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HOLY TRINITY UNIVERSITY

COLLEGE OF NURSING AND HEALTH SCIENCES


Puerto Princesa City, Palawan

Questionnaire for the Study entitled:



Personal Data:

Name (Optional): _________________________________________

Age: ___________ Gender:________________

Civil Status: ____________________

Educational Attainment: ____________________________________

Occupation: ______________________________________________

Have you heard something about HIV/AIDS?
Yes: _____ No: ____

Source of information: _________________________________


Checklist:

Directions: Place a check mark on the box which corresponds to your
answer and leave it blank if you think the answer is not provided.

Questions: Human
Immunodeficiency
Virus

Humans Infected
with Viral
Diseases
Humoral
Infectious
Virus
1. What does
HIV stands
for?

Questions: Acute Internal
Disease Syndrome
Acquired
Immunodeficiency
Syndrome
Anonymous
Infectious
Disease
Syndrome
2. What does
AIDS
stands for?


Opinion:

What is your own understanding on HIV and AIDS?

________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________.



Assessment of Awareness of Prevention of HIV/AIDS Transmission
Awareness Scale Survey

Directions: Place a check mark on the box that corresponds to your answer
for the following questions given.

A. Prevention of Its Transmission
Questions: Very
Much
Aware
5
Much
Aware
4
Aware
3
Less
Aware
2
Unaware
1
1. Abstinence
from sex is
NOT the only
way to
prevent
transmission
of HIV
infection.









2. Responsible
sexual
behavior is
one way to
stop the
spread of HIV
infection.

3. Anti-retroviral
drugs could
prevent
transmission
of HIV/AIDS.

4. Early
detection of
HIV/AIDS is
last.


B. Transmission

Questions: Very
Much
Aware
5
Much
Aware
4
Aware
3
Less
Aware
2
Unaware
1
1. Breastfeeding
could transmit
HIV/AIDS
infection.




2. Having sex,
blood
transfusion,
sharing of
needles among
injecting drug
users and even
needle pick are
modes of
transmission of
HIV/AIDS.

3. Mosquito bites,
contact with
urine, sweat,
feces, and tears
could not

transfer
HIV/AIDS
infection.
4. Kissing,
hugging,
sneezing, and
coughing,
sharing utensils
and shaking
hands doesnt
transfer
HIV/AIDS
infection.




Thank You!