The official web site of the Finlay Medical Society
 Sitio oficial de la Sociedad Médica Finlay

                                                          

Finlay AIDS Survey for Knowledge and Attitudes (FASKA)

Birth Control

  Name:              Age:     Male:   Female:

None

Race/Ethnic: White  Black  Hispanic   Oriental  Am.Indian  Other

Sexually Active:  Yes   No      If yes, age at first sexual intercourse: -10  10  11 12 13   14  15  16   17  18  19 20 21-24  25-29  30 or more 

Condom

Pill

Other

Number of sexual partners in past:
123   45 or more

Sexually transmitted diseases in the past? 
Yes  No
Genital Warts, Hepatitis B, Gonorrhea, HIV  (AIDS  Virus)  Syphilis, Chlamydia, or other

Have you ever used illegal drugs  (Cocaine, Marihuana, other?) 
YesNo
Have you ever injected drugs (Heroin or other)?
YesNo

Do you personally know anyone with HIV/AIDS?
 YesNo
Do you have anyone in your family ill with HIV/AIDS?
YesNo

Responses for Knowledge and Attitude Statements (mark only answer)
 

Statement:

Agree Disagree Don't know
1

Women with AIDS can infect men
2

Men with AIDS can infect women
3

You can get AIDS by sharing clothing
4

You can get AIDS by kissing
5

You can get AIDS from vaginal intercourse
6

You can get AIDS from anal sex
7

You can get AIDS from oral sex
8

A persons can be infected with the AIDS virus and not have symptoms
9

Sneezing and coughing can spread the disease
10

You can get AIDS from swimming pools
11

Sharing a drinking glass can spread AIDS
12

You can get AIDS from a blood transfusion
13

Almost all homosexual men have AIDS
14

People with AIDS usually do not die from the disease
15

AIDS is caused by the same virus that causes herpes
16

You can get AIDS by shaking hands or hugging someone  who is infected with the AIDS virus
17

You can get AIDS by sharing needles with drug users who are infected
18

A positive blood test for the AIDS virus means that you have AIDS
19

You can get AIDS by donating blood
20

Many gay women have the AIDS virus
21

AIDS is not as big a problem as the media suggests
22

It is important that students learn about AIDS in classes taught at this high school
23

I know enough to protect myself from the AIDS virus
24

AIDS will not spread to the general population
25

I have a good understanding of how AIDS is spread
26

People are more concerned about AIDS than is necessary
27

I feel comfortable asking someone about their past sex partners before I have sex with them
28

I am afraid of getting AIDS
29 High School students with AIDS should be allowed to attend class

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