Complementary Therapy Use in the HIV Community
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1. Default Section
1
. How old are you?
How old are you?
under 20
21-30
31-40
41-50
51-60
over 60
2
. How long have you known that you are HIV+?
How long have you known that you are HIV+?
less than 5 years
6-10 years
11-15 years
16-20 years
21-25 years
3
. Please tell us where you are from
Please tell us where you are from
City/Town:
State:
Country:
4
. What is your racial background?
What is your racial background?
Latino (a)
White, non-hispanic
Black
Asian
Pacific Islander
Other (please specify)
5
. What is your gender?
What is your gender?
Female
Male
Transgender
6
. Do you use any complementary therapies (massage, supplements, herbs, stress management techniques,others)
Do you use any complementary therapies (massage, supplements, herbs, stress management techniques,others)
Yes
No
7
. What kind of complementary therapy do you use? Check all that apply
What kind of complementary therapy do you use? Check all that apply
Nutritional supplements
Massage
Acupuncture
Chiropractic
Herbs
Meditation
Yoga
Exercise
Prayer or spiritual approaches
Other (please specify)
8
. If you use nutritional supplements or herbs, what specifically do you use? Please tell us the ingredients and NOT the brand name
If you use nutritional supplements or herbs, what specifically do you use? Please tell us the ingredients and NOT the brand name
9
. Why have you used or are you using complementary therapies? Check all the apply
Why have you used or are you using complementary therapies? Check all the apply
for stress management
for liver cleansing
for prostatic inflammation
for muscle building
for fat burning
to increase energy
to sleep well
to treat depression
to treat neuropathic pain
to improve lipodystrophy
to lower triglycerides or cholesterol
to treat diarrhea
to improve sexual function
to increase testosterone
to improve brain function
to increase CD4 cells
to grow hair
to decrease blood pressure
10
. Do you think that the complementary therapy (es) that you use help your health/quality of life?
Do you think that the complementary therapy (es) that you use help your health/quality of life?
Yes
No
I don't know
May be
Depends on when I use it
11
. If you have a perceived benefit using complementary therapies, can you tell us what they are?
If you have a perceived benefit using complementary therapies, can you tell us what they are?
12
. Have you told your physician that you are using a complementary therapies?
Have you told your physician that you are using a complementary therapies?
Yes
No, he/she would not approve
No, he/she has never asked
No, I have forgotten to do so
Depends on which therapy
13
. Have you paid for the complementary therapy or has insurance or a insurance/non-profit/government program done so?
Have you paid for the complementary therapy or has insurance or a insurance/non-profit/government program done so?
Yes, I have paid for it myself
No, I have not paid for it
It depends on the therapy
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