Hepatitis and Liver Health - Hepatitis C Reader Survey

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Hep's Hepatitis C Reader Survey

Are you living with chronic hepatitis C virus (HCV) infection? Are you concerned that you may be infected, or think you might be at risk for HCV? The editors of HepMag.com want to hear from you. Please select the answers that best describe you in our confidential survey.
 
1. Have you ever been tested for hepatitis C virus (HCV) infection?
Yes (advance to question 3)
No
I don't know (advance to question 15)
 
2. If you have not been tested, why not? (Check all that apply, then advance to question 15.)
I don't believe I'm at risk
I don't know how/where to get tested
I don't want to face the results
Other: (please specify)  
 
3. If you have been tested, what were the results?
Positive
Negative (advance to question 15)
I don't know (advance to question 15)
 
4. What were the results of confirmatory testing (e.g., viral load)?
I was diagnosed with chronic HCV infection
I had been infected at some point with the virus, but it cleared on its own (advance to question 15)
I don't know (advance to question 15)
 
5. What year were you diagnosed?
 
6. What is your HCV genotype?
1
2
3
4
I don't know
 
7. What is your IL-28B genotype?
CC
CT
TT
I don't know
 
8. Have you ever had a liver biopsy?
Yes
No
I don't know
 
9. Are you currently receiving, or have you ever taken, treatment for hepatitis C?
Yes, I'm currently on treatment (advance to question 11)
Yes, I was treated in the past, and it cured my HCV (advance to question 11)
Yes, I was treated in the past, but it did not cure my HCV (advance to question 11)
Yes, I was treated in the past but stopped early because of side effects (advance to question 11)
Yes, I was treated in the past but stopped early because of lack of support, such as childcare or household help (advance to question 11)
No, I have never been treated for HCV (advance to question 12)
 
10. If you have not been treated, why not? (Check all that apply, then advance to question 12)
I haven't discussed treatment with my health care provider
My health care provider told me I don't need to be treated
I cannot be treated because of another medical condition
I am worried about the side effects of treatment
I cannot afford the cost of treatment
I am waiting for new medications to become available
Other: (please specify)  
 
11. What type of treatment are you using or did you use? (Check all that apply)
Daily or three-times-weekly interferon injections
Weekly interferon injections
Daily oral ribavirin
A protease inhibitor (for example, Incivek/telaprevir or Victrelis/boceprevir)
Other: medications in a clinical trial (please specify)  
 
12. Do you use any alternative/complementary (non-prescription) therapies for your HCV infection?
Yes
No
 
13. Which type of physician or health care provider is/was responsible for managing your hepatitis? (Check all that apply.)
Primary care physician (NOT a specialist)
Infectious disease specialist
Gastroenterologist
Hepatologist
Nurse/nurse practitioner
Physician assistant
Other: (please specify)  
 
14. Where do you get your hepatitis C information? (Check all that apply.)
My health care provider
Friends and family
The Internet
Magazines or books
Hepatitis newsletters
Hepatitis support groups
A national or local organization
Methadone clinic
Advertisements in newspapers, magazines or online
Other: (please specify)  
 
15. What is your gender?
Male
Female
Transgender
Other
 
16. What is your sexual orientation?
Straight/Heterosexual
Gay/Lesbian
Bisexual
Other
 
17. What year were you born?
 
18. What is your ethnicity? (Check all that apply.)
American Indian or Alaska Native
Arab or Middle Eastern
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other: (please specify) 
 
19. What is your employment status?
Employed, full-time
Employed, part-time or freelance
Unemployed, on disability
Unemployed, not on disability
 
20. What is your current level of education achievement?
Some high school
High school graduate
Some college
Bachelor's degree
Graduate degree (please specify degree[s]) 
 
21. What is your household income per year?
Less than $15,000
$15,000–$34,999
$35,000–$49,999
$50,000–$74,999
$75,000–$99,999
$100,000 or more
 
22. What type of health insurance do you have?
Medicare/Medicaid
Private insurance
Other: (please specify)  
 
23. What state/province do you live in?
 
24. What country do you live in?
 
25. We would like to hear your feedback! Please provide additional comments here:
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