FEDERAL REPUBLIC OF NIGERIA
NATIONAL POPULATION COMMISSION
1999 DEMOGRAPHIC AND HEALTH SURVEY
INDIVIDUAL QUESTIONNAIRE FOR MEN
STATE NAME ___
LOCAL GOVT. AREA ___
LOCALITY NAME ___
ENUMERATION AREA ___
RURAL 2
LARGE TOWN/MEDIUM TOWN/SMALL TOWN/VILLAGE ___
(Large Towns are places with over 1 million population; Medium Towns are places with between 50,000 and 1 million population; Small Towns are places both between 20,000 and 50,000 population while places with less than 20,000 are villages.)
MEDIUM TOWN 2
SMALL TOWN 3
VILLAGE 4
BUILDING NUMBER ___
HOUSEHOLD NAME/NUMBER ___
NAME AND LINE NUMBER OF MAN IN HOUSEHOLD SCHEDULE __
FIRST VISIT
DATE __________
INTERVIEWER'S NAME ___________
RESULT _____________
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
DWELLING DESTROYED 7
OTHER (SPECIFY) ___________ 8
NEXT VISIT
DATE __________
TIME ___________
FINAL VISIT
DAY ____
MONTH ____
YEAR ____
NAME ____
RESULT _____
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
DWELLING DESTROYED 7
OTHER (SPECIFY) ___________ 8
SUPERVISOR
NAME ________ ___
DATE ________
FIELD EDITOR
NAME ________ ___
DATE ________
OFFICE EDITOR_____
KEYED BY_____
SECTION 1. RESPONDENT'S BACKGROUND
101. RECORD THE TIME (START OF INTERVIEW).
MINUTES ___
102. First I would like to ask some questions about you and your household.
For most of the time until you were 12 years old, did you live in a large town, medium town, small town, or in the village?
MEDIUM TOWN 2
SMALL TOWN 3
VILLAGE 4
103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)
104. Just before you moved here, did you live in a large town, medium town, small town, or in the village?
MEDIUM TOWN 2
SMALL TOWN 3
VILLAGE 4
105. In what month and year were you born?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.
107. Have you ever attended school?
NO 2 (GO TO 111)
108. What is the highest level of school you attended: primary, secondary, or higher?
SECONDARY 2
HIGHER 3
OTHER (SPECIFY) ___________ 4
109. What is the highest (grade/form/year) you completed at that level?
SECONDARY OR HIGHER (GO TO 112)
111. Can you read and understand a letter or 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 radio every day?
NO 2
114. Do you usually watch television at least once a week?
NO 2
115. Are you currently working?
NO 2
116. Have you done any work in the last 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 do you rent land, or 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
SELF EMPLOYED 3
121. Do you usually work at this job throughout the year, or do you work seasonally, or only once in a while?
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3
122. During the last 12 months, how many months did you work at this job?
123. How much do you earn for this work?
PROBE: Is this by the hour, by the day, by the week, by the month or by the year?
PER DAY 2 __
PER WEEK 3 __
PER MONTH 4 __
PER YEAR 5 __
OTHER (SPECIFY) _____________ 99996
PROTESTANT 2
OTHER CHRISTIAN 3
ISLAM 4
TRADITIONALIST 5
OTHER (SPECIFY) ________ 6
125. What is your ethnic group?
201. Now I would like to ask about your children. I am interested only in the children that are biologically yours. Have you ever had 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? And how many daughters live with you?
IF NONE, RECORD '00'.
204. Do you have any sons or daughters 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? And how many daughters are alive but do not live with you?
IF NONE, RECORD '00'.
206. Have you ever given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but survived only a few hours or days?
NO 2 (GO TO 208)
207. How many boys have died? And how many girls have died?
IF NONE, RECORD '00'.
208. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'.
209. CHECK 208:
Just to make 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.)
HAS NEVER HAD CHILDREN (GO TO 301)
210A. In what month and year was your last child born?
BEFORE JANUARY 1996 (GO TO 301)
211. When you were expecting your last born child, did you want to have the child then, did you want to wait until later, or did you not want to have any (more) children at all?
LATER 2
NOT AT ALL 3
Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.
CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.
CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 301 OR 302, ASK 303.
301. Which ways or methods have you heard about?
302. Have you ever heard of (METHOD)?
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
NO 3 (GO TO NEXT METHOD)
303. Have you ever used (METHOD)?
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
Have you ever had an operation to avoid having any more children?
NO, DOES NOT KNOW 2
Have you ever had a partner who had an operation to avoid having children?
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO, DOES NOT KNOW 2
NO 2
AT LEAST ONE 'YES' (EVER USED) (GO TO 307)
305. Have you or any of your wives/partners ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2 (GO TO 309)
306. What have you used or done?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).
307. Are you or your wife (wives)/partner(s) doing something or using a method to delay or avoid a pregnancy?
NO 2 (GO TO 309)
308. Which method are you using?
IUD 02 (GO TO 401)
INJECTABLES 03 (GO TO 401)
IMPLANTS 04 (GO TO 401)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 401)
CONDOM/FEMIDOM 06 (GO TO 401)
FEMALE STERILIZATION 07 (GO TO 401)
MALE STERILIZATION 08 (GO TO 401)
PERIODIC ABSTINENCE 09 (GO TO 401)
WITHDRAWAL 10 (GO TO 401)
OTHER (SPECIFY) _________ 96 (GO TO 401)
309. What is the main reason you are not using a method of contraception to avoid pregnancy?
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
WIFE SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (MORE) CHILDREN 26
WIFE PREGNANT 27
WIFE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) _____ 96
DOES NOT KNOW 98
401. Are you currently married or living with a woman?
YES, LIVING WITH A WOMAN 2 (GO TO 402A)
NO, NOT IN UNION 3 (GO TO 404)
402. How many wife/wives do you have?
402A. How many women are you living with as if you are married?
403. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR HIS WIFE/WIVES.
IF A WIFE DOES NOT LIVE IN THE HOUSEHOLD, WRITE '00'.
THE NUMBER OF BOXES FILLED MUST EQUAL THE NUMBER OF WIVES.
404. Do you currently have a regular sexual partner, an occasional sexual partner, multiple sexual partner, or no sexual partner at all?
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3
MULTIPLE SEXUAL PARTNER 4
405. Have you ever been married or lived with a woman?
YES, LIVED WITH A WOMAN 2 (GO TO 407)
NO 3 (GO TO 410)
406. What is your marital status now: 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
MARRIED/LIVED WITH A WOMAN ONLY ONCE: In what month and year did you start living with your wife/woman?
MARRIED/LIVED WITH WOMAN MORE THAN ONCE: Now we will talk about your first wife/woman you lived with. In what month and year did you start living with her?
DOES NOT KNOW MONTH 98
DOES NOT KNOW YEAR 98
409. How old were you when you started living with her?
410. Now I need to ask you some questions about sexual activities in order to gain a better understanding of some family planning issues. When was the last time you had sexual intercourse (if ever)?
DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996 __
KNOWS CONDOM: The last time you had sex, was a condom used?
DOES NOT KNOW CONDOM: Some men use a condom, which means that they put a rubber sheath on their penis for sexual intercourse. The last time you had sex, was a condom used?
NO 2
412. Do you know of a place where you can get condom?
NO 2 (GO TO 414)
413. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
COMMUNITY HEALTH WORKER 15
OTHER PUBLIC (SPECIFY) ______ 16
PHARMACY/PMS 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
COMMUNITY HEALTH WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
CHURCH 32
FRIENDS/RELATIVES 33
NGO 34
OTHER (SPECIFY) __________________ 36
CURRENTLY MARRIED/LIVING WITH A WOMAN: In the last 12 months, how many different persons have you had sex with other than your (wife/wives/women you are living with)?
NO, NOT IN UNION: In the last 12 months, how many different persons have you had sex with?
415. How old were you when you first had sexual intercourse?
FIRST TIME WHEN MARRIED 96
SECTION 5. FERTILITY PREFERENCES
CURRENTLY MARRIED OR LIVING WITH A WOMAN (GO TO 503)
OCCASIONAL SEXUAL PARTNER (GO TO 503)
MULTIPLE SEXUAL PARTNERS (GO TO 503)
NO SEXUAL PARTNER (GO TO 505A)
503. Is your wife (or one of your wives)/partner pregnant now?
NO 2 (GO TO 505A)
UNSURE 3 (GO TO 505A)
504. When she became pregnant, did you want her to become pregnant then, did you want her to wait until later, or did you not want this pregnancy at all?
LATER 2 (GO TO 505B)
NOT AT ALL 3 (GO TO 505B)
505A. WIFE/PARTNER NOT PREGNANT OR UNSURE OR NO WIFE/PARTNER: Now I have some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children?
NO MORE/NONE 2 (GO TO 507)
SAYS WIFE CAN'T GET PREGNANT 3 (GO TO 507)
SAYS HE CAN'T HAVE ONE ANY MORE 4 (GO TO 507)
UNDECIDED/DON'T KNOW 8 (GO TO 507)
505B. WIFE/PARTNER PREGNANT: Now I have some questions about the future.
After the child you are expecting now, would you like to have another child, or would you prefer not to have any more children?
NO MORE/NONE 2 (GO TO 507)
SAYS WIFE CAN'T GET PREGNANT 3 (GO TO 507)
SAYS HE CAN'T HAVE ONE ANY MORE 4 (GO TO 507)
UNDECIDED/DON'T KNOW 8 (GO TO 507)
WIFE/PARTNER NOT PREGNANT OR UNSURE NO WIFE/PARTNER: How long would you like to wait from now before the birth of (a/another) child?
WIFE/PARTNER PREGNANT: After the child your wife/partner is expecting, how long would you like to wait before the birth of another child?
YEARS 2 ___
SOON/NOW 993
SAYS WIFE CAN'T GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) _____ 996
DOES NOT KNOW 998
507. CHECK 308:
USING A METHOD?
NOT CURRENTLY USING (GO TO 508)
CURRENTLY USING (GO TO 512)
508. Do you think you will use a method to delay or avoid pregnancy within the next 12 months?
NO 2
DOES NOT KNOW 8
509. Do you think you will use a method at any time in the future?
NO 2 (GO TO 511)
DOES NOT KNOW 8 (GO TO 511)
510. Which method would you prefer to use?
IUD 02 (GO TO 512)
INJECTABLES 03 (GO TO 512)
IMPLANTS 04 (GO TO 512)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 512)
CONDOM/FEMIDOM 06 (GO TO 512)
FEMALE STERILIZATION 07 (GO TO 512)
MALE STERILIZATION 08 (GO TO 512)
PERIODIC ABSTINENCE 09 (GO TO 512)
WITHDRAWAL 10 (GO TO 512)
OTHER (SPECIFY) _________ 96 (GO TO 512)
UNSURE 98 (GO TO 512)
511. What is the main reason that you think you will never use a method?
MENOPAUSAL/HYSTERECTOMY 23
WIFE SUBFECUND/INFECUND 24
WANTS MORE CHILDREN 26
WIFE OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) _____ 96
DON'T KNOW 98
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?
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 it not matter?
OTHER (SPECIFY) ______ 96
OTHER (SPECIFY) ______ 96
OTHER (SPECIFY) ______ 96
514. Would you say that you approve or disapprove of couples using a method to avoid getting pregnant?
DISAPPROVE 2
NO OPINION 3
515. Is it acceptable or not acceptable to you for information on family planning to be provided:
On the radio?
On the television?
NOT ACCEPTABLE 2
DOES NOT KNOW 8
NOT ACCEPTABLE 2
DOES NOT KNOW 8
516. In the last few months, have you heard about family planning:
On the radio?
On the television?
In a newspaper?
From a poster?
From leaflets or brochures?
From Town Crier?
Any Other (SPECIFY) ____________
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
517. In the last few months, have you heard about any message on Radio/TV on condom use?
517B. If Yes, (Specify) _______________
NO 2
518. In the last few months, have you discussed the practice of family planning with your spouse/partner, friends, neighbors, or relatives?
NO 2 (GO TO 520)
519. With whom? Anyone else?
RECORD ALL MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
MOTHER-IN-LAW G
FRIENDS/NEIGHBORS H
SON I
OTHER (SPECIFY) _______X
LIVING WITH A WOMAN (GO TO 521)
NOT IN UNION (GO TO 601)
521. Spouse/partners do not always agree on everything. Now I want to ask you about your wife's/the woman's you live with views on family planning. Do you think that your wife/the woman you live with approves or disapproves of couples using a method to avoid pregnancy?
DISAPPROVES 2
DOES NOT KNOW 8
522. How often have you talked to your wife/the woman you live with about family planning in the past year?
ONCE OR TWICE 2
MORE OFTEN 3
523. Do you think your wife/the woman you live with wants the same number of children that you want, or does she want more or fewer than you want?
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8
524. Who decides on the number of children you want to have?
WIFE ONLY 2
HUSBAND/WIFE 3
MOTHER-IN-LAW 4
FATHER-IN-LAW 5
OTHER (SPECIFY) _____________ 6
SECTION 6. AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES
601A. Have you heard about diseases that can be transmitted through sexual intercourse?
NO 2 (GO TO 601F)
601B. Which diseases do you know?
RECORD ALL RESPONSES.
GONORRHEA B
AIDS C
GENITAL WARTS/CONDYLOMATA D
OTHER (SPECIFY) __________ W
OTHER (SPECIFY) __________ X
DOES NOT KNOW Z
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 601F)
601D. During the last twelve months, did you have any of these diseases?
NO 2 (GO TO 601F)
DOES NOT KNOW 8 (GO TO 601F)
601E. Which of the diseases did you have?
RECORD ALL RESPONSES.
GONORRHEA B
AIDS C
GENITAL WARTS/CONDYLOMATA D
OTHER (SPECIFY) __________ W
OTHER (SPECIFY) __________ X
DOES NOT KNOW Z
601F. During the last 12 months, did you have a discharge from your penis?
NO 2
DOES NOT KNOW 8
60lG. During the last 12 months, did you have a sore or ulcer on your penis?
NO 2
DOES NOT KNOW 8
601H. CHECK 601E, 601F AND 601G:
NONE OF THE DISEASES (GO TO 601N)
601I. The last time you had (DISEASE FROM 601E/DISCHARGE/SORE) did you seek advice or treatment?
NO 2 (GO TO 601J)
601J. Where did you seek advice or treatment?
ANY OTHER PLACE OR PERSON.
RECORD ALL MENTIONED.
HEALTH CENTER B
FP CLINIC C
MOBILE CLINIC D
DISPENSARY E
OTHER PUBLIC SECTOR F
PHARMACY/PMS H
PRIVATE DOCTOR I
MOBILE CLINIC J
OTHER MED. PRIVATE SECTOR K
OTHER (SPECIFY) _____________ X
RELATIVE/FRIEND M
TRADITIONAL HEALER N
NGO P
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 601N)
601K. When you had (DISEASES FROM 601E/DISCHARGE/SORE) did you inform your partner(s)?
NO 2
601L. When you had (DISEASES FROM 601E/DISCHARGE/SORE) did you do something not to infect your partner(s)?
NO 2 (GO TO 601N)
PARTNER ALREADY INFECTED 3 (GO TO 601N)
601M. What did you do?
RECORD ALL MENTIONED.
USED CONDOMS B
TOOK MEDICINES C
REFER PARTNER TO HEALTH WORKER D
OTHER (SPECIFY) ________________ X
MENTIONED 'AIDS' (GO TO 602)
601P. Have you ever heard of a disease called 'AIDS'?
NO 2 (GO TO 611C)
602. From which sources of information have you learned most about AIDS?
ANY OTHER SOURCES?
RECORD ALL MENTIONED.
TELEVISION B
NEWSPAPERS/MAGAZINES C
PAMPHLETS/POSTERS D
HEALTH WORKERS E
MOSQUES/CHURCHES F
SCHOOLS/TEACHERS G
COMMUNITY MEETINGS H
FRIENDS/RELATIVES I
WORKPLACE J
OTHER (SPECIFY) ________________ X
602B. How can a person get AIDS?
ANY OTHER WAYS?
RECORD ALL MENTIONED.
SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS B
SEX WITH PROSTITUTES C
NOT USE CONDOM D
HOMOSEXUAL CONTACT E
BLOOD TRANSFUSION F
INJECTIONS G
KISSING H
MOSQUITO BITES I
SCARIFICATION/CIRCUMCISION J
OTHER (SPECIFY) _______________ W
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z
603. Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?
NO 2 (GO TO 607)
DOES NOT KNOW 8 (GO TO 607)
604. What can a person do?
ANY OTHER WAYS?
RECORD ALL MENTIONED.
ABSTAIN FROM SEX B
USE CONDOMS C
HAVE ONLY ONE SEX PARTNER D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH HOMOSEXUALS F
ENSURE SAFE BLOOD TRANSFUSIONS G
ENSURE INJECTIONS WITH STERILIZED NEEDLES H
ENSURE CIRCUMCISION WITH CLEAN BLADES/KNIVES I
AVOID KISSING J
AVOID MOSQUITO BITES K
SEEK PROTECTION FROM TRADITIONAL HEALER L
OTHER (SPECIFY) _______________ M
OTHER (SPECIFY) _______________ X
DON'T KNOW Z
DID NOT MENTION 'SAFE SEX' (GO TO 607)
606. What does 'safe sex' mean to you?
RECORD ALL MENTIONED.
USE CONDOMS C
AVOID MULTIPLE SEX PARTNER D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH HOMOSEXUALS F
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z
607. Is it possible for a healthy-looking person to have the AIDS virus?
NO 2
DOES NOT KNOW 8
608. Do you think that persons with AIDS almost never die from the disease, sometimes die, or almost always die from the disease?
SOMETIMES 2
ALMOST ALWAYS 3
DOES NOT KNOW 8
NO 2
DOES NOT KNOW 8
608B. Can AIDS be transmitted from mother to child?
NO 2
DOES NOT KNOW 8
608C. Do you personally know someone who has AIDS or has died of AIDS?
NO 2
DOES NOT KNOW 8
608D. What can an infected mother do to avoid transmitting AIDS to her unborn child?
SHOULD NOT BREASTFEED 2
DOES NOT KNOW 8
609. Do you think your chances of getting AIDS are small, moderate, great, or no risk at all?
MODERATE 2 (GO TO 609C)
GREAT 3 (GO TO 609C)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 611A)
609B. Why do you think that you have (NO RISK/A SMALL CHANCE) of getting AIDS?
ANY OTHER REASONS?
RECORD ALL MENTIONED.
USE CONDOMS C (GO TO 611A)
HAVE ONLY ONE SEX PARTNER D (GO TO 611A)
LIMITED NUMBER OF SEX PARTNERS E (GO TO 611A)
AVOID SEX WITH PROSTITUTES F (GO TO 611A)
SPOUSE HAS NO OTHER PARTNER G (GO TO 611A)
NO HOMOSEXUAL CONTACT H (GO TO 611A)
ENSURE SAFE BLOOD TRANSFUSION I (GO TO 611A)
ENSURE INJECTION WITH STERILIZED NEEDLES J (GO TO 611A)
OTHER (SPECIFY) _______________ X (GO TO 611A)
609C. Why do you think that you have a (MODERATE/GREAT) chance of getting AIDS?
ANY OTHER REASONS?
RECORD ALL MENTIONED.
MORE THAN ONE SEXUAL PARTNER D
SEX WITH PROSTITUTES E
SPOUSE HAS OTHER PARTNER(S) F
HOMOSEXUAL CONTACT G
HAD BLOOD TRANSFUSION H
HAD INJECTIONS I
OTHERS (SPECIFY) ________ W
OTHERS (SPECIFY) ________ X
611A. Since you heard of AIDS, have you changed your behaviour to prevent getting AIDS?
IF YES, WHAT DID YOU DO?
RECORD ALL MENTIONED
STOPPED ALL SEX B (GO TO 611C)
STARTED USING CONDOMS C (GO TO 611C)
RESTRICTED SEX TO ONE PARTNER D (GO TO 611C)
REDUCED NUMBER OF PARTNERS E (GO TO 611C)
AVOID SEX WITH PROSTITUTES F (GO TO 611C)
ASK SPOUSE TO BE FAITHFUL G (GO TO 611C)
NO MORE HOMOSEXUAL CONTACTS H (GO TO 611C)
ENSURE INJECTIONS WITH STERILIZED NEEDLE J
OTHER (SPECIFY) ________ X
OTHER (SPECIFY) ________ X
NO BEHAVIOUR CHANGE Y
611B. Has your knowledge of AIDS influenced or changed your decisions about having sex or your sexual behavior?
IF YES, IN WHAT WAY?
RECORD ALL MENTIONED.
STOPPED ALL SEX B
STARTED USING CONDOMS C
RESTRICTED SEX TO ONE PARTNER D
REDUCED NUMBER OF PARTNERS E
AVOID SEX WITH PROSTITUTES F
NO MORE HOMOSEXUAL CONTACTS G
ASK SPOUSE TO BE FAITHFUL H
OTHER (SPECIFY) ________ X
NO BEHAVIOUR CHANGE Y
DOES NOT KNOW Z
611C. Some people use a condom for sexual intercourse to avoid getting AIDS or other sexually transmitted infection? Have you ever heard of this?
NO 2 (GO TO 611F)
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 701)
611E. We may already have talked about this. Have you ever used a condom for sex to avoid getting or transmitting disease, such as AIDS?
NO 2
611G. Have you given or received money, gifts or favors in return for sex at any time in the last 12 months?
NO 2
611H. If yes, was a condom used?
NO 2
701. Now I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural mother, including those who are living with you, those living elsewhere and those who have died. How many children did your mother give birth to, including you?
ONLY ONE BIRTH (RESPONDENT ONLY) (GO TO 716)
703. How many of these births did your mother have before you were born?
704. What was the name given to your oldest (next oldest) brother or sister?
705. Is (NAME) male or female?
FEMALE 2
NO 2 (GO TO 708)
DON'T KNOW 8 (GO TO NEXT SIBLINGS)
708. In what year did (NAME) die?
DON'T KNOW 98
709. How many years ago did (NAME) die?
710. How old was (NAME) when he/she died?
711. Was (NAME) pregnant when she died?
NO 2
712. Did (NAME) die during childbirth?
NO 2
713. Did (NAME) die within two months after the end of a pregnancy or childbirth?
NO 2 (GO TO 715)
714. Was her death due to complications of pregnancy or childbirth?
NO 2
715. How many children did (NAME) give birth to during her lifetime?
IF NO MORE BROTHERS OR SISTERS, GO TO 716
716. RECORD THE TIME (END OF INTERVIEW)
MINUTES ___
(To be filled in after completing interview)
Comments about Respondent:
________________________________
Comments on Specific Questions:
_________________________________
Any other Comments:
_________________________________
SUPERVISOR'S OBSERVATIONS
_________________________________
Name of Supervisor: ________________
Date: _________________
EDITOR'S OBSERVATIONS
_________________________________
Name of Editor: ________________
Date: _________________