DEMOGRAPHIC AND HEALTH SURVEY
MEN'S QUESTIONNAIRE 1998
PLACE NAME ___
NAME OF HOUSEHOLD HEAD ___
CONCESSION NUMBER ___
HOUSEHOLD NUMBER ___
CLUSTER NUMBER ___
DEPARTMENT ___
DISTRICT ___
COUNTY ___
OTHER CITY 2
RURAL 3
NO 2
COMMON ZONE 3
MAN'S NAME AND LINE NUMBER:
LINE NUMBER: ___
INTERVIEWER 1
(REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
DAY__
MONTH__
YEAR__
INTERVIEWER NAME___
RESULTS___
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTIALLY FILLED OUT
6 INCAPABLE
7 OTHER (SPECIFY): ___
NEXT VISIT [FOR INTERVIEWERS 1 AND 2]
DATE__
TIME__
FINAL VISIT
DAY__
MONTH__
YEAR 19__
INTERVIEWER__
RESULT__
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTIALLY FILLED OUT
6 INCAPABLE
7 OTHER (SPECIFY): ___
LANGUAGE OF INTERVIEW:
HAOUSSA 2
ZARMA 3
TAMASHEQ 4
FULFUDE 5
OTHER 6
INTERPRETER:
NO 2
FIELD EDITOR
NAME ___
DATE ___
OFFICE EDITOR ___
KEYED BY ___
SECTION 1. SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENT
MINUTES: ___
102) To begin, I would like to ask you questions about yourself and your household. Until the age of 12 years, did you live for the majority of the time in Niamey, in another capital, in a city or in a rural area?
LARGE CITY IN NIGER/OTHER COUNTRY 2
SMALL CITY IN NIGER/OTHER COUNTRY 3
COUNTRYSIDE IN NIGER/OTHER COUNTRY 4
103) How long have you been living continuously in (NAME OF CURRENT CITY/VILLAGE OF RESIDENCE)?
ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)
104) Just before you moved here, did you live in Niamey or another capital, in a large city in Niger or elsewhere, in a village in Niger or elsewhere, or in the countryside of Niger or elsewhere?
LARGE CITY IN NIGER/OTHER COUNTRY 2
SMALL CITY IN NIGER/OTHER COUNTRY 3
COUNTRYSIDE IN NIGER/OTHER COUNTRY 4
105) In which month and in which year were you born?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 9998
106) How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.
NO 2 (GO TO 111)
108) What is the highest level of school you attended: primary, secondary (first cycle), secondary (second cycle), or higher?
SECONDARY (FIRST CYCLE) 2
SECONDARY (SECOND CYCLE) 3
HIGHER 4
109) What is the last (year/class) that you achieved at this level?
01 CI
02 CP
03 CE1
04 CE2
05 CM1
06 CM2
98 DON'T KNOW
01 SIXTH GRADE
02 FIFTH GRADE
03 FOURTH GRADE
04 THIRD GRADE
98 DON'T KNOW
01 SECOND GRADE
02 FIRST GRADE
03 FINAL GRADE
98 DON'T KNOW
01 FIRST YEAR
02 2 OR MORE YEARS
98 DON'T KNOW
SECONDARY OR HIGHER: ___ (GO TO 112)
111) Can you understand a letter or the newspaper easily, with difficulty, or not at all?
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 113)
112) Do you usually read a newspaper or magazine at least once a week?
NO 2
113) Do you usually listen to the radio at least once a day?
NO 2
114) Do you usually watch television at least once a week?
NO 2
NO 2
116) Have you worked at all in the past 12 months?
NO 2 (GO TO 124)
117) What is your occupation, that is, what kind of work do you mainly do?
DOES NOT WORK IN AGRICULTURE: ___ (GO TO 120)
119) Do you work mainly on your own land or on family land, or did you work on land that you rent from someone else, or do you work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
120) Do you do this work for a member of your family, for someone else, or are you self-employed?
FOR SOMEONE ELSE 2
FOR HIMSELF 3
121) Do you usually work throughout the year, seasonally or only once in a while?
SEASONALLY/PART OF THE YEAR 2
SOMETIMES 3
122) During the last 12 months, how many months did you work?
123) Do you get a salary for this work?
PROBE: Do you get money for this work?
NO 2
CHRISTIAN 02
OTHER (SPECIFY): ___ 96
DJERMA 02
GOURMANTCHEE 03
HAOUSSA 04
KANOURI 05
MOSSI 06
PEUL 07
TOUAREG 08
TOUBOU 09
OTHER (SPECIFY): ___ 96
126) During the past 12 months did you leave the place where you usually live to go work elsewhere?
NO (GO TO 201)
127) Where did you go to work?
IF MULTIPLE PLACES ARE CITED, RECORD THE MAIN ONE.
OTHER CITY IN NIGER 02
RURAL NIGER 03
ABIDJAN 04
ACCRA/LAGOS 05
OTHER AFRICAN CAPITAL 06
OTHER AFRICAN CITY OR RURAL AREA 07
EUROPE/USA 08
OTHER (SPECIFY): ___ 96
128) How long did you stay in (PLACE CITED IN 127) for this work?
BETWEEN 3 AND 6 MONTHS 2
6 MONTHS OR MORE 3
201) Now I would like to talk to you about your children, but only those of which you are the biological father (not those who have another father besides you).
Have you had any children?
NO 2 (GO TO 206)
202) Do you have any sons or daughters who are now living with you?
NO 2 (GO TO 204)
203) How many sons live with you?
How many daughters live with you?
IF NONE RECORD '00'.
DAUGHTERS AT HOME: ___
204) Do you have any sons or daughters to whom you have given birth and who are alive but do not live with you?
NO 2 (GO TO 206)
205) How many sons are alive but do not live with you?
How many daughters are alive but do not live with you?
IF NONE, RECORD '00'.
DAUGHTERS ELSEWHERE: ___
206) Have you had a son or daughter who was born alive but later died?
IF NO, PROBE: Any who cried and showed signs of live at birth but did not survive?
NO 2 (GO TO 208)
207) How many sons have died?
And how many daughters have died?
IF NONE, RECORD '00'.
DAUGHTERS DECEASED: ___
208) SUM THE ANSWERS TO QUESTIONS 203, 205, AND 207 AND RECORD THE TOTAL.
IF NONE, RECORD '00'.
Just to be sure that I have this right:
You have had, in TOTAL ___ children during your life. Is that correct?
NO: ___ (PROBE AND CORRECT 201-208 AS NECESSARY)
NONE: ___ (GO TO 301)
210A) In what month and year was your last child born?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 9998
LAST CHILD BORN BEFORE 1995: ___ (GO TO 301)
210C) When you were expecting your last child, did you want a child at that time? Did you want to wait until later? Or did you not want to have any (more) children?
LATER 2
NOT AT ALL 3
Now I would like to talk to you about family planning (the various ways or methods that a couple can use to delay or avoid a pregnancy).
301) CIRCLE EACH METHOD (CODE 1) WITH WHICH THE RESPONDENT IS FAMILIAR. ONLY CIRCLE METHODS ANSWERED SPONTANEOUSLY.
Which methods have you heard about?
302) CONTINUE DOWN COLUMN 302 READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 FOR METHODS WITH WHICH THE RESPONDENT IS FAMILIAR. CIRCLE CODE 3 FOR METHODS WITH WHICH THE RESPONDENT IS UNFAMILIAR.
Have ever heard about (method)?
YES/DESCRIPTION 2
NO 3 (GO TO 02)
YES/DESCRIPTION 2
NO 3 (GO TO 03)
YES/DESCRIPTION 2
NO 3 (GO TO 04)
YES/DESCRIPTION 2
NO 3 (GO TO 05)
YES/DESCRIPTION 2
NO 3 (GO TO 06)
YES/DESCRIPTION 2
NO 3 (GO TO 07)
YES/DESCRIPTION 2
NO 3 (GO TO 08)
YES/DESCRIPTION 2
NO 3 (GO TO 09)
YES/DESCRIPTION 2
NO 3 (GO TO 10)
YES/DESCRIPTION 2
NO 3 (GO TO 11)
NO 3
FOR EACH METHOD WITH CODE 1 CIRCLED IN 301 OR 302, ASK 303.
303) Have you ever used (method)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
AT LEAST ONE USED (EVER USED): ___ (GO TO 307)
305) Have you ever used anything or tried in any way to delay or avoid pregnancy?
NO 2 (GO TO 309)
CORRECT 303 AND 304 (AND 302 IF NECESSARY).
307) Are you currently doing something or using any method to delay or avoid pregnancy?
NO 2 (GO TO 309)
308) What method(s) are you using?
IUD 02 (GO TO 401)
INJECTIONS 03 (GO TO 401)
IMPLANTS 04 (GO TO 401)
DIAPHRAGM/FOAM/VAGINAL SUPPOSITORY 05 (GO TO 401)
CONDOM 06 (GO TO 401)
FEMALE STERILIZATION 07 (GO TO 401)
MALE STERILIZATION 08 (GO TO 401)
RHYTHM METHOD 09 (GO TO 401)
WITHDRAWAL 10 (GO TO 401)
OTHER (SPECIFY): ___ 96 (GO TO 401)
309) What is the main reason why you do not use a method to avoid pregnancy?
INFREQUENT SEXUAL INTERCOURSE 22
WOMAN MENOPAUSE/HYSTERECTOMY 23
WOMAN SUB FERTILE/STERILE 24
WOMAN POST-PARTUM/BREASTFEEDING 25
WANTS (OTHER) CHILDREN 26
WOMAN PREGNANT 27
PARTNER OPPOSED 32
OTHER PEOPLE OPPOSED 33
RELIGIOUS INTERDICTION 34
DOES NOT KNOW A SOURCE 42
FEAR OF SECONDARY EFFECTS 52
NOT ACCESSIBLE/TOO FAR 53
TOO EXPENSIVE 54
NOT PRACTICAL TO USE 55
INTERFERES WITH BODILY FUNCTIONS 56
401) Are you currently married or do you live with a woman as if you were married?
YES, CURRENTLY LIVING WITH A WOMAN 2 (GO TO 402A)
NO 3 (GO TO 404)
402) How many wives do you have?
402A) How many women do you live with as if married?
403) RECORD THE WIVES/SPOUSES' LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE.
IF A WOMAN DOES NOT LIVE IN THE HOUSEHOLD, RECORD '00'. THE NUMBER OF BLANKS FILLED OUT MUST BE THE SAME AS THE NUMBER OF SPOUSES/WIVES.
LINE NUMBER: ___ (GO TO 407)
LINE NUMBER: ___ (GO TO 407)
LINE NUMBER: ___ (GO TO 407)
LINE NUMBER: ___ (GO TO 407)
LINE NUMBER: ___ (GO TO 407)
404) Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3
405) Have you ever been married or lived with a woman?
YES, HAS LIVED WITH A WOMAN 2 (GO TO 407)
NO 3 (GO TO 410F)
406) What is your current marital status: are you widowed, divorced or separated?
DIVORCED 2
SEPARATED 3
407) Have you been married or lived with a woman only once or more than once?
MORE THAN ONCE 2
IF MARRIED/HAS LIVED WITH A WOMAN ONLY ONCE:
In which month and in which year did you begin to live with your wife/partner? That is to say, when did you consummate your union?
IF MARRIED/HAS LIVED WITH A WOMAN MORE THAN ONCE:
I would like to ask about when you started living with your first wife/partner. In what month and year was that? That is to say, have you consummated your first union?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 9998
409) How old were you when you consummated your first union?
NOT IN UNION: ___ (GO TO 410F)
410) Now I would like to ask you some questions about sexual activity in order to gain a better understanding of certain problems with respect to family planning.
How long has it been since the last time you had sexual intercourse with (your/one of your spouse(s)/wife/wives/the woman you live with)?
NUMBER OF WEEKS: ___ 2
NUMBER OF MONTHS: ___ 3
NUMBER OF YEARS: ___ 4
BEFORE THE LAST BIRTH 996
KNOWS ABOUT CONDOMS:
Was a condom used the last time you had sexual intercourse with (your/one of your spouse(s)/wife/wives/ the woman you live with)?
DOESN'T KNOW ABOUT CONDOMS:
Some men use a condom, that is to say that they put a rubber sheath on their penis before having sexual intercourse. Was a condom used the last time you had sexual intercourse with (your/one of your spouse(s)/wife/wives/ the woman you live with)?
NO 2
410B) Have you had sexual intercourse with someone besides (your/one of your spouse(s)/wife/wives/ the woman you live with) in the last 12 months?
NO 2 (GO TO 410J)
410C) When did you last have sexual intercourse with someone else besides (your/one of your spouse(s)/wife/wives/ the woman you live with)?
NUMBER OF WEEKS: ___ 2
NUMBER OF MONTHS: ___ 3
NUMBER OF YEARS: ___ 4
410D) Was a condom used on this occasion?
NO 2
410E) During the last 12 months with how many different people besides (your/one of your spouse(s) /the woman you live with) did you have sexual intercourse?
DON'T KNOW 8 (GO TO 410J)
410F) Now I would like to ask you some questions about sexual activity in order to gain a better understanding of certain problems with respect to family planning.
How long has it been since the last time you had sexual intercourse (if you've ever had it)?
NUMBER OF DAYS: ___ 1
NUMBER OF WEEKS: ___ 2
NUMBER OF MONTHS: ___ 3
NUMBER OF YEARS: ___ 4
KNOWS ABOUT CONDOMS:
Did you use a condom the last time you had sexual intercourse?
DOESN'T KNOW ABOUT CONDOMS:
Some men use a condom, that is to say that they put a rubber sheath on their penis before having sexual intercourse. Did you use a condom the last time you had sexual intercourse?
NO 2
12 MONTHS OR MORE SINCE THE LAST SEXUAL INTERCOURSE: ___ (GO TO 410J)
410I) During the last 12 months with how many different people did you have sexual intercourse?
DON'T KNOW 8
CURRENTLY MARRIED OR LIVES WITH A WOMAN:
The last time you had sexual intercourse, was it with your/(one of your) spouses /the woman you live with, a regular partner, a casual encounter, someone you paid or someone else?
NO, NOT IN UNION:
The last time you had sexual intercourse, was it with a regular partner, a casual encounter, someone you paid or someone else?
REGULAR PARTNER 2
CASUAL ENCOUNTER 3
SOMEONE PAID 4
SOMEONE ELSE 5
412) Do you know of a place where you could get condoms?
NO 2 (GO TO 415)
IF THE PLACE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.
INTEGRATED HEALTH CENTER 12
MATERNITY WARD 13
HEALTH HUT 14
CONSULTATION AT A FAIR 15
OTHER PUBLIC (SPECIFY): ___ 16
PHARMACY 22
PRIVATE DOCTOR'S OFFICE 23
HEALTHCARE WORKER 24
OTHER PRIVATE MEDICAL (SPECIFY): ___ 26
TRADITIONAL HEALER 32
FRIENDS/RELATIVES 33
415) How old were you the first time you have sexual intercourse?
FIRST TIME IN MARRIAGE 96
SECTION 5. FERTILITY PREFERENCES
CURRENTLY MARRIED OR LIVING WITH A WOMAN: ___ (GO TO 503)
OCCASIONAL SEXUAL PARTNER: ___
NO SEXUAL PARTNER: ___ (GO TO 505)
503) Is (one of your spouse(s) /partner(s)) currently pregnant?
NO 2 (GO TO 505)
NOT SURE 8 (GO TO 505)
504) When she got pregnant, did you want her to get pregnant at that time, later, or did you not want her to get pregnant at all?
LATER 2
NOT AT ALL 3
SPOUSE/WIFE NOT PREGNANT OR NOT SURE:
Now I have a few questions about the future.
Would you like to have (a/another) child, or would you prefer not to have (other) children at all?
SPOUSE/WIFE PREGNANT:
Now I have a few questions about the future.
After the child that you are expecting, would you like to have (a/another) child, or would you prefer not to have (other) children at all?
NO MORE/NONE 2 (GO TO 507)
WOMAN CANNOT GET PREGNANT 3 (GO TO 507)
HE CANNOT HAVE CHILDREN 4 (GO TO 507)
NOT SURE/DOESN'T KNOW 8 (GO TO 507)
SPOUSE/WIFE NOT PREGNANT OR NOT SURE OR NO PARTNER:
How long would you like to wait from now before the birth of (a/another) child?
SPOUSE/WIFE PREGNANT:
After the birth of the child you are expecting, how long would you like to wait from now before the birth of (a/another) child?
YEARS: ___ 2
SOON/NOW 993
WOMAN CANNOT GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY): ___ 996
DON'T KNOW 998
507) CHECK 307: USES A METHOD?
DOES NOT CURRENTLY USE: ___
CURRENTLY USES: ___ (GO TO 512)
508) Do you think that you will use a method to delay or avoid a pregnancy in the next 12 months?
NO 2
DON'T KNOW 8
509) Do you think that you will use a method to delay or avoid a pregnancy in the future?
NO 2 (GO TO 511)
DON'T KNOW 8 (GO TO 511)
510) Which method would you prefer to use?
IUD 02 (GO TO 512)
INJECTIONS 03 (GO TO 512)
IMPLANTS 04 (GO TO 512)
DIAPHRAGM/JELLY/VAGINAL SUPPOSITORY 05 (GO TO 512)
CONDOM 06 (GO TO 512)
FEMALE STERILIZATION 07 (GO TO 512)
MALE STERILIZATION 08 (GO TO 512)
RHYTHM METHOD 09 (GO TO 512)
WITHDRAWAL 10 (GO TO 512)
OTHER METHOD (SPECIFY): ___96 (GO TO 512)
NOT SURE 98 (GO TO 512)
511) What is the main reason that you think that you will never use a contraception method?
INFREQUENT SEX 22
MENOPAUSE/HYSTERECTOMY 23
SUB FECUND/STERILE 24
POST-PARTUM/BREASTFEEDING 25
WANTS MORE CHILDREN 26
HUSBAND/PARTNER OPPOSED 32
OTHER PERSONS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
HAS LIVING CHILDREN:
If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
NO LIVING CHILDREN:
If you could choose exactly the number of children to have in your whole life, how many would that be?
PROBE FOR A NUMERIC RESPONSE.
OTHER (SPECIFY): ___ 96 (GO TO 514)
513) How many of these children would you like to be boys, how many would you like to be girls, and for how many would the sex not matter?
OTHER (SPECIFY): ___ 96
OTHER (SPECIFY): ___ 96
OTHER (SPECIFY): ___ 96
514) In general, would you say that you approve or disapprove of couples who use a method to avoid getting pregnant?
DISAPPROVE 2
NO OPINION 8
515) Do think it is acceptable that information about family planning is given:
On the radio?
On the television?
NOT ACCEPTABLE 2
DON'T KNOW 8
NOT ACCEPTABLE 2
DON'T KNOW 8
516) During the last few months, have you heard about family planning:
On the radio?
On the television?
In newspapers or magazines?
On a poster?
On a flyer or brochure?
NO 2
NO 2
NO 2
NO 2
NO 2
518) During the past few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?
NO 2 (GO TO 520)
519) With whom did you discuss this?
Anyone else?
RECORD EVERYONE MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
FRIEND(S)/NEIGHBOR(S) H
OTHER (SPECIFY): ___ X
YES, LIVES WITH A WOMAN: ___
NO, NOT IN A UNION: ___ (GO TO 601A)
521) Spouses/partners do not agree on everything. I would like to ask you questions about your spouse/partner's opinions on family planning.
Do you think that your (spouse(s)/partner) approves or disapproves of using methods to avoid pregnancy?
DISAPPROVES 2
DOESN'T KNOW 8
522) How many times during the past year did you speak with your partner/spouse(s) about family planning?
ONCE OR TWICE 2
MORE OFTEN 3
SECTION 6. SEXUALLY TRANSMITTED DISEASES AND AIDS
601A) Have you ever heard about infections that can be transmitted through sexual contact?
NO 2 (GO TO 601F)
601B) Which illnesses do you know of?
RECORD EVERYTHING MENTIONED.
GONORRHEA B
AIDS C
GENITAL WARTS/GENITAL TUMOR D
OTHER (SPECIFY): ___ W
OTHER (SPECIFY): ___ X
DON'T KNOW Z
HAS NEVER HAD SEXUAL INTERCOURSE: ___ (GO TO 601F)
601D) During the last 12 months, have you had one of these illnesses?
NO 2 (GO TO 601F)
DON'T KNOW 8 (GO TO 601F)
601E) Which illnesses have you had?
RECORD EVERYTHING MENTIONED.
GONORRHEA B
AIDS C
GENITAL WARTS/GENITAL TUMOR D
OTHER (SPECIFY): ___X
DON'T KNOW Z
601F) During the last 12 months have you had discharge from your penis?
NO 2
DON'T KNOW 8
601G) During the last 12 months have you had a sore or ulcer on your penis?
NO 2
DON'T KNOW 8
HAS NOT HAD AN ILLNESS: ___ (GO TO 601N)
601I) The last time you had (ILLNESS FROM 601E/DISCHARGE/SORE), did you seek advice or treatment?
NO 2 (GO TO 601JA)
601J) Where did you seek advice or treatment?
Any other place?
RECORD ALL MENTIONED
INTEGRATED HEALTH CENTER B
MATERNITY WARD C
HEALTH HUT D
CONSULTATION AT A FAIR E
OTHER PUBLIC (SPECIFY): ___ F
PHARMACY H
PRIVATE DOCTOR'S OFFICE I
HEALTHCARE WORKER J
OTHER PRIVATE MEDICAL (SPECIFY): ___ K
TRADITIONAL PRACTITIONER M
FRIENDS/RELATIVES N
OTHER (SPECIFY): ___ X
HAS NEVER HAD SEXUAL INTERCOURSE: ___ (GO TO 601N)
601K) When you had (ILLNESS FROM 601E/DISCHARGE/SORE), did you tell your partner?
NO 2
601L) When you had (ILLNESS FROM 601E/DISCHARGE/SORE), did you do anything to avoid infecting your partner?
NO 2 (GO TO 601N)
PARTNER ALREADY INFECTED 3 (GO TO 601N)
RECORD ALL MENTIONED.
USED CONDOMS B
TOOK MEDICINE C
OTHER (SPECIFY): ___ X
MENTIONED AIDS: ___ (GO TO 602)
601O) Have you heard of an illness called AIDS?
NO 2 (GO TO 611C)
602) From which sources have you learned the most about AIDS?
Anywhere else?
RECORD ALL MENTIONED
TELEVISION B
NEWSPAPERS/MAGAZINES C
BROCHURES/POSTERS D
HEALTHCARE WORKERS E
MOSQUES/CHURCHES F
SCHOOL/INSTRUCTORS G
COMMUNITY ENCOUNTERS H
FRIENDS/RELATIVES I
WORKPLACE J
OTHER (SPECIFY): ___ X
602B) How can someone get AIDS?
Any other source?
RECORD ALL MENTIONED
SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS B
SEXUAL INTERCOURSE WITH PROSTITUTES C
NOT USING CONDOMS D
SEXUAL INTERCOURSE WITH HOMOSEXUALS E
INJECTIONS F
BLOOD TRANSFUSIONS G
KISSING H
MOSQUITO BITES I
OTHER (SPECIFY): ___ X
DON'T KNOW Z
603) Is there something that a person can do to avoid contracting AIDS?
NO 2 (GO TO 607)
DOESN'T KNOW 8 (GO TO 607)
Anything else?
RECORD EVERYTHING CITED
USE CONDOMS C
AVOID MULTIPLE PARTNERS D
AVOID PROSTITUTES E
AVOID HOMOSEXUALS F
AVOID BLOOD TRANSFUSIONS G
AVOID INJECTIONS H
AVOID KISSING I
AVOID MOSQUITO BITES J
SEEK PROTECTION FROM A TRADITIONAL HEALER K
OTHER (SPECIFY): ___ X
DON'T KNOW Z
607) Is it possible that a person who appears to be healthy can in fact have the AIDS virus?
NO 2
DOESN'T KNOW 8
608) Do you think a person infected with AIDS never dies from this illness, dies sometimes from this illness, or nearly always dies from this illness?
SOMETIMES 2
NEARLY ALWAYS 3
DON'T KNOW 8
NO 2
DON'T KNOW 8
608B) Can AIDS be transmitted from mother to her baby?
NO 2
DON'T KNOW 8
608C) Do you know someone who has AIDS or who has died of AIDS?
NO 2
DON'T KNOW 8
609) Do you think your risk of catching AIDS is small, average, or significant, or do you think that you have no risk of catching AIDS?
AVERAGE 2 (GO TO 609C)
SIGNIFICANT 3 (GO TO 609C)
NO RISK 4
HAS AIDS 5 (GO TO 611A)
609B) Why do you think that you (are not at risk or have a small risk) of catching AIDS?
Any other reason?
RECORD EVERYTHING MENTIONED
USE CONDOMS C (GO TO 611)
ONLY ONE PARTNER D (GO TO 611A)
LIMITED NUMBER OF SEX PARTNERS E (GO TO 611A)
AVOIDS PROSTITUTES F (GO TO 611A)
PARTNER IS LOYAL G (SKIP TO 611A)
NO SEX WITH HOMOSEXUALS H (GO TO 611A)
NO BLOOD TRANSFUSIONS I (GO TO 611A)
NO INJECTIONS J (GO TO 611A)
OTHER (SPECIFY): ___ X (GO TO 611A)
609C) Why do you think that you (have an average or significant risk) of catching AIDS?
Any other reason?
RECORD EVERYTHING MENTIONED
MORE THAN ONE SEXUAL PARTNER D
MANY SEXUAL PARTNERS E
GOES TO PROSTITUTES F
PARTNER IS NOT LOYAL G
SEX WITH HOMOSEXUALS H
HAS BLOOD TRANSFUSIONS I
HAS INJECTIONS J
OTHER (SPECIFY): ___ X
611A) Since hearing about AIDS, have you changed your behavior to avoid contracting AIDS?
IF YES: What have you done?
RECORD ALL MENTIONED
STOPPED HAVING SEX B (GO TO 611C)
BEGAN TO USE CONDOMS C (GO TO 611C)
ONLY ONE SEXUAL PARTNER D (GO TO 611C)
LIMITED SEXUAL PARTNERS E (GO TO 611C)
ASKED PARTNER TO BE LOYAL F (GO TO 611C)
STOPPED HAVING SEX WITH HOMOSEXUALS H (GO TO 611C)
NO INJECTIONS J
OTHER (SPECIFY): ___ X
NO CHANGE Y
611B) Has knowing about AIDS changed your decision to have sexual intercourse or your sexual behavior?
IF YES, PROBE: In what way?
RECORD ALL MENTIONED
STOPPED HAVING SEX B
BEGAN TO USE CONDOMS C
RESTRICTED TO ONE SEXUAL PARTNER D
REDUCED NUMBER OF PARTNERS E
AVOIDED PROSTITUTES F
STOPPED HAVING SEX WITH HOMOSEXUALS H
OTHER (SPECIFY): ___ X
NO CHANGE IN SEXUAL BEHAVIOR Y
DON'T KNOW Z
611C) Certain people use a condom during sexual intercourse to avoid contracting AIDS or other sexually transmitted illnesses. Have you heard of this?
NO 2 (GO TO 611F)
HAS NEVER HAD SEXUAL INTERCOURSE: ___ (GO TO 611H)
611E) It is possible that we have already talked about this. Have you ever used a condom during sexual intercourse to avoid contracting AIDS or other sexually transmitted illnesses?
NO 2 (GO TO 611G)
HAS NEVER HAD SEXUAL INTERCOURSE: ___ (GO TO 611H)
611G) During the last 12 months, have you given or received money, gifts or favors in exchange for sexual intercourse?
NO 2
611H) RECORD IF THE RESPONDENT HAS A GOITER
NO 2
NOT SURE 8
SECTION 7. TRADITIONAL PRACTICES
701) In Niger, as in other countries, there is a practice that involves removing a part of the genital organs of young girls or young women. Have you heard of this practice?
NO 2 (GO TO 707)
702) Do you think that this type of practice should continue or that it should be stopped?
STOPPED 2 (GO TO 705)
DON'T KNOW 8 (GO TO 707)
703) Why do you think that this type of practice should continue?
What other reason?
RECORD ALL REASONS MENTIONED
CUSTOM AND TRADITION B
RELIGIOUS NECESSITY C (GO TO 707)
HYGIENE D (GO TO 707)
BETTER CHANCE OF MARRIAGE E (GO TO 707)
MORE PLEASURE FOR HUSBAND F (GO TO 707)
PRESERVATION OF VIRGINITY/AVOID IMMORALITY G (GO TO 707)
OTHER (SPECIFY): ___ X (GO TO 707)
DON'T KNOW Y (GO TO 707)
704) What do you mean by 'good tradition/custom and tradition'?
RECORD ALL REASONS MENTIONED
RELIGIOUS NECESSITY C (GO TO 707)
HYGIENE D (GO TO 707)
BETTER CHANCE OF MARRIAGE E (GO TO 707)
MORE PLEASURE FOR HUSBAND F (GO TO 707)
PRESERVATION OF VIRGINITY/AVOID IMMORALITY G (GO TO 707)
OTHER (SPECIFY): ___ X (GO TO 707)
DON'T KNOW Y (GO TO 707)
705) Why do you think this type of tradition should be stopped?
What other reason?
RECORD ALL REASONS MENTIONED
AGAINST RELIGION B (GO TO 707)
MEDICAL COMPLICATIONS C (GO TO 707)
PAINFUL EXPERIENCE D (GO TO 707)
AGAINST WOMEN'S DIGNITY E (GO TO 707)
PREVENT SEXUAL SATISFACTION F (GO TO 707)
OTHER (SPECIFY): ___ X (GO TO 707)
DON'T KNOW Y (GO TO 707)
706) What do you mean by 'bad tradition'?
RECORD ALL REASONS MENTIONED
MEDICAL COMPLICATIONS C
PAINFUL EXPERIENCE D
AGAINST WOMEN'S DIGNITY E
PREVENT SEXUAL SATISFACTION F
OTHER (SPECIFY): ___ X
DON'T KNOW Y
MINUTES:___
INTERVIEWER'S OBSERVATIONS:
FILL OUT AFTER HAVING ENDED THE INTERVIEW
COMMENTS ABOUT THE RESPONDENT:
COMMENTS ON PARTICULAR QUESTIONS:
OTHER COMMENTS:
SUPERVISOR'S OBSERVATIONS:
SUPERVISOR'S NAME ___
DATE ___
FIELD EDITOR'S OBSERVATIONS:
FIELD EDITOR'S NAME ___
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