Module 34: Partner Disclosure Risk Form

A Module Used in The Measurement Group's Cross-Cutting Evaluation of the HRSA HIV/AIDS Bureau's Special Projects of National Significance on Innovative Models of HIV/AIDS Care

Purpose

• Code likelihood of being recipient of partner violence if HIV status is disclosed.

Content Domain - Indicators of potential partner psychological, verbal, and physical violence at disclosure of HIV status.

Operational Data Items - ID Letters/ID Numbers, Site, Sub-Provider, Date, Staff Code, Client Gender, HIV Status, Disclosed Status to Partner, (if disclosed) Partner Reactions, (if not disclosed) Perceived Partner Reactions, Intent to Disclose, Timeline of Disclosure.

Citation - Huba, G. J., Melchior, L. A., Staff of The Measurement Group, and Staff of the Washington University HRSA SPNS Cooperative Agreement Project (1996). Module 34: Partner Disclosure Risk Form. 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