The Division of Social Work at Indiana University Northwest has received a grant from the Indiana Minority Health Coalition to conduct a needs assessment for the Ryan White HIV Title III Planning Grant. The needs assessment will target people who live with HIV (PLWH) in Northwest Indiana. The purpose of this study is to learn about the HIV/AIDS prevention and service needs of communities in Lake, Porter, and LaPorte Counties in Indiana.
This needs assessment is a vital component to the overall planning process for the Lake County Ryan White HIV Title III Advisory Council. A proposal for early intervention services will be submitted to the HIV/AIDS Bureau of the Health Resources and Services Administration.
The results from participation will be held in the strictest confidence by all individuals involved in this needs assessment. Any reports or publications resulting from this needs assessment will not identify the participant by name.
We would greatly appreciate you participation in completing this survey. The possible benefits of participitating in this needs assessment may help identify those factors that interfere with prevention of acquiring the HIV virus or access to necessary services.
Please download the Word 6.0 file which contains the survey.
When completing this form in Microsoft Word, it will be hard to circle or underline answers...you may indicate your answers from multiple choice selection by leaving the correct answer, deleting the ones that do not apply to you. Should you wish to print the survey and make changes by hand, please leave survey as is, and circle or check items as requested. Once you complete the survey you may save it, and:
Thank you for your participation
Comments: Dr. Denise Travis