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Purpose
Content Domain - Items particularly related to women's health including reproductive history and medical syndromes and symptoms, STDs, other medical issues. Operational Data Items - ID Letters/ID Numbers, Site, Sub-Provider, Date, Gender, Have You Had the Following (4 items)? In the Past 6 months? In the Past 30 Days?, Pregnancy (7 items). Citation - Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and HRSA/HAB's SPNS Cooperative Agreement Steering Committee (1996). Module 19: HIV/AIDS Health Form - Women. Available: www.TheMeasurementGroup.com. Culver City, California: The Measurement Group. Usage - Permission is granted for non-commercial use so long as form is not altered, the copyright is not removed, and a proper citation is made to the instrument. Non-commercial use is use by a not-for-profit organization in which the instrument is not sold. If you have questions about appropriate and proper uses, contact The Measurement Group. Findings from Evaluating HIV/AIDS Programs Reliability and Validity Studies
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