Name - Sahil Malhotra
Subject – Written Communication(COM 210)
Topic – Sample Questionnaire
Assignment no – 4
Date of submission – 1st October 2008
Attitude, Awareness Level towards Sex Education in India
This survey questionnaire is being undertaken to find the Attitude & Awareness Level towards Sex Education for Men and Women in the age group of 18-24.
1. Use a tick mark or a circle to select the appropriate answer. 2. Certain questions have multiple answers. The word ‘Multiple’ next to the question signifies the same. 3. The answers of the questions will be kept discreet from others and your privacy will be best maintained. 4. Please answer the questions with utmost honesty.
Sex - Occupation -
Marital Status -
1. When was Sex Education first imparted to you?
2. How do/did you clarify your doubts on Sex Education? (Multiple)
Teachers or Professors in school/college
3. How often do you or make your partner use protection for sex?
Always Frequently Rarely Never
4. Which form of protection is most likely used by you or by your partner? (Multiple)
Birth control pills Condoms
Don’t use any
5. What compels you to have safe sex? (Multiple)
Fear of STD
Fear of HIV/AIDS
Request/Authority of the opposite partner Do not practice safe sex
6. How many sexual partners have you had?
10 & above
7. Expand the abbreviation AIDS.
- Additional Illness during sex
- Affected Immune Disability Syndrome
- Acute Intercourse Disease System
- Acquired Immune Deficiency Syndrome
8. What does HIV stand for?
- High Immune Virus
- Human Immunodeficiency Virus
- Human Intersexual Virus
- Human Immune Virus
9. How does the HIV Virus spread? (Multiple)
- Unsafe Sex
- Sharing household items such as utensils, towels
- From an infected mother to her unborn child
- Kissing or French Kiss
- Sharing facilities such as swimming pool, sauna, toilets - Sharing needles with an infected person
10. Is HIV synonym (another word) for AIDS?
11. Can a person become HIV+ or acquire AIDS without any sexual activity?
12. Commonly, how soon can the HIV virus be detected?
6-12 weeks 13-20 weeks 21-27 weeks 28 weeks and above
13. What is the full form of STD?
- Sex with Deficient Immunity
- Sex Transferred Deficiency
- Sexually Transmitted Disease
- Socially Transferred Sexual Disease
14. What do you understand by the term monogamy/polygamy?
- Different form of Sexual Diseases
- Single and Multiple sexual partners at any particular time - Sexual organs of men and women
- Terms given to rapists, molesters and other sexual offenders
15. What is the most suitable age to impart Sex Education?
16. What do you think is the best medium to impart sexual education to today’s youth? (Multiple)
Let them decide
17. Are you comfortable in clarifying Sexual issues/doubts to your friends and/or siblings of the same sex?
- Comfortable in dealing with friends and siblings
- Comfortable in dealing with friends only
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