What to Ask | Appointment Questionnaire | HIV is: Just a part of me

1. Do you find yourself thinking about any of the following regularly? You can select more than one

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2. How long have you been living with HIV for?

Less than 1 year

1 to 3 years

3 to 5 years

5 to 10 years

More than 10 years

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3. Which statement best describes how you manage your HIV?

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4. Which statement best describes your health? You can select more than one

I feel healthy and living with HIV has encouraged me to lead a healthier lifestyle
Right now I feel healthy
I feel healthy now but I worry about the future
I feel unwell more than I feel well

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5. Which statement best describes how often you talk about living with HIV?

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6. How often do you miss taking your tablets in a typical month?

Never

About once a month

2 or 3 times a month

4 or more times a month

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7. What is the main reason for this?

I’m concerned that other drugs I use affect the HIV treatment I take (recreational, other prescribed or over the counter drugs)
Other reasons
Not applicable

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8. In the last month, how often have you had difficulty sleeping?

Never

Up to four times a month

More than once a week

Daily or almost daily

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9. Which best describes your doctor’s appointment?

My appointment is led by me and my needs. I discuss everything I want to
I always want to know all my test results including viral load, glucose, cholesterol and others
I often forget to mention things that have been on my mind
None of these

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Appointment Questionnaire