Attachment 4 Information sheet

SciMetrika Health Survey

In Coordination with CDC and the Local Health Department

SciMetrika is a contractor working with the Centers for Disease Control and Prevention to conduct a Health Survey in major U.S. cities. Results from the survey will be used by CDC and the local health department to help assess progress in reducing new HIV infections, making access to HIV care easier and helping people stay healthy, and reducing HIV-related health disparities.

The SciMetrika Health Survey will interview people in community settings as well as in clinics that provide HIV medical care to people who have been diagnosed with HIV infection. A survey interviewer will read questions to you out loud and the interview will last an average of 40 minutes.

Your experiences and perspectives on HIV-related topics will be combined with others’ to help evaluate HIV-prevention programs in your city. This information will help make decisions about how HIV-treatment and prevention resources may be provided in the future.

Your participation in this survey is completely voluntary and your responses will be kept secure, to the extent permitted by law. None of the information that is collected will be associated with you in any way and it will not be possible to identify you based on your responses or any information you provide. Upon completion of the survey, you will be provided with a token of appreciation ($XX).

If you are interested in participating in this survey, please contact:

[Insert local SciMetrika employee contact info]

If you have overall questions or comments about the survey, please contact:

Wayne Wilson, SciMetrika Project Manager:

Call [toll-free number], or email: wwilson@scimetrika.com