1. FNBE MARCH 2015 l MATHEMATICS (MTH 30104) l SUREVEY
QUESTIONNAIRE ASSIGNMENT l
We are conducting a research study to examine determine your knowledge about HIV
(Human immunodeficiency virus) disease.Your participation in this research project is
entirely voluntary and your responses will be kept completely confidential. The survey
questionnaire is composed of 25 questions and it takes about 10 minutes to complete
it. Thank you for your time and effort.
1. What gender do you identify as? (Please mark only one answer)
o Female
o Male
o Trans person
o _________________________ (write your term of choice)
2. How old are you? (Please mark only one answer)
o Under 18
o 18 to 24
o 25 to 39
o 40 or over
3. Have you ever heard of HIV/AIDS ?
o Yes
o No
For each statement below, please check the appropriate box to indicate if it is true,
false, or if you’re not sure.
Please mark only one answer for each statement.
TRUE FALSE NOT
SURE
4. Coughing and sneezing DO NOT spread HIV.
5. A person can get HIV by sharing a glass of
water with someone who has HIV.
6. AIDS is the cause of HIV.
2. FNBE MARCH 2015 l MATHEMATICS (MTH 30104) l SUREVEY
QUESTIONNAIRE ASSIGNMENT l
7. HIV is killed by bleach
8. A person with HIV can look and feel healthy.
9. People who have been infected with HIV
quickly show serious signs of being infected.
10. A person can be infected with HIV for 5 years
or more without getting AIDS.
11. A person cannot get HIV by having oral sex,
mouth-to-penis, with a man who has HIV
12. A person can get HIV even if she or he has sex
with anotherperson only one time.
13. Taking vitamins keeps a person from getting
HIV.
14. HIV can be transmitted by sexual intercourse
15. HIV can be transmitted from mother to child
16. HIV can be transmitted by sharing needle or
syringe
17. HIV can be transmitted by blood transfusion
18. HIV can be transmitted by shaking hand
19. HIV can be transmitted by eating and drinking
from the same plate or glass of an HIV-positive
person
20. Eating healthy foods can keep a person from
getting HIV
21. A person can get HIV by sitting in a hot tub or a
swimming pool with a person who has HIV.
22. All pregnant women infected with HIV will
have babies born with AIDS.
23. HIV can be transmitted through a mosquito bite
24. HIV can be prevented by properly using
condomduring sexual intercourse
25. HIV transmission can be avoided by a blood test
before marriage
