s/n		Questions	Responses	Skip Pattern
Section A: Respondents’ Socio-Demographic Characteristics
101	Age (in completed years)
102	Sex		☐ Male. ☐ Female
103	Marital status		☐ Single ☐ Married ☐ Widow/Widower ☐ Divorced/Separated
104	Highest level of education		☐ No Formal Education ☐ Completed Primary Education ☐ Completed Secondary Education ☐ Completed Tertiary Education
105	Occupation		☐ Civil Servant ☐ Self-employed/Business ☐ Retired ☐ Others_specify (____)
106	Religion		☐ Christianity ☐ Islam ☐ Traditional
107	What is your daily income level		☐ Less than 500 naira ☐ 500 - 1000 naira ☐ More than 1000 naira
108	What is your household monthly income level?		☐ Less than 30,000 naira ☐ 30,000 - 50,000 naira ☐ More than 50,000 naira
109	What is the size of your household?		☐ Less than 5 ☐ Less than 10 ☐ 10 and above
Section B: Health-Related Characteristics
201	Respondents weight (__Kg)		-
202	Respondent’s height (__meter)		-
203	BMI (Kg/m²)		-
204	Do you know your HIV status?		☐ Yes ☐ No
205	What is your HIV status?		☐ Positive ☐ Negative	Skip if no to Q 204
206	Are you on ARVs?		☐ Yes ☐ No	Skip if the response to Q 205 is negative
207	If yes, for how long have you been on ARVs		☐ 0 - 1 years ☐ 1 - 2 years ☐ 3 - 5 years ☐ 6 - 10 years ☐ >10 years	Skip if no to Q 206