/* SHORT TITLE: Codebook for Patient Quest-Time 5 Specific Data */ ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * WESTAT ADULT/ADOLESCENT QUESTIONNAIRE TIME 5 - PUBLIC USE * * 30 JUNE 1994 * ******************************************************************************** ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * WESTAT ADULT/ADOLESCENT QUESTIONNAIRE TIME 5 - PUBLIC USE * * 30 JUNE 1994 * ******************************************************************************** (0) 27 Jun. 1994 Record 01 STUDY OF HEALTH CARE COSTS WESTAT ADULT/ADOLESCENT QUESTIONNAIRE TIME 5 - PUBLIC USE 30 JUNE 1994 Question Column Name Number(s) ________ _________ HPID01 001-009 PATIENT ID NUMBER _________________ 000000001- 999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER HREC01 010-011 RECORD NUMBER _____________ 01 = NUMBER HSREC01 012-013 SUBRECORD NUMBER ________________ 00 = NOT A REPEATING RECORD HITYPE 014 WHAT IS THE INSTRUMENT TYPE? _____________________________ H = INSTRUMENT TYPE HRTYPE 015 RESPONDENT TYPE _______________ 1 = STUDY SUBJECT 2 = PROXY HLANG 016 QUESTIONNAIRE LANGUAGE VERSION ______________________________ 1 = ENGLISH 2 = SPANISH HREFDT (017-022) REFERENCE BEGIN DATE ____________________ HREFMO 017-018 REFERENCE BEGIN MONTH _____________________ 01-12 = MONTH (1) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HREFDY 019-020 REFERENCE BEGIN DAY ___________________ 01-31 = DAY HREFYR 021-022 REFERENCE BEGIN YEAR ____________________ 91-92 = YEAR HENDDT (023-028) REFERENCE END DATE __________________ HENDMO 023-024 MONTH OF END DATE _________________ + = INAPPLICABLE 01-12 = MONTH HENDDY 025-026 DAY OF END DATE _______________ + = INAPPLICABLE 01-31 = DAY HENDYR 027-028 YEAR OF END DATE ________________ + = INAPPLICABLE 91-92 = YEAR T5_STAT 029-030 QUESTIONNAIRE STATUS ____________________ CO = COMPLETE, WITH RESPONDENT PR = COMPLETE, WITH PROXY DD = COMPLETE, WITH PROXY PATUIENT DECEASED AT TIME OF INTERVIEW OBSDAYS5 031-033 OBSERVATION DAYS WITHIN REFERENCE PERIOD EXCLUDING PERIODS OF INELIGIBILITY ___________________________________________________________________________ 001-600 = NUMBER 999 = NUMBER (2) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ GAP5FLAG 034 PATIENT HAD TIME GAP DURING THE REFERENCE PERIOD ________________________________________________ + = INAPPLICABLE, NO TIME GAP 1 = YES TIME GAP ADM5 035-036 NUMBER OF INPATIENT ADMISSIONS (UNSTANDARDIZED) _______________________________________________ 00 = NONE 01-99 = NUMBER OF ADMISSIONS IPNGT5 037-039 NUMBER OF INPATIENT NIGHTS (UNSTANDARDIZED) ___________________________________________ 000 = NONE 001-999 = NUMBER OF NIGHTS AMBVS5 040-042 NUMBER OF AMBULATORY VISITS, INCLUDES HOSPITAL CLINIC, OTHER CLINIC AND PRIVATE MD (UNSTANDARDIZED) ________________ 000 = NONE 001-999 = NUMBER OF AMBULATORY VISITS ERVS5 043-045 NUMBER OF EMERGENCY ROOM VISITS (UNSTANDARDIZED) ________________________________________________ 000 = NONE 001-999 = NUMBER OF EMERGENCY ROOM VISITS HCVS5 046-048 NUMBER OF HOSPITAL CLINIC VISITS ________________________________ 000 = NONE 001-999 = NUMBER OF HOSPITAL CLINIC VISITS OCVS5 049-051 NUMBER OF OTHER CLINIC VISITS (UNSTANDARDIZED) ______________________________________________ 000 = NONE 001-999 = NUMBER OF OTHER CLINIC VISITS (3) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ MDVS5 052-054 NUMBER OF PRIVATE MD VISITS (UNSTANDARDIZED) ____________________________________________ 000 = NONE 001-999 = NUMBER OF PRIVATE MD VISITS HHSEHOLD (055-129) HOUSEHOLD COMPOSITION _____________________ HA01CT 055-056 COUNTER OF PEOPLE LISTED IN Q.A1. __________________________________ * 00 = NONE 01-99 = AMOUNT * SKIP HAIREL1 - HA1SST10 PERSON1 (057-062) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL1 057-058 RELATIONSHIP ____________ + = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE) 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX1 059 SEX ___ + = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE) 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (4) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE1 060-061 AGE ___ + = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE) 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST1 062 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE) 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON2 (063-068) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL2 063-064 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX2 065 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (5) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE2 066-067 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST2 068 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON3 (069-074) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL3 069-070 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX3 071 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (6) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE3 072-073 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST3 074 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON4 (075-080) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL4 075-076 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX4 077 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (7) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE4 078-079 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST4 080 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON5 (081-086) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL5 081-082 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX5 083 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (8) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE5 084-085 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST5 086 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON6 (087-092) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL6 087-088 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX6 089 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (9) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE6 090-091 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST6 092 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON7 (093-098) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL7 093-094 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX7 095 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (10) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE7 096-097 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST7 098 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON8 (099-104) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL8 099-100 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX8 101 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (11) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE8 102-103 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST8 104 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON9 (105-110) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL9 105-106 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX9 107 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (12) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE9 108-109 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST9 110 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED PERSON10 (111-116) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS (PERSON)? __________ HA1REL10 111-112 RELATIONSHIP ____________ + = INAPPLICABLE, NO OTHER NAMES LISTED 01-21 = USE CODES IN APPENDIX 55 91 = OTHER RELATIVE 92 = OTHER NON -RELATIVE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SEX10 113 SEX ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = MALE 2 = FEMALE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (13) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA1AGE10 114-115 AGE ___ + = INAPPLICABLE, NO OTHER NAMES LISTED 00 = NEWBORN TO 11 MONTHS 01-90 = YEARS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA1SST10 116 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE? ___________________________________________________ + = INAPPLICABLE, NO OTHER NAMES LISTED 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HABOX1 (117-118) BOX A -1 ________ HABOX1A 117 CHILDREN LISTED? _________________ 1 = YES 2 = NO HABOX1B 118 SPOUSE/PARTNER LISTED? _______________________ * 1 = YES 2 = NO * SKIP HA2 - HA4 (14) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA2 119 ARE YOU CURRENTLY LEGALLY MARRIED, WIDOWED, DIVORCED, SEPARATED, OR HAVE YOU NEVER BEEN MARRIED? _________ + = INAPPLICABLE, CODED 1 IN HABOX1B. * 1 = MARRIED 2 = WIDOWED 3 = DIVORCED 4 = SEPARATED 5 = NEVER MARRIED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED * SKIP HA3 HA3 120 ARE YOU CURRENTLY INVOLVED IN A COMMITTED RELATIONSHIP WITH ONE OTHER PERSON? ______________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HABOX1B; OR CODED 1 IN HA2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HA4 HA4 121 HAS (YOUR SPOUSE/THAT PERSON) ALSO BEEN DIAGNOSED AS BEING HIV POSITIVE? _________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HABOX1B; OR CODED 2, 7, 8 OR 9 IN HA3. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (15) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA5 122-123 PLEASE LOOK AT THIS CARD, WHICH DESCRIBES DIFFERENT TYPES OF PLACES WHERE PEOPLE LIVE. SINCE (REF. DATE), IN WHICH ONE OF THESE TYPES OF PLACES DID YOU LIVE MOST OF THE TIME? CODE ONE. __________ 01 = APARTMENT OR HOUSE WHICH YOU OWN OR HOLD THE LEASE 02 = APARTMENT OR HOUSE OF ANOTHER IN WHICH YOU PAY RENT BUT DON'T HOLD THE LEASE 03 = "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC. 04 = SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL' 05 = SPECIALIZED AIDS HOUSING 06 = SHELTERS 07 = STREET OR OTHER PUBLIC PLACE 08 = HOSPITAL, NURSING HOME, RESIDENTIAL CARE FACILITY 09 = IN FOSTER HOMES 10 = LIVES WITH SOMEONE ELSE 11 = JAIL 12 = PUBLIC HOUSING 13 = TRAILER/HOUSE, ETC NOT KNOWN IF OWNED OR LEASED 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HA6 (124-129) PLEASE LOOK AT THIS CARD. SINCE (REF. DATE), DID YOU LIVE IN ANY OF THESE PLACES OR SITUATIONS? (CODE ALL THAT APPLY) __________________________________ HA6A 124 TEMPORARILY "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC. ______________________________________________________________________ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HA6B 125 SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL' ______________________________________________ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (16) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HA6C 126 SPECIALIZED AIDS HOUSING ________________________ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HA6D 127 SHELTERS ________ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HA6E 128 STREET OR OTHER PUBLIC PLACE ____________________________ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HA6F 129 NONE ____ 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HINSCOVR (130-219) INSURANCE COVERAGE __________________ (17) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB1 130 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY ANY PRIVATE HEALTH INSURANCE PLAN, INCLUDING AN HMO, THAT PAYS FOR ANY PART OF HOSPITAL BILLS, DOCTOR BILLS, OR SURGEON BILLS? __________________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HBBOX2 HBBOX2 131 TIME 4 = PRIVATE INSURANCE __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB1 * 1 = YES ** 2 = NO * SKIP HBBOX3 ** SKIP HBBOX3 - HBBOX4 HBBOX3 132 TIME 4 = PRIVATE INSURANCE __________________________ + = INAPPLICABLE, CODED 1 IN HB1 * 1 = YES ** 2 = NO * SKIP HB2 - HB4L ** SKIP HB2 - HB10 HB2 133 IS THIS THE SAME PRIVATE HEALTH INSURANCE PLAN YOU TOLD ME ABOUT LAST TIME? ____________________________________________________________________________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3. 1 = YES * 2 = NO * 7 = REFUSED 8 = DK * 9 = NOT ASCERTAINED * SKIP HB3 - HB4L (18) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB3 134 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE TIME? ______ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2. * 1 = THE WHOLE TIME 2 = PART OF THE TIME * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB4A - HB10 HB4 (135-146) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY PRIVATE INSURANCE FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS THAT APPLY. CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF AT LEAST ONE IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). HB4A 135 JANUARY _______ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4B 136 FEBRUARY ________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (19) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB4C 137 MARCH _____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4D 138 APRIL _____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4E 139 MAY ___ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4F 140 JUNE ____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (20) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB4G 141 JULY ____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4H 142 AUGUST ______ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB4I 143 SEPTEMBER _________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB4J 144 OCTOBER _______ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (21) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB4K 145 NOVEMBER ________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB4L 146 DECEMBER ________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED IN HBBOX3; OR CODED 2, 7 OR 9 IN HB2; OR CODED 1, 7, 8 OR 9 IN HB3. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED GO TO HB12 HB5 (147-150) WHEN DID YOUR (PREVIOUS) HEALTH INSURANCE COVERAGE END? CODER: IF HB5YR EQUALS 97, 98 OR 99, CODE 99 IN HB5MO. HB5MO 147-148 MONTH _____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED 2 IN HBBOX3; OR CODED 1 OR 8 IN HB2. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (22) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB5YR 149-150 YEAR ____ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED 2 IN HBBOX3; OR CODED 1 OR 8 IN HB2. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB6 151 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED? _________________________________________________________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED 2 IN HBBOX3; OR CODED 1 OR 8 IN HB2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HBBOX4 152 LOOK AT Q. B-1. R ANSWERED: ______________________________ + = INAPPLICABLE, CODED 2 IN HBBOX2; OR CODED 2 IN HBBOX3; OR CODED 1 OR 8 IN HB2. 1 = YES * 2 = NO * SKIP HB7 - HB10 HB7 153 IS YOUR CURRENT PLAN INDIVIDUAL OR FAMILY COVERAGE? ____________________________________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX2 = 2 OR HBBOX4 = 1. 1 = INDIVIDUAL PLAN 2 = FAMILY PLAN 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (23) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB8 154-155 HOW DO YOU GET YOUR CURRENT HEALTH INSURANCE OR HEALTH PLAN - THROUGH AN EMPLOYER OR FAMILY BUSINESS, A UNION, OR SOME OTHER GROUP, OR DIRECTLY FROM AN INSURANCE COMPANY? + = INAPPLICABLE, CODED ONLY IF HBBOX2 = 2 OR HBBOX4 = 1. 01 = EMPLOYER/FAMILY BUSINESS 02 = UNION 03 = INSURANCE COMPANY 04 = SPECIAL INTEREST GROUP 05 = PUBLIC ASSISTANCE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB9 (156-159) WHEN DID YOUR CURRENT HEALTH INSURANCE COVERAGE BEGIN? CODER: IF HB9YR EQUALS 97, 98 OR 99, CODE 99 IN HB9MO. HB9MO 156-157 MONTH CURRENT HEALTH INSURANCE BEGAN ____________________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX2 = 2 OR HBBOX4 = 1. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB9YR 158-159 YEAR CURRENT HEALTH INSURANCE BEGAN ___________________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX2 = 2 OR HBBOX4 = 1. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (24) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB10 160 IS THIS PLAN A HEALTH MAINTENANCE ORGANIZATION OR HMO? _______________________________________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX2 = 2 OR HBBOX4 = 1. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB12 161 AT ANY TIME SINCE (REF. DATE), HAVE YOU BEEN COVERED BY (MEDICAID/STATE NAME FOR MEDICAID)? ___________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB13 - HB14L HB13 162 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE TIME? ______ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12. * 1 = THE WHOLE TIME 2 = PART OF THE TIME * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB14A - HB14L HB14 (163-174) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY (MEDICAID/STATE NAME FOR MEDICAID) FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS THAT APPLY. CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF AT LEAST ONE ITEM IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). (25) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB14A 163 JANUARY _______ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14B 164 FEBRUARY ________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14C 165 MARCH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14D 166 APRIL _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (26) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB14E 167 MAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14F 168 JUNE ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14G 169 JULY ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB14H 170 AUGUST ______ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (27) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB14I 171 SEPTEMBER _________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB14J 172 OCTOBER _______ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB14K 173 NOVEMBER ________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB14L 174 DECEMBER ________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB12; OR CODED 1, 7, 8 OR 9 IN HB13. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED GO TO HB19 (28) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HBBOX5 175 TIME 4 = MEDICAID _________________ + = INAPPLICABLE, CODED 1 IN HB12. 1 = YES * 2 = NO * SKIP HB16MO - HB16YR HB16 (176-179) WHEN DID YOUR (MEDICAID/STATE NAME FOR MEDICAID) COVERAGE END? CODER: IF HB16YR EQUALS 97, 98 OR 99, CODE 99 IN HB16MO. HB16MO 176-177 MONTH _____ + = INAPPLICABLE, CODED 1 IN HB12; OR CODED 2 IN HBBOX5. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB16YR 178-179 YEAR ____ + = INAPPLICABLE, CODED 1 IN HB12; OR CODED 2 IN HBBOX5. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB17 180 HAVE YOU (RE-)APPLIED FOR MEDICAID? ____________________________________ + = INAPPLICABLE, CODED 1 IN HB12. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB18 (29) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB18 181 HAVE YOU BEEN TURNED DOWN FOR MEDICAID? ________________________________________ + = INAPPLICABLE, CODED 1 IN HB12; OR CODED 2, 7, 8 OR 9 IN HB17. 1 = YES 2 = NO/ NO DECISION YET 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB19 182 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY MEDICARE? MEDICARE IS A SOCIAL SECURITY HEALTH INSURANCE PROGRAM FOR DISABLED PERSONS AND FOR PERSONS 65 YEARS OLD AND OLDER. ______________________________________________________________________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB21 183 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY ANY OTHER PUBLIC ASSISTANCE PROGRAM (BESIDES MEDICAID/STATE NAME FOR MEDICAID OR MEDICARE) THAT PAYS FOR MEDICAL CARE? __________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HBBOX6 HBBOX6 184 TIME 4 = OTHER PUBLIC ASSISTANCE ________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB21. * 1 = YES ** 2 = NO * SKIP HBBOX7 ** SKIP HBBOX7 - HBBOX8 (30) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HBBOX7 185 TIME 4 = OTHER PUBLIC ASSISTANCE ________________________________ + = INAPPLICABLE, CODED 1 IN HB21. * 1 = YES ** 2 = NO * SKIP HB22 - HB24L ** SKIP HB22 - HB27YR HB22 186 IS THIS THE SAME PUBLIC ASSISTANCE PROGRAM YOU TOLD ME ABOUT LAST TIME? ________________________________________________________________________ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB23 - HB24L HB23 187 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE TIME? ______ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22. * 1 = THE WHOLE TIME 2 = PART OF THE TIME * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB24A - HB27YR HB24 (188-199) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY (OTHER PUBLIC ASSISTANCE PROGRAM) FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS THAT APPLY. CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF AT LEAST ONE ITEM IS CIRCLED CODE 1 FOR EACH CIRCLED ITEM(S). CODE 2 FOR EACH UNCIRCLED ITEM(S). (31) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB24A 188 JANUARY _______ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24B 189 FEBRUARY ________ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24C 190 MARCH _____ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24D 191 APRIL _____ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (32) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB24E 192 MAY ___ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24F 193 JUNE ____ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24G 194 JULY ____ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24H 195 AUGUST ______ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (33) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB24I 196 SEPTEMBER _________ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24J 197 OCTOBER _______ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24K 198 NOVEMBER ________ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HB24L 199 DECEMBER ________ + = INAPPLICABLE, CODED 2 IN HBBOX6; OR CODED IN HBBOX7; OR CODED 2, 7, 8 OR 9 IN HB22; OR CODED 1, 7, 8 OR 9 IN HB23. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED GO TO HBBOX9 (34) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB25 (200-203) (LAST TIME YOU TOLD ME YOU WERE COVERED BY SOME PUBLIC ASSISTANCE PROGRAM.) WHEN DID YOUR COVERAGE UNDER THAT PROGRAM END? CODER: IF HB25YR EQUALS 97, 98 OR 99, CODE 99 IN HB25MO. HB25MO 200-201 MONTH _____ + = INAPPLICABLE, CODED ONLY IF HBBOX7 = 1; OR HB22 = 2, 7, 8 OR 9. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB25YR 202-203 YEAR ____ + = INAPPLICABLE, CODED ONLY IF HBBOX7 = 1; OR HB22 = 2, 7, 8 OR 9. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HBBOX8 204 LOOK AT Q B-21. R ANSWERED: _____________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX7 = 1; OR HB22 = 2, 7, 8 OR 9. 1 = YES * 2 = NO * SKIP HB26 - HB27YR (35) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB26 205-206 WHAT IS THE NAME OF THIS CURRENT PROGRAM? __________________________________________ + = INAPPLICABLE, CODED ONLY IF HBBOX6 = 2; OR HBBOX8 = 1. 70 = DRUG ASSISTANCE PROGRAM 71 = ASSISTANCE FROM PROVIDER-FUNDING UNKNOWN 72 = CITY FUNDED PROGRAM 73 = COUNTY FUNDED PROGRAM 74 = STATE FUNDED PROGRAM 75 = FEDERALLY FUNDED PROGRAM 76 = GOVT PROGRAM, NOS 77 = COMMUNITY PROGRAM -FUNDING UNKNOWN 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB27 (207-210) WHEN DID YOUR COVERAGE UNDER THIS CURRENT PROGRAM BEGIN? CODER: IF HB27YR EQUALS 97, 98 OR 99, CODE 99 IN HB27MO. HB27MO 207-208 MONTH _____ + = INAPPLICABLE, CODED ONLY IF HBBOX6 = 2; OR HBBOX8 = 1. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HB27YR 209-210 YEAR ____ + = INAPPLICABLE, CODED ONLY IF HBBOX6 = 2; OR HBBOX8 = 1. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (36) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HBBOX9 211 TIME 4 - CHAMPUS/CHAMPVA ________________________ 1 = YES * 2 = NO * SKIP HB28 HB28 212 ARE YOU NOW COVERED BY CHAMPUS (WHICH COVERS BOTH ACTIVE DUTY AND RETIRED CAREER MILITARY PERSONNEL, THEIR DEPENDENTS AND SURVIVORS) OR CHAMPVA (WHICH COVERS DISABLED VETERANS, THEIR DEPENDENTS AND SURVIVORS?) ________________________________ + = INAPPLICABLE, CODED 2 IN HBBOX9 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB29 213 ARE YOU CURRENTLY PARTICIPATING IN ANY CLINICAL TRIALS FOR ANY MEDICATIONS? ____________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HB31A1 - HB31B2 HB31 (214-219) HOW LONG HAVE YOU BEEN PARTICIPATING IN THIS/THESE TRIALS? ___________________________________________________________ HB31A (214-216) LENGTH OF TIME IN FIRST TRIAL _____________________________ (37) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB31A1 214-215 LENGTH OF FIRST TRIAL _____________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB29. 01-90 = AMOUNT * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HB31A2 HB31A2 216 UNIT OF TIME 1 ______________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB29; OR CODED 97, 98 OR 99 IN HB31A1. 1 = DAYS 2 = WEEKS 3 = MONTHS 4 = YEARS 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HB31B (217-219) LENGTH OF TIME IN SECOND TRIAL ______________________________ HB31B1 217-218 LENGTH OF SECOND TRIAL ______________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB29; OR ONLY ONE TRIAL. 01-90 = AMOUNT * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HB31B2 (38) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HB31B2 219 UNIT OF TIME 2 ______________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HB29; OR CODED 97, 98 OR 99 IN HB31B1; OR ONLY ONE TRIAL 1 = DAYS 2 = WEEKS 3 = MONTHS 4 = YEARS 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HLTHSTAT (220-251) HEALTH STATUS _____________ HC15 (220-224) IN THE PAST 5 YEARS, HAVE YOU EVER HAD ANY OF THE FOLLOWING SYMPTOMS? (CIRCLE ALL THAT APPLY.) _______ HC15A 220 SWOLLEN GLANDS (LYMPH NODES) ____________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC15B 221 PERSISTENT FEVER ________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (39) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC15C 222 DIARRHEA ________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC15D 223 WEIGHT LOSS (NOT INTENTIONAL) _____________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC15E 224 NONE ____ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16 (225-242) IN THE PAST 5 YEARS HAVE YOU EVER HAD A DOCTOR TELL YOU THAT YOU HAD ANY OF THE FOLLOWING DISEASES OR CONDITIONS? ________________________ HC16A 225 CANDIDIASIS (THRUSH) ____________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (40) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC16B 226 PCP (PNEUMOCYSTIS CARINII PNEUMONIA) ____________________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16C 227 KAPOSI'S SARCOMA (KS) _____________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16D 228 LYMPHOMA ________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16E 229 WASTING SYNDROME ________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16F 230 TB (TUBERCULOSIS) _________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (41) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC16G 231 CRYPTOCOCCOSIS ______________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16H 232 CMV (CYTOMEGALOVIRUS) _____________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16I 233 MAI ___ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16J 234 CRYPTOSPORIDIOSIS _________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16K 235 DEMENTIA ________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (42) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC16L 236 HERPES SIMPLEX CAUSING SORES FOR A MONTH OR MORE IN THE MOUTH OR THROUGHOUT THE BODY ____________________________________________________________________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16M 237 HISTOPLASMOSIS ______________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16N 238 TOXOPLASMOSIS _____________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16O 239 ISOSPORIASIS ____________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16P 240 LEUKOENCEPHALOPATHY ___________________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED (43) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC16Q 241 SALMONELLOSIS _____________ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC16R 242 NONE ____ 1 = YES 2 = NO 7 = REFUSED 8 = DON'T KNOW 9 = NOT ASCERTAINED HC17 243 SINCE (REF. DATE), HAVE YOU HAD A T4 TEST? ____________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HC18 - HC20 HC18 244 WHAT WAS YOUR MOST RECENT T4 COUNT? WAS IT: PROBE: YOUR CD4 COUNT? ______________________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HC17 1 = 0 - 100 2 = 101 - 200 3 = 201 - 300 4 = 301 - 500 5 = GREATER THAN 500 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HC19 (245-250) WHAT WAS THE DATE OF YOUR MOST RECENT T4 TEST? CODER: IF HC19YR EQUALS 97, 98 OR 99, CODE 99 IN HC19MO AND HC19DA. (44) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HC19MO 245-246 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HC17. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HC19DA 247-248 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HC17 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HC19YR 249-250 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HC17 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HC20 251 SINCE (REF. DATE), HAS YOUR T4 COUNT EVER BEEN LESS THAN 200? _______________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HC17 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HIPSTAYS (252-256) INPATIENT HOSPITAL STAYS ________________________ (45) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HD1A 252 SINCE (REF. DATE), HAVE YOU BEEN A PATIENT IN A HOSPITAL OVERNIGHT OR LONGER? _______________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HD1B HD1B 253-254 HOW MANY TIMES HAVE YOU BEEN IN THE HOSPITAL OVERNIGHT OR LONGER SINCE (REF. DATE)? _____________________________________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HD1A. 01-96 = NUMBER OF TIMES 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HD05CT 255-256 NUMBER OF INPATIENT STAY RECORDS ________________________________ 00 = NONE LISTED 01-99 = NUMBER HNURSHOM (257-261) NURSING HOME/RESIDENTIAL CARE STAYS ___________________________________ HE1A 257 HAVE YOU BEEN A PATIENT IN A RESIDENTIAL CARE FACILITY, A NURSING HOME OR HOSPICE OVERNIGHT OR LONGER? _____________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HE1B (46) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HE1B 258-259 HOW MANY TIMES HAVE YOU BEEN IN A RESIDENTIAL CARE FACILITY, NURSING HOME OR HOSPICE OVERNIGHT OR LONGER SINGE (REF DATE)? ______________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HE1A. 01-96 = NUMBER OF TIMES 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HE07CT 260-261 NUMBER OF NURSING HOME/RESIDENTIAL CARE RECORDS _______________________________________________ 00 = NONE LISTED 01-99 = NUMBER HMEDVIST (262-281) MEDICAL VISITS ______________ HF1 262 SINCE (REF. DATE), DID YOU GO TO A HOSPITAL EMERGENCY ROOM FOR MEDICAL CARE? INCLUDE ANY VISITS TO THE EMERGENCY ROOM, (EVEN IF YOU WERE ADMITTED TO THE HOSPITAL FROM THERE). __________________________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HF1A HF1A 263-264 HOW MANY DIFFERENT EMERGENCY ROOMS DID YOU VISIT SINCE (REF. DATE)? _____________________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HF1. 01-96 = NUMBER OF EMERGENCY ROOMS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HF09CT 265-266 NUMBER OF EMERGENCY ROOM RECORDS ________________________________ 00 = NONE LISTED 01-99 = NUMBER (47) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HF2 267 DID YOU GO TO A HOSPITAL CLINIC OR HOSPITAL OUT-PATIENT DEPARTMENT FOR MEDICAL CARE? THESE VISITS COULD INCLUDE AN AEROSOL PENTAMIDINE CLINIC, AN EYE CLINIC, A LABORATORY WHERE THEY MIGHT CONDUCT BLOOD TESTS, OR A THERAPIST WHO WORKS IN A HOSPITAL. ______________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HF2A HF2A 268-269 HOW MANY DIFFERENT HOSPITAL CLINICS AND-OR HOSPITAL OUT-PATIENT DEPARTMENTS DID YOU VISIT SINCE (REF. DATE)? ____________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HF2. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HF10CT 270-271 NUMBER OF HOSPITAL CLINIC RECORDS _________________________________ 00 = NONE LISTED 01-99 = NUMBER HF3 272 HAVE YOU BEEN TO ANY OTHER MEDICAL CLINIC, FOR EXAMPLE, A COMMUNITY CLINIC OR A NEIGHBORHOOD HEALTH CENTER? THESE VISITS COULD INCLUDE BLOOD TESTS, OR OTHER LAB WORK, OR SCANS LIKE MRI'S OR X-RAY PROCEDURES. _________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HF3A (48) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HF3A 273-274 HOW MANY DIFFERENT MEDICAL CLINICS DID YOU VISIT SINCE (REF. DATE)? _____________________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HF3. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HF11CT 275-276 NUMBER OF MEDICAL CLINIC RECORDS ________________________________ 00 = NONE LISTED 01-99 = NUMBER HF4 277 HAVE YOU BEEN TO A PRIVATE DOCTOR'S OFFICE FOR MEDICAL CARE? THESE VISITS COULD ALSO INCLUDE BLOOD TESTS, OTHER LAB WORK, OR SCANS LIKE MRI'S OR X-RAY PROCEDURES. ______________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HF4A HF4A 278-279 HOW MANY DIFFERENT PRIVATE DOCTOR'S OFFICES DID YOU VISIT SINCE (REF. DATE)? ______________________________________________________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HF4. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HF12CT 280-281 NUMBER OF PRIVATE DOCTOR'S OFFICE RECORDS _________________________________________ 00 = NONE LISTED 01-99 = NUMBER HOTHPROV (282-299) OTHER HEALTH CARE PROVIDERS ___________________________ (49) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HG1 282 SINCE (REF. DATE), HAVE YOU ATTENDED A SUPPORT GROUP, OR RECEIVED ANY PSYCHOLOGICAL COUNSELING OR THERAPY? PLEASE DO NOT INCLUDE TREATMENT RECEIVED FOR PROBLEMS RELATED TO DRUG OR ALCOHOL USE. _____________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HG1A HG1A 283-284 HOW MANY DIFFERENT SUPPORT GROUPS OR PSYCHOLOGICAL COUNSELORS DID YOU VISIT SINCE (REF. DATE)? _______ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HG1. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HG13CT 285-286 NUMBER OF MENTAL HEALTH PROVIDER RECORDS ________________________________________ 00 = NONE LISTED 01-99 = NUMBER HG2 287 HAVE YOU RECEIVED CARE FROM ANY MEDICAL PRACTICIONERS SUCH AS OPTOMETRISTS, FOOT DOCTORS, OR CHIROPRACTORS? __________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HG2A (50) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HG2A 288-289 YOU TOLD ME YOU USED THE SERVICES OF A (PROVIDER). HOW MANY DIFFERENT (PROVIDERS) DID YOU VISIT SINCE (REF. DATE)? ______________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HG2. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HG14CT 290-291 NUMBER OF MEDICAL PRACTITIONER RECORDS ______________________________________ 00 = NONE LISTED 01-99 = NUMBER HG3 292 HAVE YOU RECEIVED TREATMENT FROM ANY ALTERNATIVE THERAPIST, A PRACTICIONER OF HOLISTIC MEDICINE, A NUTRITIONIST, OR ANY OTHER ALTERNATIVE THERAPY LIKE BIOFEEDBACK? _____________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HG3A HG3A 293-294 YOU TOLD ME YOU USED THE SERVICES OF A (PROVIDER). HOW MANY DIFFERENT (PROVIDERS) DID YOU VISIT SINCE (REF. DATE)? ______________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HG3. 01-96 = NUMBER OF PROVIDERS 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HG15CT 295-296 NUMBER OF ALTERNATIVE THERAPIST RECORDS _______________________________________ 00 = NONE LISTED 01-99 = NUMBER (51) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HG4 297 SINCE (REF. DATE), DID YOU BUY OR REPLACE ANY SPECIAL MEDICAL EQUIPMENT LIKE EYEGLASSES, A CANE OR A NEBULIZER? _______________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HG16CT 298-299 NUMBER OF MEDICAL EQUIPMENT PROVIDER RECORDS ____________________________________________ 00 = NONE LISTED 01-99 = NUMBER HHOMHLTH (300-303) HOME HEALTH CARE ________________ HH1 300 SOMETIMES WHEN PEOPLE ARE ILL, THEY NEED TO RECEIVE HELP AT HOME. THIS HELP COULD BE FOR MEDICAL PROBLEMS, FOR HELP WITH PERSONAL CARE OR HOUSEKEEPING, OR FOR OTHER SERVICES THEY MIGHT NEED. PLEASE LOOK AT THIS CARD. SINCE (REF. DATE), HAVE YOU RECEIVED ANY OF THESE KINDS OF SERVICES AT HOME? _________________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HH2 301 HAVE YOU RECEIVED HELP AT HOME BY ANY OTHER PEOPLE NOT SHOWN ON THE CARD? (SPECIFY THE PROVIDER TYPE IN COLUMN A.) ___________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (52) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HH18CT 302-303 NUMBER OF HOME HEALTH CARE PROVIDER RECORDS ___________________________________________ 00 = NONE LISTED 01-99 = NUMBER H_NONMED (304-324) NON - MEDICAL SERVICES ______________________ HI1 304 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH FINDING OR KEEPING A PLACE TO LIVE? ____________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI20CT 305-306 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH HOUSING ____________________________________________________ 00 = NONE 01-99 = NUMBER HI2 307 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH LEGAL SERVICES? __________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI21CT 308-309 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH LEGAL SERVICES ___________________________________________________________ 00 = NONE 01-99 = NUMBER (53) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HI3 310 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH CHILD CARE? ______ 1 = YES 2 = NO 3 = NO CHILDREN 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI22CT 311-312 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH CHILD CARE _______________________________________________________ 00 = NONE 01-99 = NUMBER HI4 313 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH TRANSPORTATION? ________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI23CT 314-315 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH TRANSPORTATION ___________________________________________________________ 00 = NONE 01-99 = NUMBER HI5 316 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH OBTAINING FOOD EITHER GROCERIES YOU WERE GIVEN OR MEALS YOU WERE SERVED OUTSIDE YOUR HOME? ______ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (54) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HI24CT 317-318 NUMBER OF RECORDS FOR PROVIDERS HELPING OBTAIN FOOD ___________________________________________________ 00 = NONE 01-99 = NUMBER HI6 319 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH FINANCIAL ASSISTANCE? ______________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI25CT 320-321 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH FINANCIAL ASSISTANCE _________________________________________________________________ 00 = NONE 01-99 = NUMBER HI7 322 ARE YOU CURRENTLY RECEIVING TREATMENT OR COUNSELING FOR PROBLEMS RELATED TO ALCOHOL OR DRUG USE? __________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HI26CT 323-324 NUMBER OF RECORDS FOR ALCOHOL/DRUG TREATMENT PROVIDERS ______________________________________________________ 00 = NONE 01-99 = NUMBER HDNTLSRV (325-329) DENTAL SERVICES _______________ (55) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HJ1 325 SINCE (REF. DATE), HAVE YOU SEEN A DENTIST, ORAL SURGEON, OR OTHER PROFESSIONAL DENTAL CARE PROVIDER? _______________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HJ1A HJ1A 326-327 SINCE (REF. DATE), HOW MANY TIMES HAVE YOU SEEN A DENTIST, ORAL SURGEON, OR OTHER PROFESSIONAL DENTAL CARE PROVIDER? ___________________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HJ1. 01-95 = NUMBER 97 = REFUSED 98 = DON'T KNOW 99 = NOT ASCERTAINED HJ28CT 328-329 NUMBER OF DENTAL VISIT RECORDS ______________________________ 00 = NONE 01-99 = NUMBER HWMNHLTH (330-378) WOMEN'S HEALTH CARE ___________________ HKSEX 330-331 SEX OF PATIENT (MALE OR FEMALE) _______________________________ * 1 = MALE 2 = FEMALE * SKIP HK1A - HK8B HK1 (332-338) SINCE (REF. DATE), HAS A DOCTOR EVER TOLD YOU THAT YOU HAD ... ________________________________________________________________ (56) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK1A 332 A SEXUALLY TRANSMITTED DISEASE, AN STD, LIKE SYPHILIS, CHANCROID OR GONORRHEA? _______________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK1B 333 CHRONIC VAGINITIS? ___________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK1C 334 PID, PELVIC INFLAMMATORY DISEASE? __________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK1D 335 HERPES SIMPLEX ______________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (57) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK1E 336 VAGINAL CANDIDIASIS OR A "YEAST INFECTION"? ____________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK1F 337 HPV, HUMAN PAPILLOMAVIRUS? ___________________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK1G 338 AN ABNORMAL PAP TEST ____________________ + = INAPPLICABLE, CODED 1 IN HKSEX. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK2 339 ARE YOU PREGNANT NOW? ______________________ + = INAPPLICABLE, CODED 1 IN HKSEX. * 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED * SKIP HK3 (58) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK3 340 SINCE (REF. DATE),HAVE YOU BEEN PREGNANT? ___________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2. * 1 = YES ** 2 = NO ** 7 = REFUSED ** 8 = DK ** 9 = NOT ASCERTAINED * SKIP HK4A - HK8A ** SKIP HK4A - HK8B HK4A 341 ARE YOU CURRENTLY RECEIVING PRENATAL CARE? ___________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HK5APROV - HK7A HK5APROV 342-348 PROVIDER ID ___________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 0000001- 9999996 = RANDOMLY ASSIGNED SEUQENTIAL NUMBER 9999997 = REFUSED 9999998 = DK 9999999 = NOT ASCERTAINED HK6A (349-356) HOW IS THIS CARE PAID FOR? CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF ONE IS CIRCLED CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). (59) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK6AA 349 MEDICAID ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6AB 350 OTHER PUBLIC ASSISTANCE _______________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6AC 351 PRIVATE INSURANCE _________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6AD 352 MEDICARE ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (60) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK6AE 353 SELF PAY ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6AF 354 OTHER _____ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = CIRCLED * 2 = NOT CIRCLED * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HK6AFOS HK6AFOS 355-356 OTHER SPECIFIED _______________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A, OR CODED 2, 7, 8 OR 9 IN HK6AF. 01 = RESEARCH STUDY 03 = FLAT FEE 05 = GAY AIDS TASK FORCE/AIDS NETWORK 14 = FAMILY/FRIEND 29 = COMMUNITY HEALTH PROJECT 46 = PROVIDER 47 = PRIVATE CHARITY/GRANT FROM AIDS FOUNDATION 50 = DRUG COMPANY 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (61) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK7A 357 DURING YOUR CARE ARE YOU BEING GIVEN ANY SPECIAL COUNSELING RELATING TO YOUR HIV INFECTION? ___________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK4A. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK8A 358-359 WHAT KINDS OF PROBLEMS ARE YOU FACING IN RECEIVING PRE-NATAL CARE? RECORD VERBATIM. _____________________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 2, 7, 8 OR 9 IN HK2; * 01 = NO PROBLEMS * 02 = DIDN'T WANT TO GO FOR CARE * 03 = NONE BECAUSE TERMINATED PREGNANCY OR ABORTION * 04 = HAD MISCARRIAGE * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HK4B - HK8B HK4B 360 DID YOU RECEIVE PRENATAL CARE? _______________________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HK5BPROV - HK7B (62) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK5BPROV 361-367 PROVIDER ID ___________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 0000001- 9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER 9999997 = REFUSED 9999998 = DK 9999999 = NOT ASCERTAINED HK6B (368-375) HOW WAS THIS CARE PAID FOR? CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF ONE IS CIRCLED CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). HK6BA 368 MEDICAID ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6BB 369 OTHER PUBLIC ASSISTANCE _______________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (63) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK6BC 370 PRIVATE INSURANCE _________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6BD 371 MEDICARE ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6BE 372 SELF PAY ________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK6BF 373 OTHER _____ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = CIRCLED * 2 = NOT CIRCLED * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HK6BFOS (64) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HK6BFOS 374-375 OTHER SPECIFIED _______________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B; OR CODED 2, 7, 8 OR 9 IN HK6BF. 01 = RESEARCH STUDY 03 = FLAT FEE 05 = GAY AIDS TASK FORCE/AIDS NETWORK 14 = FAMILY/FRIEND 29 = COMMUNITY HEALTH PROJECT 46 = PROVIDER 47 = PRIVATE CHARITY/GRANT FROM AIDS FOUNDATION 50 = DRUG COMPANY 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HK7B 376 DURING YOUR CARE WERE YOU BEING GIVEN ANY SPECIAL COUNSELING RELATING TO YOUR HIV INFECTION? ___________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3; OR CODED 2, 7, 8 OR 9 IN HK4B. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HK8B 377-378 WHAT KINDS OF PROBLEMS DID YOU FACE IN RECEIVING PRE-NATAL CARE? RECORD VERBATIM. ___________________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HKSEX; OR CODED 1 IN HK2; OR CODED 2, 7, 8 OR 9 IN HK3. 01 = NO PROBLEMS 02 = DIDN'T WANT TO GO FOR CARE 03 = NONE BECAUSE TERMINATED PREGNANCY OR ABORTION 04 = HAD MISCARRIAGE 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HDRGSECT (379-463) HIV - RELATED MEDICINES _______________________ (65) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL1 379 SINCE (REF. DATE), HAVE YOU TAKEN ANY OF THE MEDICINES OR DRUGS LISTED ON THIS CARD? (RECORD NAMES IN COLUMN A.) ___________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HL2 380 SINCE (REF. DATE), HAVE YOU TAKEN ANY OTHER PRESCRIPTION MEDICINES OR DRUGS? IF YES TO L-2 OR L-3, RECORD NAMES IN COLUMN A. IF NAME IS UNKNOWN, PROBE FOR CONDITION AND RECORD IN COLUMN A. IF MEDICINE NAME OR CONDITION IS UNKNOWN, PROBE FOR DRUG PROVIDER NAME AND ADDRESS. ASK B THROUGH I FOR EACH DRUG LISTED BEFORE MOVING TO NEXT DRUG. ___________________________________________________________________________ 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HL31CT 381-382 NUMBER OF PRESCRIPTION DRUG RECORDS ___________________________________ 00 = NONE LISTED 01-99 = NUMBER HL3 383 SINCE (REF. DATE), HAVE YOU TAKEN ANY NON-PRESCRIPTION MEDICINES OR DRUGS OR ANY NON -TRADITIONAL SUBSTANCES TO HELP DEAL WITH HIV/AIDS RELATED ILLNESSES? ______________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HL4A - HL5 HL4CT 384-385 NUMBER OF NON-PRESCRIPTION DRUGS/NON-TRADITIONAL SUBSTANCES LISTED IN Q L-4 ___________________________________________________________________________ * 00 = NO DRUGS LISTED 01-99 = NUMBER OF DRUGS LISTED * SKIP HL4A - HL5 (66) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4 (386-457) WHAT ARE THE NAMES OF THE NON-PRESCRIPTION DRUGS OR NON-TRADITIONAL SUBSTANCES THAT YOU ARE TAKING? ____________ HL4A 386-388 NON - PRESCRIPTION DRUG 1 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4B 389-391 NON - PRESCRIPTION DRUG 2 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4C 392-394 NON - PRESCRIPTION DRUG 3 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4D 395-397 NON - PRESCRIPTION DRUG 4 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (67) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4E 398-400 NON - PRESCRIPTION DRUG 5 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4F 401-403 NON - PRESCRIPTION DRUG 6 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4G 404-406 NON - PRESCRIPTION DRUG 7 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4H 407-409 NON - PRESCRIPTION DRUG 8 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = NON - PRESCRIPTION DRUG CODES 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (68) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4I 410-412 NON - PRESCRIPTION DRUG 9 _________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4J 413-415 NON - PRESCRIPTION DRUG 10 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4K 416-418 NON - PRESCRIPTION DRUG 11 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4L 419-421 NON - PRESCRIPTION DRUG 12 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (69) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4M 422-424 NON - PRESCRIPTION DRUG 13 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4N 425-427 NON - PRESCRIPTION DRUG 14 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4O 428-430 NON - PRESCRIPTION DRUG 15 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4P 431-433 NON - PRESCRIPTION DRUG 16 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (70) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4Q 434-436 NON - PRESCRIPTION DRUG 17 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4R 437-439 NON - PRESCRIPTION DRUG 18 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4S 440-442 NON - PRESCRIPTION DRUG 19 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4T 443-445 NON - PRESCRIPTION DRUG 20 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (71) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL4U 446-448 NON - PRESCRIPTION DRUG 21 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4V 449-451 NON - PRESCRIPTION DRUG 22 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4W 452-454 NON - PRESCRIPTION DRUG 23 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HL4X 455-457 NON - PRESCRIPTION DRUG 24 __________________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3, AND CODED 00 IN HL4CT, OR NO OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED. 001-720 = USE CODES IN APPENDIX 28 991 = OTHER SPECIFIED 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED (72) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HL5 458-463 WE'RE INTERESTED IN THE TOTAL AMOUNT YOU SPENT ON (MEDICINE). HOW MUCH DID YOU PAY FOR (MEDICINES IN Q L-4) SINCE (REF. DATE)? CODER: CODE AMOUNTS IN WHOLE DOLLARS. + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HL3. 000000 = NOTHING 000001-999996 = AMOUNT 999997 = REFUSED 999998 = DK 999999 = NOT ASCERTAINED HEMPLYMT (464-559) EMPLOYMENT AND INCOME _____________________ HM1 464 ARE YOU CURRENTLY WORKING FULL-TIME, PART-TIME, OR ARE YOU CURRENTLY NOT WORKING? __________________________________________________________________________________ * 1 = FULL - TIME 2 = PART - TIME ** 3 = NOT WORKING ** 7 = REFUSED ** 8 = DK ** 9 = NOT ASCERTAINED * SKIP HMBOX1 - HMBOX2 ** SKIP HMBOX1 HMBOX1 465 R CURRENTLY WORKING PART-TIME. LOOK AT FACE SHEETS. LAST TIME R WAS: _______________________________________________________________________ + = INAPPLICABLE, CODED 1, 3, 7, 8 OR 9 IN HM1 * 1 = WORKING FULL TIME (FT) ** 2 = WORKING PART -TIME (PT) ** 3 = NOT WORKING (NW) * SKIP HMBOX2 - HM6 ** SKIP HMBOX2 - HM15 (73) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HMBOX2 466 R CURRENTLY NOT WORKING. LOOK AT FACE SHEETS. LAST TIME R WAS: _________________________________________________________________ + = INAPPLICABLE, CODED 1 OR 2 IN HM1. * 1 = WORKING FULL TIME (FT) * 2 = WORKING PART -TIME (PT) ** 3 = NOT WORKING (NW) * SKIP HM2 - HM21 ** SKIP HM2 - HM27 HM2 467-469 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK? ____________________________________________________________________________ + = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN HM1. 001-050 = HOURS PER WEEK 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HM304 470-473 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT THIS JOB? CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION, 1983. + = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN HM1. 0001-9990 = 1983 CENSUS OCCUPATIONAL CODES 9994 = UNCODEABLE 9997 = REFUSED 9998 = DK 9999 = NOT ASCERTAINED (74) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM4A 474 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK? WOULD YOU SAY IT WAS: ______________________ + = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN HM1. 1 = LESS THAN 25 PEOPLE 2 = 25 - 99 PEOPLE 3 = 100 - 499 PEOPLE 4 = 500 OR MORE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM5 475 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS? _________________________ + = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN HM1. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM6 - HM30 HM6 476-477 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM. _______________________________________________________ + = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN HM1; OR CODED 2, 7, 8 OR 9 IN HM5. * 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS * 02 = CAN'T DO WHAT I USED TO DO * 03 = CHANGED TYPE/AMOUNT OF WORK * 91 = OTHER SPECIFIED * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM7 - HM30 (75) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM7 478-480 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK? ____________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 001-050 = HOURS PER WEEK 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HM8O9 481-484 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT THIS JOB? CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION, 1983. + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 0001-9990 = 1983 CENSUS OCCUPATIONAL CODES 9994 = UNCODEABLE 9997 = REFUSED 9998 = DK 9999 = NOT ASCERTAINED HM9A 485 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK? WOULD YOU SAY IT WAS: ______________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = LESS THAN 25 PEOPLE 2 = 25 - 99 PEOPLE 3 = 100 - 499 PEOPLE 4 = 500 OR MORE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (76) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM10 486 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK? _______________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM11 487-488 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER REASON? ________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 01 = LEAVE OF ABSENCE/DISABILITY LEAVE 02 = QUIT 03 = LAID OFF 04 = FIRED 05 = TOO ILL 06 = PREGNANCY 07 = ARRESTED/IN PRISON 08 = RETIRED 09 = KEPT SAME JOB CHANGED TO PT 10 = MOVED/LEFT AREA 11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD 12 = WENT TO SCHOOL 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM12 489 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED? _________________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (77) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM13 (490-493) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT (FULL TIME) JOB? CODER: IF HM13YR EQUALS 97, 98 OR 99, CODE 99 IN HM13MO. CODE 99 IN HM13MO. HM13MO 490-491 MONTH THAT LEAVE BEGAN ______________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM13YR 492-493 YEAR THAT LEAVE BEGAN _____________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM14 494 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS? _________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM15 - HM30 (78) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM15 495-496 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM. _______________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 2 OR 3 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2; OR CODED 2, 7, 8 OR 9 IN HM14. * 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS * 02 = CAN'T DO WHAT I USED TO DO * 03 = CHANGED TYPE/AMOUNT OF WORK * 91 = OTHER SPECIFIED * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM16 - HM30 HM16 497-499 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK? ____________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 001-050 = HOURS PER WEEK 997 = REFUSED 998 = DK 999 = NOT ASCERTAINED HM17O18 500-503 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT THIS JOB? CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION, 1983. + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 0001-9990 = 1983 CENSUS OCCUPATIONAL CODES 9994 = UNCODEABLE 9997 = REFUSED 9998 = DK 9999 = NOT ASCERTAINED (79) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM18A 504 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK? WOULD YOU SAY IT WAS: ______________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = LESS THAN 25 PEOPLE 2 = 25 - 99 PEOPLE 3 = 100 - 499 PEOPLE 4 = 500 OR MORE 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM19 505 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK? _____________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM20 506 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS? _________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM21 - HM30 (80) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM21 507-508 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM. _______________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1 IN HMBOX1; OR CODED 1, 2 OR 3 IN HMBOX2. OR CODED 2, 7, 8 OR 9 IN HM20. * 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS * 02 = CAN'T DO WHAT I USED TO DO * 03 = CHANGED TYPE/AMOUNT OF WORK * 91 = OTHER SPECIFIED * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM22 - HM30 HM22 509 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK? _______________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM23 510-511 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER REASON? ________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 01 = LEAVE OF ABSENCE/DISABILITY LEAVE 02 = QUIT 03 = LAID OFF 04 = FIRED 05 = TOO ILL 06 = PREGNANCY 07 = ARRESTED/IN PRISON 08 = RETIRED 09 = KEPT SAME JOB CHANGED TO PT 10 = MOVED/LEFT AREA 11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD 12 = WENT TO SCHOOL 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (81) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM24 512 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED? _________________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 1 = YES 2 = NO 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HM25 (513-516) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT JOB? CODER: IF HM25YR EQUALS 97, 98 OR 99, CODE 99 IN HM25MO. CODE 99 IN HM25MO. HM25MO 513-514 MONTH THAT LEAVE BEGAN ______________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM25YR 515-516 YEAR THAT LEAVE BEGAN _____________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (82) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM26 517 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS? _________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM27 - HM30 HM27 518-519 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM. _______________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2, OR 3 IN HMBOX1; OR CODED 3 IN HMBOX2; OR CODED 2, 7, 8 OR 9 IN HM26. * 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS * 02 = CAN'T DO WHAT I USED TO DO * 03 = CHANGED TYPE/AMOUNT OF WORK * 91 = OTHER SPECIFIED * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM28 - HM30 HM28 520 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK? _____________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2 OR 3 IN HMBOX1; OR CODED 1 OR 2 IN HMBOX2. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM29 - HM30 (83) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM29 521 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS? _________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2 OR 3 IN HMBOX1; OR CODED 1 OR 2 IN HMBOX2; OR CODED 2, 7, 8 OR 9 IN HM28. 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM30 HM30 522-523 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM. _______________________________________________________ + = INAPPLICABLE, CODED 1 IN HM1; OR CODED 1, 2 OR 3 IN HMBOX1; OR CODED 1 OR 2 IN HMBOX2; OR CODED 2, 7, 8 OR 9 IN HM28; OR CODED 2, 7, 8 OR 9 IN HM29. 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS 02 = CAN'T DO WHAT I USED TO DO 03 = CHANGED TYPE/AMOUNT OF WORK 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (84) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM31 524-525 WOULD YOU PLEASE LOOK AT THIS CARD AND TELL ME WHICH NUMBER REPRESENTS YOUR TOTAL INCOME BEFORE TAXES FOR THE PAST MONTH. INCLUDE INCOME FROM ALL SOURCES: YOUR SALARIES, WAGES, SOCIAL SECURITY, WELFARE AND ANY OTHER INCOME. IF YOU SHARE OR RECEIVE INCOME FROM A SPOUSE/PARTNER, PLEASE INCLUDE IT IN HERE. CIRCLE ONE CODE. _____________________________________________________________ 01 = $ 0 -200/MO 02 = $ 201 -350/MO 03 = $ 351 -500/MO 04 = $ 501 -750/MO 05 = $ 751 -900/MO 06 = $ 901 -1,150/MO 07 = $ 1,151 -1,300/MO 08 = $ 1,301 -1,450/MO 09 = $ 1,451 -1,600/MO 10 = $ 1,601 -1,750/MO 11 = $ 1,751 -2000/MO 12 = $ 2,001 -3000/MO 13 = $ 3,001 -4,000/MO 14 = $ 4,001 OR MORE/MO 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HMBOX3 526 R WORKING FULL TIME (Q.O-1) ___________________________ * 1 = YES 2 = NO * SKIP HM32 - HM41YR HM32 527 SINCE (REF. DATE), HAVE YOU RECEIVED ANY SOCIAL SECURITY DISABILITY PAYMENTS? _______________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM33MO - HM33BX HM33 (528-532) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SOCIAL SECURITY DISABILITY PAYMENT? ______________________________________________________________________________________ (85) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM33DT (528-531) DATE YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT CODER: IF HM33YR EQUALS 97, 98 OR 99, CODE 99 IN HM33MO. HM33MO 528-529 MONTH YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT ___________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM32 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM33YR 530-531 YEAR YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT __________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM32 * 92 = YEAR * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM33BX - HM35 HM33BX 532 FIRST SOCIAL SECURITY DISABILITY PAYMENT BEFORE REF. DATE BOX ______________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM32, OR CODED IN HM33YR * 1 = CHECKED * SKIP HM34 - HM35 HM34 533 HAVE YOU APPLIED FOR SOCIAL SECURITY DISABILITY PAYMENTS? __________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED IN HM33YR, OR CODED IN HM33BX 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM35 (86) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM35 534 HAVE YOU BEEN TURNED DOWN FOR SOCIAL SECURITY DISABILITY? __________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED IN HM33YR, OR CODED IN HM33BX, OR CODED 2, 7, 8 OR 9 IN HM34 1 = YES 2 = NO/NO DECISION YET 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED HMBOX4 535 R HAS: CHILDREN (SEE FLAP) ___________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3. * 1 = NO CHILDREN LIVING WITH THEM (SEE FLAP) 2 = 1 OR MORE CHILDREN LIVING WITH THEM (SEE FLAP) * SKIP HM36 - HM37BX HM36 536 SINCE (REF. DATE), HAVE YOU RECEIVED ASSISTANCE THROUGH THE AID TO FAMILIES WITH DEPENDENT CHILDREN PROGRAM, SOMETIMES CALLED AFDC OR ADC? __________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 1 IN HMBOX4 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM37MO - HM37BX HM37 (537-541) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST AFDC PAYMENT? ________________________________________________________________ HM37DT (537-540) DATE YOU RECEIVED YOUR FIRST AFDC PAYMENT CODER: IF HM37YR EQUALS 97, 98 OR 99, CODE 99 IN HM37MO. CODE 99 IN HM37MO. (87) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM37MO 537-538 MONTH YOU RECEIVED YOUR FIRST AFDC PAYMENT. ____________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 1 IN HMBOX4, OR CODED 2, 7, 8 OR 9 IN HM36; OR CODED IN HM37BX. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM37YR 539-540 YEAR YOU RECEIVED YOUR FIRST AFDC PAYMENT _________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 1 IN HMBOX4, OR CODED 2, 7, 8 OR 9 IN HM36; OR CODED IN HM37BX. * 92 = YEAR * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM37BX HM37BX 541 FIRST AFDC PAYMENT BEFORE REF. DATE BOX ________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 1 IN HMBOX4, OR CODED 2, 7, 8 OR 9 IN HM36, OR CODED IN HM37DT. 1 = CHECKED HM38 542 SINCE (REF. DATE), HAVE YOU RECEIVED THE SUPPLEMENTAL SECURITY INCOME OR SSI CHECK? _____________________________________________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM39MO - HM39BX HM39 (543-547) IN WHAT MONTH DID YOU RECEIVE YOUR FIRST SSI PAYMENT? ______________________________________________________ (88) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM39DT (543-546) DATE YOU RECEIVED YOUR FIRST SSI PAYMENT? CODER: IF HM39YR EQUALS 97, 98 OR 99, CODE 99 IN HM39MO. CODE 99 IN HM39MO HM39MO 543-544 MONTH YOU RECEIVED YOUR FIRST SSI PAYMENT _________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM38; OR CODED IN HM39BX. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM39YR 545-546 YEAR YOU RECEIVED YOUR FIRST SSI PAYMENT ________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM38; OR CODED IN HM39BX. * 92 = YEAR * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HM39BX HM39BX 547 FIRST SSI PAYMENT BEFORE REF. DATE BOX _______________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED IN HM39DT. 1 = CHECKED HM40 548 SINCE (REF. DATE), HAVE YOU RECEIVED FOOD STAMPS? ___________________________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM41MO - HM41YR (89) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM41 (549-552) IN WHAT MONTH DID YOU FIRST RECEIVE FOOD STAMPS? CODER: IF HM41YR EQUALS 97, 98 OR 99, CODE 99 IN HM41MO. HM41MO 549-550 MONTH YOU FIRST RECEIVED FOOD STAMPS ____________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM40 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM41YR 551-552 YEAR YOU FIRST RECEIVED FOOD STAMPS ___________________________________ + = INAPPLICABLE, CODED 1 IN HMBOX3, OR CODED 2, 7, 8 OR 9 IN HM40 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HM42 553 SINCE (REF. DATE), HAVE YOU REGULARLY RECEIVED FINANCIAL SUPPORT, LIKE MONEY TO PAY BILLS OR FOR FOOD OR RENT, FROM YOUR PARENTS, FRIENDS OR FAMILY MEMBERS? _________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HM43 (90) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HM43 554-559 HOW MUCH HAVE YOU RECEIVED SINCE (REF. DATE)? CODER: CODE AMOUNTS IN WHOLE DOLLARS + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HM42 000001-999996 = AMOUNT RECEIVED 999997 = REFUSED 999998 = DK 999999 = NOT ASCERTAINED HTIMEGAP (560-637) TIME GAPS _________ HN1 560 SINCE (REF. DATE), HAVE YOU BEEN OUT OF THE UNITED STATES FOR A PERIOD OF TWO WEEKS OR LONGER? ________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HN2 - HN3R3YR HN2 561-562 HOW MANY DIFFERENT TIMES HAVE YOU BEEN OUT OF THE UNITED STATES FOR TWO WEEKS OR LONGER SINCE (REF. DATE)? ____________________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 01-95 = NUMBER * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HN3L1MO - HN3R3YR HN3 (563-598) WHAT WAS THE DATE YOU LEFT THE UNITED STATES THE (FIRST/NEXT) TIME? WHAT WAS THE DATE YOU RETURNED TO THE UNITED STATES THE (FIRST/NEXT) TIME? CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY". (91) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ TRIP1 (563-574) FIRST TRIP __________ HN3L1MO 563-564 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3L1DY 565-566 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3L1YR 567-568 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R1MO 569-570 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 01-12 = MONTH 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (92) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN3R1DY 571-572 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 01-31 = DAY 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R1YR 573-574 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3. 92 = YEAR 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED TRIP2 (575-586) SECOND TRIP ___________ HN3L2MO 575-576 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3L2DY 577-578 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (93) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN3L2YR 579-580 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R2MO 581-582 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-12 = MONTH 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R2DY 583-584 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-31 = DAY 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R2YR 585-586 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 92 = YEAR 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED TRIP3 (587-598) THIRD TRIP __________ (94) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN3L3MO 587-588 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3L3DY 589-590 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3L3YR 591-592 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R3MO 593-594 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-12 = MONTH 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (95) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN3R3DY 595-596 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 01-31 = DAY 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN3R3YR 597-598 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN1; OR CODED 97, 98 OR 99 IN HN3; OR NO OTHER TRIPS LISTED. 92 = YEAR 95 = STILL OUTSIDE OF U.S 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN4 599 SINCE (REF. DATE), HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS OR LONGER? _____________________________________________________________________________ 1 = YES * 2 = NO * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP HN5 - HN6EX3YR HN5 600-601 HOW MANY DIFFERENT TIMES HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS OR LONGER SINCE (REF. DATE)? ______________ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 01-95 = NUMBER * 97 = REFUSED * 98 = DK * 99 = NOT ASCERTAINED * SKIP HN6EN1MO - HN6EX3YR (96) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN6 (602-637) WHAT WAS THE DATE YOU (FIRST/NEXT) TIME? WHAT WAS THE DATE YOU WERE RELEASED FROM JAIL OR PRISON THE (FIRST/NEXT) TIME? CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY". PRISON1 (602-613) FIRST PRISON TERM _________________ HN6EN1MO 602-603 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EN1DY 604-605 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EN1YR 606-607 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (97) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN6EX1MO 608-609 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 01-12 = MONTH 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX1DY 610-611 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 01-31 = DAY 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX1YR 612-613 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5. 92 = YEAR 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED PRISON2 (614-625) SECOND PRISON TERM __________________ HN6EN2MO 614-615 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (98) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN6EN2DY 616-617 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EN2YR 618-619 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX2MO 620-621 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-12 = MONTH 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX2DY 622-623 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-31 = DAY 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (99) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN6EX2YR 624-625 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 92 = YEAR 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED PRISON3 (626-637) THIRD PRISON TERM _________________ HN6EN3MO 626-627 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO THER PRISON TERMS LISTED. 01-12 = MONTH 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EN3DY 628-629 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-31 = DAY 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EN3YR 630-631 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 92 = YEAR 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (100) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HN6EX3MO 632-633 MONTH _____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-12 = MONTH 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX3DY 634-635 DAY ___ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 01-31 = DAY 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HN6EX3YR 636-637 YEAR ____ + = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN HN4; OR CODED 97, 98 OR 99 IN HN5; OR NO OTHER PRISON TERMS LISTED. 92 = YEAR 95 = STILL IN PRISON 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED HINTOBS (638-649) INTERVIEWER OBSERVATIONS ________________________ (101) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HP1 638 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S TRUTHFULNESS. __________________________________________________________________ * 1 = VERY CONFIDENT * 2 = CONFIDENT 3 = UNSURE 4 = DOUBTFUL 5 = VERY DOUBTFUL * 8 = DK * 9 = NOT ASCERTAINED * SKIP HP2 HP2 639-640 WHY? _____ + = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN HP1 91 = FLAG FOR QUESTION ANSWERED 98 = DK 99 = NOT ASCERTAINED HP3 641 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S ACCURACY. ______________________________________________________________ * 1 = VERY CONFIDENT * 2 = CONFIDENT 3 = UNSURE 4 = DOUBTFUL 5 = VERY DOUBTFUL * 8 = DK * 9 = NOT ASCERTAINED * SKIP HP4 HP4 642-643 WHY? _____ + = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN HP3. 91 = FLAG FOR QUESTION ANSWERED 98 = DK 99 = NOT ASCERTAINED HP5 (644-649) GENERALLY THE RESPONDENT WAS: ______________________________ (102) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HP5A 644 ABLE TO UNDERSTAND QUESTIONS ____________________________ 1-7 = DEGREE OF UNDERSTANDING CODER: CODE 1 = ABLE TO UNDERSTAND QUESTIONS EASILY TO CODE 7 = HARDLY ABLE TO UNDERSTAND THE QUESTION 8 = DK 9 = NOT ASCERTAINED HP5B 645 COOPERATIVE ___________ 1-7 = DEGREE OF COOPERATION CODER: CODE 1 = COOPERATIVE TO CODE 7 = UNCOOPERATIVE 8 = DK 9 = NOT ASCERTAINED HP5C 646 NO LANGUAGE PROBLEM ___________________ 1-7 = DEGREE OF LANGUAGE PROBLEM CODER: CODE 1 = NO LANGUAGE PROBLEM TO CODE 7 = SPOKE ENHLGSH WITH DIFFICULTY 8 = DK 9 = NOT ASCERTAINED HP5D 647 INTERVIEWED WITHOUT INTERRUPTION ________________________________ 1-7 = DEGREE OF INTERRUPTIONS DURING INTERVIEW CODER: CODE 1 = INTERVIEWED WITHOUT INTERRUPTION TO CODE 7 = INTERRUPTED OFTEN 8 = DK 9 = NOT ASCERTAINED (103) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ HP5E 648 SOBER _____ 1-7 = LEVEL OF SOBRIETY CODER: CODE 1 = SOBER TO CODE 7 = INEBRIATED/HIGH 8 = DK 9 = NOT ASCERTAINED HP5F 649 NOT PHYSICALLY OR MENTALLY FATIGUED ___________________________________ 1-7 = LEVEL OF PHYSICAL/MENTAL FATIGUE CODER: CODE 1 = NOT PHYSICALLY OR MENTALLY FATIGUED TO CODE 7 = PHYSICALLY OR MENTALLY FATIGUED 8 = DK 9 = NOT ASCERTAINED (104) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ INDEX OF VARIABLES PAGE 001 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== A ===== ADM5 035-036 Record 01 003 AMBVS5 040-042 Record 01 003 ===== E ===== ERVS5 043-045 Record 01 003 ===== G ===== GAP5FLAG 034 Record 01 003 ===== H ===== H_NONMED (304-324) Record 01 053 HABOX1 (117-118) Record 01 014 HABOX1A 117 Record 01 014 HABOX1B 118 Record 01 014 HA01CT 055-056 Record 01 004 HA1AGE1 060-061 Record 01 005 HA1AGE10 114-115 Record 01 014 HA1AGE2 066-067 Record 01 006 HA1AGE3 072-073 Record 01 007 HA1AGE4 078-079 Record 01 008 HA1AGE5 084-085 Record 01 009 HA1AGE6 090-091 Record 01 010 HA1AGE7 096-097 Record 01 011 HA1AGE8 102-103 Record 01 012 HA1AGE9 108-109 Record 01 013 HA1REL1 057-058 Record 01 004 HA1REL10 111-112 Record 01 013 HA1REL2 063-064 Record 01 005 HA1REL3 069-070 Record 01 006 HA1REL4 075-076 Record 01 007 HA1REL5 081-082 Record 01 008 HA1REL6 087-088 Record 01 009 HA1REL7 093-094 Record 01 010 HA1REL8 099-100 Record 01 011 HA1REL9 105-106 Record 01 012 HA1SEX1 059 Record 01 004 HA1SEX10 113 Record 01 013 HA1SEX2 065 Record 01 005 HA1SEX3 071 Record 01 006 HA1SEX4 077 Record 01 007 HA1SEX5 083 Record 01 008 HA1SEX6 089 Record 01 009 INDEX OF VARIABLES PAGE 002 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HA1SEX7 095 Record 01 010 HA1SEX8 101 Record 01 011 HA1SEX9 107 Record 01 012 HA1SST1 062 Record 01 005 HA1SST10 116 Record 01 014 HA1SST2 068 Record 01 006 HA1SST3 074 Record 01 007 HA1SST4 080 Record 01 008 HA1SST5 086 Record 01 009 HA1SST6 092 Record 01 010 HA1SST7 098 Record 01 011 HA1SST8 104 Record 01 012 HA1SST9 110 Record 01 013 HA2 119 Record 01 015 HA3 120 Record 01 015 HA4 121 Record 01 015 HA5 122-123 Record 01 016 HA6 (124-129) Record 01 016 HA6A 124 Record 01 016 HA6B 125 Record 01 016 HA6C 126 Record 01 017 HA6D 127 Record 01 017 HA6E 128 Record 01 017 HA6F 129 Record 01 017 HBBOX2 131 Record 01 018 HBBOX3 132 Record 01 018 HBBOX4 152 Record 01 023 HBBOX5 175 Record 01 029 HBBOX6 184 Record 01 030 HBBOX7 185 Record 01 031 HBBOX8 204 Record 01 035 HBBOX9 211 Record 01 037 HB1 130 Record 01 018 HB10 160 Record 01 025 HB12 161 Record 01 025 HB13 162 Record 01 025 HB14 (163-174) Record 01 025 HB14A 163 Record 01 026 HB14B 164 Record 01 026 HB14C 165 Record 01 026 HB14D 166 Record 01 026 HB14E 167 Record 01 027 HB14F 168 Record 01 027 HB14G 169 Record 01 027 HB14H 170 Record 01 027 INDEX OF VARIABLES PAGE 003 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HB14I 171 Record 01 028 HB14J 172 Record 01 028 HB14K 173 Record 01 028 HB14L 174 Record 01 028 HB16 (176-179) Record 01 029 HB16MO 176-177 Record 01 029 HB16YR 178-179 Record 01 029 HB17 180 Record 01 029 HB18 181 Record 01 030 HB19 182 Record 01 030 HB2 133 Record 01 018 HB21 183 Record 01 030 HB22 186 Record 01 031 HB23 187 Record 01 031 HB24 (188-199) Record 01 031 HB24A 188 Record 01 032 HB24B 189 Record 01 032 HB24C 190 Record 01 032 HB24D 191 Record 01 032 HB24E 192 Record 01 033 HB24F 193 Record 01 033 HB24G 194 Record 01 033 HB24H 195 Record 01 033 HB24I 196 Record 01 034 HB24J 197 Record 01 034 HB24K 198 Record 01 034 HB24L 199 Record 01 034 HB25 (200-203) Record 01 035 HB25MO 200-201 Record 01 035 HB25YR 202-203 Record 01 035 HB26 205-206 Record 01 036 HB27 (207-210) Record 01 036 HB27MO 207-208 Record 01 036 HB27YR 209-210 Record 01 036 HB28 212 Record 01 037 HB29 213 Record 01 037 HB3 134 Record 01 019 HB31 (214-219) Record 01 037 HB31A (214-216) Record 01 037 HB31A1 214-215 Record 01 038 HB31A2 216 Record 01 038 HB31B (217-219) Record 01 038 HB31B1 217-218 Record 01 038 HB31B2 219 Record 01 039 HB4 (135-146) Record 01 019 INDEX OF VARIABLES PAGE 004 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HB4A 135 Record 01 019 HB4B 136 Record 01 019 HB4C 137 Record 01 020 HB4D 138 Record 01 020 HB4E 139 Record 01 020 HB4F 140 Record 01 020 HB4G 141 Record 01 021 HB4H 142 Record 01 021 HB4I 143 Record 01 021 HB4J 144 Record 01 021 HB4K 145 Record 01 022 HB4L 146 Record 01 022 HB5 (147-150) Record 01 022 HB5MO 147-148 Record 01 022 HB5YR 149-150 Record 01 023 HB6 151 Record 01 023 HB7 153 Record 01 023 HB8 154-155 Record 01 024 HB9 (156-159) Record 01 024 HB9MO 156-157 Record 01 024 HB9YR 158-159 Record 01 024 HCVS5 046-048 Record 01 003 HC15 (220-224) Record 01 039 HC15A 220 Record 01 039 HC15B 221 Record 01 039 HC15C 222 Record 01 040 HC15D 223 Record 01 040 HC15E 224 Record 01 040 HC16 (225-242) Record 01 040 HC16A 225 Record 01 040 HC16B 226 Record 01 041 HC16C 227 Record 01 041 HC16D 228 Record 01 041 HC16E 229 Record 01 041 HC16F 230 Record 01 041 HC16G 231 Record 01 042 HC16H 232 Record 01 042 HC16I 233 Record 01 042 HC16J 234 Record 01 042 HC16K 235 Record 01 042 HC16L 236 Record 01 043 HC16M 237 Record 01 043 HC16N 238 Record 01 043 HC16O 239 Record 01 043 HC16P 240 Record 01 043 INDEX OF VARIABLES PAGE 005 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HC16Q 241 Record 01 044 HC16R 242 Record 01 044 HC17 243 Record 01 044 HC18 244 Record 01 044 HC19 (245-250) Record 01 044 HC19DA 247-248 Record 01 045 HC19MO 245-246 Record 01 045 HC19YR 249-250 Record 01 045 HC20 251 Record 01 045 HDNTLSRV (325-329) Record 01 055 HDRGSECT (379-463) Record 01 065 HD05CT 255-256 Record 01 046 HD1A 252 Record 01 046 HD1B 253-254 Record 01 046 HEMPLYMT (464-559) Record 01 073 HENDDT (023-028) Record 01 002 HENDDY 025-026 Record 01 002 HENDMO 023-024 Record 01 002 HENDYR 027-028 Record 01 002 HE07CT 260-261 Record 01 047 HE1A 257 Record 01 046 HE1B 258-259 Record 01 047 HF09CT 265-266 Record 01 047 HF1 262 Record 01 047 HF1A 263-264 Record 01 047 HF10CT 270-271 Record 01 048 HF11CT 275-276 Record 01 049 HF12CT 280-281 Record 01 049 HF2 267 Record 01 048 HF2A 268-269 Record 01 048 HF3 272 Record 01 048 HF3A 273-274 Record 01 049 HF4 277 Record 01 049 HF4A 278-279 Record 01 049 HG1 282 Record 01 050 HG1A 283-284 Record 01 050 HG13CT 285-286 Record 01 050 HG14CT 290-291 Record 01 051 HG15CT 295-296 Record 01 051 HG16CT 298-299 Record 01 052 HG2 287 Record 01 050 HG2A 288-289 Record 01 051 HG3 292 Record 01 051 HG3A 293-294 Record 01 051 HG4 297 Record 01 052 INDEX OF VARIABLES PAGE 006 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HHOMHLTH (300-303) Record 01 052 HHSEHOLD (055-129) Record 01 004 HH1 300 Record 01 052 HH18CT 302-303 Record 01 053 HH2 301 Record 01 052 HINSCOVR (130-219) Record 01 017 HINTOBS (638-649) Record 01 101 HIPSTAYS (252-256) Record 01 045 HITYPE 014 Record 01 001 HI1 304 Record 01 053 HI2 307 Record 01 053 HI20CT 305-306 Record 01 053 HI21CT 308-309 Record 01 053 HI22CT 311-312 Record 01 054 HI23CT 314-315 Record 01 054 HI24CT 317-318 Record 01 055 HI25CT 320-321 Record 01 055 HI26CT 323-324 Record 01 055 HI3 310 Record 01 054 HI4 313 Record 01 054 HI5 316 Record 01 054 HI6 319 Record 01 055 HI7 322 Record 01 055 HJ1 325 Record 01 056 HJ1A 326-327 Record 01 056 HJ28CT 328-329 Record 01 056 HKSEX 330-331 Record 01 056 HK1 (332-338) Record 01 056 HK1A 332 Record 01 057 HK1B 333 Record 01 057 HK1C 334 Record 01 057 HK1D 335 Record 01 057 HK1E 336 Record 01 058 HK1F 337 Record 01 058 HK1G 338 Record 01 058 HK2 339 Record 01 058 HK3 340 Record 01 059 HK4A 341 Record 01 059 HK4B 360 Record 01 062 HK5APROV 342-348 Record 01 059 HK5BPROV 361-367 Record 01 063 HK6A (349-356) Record 01 059 HK6AA 349 Record 01 060 HK6AB 350 Record 01 060 HK6AC 351 Record 01 060 INDEX OF VARIABLES PAGE 007 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HK6AD 352 Record 01 060 HK6AE 353 Record 01 061 HK6AF 354 Record 01 061 HK6AFOS 355-356 Record 01 061 HK6B (368-375) Record 01 063 HK6BA 368 Record 01 063 HK6BB 369 Record 01 063 HK6BC 370 Record 01 064 HK6BD 371 Record 01 064 HK6BE 372 Record 01 064 HK6BF 373 Record 01 064 HK6BFOS 374-375 Record 01 065 HK7A 357 Record 01 062 HK7B 376 Record 01 065 HK8A 358-359 Record 01 062 HK8B 377-378 Record 01 065 HLANG 016 Record 01 001 HLTHSTAT (220-251) Record 01 039 HL1 379 Record 01 066 HL2 380 Record 01 066 HL3 383 Record 01 066 HL31CT 381-382 Record 01 066 HL4 (386-457) Record 01 067 HL4A 386-388 Record 01 067 HL4B 389-391 Record 01 067 HL4C 392-394 Record 01 067 HL4CT 384-385 Record 01 066 HL4D 395-397 Record 01 067 HL4E 398-400 Record 01 068 HL4F 401-403 Record 01 068 HL4G 404-406 Record 01 068 HL4H 407-409 Record 01 068 HL4I 410-412 Record 01 069 HL4J 413-415 Record 01 069 HL4K 416-418 Record 01 069 HL4L 419-421 Record 01 069 HL4M 422-424 Record 01 070 HL4N 425-427 Record 01 070 HL4O 428-430 Record 01 070 HL4P 431-433 Record 01 070 HL4Q 434-436 Record 01 071 HL4R 437-439 Record 01 071 HL4S 440-442 Record 01 071 HL4T 443-445 Record 01 071 HL4U 446-448 Record 01 072 INDEX OF VARIABLES PAGE 008 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HL4V 449-451 Record 01 072 HL4W 452-454 Record 01 072 HL4X 455-457 Record 01 072 HL5 458-463 Record 01 073 HMBOX1 465 Record 01 073 HMBOX2 466 Record 01 074 HMBOX3 526 Record 01 085 HMBOX4 535 Record 01 087 HMEDVIST (262-281) Record 01 047 HM1 464 Record 01 073 HM10 486 Record 01 077 HM11 487-488 Record 01 077 HM12 489 Record 01 077 HM13 (490-493) Record 01 078 HM13MO 490-491 Record 01 078 HM13YR 492-493 Record 01 078 HM14 494 Record 01 078 HM15 495-496 Record 01 079 HM16 497-499 Record 01 079 HM17O18 500-503 Record 01 079 HM18A 504 Record 01 080 HM19 505 Record 01 080 HM2 467-469 Record 01 074 HM20 506 Record 01 080 HM21 507-508 Record 01 081 HM22 509 Record 01 081 HM23 510-511 Record 01 081 HM24 512 Record 01 082 HM25 (513-516) Record 01 082 HM25MO 513-514 Record 01 082 HM25YR 515-516 Record 01 082 HM26 517 Record 01 083 HM27 518-519 Record 01 083 HM28 520 Record 01 083 HM29 521 Record 01 084 HM30 522-523 Record 01 084 HM304 470-473 Record 01 074 HM31 524-525 Record 01 085 HM32 527 Record 01 085 HM33 (528-532) Record 01 085 HM33BX 532 Record 01 086 HM33DT (528-531) Record 01 086 HM33MO 528-529 Record 01 086 HM33YR 530-531 Record 01 086 HM34 533 Record 01 086 INDEX OF VARIABLES PAGE 009 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HM35 534 Record 01 087 HM36 536 Record 01 087 HM37 (537-541) Record 01 087 HM37BX 541 Record 01 088 HM37DT (537-540) Record 01 087 HM37MO 537-538 Record 01 088 HM37YR 539-540 Record 01 088 HM38 542 Record 01 088 HM39 (543-547) Record 01 088 HM39BX 547 Record 01 089 HM39DT (543-546) Record 01 089 HM39MO 543-544 Record 01 089 HM39YR 545-546 Record 01 089 HM4A 474 Record 01 075 HM40 548 Record 01 089 HM41 (549-552) Record 01 090 HM41MO 549-550 Record 01 090 HM41YR 551-552 Record 01 090 HM42 553 Record 01 090 HM43 554-559 Record 01 091 HM5 475 Record 01 075 HM6 476-477 Record 01 075 HM7 478-480 Record 01 076 HM8O9 481-484 Record 01 076 HM9A 485 Record 01 076 HNURSHOM (257-261) Record 01 046 HN1 560 Record 01 091 HN2 561-562 Record 01 091 HN3 (563-598) Record 01 091 HN3L1DY 565-566 Record 01 092 HN3L1MO 563-564 Record 01 092 HN3L1YR 567-568 Record 01 092 HN3L2DY 577-578 Record 01 093 HN3L2MO 575-576 Record 01 093 HN3L2YR 579-580 Record 01 094 HN3L3DY 589-590 Record 01 095 HN3L3MO 587-588 Record 01 095 HN3L3YR 591-592 Record 01 095 HN3R1DY 571-572 Record 01 093 HN3R1MO 569-570 Record 01 092 HN3R1YR 573-574 Record 01 093 HN3R2DY 583-584 Record 01 094 HN3R2MO 581-582 Record 01 094 HN3R2YR 585-586 Record 01 094 HN3R3DY 595-596 Record 01 096 INDEX OF VARIABLES PAGE 010 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== H ===== HN3R3MO 593-594 Record 01 095 HN3R3YR 597-598 Record 01 096 HN4 599 Record 01 096 HN5 600-601 Record 01 096 HN6 (602-637) Record 01 097 HN6EN1DY 604-605 Record 01 097 HN6EN1MO 602-603 Record 01 097 HN6EN1YR 606-607 Record 01 097 HN6EN2DY 616-617 Record 01 099 HN6EN2MO 614-615 Record 01 098 HN6EN2YR 618-619 Record 01 099 HN6EN3DY 628-629 Record 01 100 HN6EN3MO 626-627 Record 01 100 HN6EN3YR 630-631 Record 01 100 HN6EX1DY 610-611 Record 01 098 HN6EX1MO 608-609 Record 01 098 HN6EX1YR 612-613 Record 01 098 HN6EX2DY 622-623 Record 01 099 HN6EX2MO 620-621 Record 01 099 HN6EX2YR 624-625 Record 01 100 HN6EX3DY 634-635 Record 01 101 HN6EX3MO 632-633 Record 01 101 HN6EX3YR 636-637 Record 01 101 HOTHPROV (282-299) Record 01 049 HPID01 001-009 Record 01 001 HP1 638 Record 01 102 HP2 639-640 Record 01 102 HP3 641 Record 01 102 HP4 642-643 Record 01 102 HP5 (644-649) Record 01 102 HP5A 644 Record 01 103 HP5B 645 Record 01 103 HP5C 646 Record 01 103 HP5D 647 Record 01 103 HP5E 648 Record 01 104 HP5F 649 Record 01 104 HREC01 010-011 Record 01 001 HREFDT (017-022) Record 01 001 HREFDY 019-020 Record 01 002 HREFMO 017-018 Record 01 001 HREFYR 021-022 Record 01 002 HRTYPE 015 Record 01 001 HSREC01 012-013 Record 01 001 HTIMEGAP (560-637) Record 01 091 HWMNHLTH (330-378) Record 01 056 INDEX OF VARIABLES PAGE 011 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== I ===== IPNGT5 037-039 Record 01 003 ===== M ===== MDVS5 052-054 Record 01 004 ===== O ===== OBSDAYS5 031-033 Record 01 002 OCVS5 049-051 Record 01 003 ===== P ===== PERSON1 (057-062) Record 01 004 PERSON10 (111-116) Record 01 013 PERSON2 (063-068) Record 01 005 PERSON3 (069-074) Record 01 006 PERSON4 (075-080) Record 01 007 PERSON5 (081-086) Record 01 008 PERSON6 (087-092) Record 01 009 PERSON7 (093-098) Record 01 010 PERSON8 (099-104) Record 01 011 PERSON9 (105-110) Record 01 012 PRISON1 (602-613) Record 01 097 PRISON2 (614-625) Record 01 098 PRISON3 (626-637) Record 01 100 ===== T ===== TRIP1 (563-574) Record 01 092 TRIP2 (575-586) Record 01 093 TRIP3 (587-598) Record 01 094 T5_STAT 029-030 Record 01 002