Is the information understandable?                                                   
Yes                          
 No  

Have you had any HIV/AIDS education in the past?                              
 Yes                         
 No  

Did the video increase your knowledge about HIV and AIDS?             
 Yes                          
 No  

Do you have a better understanding of HIV "Risk Behavior"?           
 Yes                          
 No  

After viewing this video will you be more comfortable
talking to your doctor about HIV?                                                  
 Yes                          
 No  

After viewing this video do you plan to get tested for HIV
within the next three months?                                                                   
 Yes                          
 No  

Would you recommend someone else see this DVD/Video?             
 Yes                          
 No  


What is your race?             
 Black
White  
 Hispanic  
 Asian  
 Multicultural  

What city do you live In?


What state do you live In?


Are you HIV positive?             
Yes                          
 No  

Do you know someone who is HIV positive?             
 Yes                          
 No  

What did you learn?



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Gender:
Male
Female
 Marital Status: 
Single
Married
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Age:
Under 44
45 to 49
50 to 59
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70 to 79
80 and older
 Annual Income:        
 $14,999 or less
 $15,000 to 24,999
 $25,000 to $34,999
 $35,000 to $44,999 
 $45,000 to $54,999
 $55,000 or more
Education:           
Grade School  
 High School
 Some College
 Associates Degree
 College Degree (BA/BS)
 Post grad and above     
 Retired?                   
Yes                  
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