Module 75: Disclosure Questionnaire

A Module Used in The Measurement Group's Cross-Cutting Evaluation of the HRSA HIV/AIDS Bureau's Special Projects of National Significance on Innovative Models of HIV/AIDS Care

Purpose

• The purpose of this module is to record which close friends and service providers the individual has informed about his/her HIV.

Content Domain - Codes individuals who are close to the person, individuals who were told about client HIV, reasons for not disclosing, and whether or not service providers have been told.

Operational Data Items - ID Letters/ID Numbers, Site, Sub-Provider, Date, Staff Code, Client Gender, People Who Are Close, People Told about Being HIV-Infected, Reasons Why Close People Are Not Told, Service Providers Told About HIV Status.

Citation - Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and the Washington University HRSA SPNS Cooperative Agreement Project (1996). Module 75: Disclosure Questionnaire. Available: www.TheMeasurementGroup.com. Culver City, California: The Measurement Group.

Usage - Permission is granted for non-commercial use so long as form is not altered, the copyright is not removed, and a proper citation is made to the instrument. Non-commercial use is use by a not-for-profit organization in which the instrument is not sold. If you have questions about appropriate and proper uses, contact The Measurement Group.

Findings from Evaluating HIV/AIDS Programs

Reliability and Validity Studies