a a. DURING PREGNANCY 1 0
mother can transmit HIV/AIDS to her b. DURING LABOUR/DELIVERY 1 0
baby? c. THROUGH BREAST MILK 1 0
d. OTHER, SPECIFY: ________________ 77
e. DON’T KNOW 88

Section C: ATTITUDES RELATED to SEXUALITY

In this next section I will ask about your beliefs and opinions regarding sexual behaviour. After I read you each statement, please tell
me whether you AGREE or DISAGREE.

INTERVIEWER: Tell respondent that he/she will be expected to indicate his/her position regarding the statements that you will
read. PLEASE DO NOT MENTION THE OPTION NEUTRAL

INTERVIEWER: Circle the value corresponding to the option mentioned by the respondent.

No Questions RESPONSE Value Skip to

SRA 22 If a person is in possession of a male condom, it AGREE 1
implies they are planning to have sex. NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 23 Using a male condom reduces sexual pleasure. AGREE 1
NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 24 A man will be offended if a woman insists that AGREE 1
he should use a condom. NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
It is embarrassing to buy or ask for condoms. AGREE 1
SRA 25 NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 26 Men need to have more than one sexual partner. AGREE 1
NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 27 Women need to have more than one sexual AGREE 1
partner. NEUTRAL 2
DISAGREE 3

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NOT SURE 88
NO RESPONSE 99
SRA 28 Sexual intercourse should only take place AGREE 1
between married couples. NEUTRAL 2
DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 29 On the issue of HIV/AIDS, a person can safely AGREE 1
accept blood transfusion if the blood have been NEUTRAL 2
screened for HIV/AIDS. DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 30 It is safe to share sharp objects such as clippers, AGREE 1
nail cutters, razor blades, etc with friends or NEUTRAL 2
family members. DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 31 The sharing of equipment (without washing) to AGREE 1
perform circumcision on boys and girls can NEUTRAL 2
expose them to HIV infection and AIDS. DISAGREE 3
NOT SURE 88
NO RESPONSE 99
SRA 32 The use of unsterilized equipment to perform AGREE 1
circumcision on boys and girls can expose them NEUTRAL 2
to HIV infection and AIDS. DISAGREE 3
NOT SURE 88
NO RESPONSE 99

Section D: HIV/AIDS TESTING AND ARV

Interviewer read: The following questions seek to know your knowledge about HIV/AIDS testing and Antiretroviral medicine.

INTERVIEWER: Circle the value corresponding to the option mentioned by the respondent.
No Questions RESPONSE Value Skip to
HTA 33 NO 0
Have you ever heard about Voluntary YES 1
Counselling and Testing for NOT SURE 88
HIV/AIDS? NO RESPONSE 99

HTA 34 Have you ever had a test for HIV, the NO 0 HTA 39
virus that causes AIDS? YES 1
DON’T KNOW 88 HTA 40
NO RESPONSE 99 HTA 39
HTA 35 If YES, when was the first time? WITHIN THE LAST YEAR (LAST 12 1
MONTHS)
BETWEEN 1-5 YEARS AGO 2
MORE THAN 5 YEARS AGO 3
DON’T KNOW 88
NO RESPONSE 99
HTA 36 Did you receive the results of your NO 0
first test? YES 1
DON’T KNOW 88
NO RESPONSE 99
HTA 37 What is your HIV status? NEGATIVE 1
POSITIVE 2
DON’T KNOW 88
NO RESPONSE 99
HTA 38 If you have been tested and IN THE LAST 12 MONTHS 1
counselled for HIV more than once, MORE THAN A YEAR AGO 2
when was the MOST RECENT time? DON’T REMEMBER 88
NO RESPONSE 99
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HTA 39 If you have NEVER been tested, why NOT LIKEY TO HAVE HIV INFECTION 1
have you NOT been tested?
AFRAID TO FIND OUT THAT I AM INFECTED 2

PREFER NOT TO THINK ABOUT HIV 3

DO NOT LIKE NEEDLES OR BLOOD DRAWING 4

WORRIED THAT TEST RESULTS WOULD NOT 5

REMAIN CONFIDENTIAL
AFRAID OF LOSING JOB, FAMILY, HOUSING , 6
FRIENDS IF FOUND TO BE INFECTED
NOT SURE HOW TO TELL SPOUSE OR OTHER 7
SEXUAL PARTNER IF INFECTED
DO NOT KNOW WHERE TO BE TESTED AND 8
COUNSELLED
OTHER (SPECIFY) 77

NOT SURE/ DON’T KNOW 88

NO RESPONSE 99

HTA 40 Approximately, how many injections NONE 0

of medicine have you received in the RECORD NUMBER OF INJECTIONS ____
last 12 months? DON’T REMEMBER 88
NO RESPONSE 99

HTA 41 Approximately, how many blood NONE 0

transfusions have you received in the RECORD NUMBER OF INJECTIONS ____
last 12 months? DON’T REMEMBER 88
NO RESPONSE 99

No Questions RESPONSE Value Skip to

HTA 42 Have you ever heard about Antiretroviral drugs NO 0 HRB 46
for HIV/AIDS? YES 1
NOT SURE 88 HRB 46
Interviewer read: In the following questions, please when I read a statement to you, tell me if you AGREE or DISAGREE.

HTA 43 Antiretroviral drugs can cure HIV/AIDS AGREE 1

NEUTRAL 2
DISAGREE 3
DON’T KNOW or NOT SURE 88
NO RESPONSE 99
HTA 44 Antiretroviral drugs can prolong the life of AGREE 1
people infected with HIV/AIDS. NEUTRAL 2
DISAGREE 3
DON’T KNOW or NOT SURE 88
NO RESPONSE 99
HTA 45 People can easily get into an Antiretroviral AGREE 1
treatment program if they have HIV/AIDS. NEUTRAL 2
DISAGREE 3
DON’T KNOW 88
NO RESPONSE 99

Section E: HIV/AIDS RELATED BEHAVIOR

Interviewer read: Thank you for your responses. I would now like to ask you about behaviours that may be related to the risk of
HIV/AIDS and sexual diseases.

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CIRCLE 1 IN THE YES COLUMN WHEN AN OPTION IS MENTIONED BY RESPONDENT

No Questions RESPONSE Value Skip to
What do you do to avoid getting Yes No
HRB 46 infected with HIV/AIDS? a. Advise spouse/sexual partner to take care 1 0
b. Prayer can protect 1 0
INTERVIEWER: Do not read list.
c. Practice sexual abstinence 1 0
Use Condoms with:
More than one answer is
possible. d. All other partners except spouse 1 0
e. Commercial sex workers/Bar girls 1 0
NOTE: DO NOT PROMPT f. People from town 1 0
RESPONDENT. RECORD ALL g. People you think might be infected 1 0
RESPONSES MENTIONED. Avoid having sexual intercourse with:
h. Any partners except spouse 1 0
CIRCLE 1 IN THE YES i. Commercial sex workers/Bar girls 1 0
COLUMN WHEN AN OPTION j. Many Partners 1 0
IS MENTIONED BY k. People from town 1 0
RESPONDENT. l. People you think might be infected 1 0
m. People of the same sex 1 0
Other:
All without “1” will be coded as n. avoid blood transfusions and injections 1 0
“0” o. Nothing can be done 1 0
p. Other (Specify) ____________________ 77
q. Don’t Know 88
r. NO RESPONSE 99

Section F: HIV/AIDS RELATED RISK BEHAVIOR

Interviewer read: I am now going to ask some specific personal questions about sexual behaviour and your sexual partners in the last
12 months. These include anyone you might have had sex with: husband, wife or wives, girlfriends, boyfriends, friend, casual partner,
commercial sex worker, someone you might have met at a bar, wedding, special event, etc. Please note that all your responses are
confidential. Please try to be as accurate as possible with your responses.

Interviewer: Circle the value corresponding to the option mentioned by the respondent.
No Questions RESPONSE Value Skip to
HRR 47 In this community, at what age do young ___________ years
men begin having sexual intercourse?
HRR 48 In this community, at what age do young ___________ years
women begin having sexual intercourse?
HRR 49 Do you have a regular sexual partner? NO 0
YES 1
NO RESPONSE 99
HRR 50 How many regular sexual partners do you ___________________
have?
HRR 51 About how old were you when you first
had sexual intercourse? Interviewer: AGE IN YEARS [ ]
probe for age estimation. NO RESPONSE 99
HRR 52 How many different people have you had NUMBER OF PEOPLE RESPONDENT [ ]
sexual intercourse with in the past 3 HAS HAD SEX WITH
months? CAN’T REMEMBER 88
NO RESPONSE 99
HRR 53 Do you have a spouse or regular sexual NO 0 HRR 60
partner? YES, SPOUSE 1
YES, OTHER REGULAR PARTNER 2
NO RESPONSE 99 HRR 60
HRR 54 The last time you had sex with your NO 0
spouse or regular partner, did you or your YES 1
partner use a condom? DON’T KNOW 88
NO RESPONSE 99

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HRR 55 How often do you use a condom with Never or almost never 0 HRR 57
your spouse or regular partner? Not often 1
Usually but not always 2
Always 3
NO RESPONSE 99 HRR 57
HRR 56 Who usually places the condom on? SELF 1
PARTNER 2
EITHER 3
HRR 57 Did you drink alcohol heavily the last NO 0
time you had sex? YES 1
DON’T KNOW 88
NO RESPONSE 99
HRR 58 Did your spouse (or other regular partner) NO 0
drink alcohol heavily the last time you YES 1
had sex together? DON’T KNOW 88
NO RESPONSE 99
HRR 59 Do you think your spouse or regular NO 0
partner has other sexual partners? YES 1
DON’T KNOW 88
NO RESPONSE 99
HRR 60 Have you ever been formally instructed NO 0
on how to use a condom? YES 1
DON’T KNOW 88
NO RESPONSE 99
HRR 61 Have you had any sexual partners (aside NO 0 HRR 65
from/a your spouse or regular sexual YES 1
partner) in the past THREE months? DON’T KNOW 88
NO RESPONSE 99
HRR 62 If YES, the last time you had sex with NO 0
this other sexual partner, did you or this YES 1
partner use a condom? DON’T REMEMBER 88
NO RESPONSE 99
HRR 63 Did you drink alcohol heavily the last NO 0
time you had sex with this partner? YES 1
DON’T REMEMBER 88
NO RESPONSE 99
HRR 64 Did this other sexual partner drink NO 0
alcohol heavily the last time you had sex YES 1
together? DON’T REMEMBER 88
NO RESPONSE 99

No. Questions RESPONSE Value Skip to

HRR 65 FOR MALES: In the last 12 months, NO 0 HRB 69

have you had sex with a commercial sex YES 1
worker or bar girl? NO RESPONSE 99

HRR 66 If YES to HRR 65, approximately how ONLY ONCE 1

many times did you have sex with a 2-5 times 2
commercial sex worker or bar girl in the 6 or more times 6
past 12 months? DON’T REMEMBER 88
NO RESPONSE 99
HRR 67 If YES to HRR 65, did you use a condom NO 0 HRB 69
the most recent time you had sex with a YES 1
commercial sex worker or bar girl? DON’T KNOW 88 HRB 69
NO RESPONSE 99 HRB 69

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HRR 68 If YES to HRR 67, who placed the SELF 1

condom? PARTNER 2
DON’T REMEMBER 88
NO RESPONSE 99

Interviewer read: The following questions may make you uncomfortable. Please know that you may refuse to answer any question
that you are uncomfortable with but your responses could be very useful to us in learning about HIV/AIDS prevention.
HRB 69 Is it a common practice in this community NO 0
to have sex for money, gifts, or other YES 1
favours? DON’T KNOW 88
NO RESPONSE 99
HRB 70 In some places in the world, poor women NO 0
exchange sex for food or for money that
they use to buy enough food for their YES, BUT NOT A COMMON PRACTICE 1
families. Do you think that poor women
in this community and in nearby YES, HAPPENS COMMONLY 2
communities have/exchange sex for food
DON’T KNOW 88
or for money to use to buy food for their
families? NO RESPONSE 99

HRB 71 In some places in the world, some men or NO 0

women have sex with other men of YES 1
women of the same sex. Have you heard DON’T KNOW 88
of this type of sexual practice? NO RESPONSE 99
HRB 72 Do some men in this community have sex NO 0
with other men or boys? YES 1
DON’T KNOW 88
NO RESPONSE 99
HRB 73 Would you consider the practice (of men NO 0
having sex with men in this community) YES 1
to be common? DON’T KNOW 88
NO RESPONSE 99
HRB 74 Do you know someone who has regular NO 0
sex with members of the same sex? YES 1
DON’T KNOW 88
NO RESPONSE 99

Section G: HIV/AIDS RISK PERCEPTION

Interviewer read: I am going to ask some specific personal questions about how worried you are concerning contacting HIV/AIDS.

INTERVIEWER: Circle the value corresponding to the option mentioned by the respondent.

No Questions RESPONSE Value Skip to

HRP 75 How worried are you that you might NOT WORRIED AT ALL 1
already be infected with HIV/AIDS? WORRIED A LITTLE 2
WORRIED A LOT 3
UNSURE / DON’T KNOW 88
NO RESPONSE 99
HRP 76 Do you think that your current sexual NO 0
behaviour puts you at risk of infection YES 1
with HIV? DON’T KNOW 88
NO RESPONSE 99
HRP 77 Do you think your partner’s current NO 0
sexual behavior puts you at risk of YES 1
infection? DON’T KNOW 88
NO RESPONSE 99

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Section H: DOMESTIC AND SEXUAL VIOLENCE

Interviewer read: I am going to ask you some more personal questions about sex and your sexual partner in the last 12 months.
This includes anyone you might have had sex with: husband, wife or wives, girlfriends, boyfriends, friend, casual partner, commercial
sex worker, someone you may have met at a bar, wedding, special event, etc. All the information you provide will be confidential.
No Questions RESPONSE Value Skip to
DSV 78 Has your sexual partner ever forced you NO 0 DSV 80
to have sex when you didn’t want to? YES 1
DON’T KNOW 88 DSV 80
NO RESPONSE 99 DSV 80
DSV 79 In the past 12 months, how many times
have you been forced to have sex? [ ]
DSV 80 Have you ever been forced to have sex NO 0 DSV 82
with someone by another person? YES 1
DON’T KNOW 88 DSV 82
NO RESPONSE 99 DSV 82
DSV 81 In the past 12 months, how many times
has this happened? [ ]
DSV 82 Has your partner ever hit, kicked, or hurt NO 0 DSV 84
you physically? YES 1
DON’T KNOW 88 DSV 84
NO RESPONSE 99 DSV 84
DSV 83 If YES, who was this partner? CONCUBINE 1
SPOUSE 2
CASUAL MALE 3
ACQUAINTANCE
CASUAL FEMALE 4
ACQUAINTANCE
PAID PARTNER 5
OTHER specify (_______________) 77
NO RESPONSE 99
DSV 84 Has your partner ever yelled at you, NO 0 DSV 86
called you names, or said things to deeply YES 1
hurt your feelings? DON’T KNOW 88 DSV 86
NO RESPONSE 99 DSV 86
DSV 85 If YES, who was this partner? CONCUBINE 1
SPOUSE 2
CASUAL MALE 3
ACQUAINTANCE
CASUAL FEMALE 4
ACQUAINTANCE
PAID PARTNER 5
OTHER specify (_______________) 77
NO RESPONSE 99
DSV 86 Are you afraid of your sexual partner or NO 0
anyone you listed above? YES 1
DON’T KNOW 88
NO RESPONSE 99
DSV 87 Have you ever been the one to hit, kick or NO 0
hurt your sexual partner physically? YES 1
DON’T REMEMBER 88
NO RESPONSE 99
DSV 88 Have you ever been the one to yell at, call NO 0
names or deeply hurt the feelings of your YES 1
sexual partner? DON’T REMEMBER 88
NO RESPONSE 99

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Section I: STIGMA AND DISCRIMINATION

Interviewer read: Now, I want to ask you a few questions about your opinion on people infected with HIV. Please tell me if you
AGREE or DISAGREE. There are no right or wrong answers.

No Questions RESPONSE Value Skip to

SDI 89 People infected with HIV should be ashamed of AGREE 1
themselves. NEUTRAL 2
DISAGREE 3
DON’T KNOW 88
NO RESPONSE 99
SDI 90 People infected with HIV are promiscuous. AGREE 1
NEUTRAL 2
DISAGREE 3
DON’T KNOW 88
NO RESPONSE 99
SDI 91 I would feel ashamed if I were infected with AGREE 1
HIV. NEUTRAL 2
DISAGREE 3
DON’T KNOW 88
NO RESPONSE 99
SDI 92 People infected with HIV should be expelled AGREE 1
from their community. NEUTRAL 2
DISAGREE 3
DON’T KNOW 88
NO RESPONSE 99

Section J: AWARENESS OF, AND ACCESS TO, HIV/AIDS PREVENTION SERVICES

Interviewer read: Finally, I will ask you some questions about services and programs that you may know about - or can help us think
about - that may help people in your community or in nearby communities avoid getting or transmitting HIV/AIDS.
No. Questions Responses Code / Value Skip to:
SER 93 Are you aware of any programs from the central NO 0
government of Nigeria that are intended to help YES 1
prevent infection with HIV/AIDS? NOT SURE 88
NO RESPONSE 99
SER 94 Are you aware of any programs from the State NO 0
government of [ state name that are intended YES 1
to help prevent infection with HIV/AIDS? NOT SURE 88
NO RESPONSE 99
SER 95 Are there any local programs or activities from NO 0 SER 97
the local government that are intended to help YES 1
prevent infection with HIV/AIDS? NOT SURE 88 SER 97
NO RESPONSE 99 SER 97
SER 96 If YES, have you had any direct contact with NO 0
any of these local HIV prevention programs? YES 1
NO RESPONSE 99
SER 97 Are there any programs or activities sponsored NO 0 SER 99
by local mosques or churches that are intended YES 1
to help prevent infection with HIV/AIDS? NOT SURE 88 SER 99
NO RESPONSE 99 SER 99
SER 98 If YES, have you had any direct contact with NO 0
any of these mosque or church HIV/AIDS YES 1
prevention programs? NO RESPONSE 99
SER 99 In the last year, have you had any visits to any NO 0 SER 103
local clinics, hospitals or doctor’s offices? YES 1
DON’T REMEMBER 88 SER 103
NO RESPONSE 99 SER 103
SER 100 If YES to SER 99, while you took part in these NO 0
visits, were you asked if you had any concerns YES 1
or questions about HIV/AIDS DON’T REMEMBER 88
NO RESPONSE 99
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SER 101 If YES to SER 99, during any of these visits, NO 0

were you asked about your risks of HIV/AIDS? YES 1
DON’T REMEMBER 88
NO RESPONSE 99

SER 102 If YES to SER 99, while you were on any of NO 0

these visits, were you given any information YES 1
about preventing HIV/AIDS? DON’T REMEMBER 88
NO RESPONSE 99
SER 103 Do you think that, before they become sexually NO 0
active, children should be taught about how to YES 1
protect themselves from getting HIV/AIDS? NOT SURE 88
NO RESPONSE 99

SER 104 If YES, where and how should that teaching In the home 1
take place? In church or mosque 2
In clinics hospitals or doctors’ offices 3
NOTE: Ask about each one. MORE THAN From traditional healer 4
ONE ANSWER CAN BE RECORDED. In schools 5
From RADIO, TELEVISION or 6
NEWSPAPERS
From peers and friends 7
Other place (list: _______________) 77
NOT SURE 88
NO RESPONSE 99

For WOMEN ONLY

No. Questions RESPONSES CODE/ Skip to
VALUE
SER105 Have you given birth during the last three years? NO 0 PAQ 109
YES 1
NOT SURE 88 PAQ 109
NO RESPONSE 99 PAQ 109
SER 106 If YES, did you receive any antenatal care NO 0
before giving birth? YES 1
NO RESPONSE 99
SER 107 If you received such care, did you have an HIV NO 0
test and counselling while pregnant? YES 1
NOT SURE 88
NO RESPONSE 99
SER 108 If you had an HIV test and counselling, did you NO 0
go back to the clinic or doctor’s office to receive YES 1
the results of the HIV test? NOT SURE 88
NO RESPONSE 99

Section K: POLICY AWARENESS QUESTIONS

INTERVIEWER: Circle the value corresponding to the option chosen by the respondent.

No Questions RESPONSE Value Skip to

PAQ 109 Is there a national government policy on HIV NO 0
prevention? YES 1
DON’T KNOW 88
NO RESPONSE 99
PAQ 110 Are you aware of any programmes or activities NO 0 PAQ 112
aimed at preventing the spread of HIV/AIDS YES 1
in your community? DON’T KNOW 88 PAQ 112
NO RESPONSE 99 PAQ 112

CONFIDENTIAL
REACH Semi-longitudinal Individual Survey Page 15 of 15

PAQ 111 Can you briefly tell me about these 1.

programmes? a.
a. What are their names?
b. Who provides these services?
c. Do you have to go to an office/centre to get
the information?
b.

c.

2.
a.

b.

c.

3.
a.

b.

c.

PAQ 112 Have you ever participated in a stakeholder’s NO 0

meeting or workshop or conference on YES 1
HIV/AIDS? DON’T KNOW 88
NO RESPONSE 99
PAQ 113 If any of opposing political party or Interest NO 0
group provides this service, will you patronize YES 1
them? DON’T KNOW 88
NO RESPONSE 99
PAQ 114 If no, please explain why?

I THANK YOU MOST SINCERELY FOR ANSWERING THESE QUESTIONS

Interview End Time:

CONFIDENTIAL