| 1. |
Have you ever been taught about AIDS or HIV infection in school? |
|
- Yes
- No
- Not sure
|
| 2. |
Have your parents, or other adults in your family, ever talked with you
about what they expect you to do or not to do when it comes to sex? |
|
- Yes
- No
- Not sure
|
| 3. |
Have you ever had sexual intercourse? |
|
- Yes
- No
|
| 4.
|
How old were you when you had sexual intercourse for the first time? |
|
- I have
never had sexual intercourse
- 11 years
old or younger
- 12 years
old
- 13 years
old
- 14 years
old
- 15
years old
- 16 years
old
- 17 years
old or older
|
| 5. |
At the time you first had sexual intercourse, how old was your partner? |
|
- I have
never had sexual intercourse
- 5 or
more years younger than me
- 3 to 4
years younger than me
- About
the same age
- 3 to 4
years older than me
- 5
or more years older than me
|
| 6.
|
During your life, with how many people have you had sexual intercourse? |
|
- I have
never had sexual intercourse
- 1 person
- 2 people
- 3 people
- 4 people
- 5
people
- 6 or
more people
|
| 7. |
During the past 3 months, with how many people did you have sexual
intercourse? |
|
- I
have never had sexual intercourse
- I
have had sexual intercourse, but not during the past 3 months
- 1
person
- 2
people
- 3
people
- 4 people
- 5
people
- 6
or more people
|
| 8. |
Did you drink alcohol or use drugs before you had sexual intercourse the last
time? |
|
- I
have never had sexual intercourse
- Yes
- No
|
| 9. |
The last time you had sexual
intercourse, did you or your partner use a condom? |
|
- I
have never had sexual intercourse
- Yes
- No
|
| 10. |
The last time you had sexual
intercourse, what one method did you
or your partner use to prevent pregnancy?
(Select only one response.) |
|
- I
have never had sexual intercourse
- No
method was used to prevent pregnancy
- Birth
control pills
- Condoms
- Depo-Provera (injectable birth control)
- Withdrawal
- Some
other method
- Not
sure
|
| 11. |
How many times have you been pregnant or gotten someone pregnant? |
|
- 0 times
- 1 time
- 2 or more times
- Not sure
|
| 12. |
Have you ever been physically forced to have sexual intercourse when you
did not want to? |
|
- Yes
- No
|