Home-Based HIV Test Follow-Up QuestionnaireThank you for taking the time to answer questions about your experience with the HIV self-testing (HIVST) kit. The questionnaire will take less than 5 minutes to complete.Please enable JavaScript in your browser to complete this form.1. After receiving the HIVST kit, how many days did you wait to use it?None - I used it the day I received it1 to 3 days after receiving it4 to 7 days after receiving it8 or more days after receiving itI did not use the kit2. How easy or difficult did you find it to use the HIVST kit?Very easyEasyNeither easy nor difficultDifficultVery difficult3. How confident are you in your interpretation of the HIVST kit result?Very confidentConfidentSomewhat confidentNot so confidentNot confident at all4. What was the result of your test?Non-reactive (negative)Reactive (preliminary positive)Inconclusive5. If your test result was reactive (preliminary positive) or inconclusive, did you get a second test?YesNoNot applicableAIDS Resource offers free in-person HIV testing. If you do not live near one of our offices, we can give you a referral to a local laboratory.6. How interested are you in using HIVST in the future?Very interestedInterestedUnsureNot interestedDefinitely not interested7. How likely are you to access other services at AIDS Resource, such as sexually transmitted infection (STI) testing and free condoms?Very likelyLikelyUnsureNot likelyDefinitely not likely8. Do you plan on talking with a professional about taking PrEP to prevent HIV? YesNo9. Would you like to meet with our physician to discuss PrEP or our other services? YesNo10. If you are interested in meeting with our physician, please provide your name, phone number, and best time to call. A staff member will contact you within 1 to 2 business days.Submit
