N°

Questions

Responses

JUMP

Q04

Is PLHIV co-infected/Case or control?

0. NO

1. YES

Q05

What is your date of birth?

/___/___/_________/

Q06

Gender of patient?

1. M

2. F

Q07

What is your marital status?

1. married

2. single

3. divorced

4. common-law

99. not stated

Q08

What is your level of education?

1. no education

2. primary

3. secondary

4. university

99. not stated

Q09

Are you gainfully employed?

1. YES

2. NO

Q10

Are you from the Health Zone?

1. Health Zone

2. Outside health zone