For completion by survey administrator:

Name of school: ______

Age group of class: ______

Tobago Youth Health Needs Assessment

A project of the

Family Planning Association of Trinidad and Tobago

Tobago AIDS Society

Caribbean Epidemiology Centre

QUESTIONNAIRE FOR SCHOOL AGE GROUP 10-14

Dear Student,

WELCOME to the Tobago Youth Health Needs Assessment.

Please answer the following questions. We need to know what you know and what you feel so that we can help you and other young people in Tobago to live healthy and happy lives.

INSTRUCTIONS

Read each question carefully. Follow the instructions for recording your answers. In some cases you will write your answer in the space provided. For other questions you will tick the box next to the answer or answers which you agree with.

SECTION A

Gender. Tick “MALE” if boy or “FEMALE” if girl
[ ] MALE[ ] FEMALE
2. / How old are you now? Age [ ] years

SECTION B

For the following statements, tick to show which are “TRUE” and which are “FALSE”. If you don’t know, tick “DON’T KNOW”

1. / I go to church regularly[ ] TRUE [ ] FALSE[ ] DON’T KNOW
2. / Staff of the Family Planning Association have come to my school to talk to us about sexually transmitted diseases
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
3. / The best way to avoid getting HIV/AIDS is not to have sex
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
4. / A woman can pass on HIV to an unborn child
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
5. / You can get HIV/ AIDS from living in a home with an infected person
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
6. / You can get HIV/ AIDS from kissing an infected person on the cheek
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
7. / You can get HIV/ AIDS from having sex with someone who is infected
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
8. / You can get HIV/ AIDS from shaking hands with someone who is infected
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
9. / You can get HIV/ AIDS from mosquitoes
[ ] TRUE [ ] FALSE[ ] DON’T KNOW
10. / You can get HIV/ AIDS from the seat of a toilet
[ ] TRUE [ ] FALSE[ ] DON’T KNOW

SECTION C

For the questions in this section, you can tick more than one answer.
1. / Which of the following methods can successfully prevent pregnancy?
[ ] Douching / [ ] Bush medicine / [ ] Anal sex/ bulling/ sex in the bottom
[ ] Pill / [ ] Blue soap / [ ] Injection
[ ] Abortion / [ ] Condom / [ ] Hot Guinness
[ ] Rhythm method / [ ] Sterilisation / [ ] No sex
2. / Which of the following methods can successfully prevent getting HIV/AIDS or any other sexually transmitted diseases?
[ ] Douching / [ ] Bush medicine / [ ] Anal sex/ bulling/ sex in the bottom
[ ] Pill / [ ] Praying to God / [ ] Condom
[ ] No sex / [ ] Taking HIV test

SECTION D

Please indicate whether you agree, are undecided or disagree with the statements in this section. Only one tick per question
1.Having sex with someone is the best way to prove you love them
[ ] Agree[ ] Undecided[ ] Disagree
2.A girl should wait until she is married to have sex
[ ] Agree[ ] Undecided[ ] Disagree
3.A boy should wait until he is married to have sex
[ ] Agree[ ] Undecided[ ] Disagree
4.I feel I could get the type of job I want in Tobago
[ ] Agree[ ] Undecided[ ] Disagree
5.AIDS is a serious problem in Tobago
[ ] Agree[ ] Undecided[ ] Disagree
6.Tourists coming to Tobago are the main source of AIDS
[ ] Agree[ ] Undecided[ ] Disagree
7.Older people respect the youth in Tobago
[ ] Agree[ ] Undecided[ ] Disagree
8.AIDS is a serious problem in my community or village
[ ] Agree[ ] Undecided[ ] Disagree
9.I would like to live in Tobago for most of my life
[ ] Agree[ ] Undecided[ ] Disagree
10.There is nothing wrong with somebody having sex with somebody who is a member of their family
[ ] Agree[ ] Undecided[ ] Disagree
11.The staff of the Family Planning Association treat young people with respect
[ ] Agree[ ] Undecided[ ] Disagree
12.The staff of the Family Planning Association keep young peoples’ personal business confidential
[ ] Agree[ ] Undecided[ ] Disagree
13.If I have a question about sex, I would ask my father (or male guardian)
[ ] Agree[ ] Undecided[ ] Disagree
14.If I have a question about sex, I would ask my friends or people my age
[ ] Agree[ ] Undecided[ ] Disagree

SECTION E

1. / If you wanted to get a condom, can you get one easily? [ ] YES[ ] NO
2. / Would you be comfortable buying a condom?[ ] YES[ ] NO
If YES, go to question 4
3. / If ‘NO’, please tick your reason. (You can tick more than one)
[ ] Someone I know might see me buying it
[ ] Someone might see me buying it and tell my family
[ ] It is embarassing[ ] Nowhere sells them
[ ] Too expensive[ ] Sex feels better without a condom
[ ] No-one uses them[ ] I don’t know why
[ ] I don’t think people should have sex until they are married
4. / If you wanted to get a condom, where would you get it? (You can tick more than one)
[ ] Shop/ pharmacy[ ] Clinic/ health centre
[ ] Family Planning Association[ ] From a friend
[ ] From my brother or sister[ ] From my mother or father
[ ] From another family member[ ] From my home
[ ] From my pocket or wallet[ ] Don’t know
5. / Has anyone close to you been infected with HIV or died of AIDS?
[ ] YES[ ] NO
6. / Do you know someone with AIDS?[ ] YES[ ] NO
7. / Have you ever had sex?[ ] YES[ ] NO
If ‘NO’, STOP HERE. THIS IS THE LAST QUESTION. THANK YOU.
8. / If ‘YES’, how old were you when you had sex the first time?Age [ ] years
9. / How old was the person you had sex with the first time?Age [ ] years
If you don’t know, please estimate how old the person was by ticking one of the following
[ ] Under 15 [ ] 15-20[ ] 21-30[ ] 31-40[ ] Over 40
10. / Was that person a member of your family? [ ] YES[ ]NO[ ] DON’T KNOW
11. / Did you agree to have sex with that person?
[ ] YES[ ]NO[ ] DON’T KNOW
12. / That first time, did you do or use anything to prevent pregnancy or any sexual diseases?
[ ] YES[ ]NO[ ] DON’T KNOW
13. / That first time, which of the following things happened? (You can tick more than one)
[ ] One person put his or her tongue inside the mouth of the other person
[ ] I laid down with the other person and hugged him or her
[ ] The boy or man put his penis in the vagina of the girl or woman
[ ] The boy or man put his penis in the anus or bottom of the other person
14. / Have you had sex in the last six months?[ ] YES[ ] NO
15. / How many times did you have sex with a condom in the last six months?
[ ] Always[ ] Sometimes[ ] Never
16. / How many people have you had sex with in your life?
[ ] None (I have never had sex)[ ] 1 person[ ] 2-4people[ ] 5-9 people
[ ]10-20 people[ ] more than 20 people[ ] Can’t remember

Thank you for answering these questions.

You have helped to make Tobago a healthier and safer place for

young people.

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