Please help us compile statistics by answering the following questions. The information you provide is important and will remain completely anonymous.
1. Do you notice KHAP Center offering HIV testing service for foreigners who live in Korea?
a) know -> go 1-1
b) Don't know
1-1 Source of the information about KHAP Center?
a) Information brochure or leaflets
b) Advertisment on web site
c) web search
d) campaign ( street or club( bar ) )
e) referred by a friend
2. Your gender
a) Male
b) Female
3.In what age group are you ?
a) 19 and under
b) 20-29
c) 30-39
d) 40-49
e) 50+
4. How long have you been in Korea?
a) under 1year
b) 1~2 year
c) 3-5 year
Option4
5.In terms of your current occupation, how would you characterize yourself?
a) Teacher / Professor
b) Student
c) Business person
d) Entertainer
e)Engineer
f) other
6. Have you ever had a HIV test in korea before?
a) Yes -> go -> 2-1 -> 2-2
b) No
2-1 If yes, when was the last time had a HIV test?
a) 3month ago
b) 6month ago
c) 1year ago
d) Over 1 year ago
2-2 Where was the place that you had a HIV test?
a) at Hospital/ Clinic
b) at Public health Center
c) at NGOs center
d) others
7. What do you think of the best place for HIV test in Korea?
a) Hospital/ Clinic
b) Public health Center
c) NGOs
d) other
8. What do you think that you have a HIV test regularly?
a) Strongly Agree
b) Agree
c) Neutral
d) Disagree
e) Strongly Disagree
9.How much do you seriously think about HIV/AIDS epidemics in korea ? ( From a "Not at all dangerous" - e "Very dangerous" )
a
b
c
d
e
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