30 Partner ART If HIV-positive, is 1. Yes status your 2. No 97. Refused currently on HIV treatment (ARVs)? Alcohol and drug use 31 Alcohol Do you consume 1. Yes alcohol? 2. No Go to 34 97. Refused Go to 34 32 Alcohol How many days in Number(1 to 7)_______ If yes to frequency a week do you alcohol consume alcohol? 97. Refused use; 98. Don’t know/can’t remember 33 Alcohol How often do you 1. Monthly or less If yes to amount have a quarter 2. 2-4 a month alcohol bottle or more on 3. 2-3 times per week use; one occasion? 4. 4 + times per week 97. Refused 98. Don't know 34 Drug use Did you use drugs 1. Yes during the last 3 2. No Go to 37 months? 97. Refused Go to 37 35 Injection Among the drugs 1. Yes drug use you have used in 2. No Go to 37 the past 3 months, 97. Refused Go to 37 are there some that you injected? 36 Needle/ In the past 3 a. New needle/syringe If yes to syringe type months, types b. Used needle/syringe drug use of (only by yourself) and needles/syringes c. Used needle/syringe injection; did you use to (previously used by inject drugs? someone else) Note: can 97. Refused choose, 98. Don’t know/can’t multiple Remember Contraceptive use/fertility intentions 37 Are you currently 1. Yes use using 2. No Go to 40 contraception 3. No (Trying to conceive) Go to 40 97. Refused Go to 40
30 Partner ART status If HIV-positive, is your currently on HIV treatment (ARVs)? 1. Yes 2. No 97. Refused Alcohol and drug use 31 Alcohol Do you consume alcohol? 1. Yes 2. No 97. Refused Go to 34 Go to 34 32 Alcohol frequency How many days in a week do you consume alcohol? Number(1 to 7)_______ 97. Refused 98. Don’t know/can’t remember If yes to alcohol use; 33 Alcohol amount How often do you have a quarter bottle or more on one occasion? 1. Monthly or less 2. 2-4 a month 3. 2-3 times per week 4. 4 + times per week 97. Refused 98. Don't know If yes to alcohol use; 34 Drug use Did you use drugs during the last 3 months? 1. Yes 2. No 97. Refused Go to 37 Go to 37 35 Injection drug use Among the drugs you have used in the past 3 months, are there some that you injected? 1. Yes 2. No 97. Refused Go to 37 Go to 37 36 Needle/ syringe type In the past 3 months, types of needles/syringes did you use to inject drugs? a. New needle/syringe b. Used needle/syringe (only by yourself) c. Used needle/syringe (previously used by someone else) 97. Refused 98. Don’t know/can’t Remember If yes to drug use and injection; Note: can choose, multiple Contraceptive use/fertility intentions 37 use Are you currently using contraception 1. Yes 2. No 3. No (Trying to conceive) 97. Refused Go to 40 Go to 40 Go to 40
Ashodaya_exit-questionnaire.docx