Campaign for Black Gay Men's Lives Survey

This survey is an effort of the New York State Black Gay Network to better understand the impact the "We Are Part of You" campaign is having on people who view it.

1. What is your zip code?

What is your zip code?

2. How did you find out about www.wearepartofyou.org?

How did you find out about www.wearepartofyou.org? Subway Posters

Billboard

Word of mouth

Other (please specify)

3. What is your race?

What is your race? American Indian or Alaska Native

Asian

Black or African-American

Latino or Hispanic

Mixed race

Native Hawaiian or other Pacific Islander

White

Other (please specify)

4. What did you feel about the Campaign?

What did you feel about the Campaign? I liked it

I disliked it

I was offended

It made me want to get involved

I wanted to talk about it with someone

I am not sure

Other (please specify)

5. What is your religious affiliation?

What is your religious affiliation? Christianity

Nonreligious/Secular

Judaism

Islam

Buddhism

Agnostic/ Atheist

Other (please specify)

6. What is your gender?

What is your gender? Male

Female

Trans-male

Trans-female

Other (please specify)

7. What is your sexual orientation?

What is your sexual orientation? Bisexual

Heterosexual/Straight

Homosexual/Gay/SGL

Other (please specify)

8. What is your age?

What is your age?

9. What are your thoughts on the following statements?

	Agree	Somewhat Agree	Disagree	Somewhat Disagree
Black gay men are valuable members of the Black community	*What are your thoughts on the following statements? Black gay men are valuable members of the Black community Agree	Black gay men are valuable members of the Black community Somewhat Agree	Black gay men are valuable members of the Black community Disagree	Black gay men are valuable members of the Black community Somewhat Disagree
Black gay men are responsible for HIV in the Black community	Black gay men are responsible for HIV in the Black community Agree	Black gay men are responsible for HIV in the Black community Somewhat Agree	Black gay men are responsible for HIV in the Black community Disagree	Black gay men are responsible for HIV in the Black community Somewhat Disagree
The Black community's views regarding homosexuality affect the lives of Black gay men	The Black community's views regarding homosexuality affect the lives of Black gay men Agree	The Black community's views regarding homosexuality affect the lives of Black gay men Somewhat Agree	The Black community's views regarding homosexuality affect the lives of Black gay men Disagree	The Black community's views regarding homosexuality affect the lives of Black gay men Somewhat Disagree
The Black gay men have always been a part of the Black community	The Black gay men have always been a part of the Black community Agree	The Black gay men have always been a part of the Black community Somewhat Agree	The Black gay men have always been a part of the Black community Disagree	The Black gay men have always been a part of the Black community Somewhat Disagree
The Black community will never change its views on Black gay men	The Black community will never change its views on Black gay men Agree	The Black community will never change its views on Black gay men Somewhat Agree	The Black community will never change its views on Black gay men Disagree	The Black community will never change its views on Black gay men Somewhat Disagree
I have witnessed verbal (name calling) forms of violence against black gay men	I have witnessed verbal (name calling) forms of violence against black gay men Agree	I have witnessed verbal (name calling) forms of violence against black gay men Somewhat Agree	I have witnessed verbal (name calling) forms of violence against black gay men Disagree	I have witnessed verbal (name calling) forms of violence against black gay men Somewhat Disagree
I have witnessed physical (hitting) forms of violence against black gay men	I have witnessed physical (hitting) forms of violence against black gay men Agree	I have witnessed physical (hitting) forms of violence against black gay men Somewhat Agree	I have witnessed physical (hitting) forms of violence against black gay men Disagree	I have witnessed physical (hitting) forms of violence against black gay men Somewhat Disagree
I have witnessed emotional (rejection) forms of violence against black gay men	I have witnessed emotional (rejection) forms of violence against black gay men Agree	I have witnessed emotional (rejection) forms of violence against black gay men Somewhat Agree	I have witnessed emotional (rejection) forms of violence against black gay men Disagree	I have witnessed emotional (rejection) forms of violence against black gay men Somewhat Disagree

10. How do you know gay men?

How do you know gay men? Family member(s)

Friend(s)

Co-worker(s)

Friend of a friend

I dont know gay men

Other (please specify)

Campaign for Black Gay Men's Lives
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1. Welcome and thank you for visiting!

Campaign for Black Gay Men's Lives
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