Internet Survey Purpose: This survey and your participation in it are vital in helping us to create better marketing materials that speak directly to our community. The materials will feature images and messages about safer sex, positive body images and where to get services. This survey is voluntary and anonymous so please be as honest as possible. Current Age Date of Birth / / Bronx Manhattan [1[ Gender 1.Male 2.Female 3.Transgender (TG) 3.1M to F 3.2F to M 4.Other_______
[5] Race 1.African American/Black 2.Asian Amer/Pac. Is./Filipino 3.Caucasian/White 4.Native Amer/ Amer. Ind. 5.Mixed Heritage 6.Other
[2] Sexual Orientation 1.Gay/Lesbian 2.Bisexual 3.Heterosexual 4.Down Low (DL) 5.Questioning 6.Men who have Sex with Men (MSM) 7.Same Gender Loving (SGL) 8.Other
[6] Enter the Zip code you reside in
[3] Age
[4] Ethnicity
1.13-16 2.17-20 3.21-24 4.25-36 5.37-49 6.50 & over
1.Hispanic 2.Not Hispanic/Latino 3.Ethnicity Unknown
[7] Highest Education
[8] HIV Status
1.Some High School 2.High School 3.GED 4.Some College 5.College 6.Post Grad 7.Other_____
1.Positive 2.Negative 3.Don’t Know 4.Prefer not to answer