Not at all A little moderate amount Very much An extreme amount
3. To what extent do you feel that physical pain prevents you from doing what you need
to do?
1 2 3 4 5
4. How much are you bothered by any physical problems related to your HIV
infection?
1 2 3 4 5
5. How much do you need any medical
treatment to function in your daily life?
1 2 3 4 5
6. How much do you enjoy life? 1 2 3 4 5
7. To what extent do you feel your life to be
meaningful?
1 2 3 4 5
8. To what extent are you bothered by
people blaming you for your HIV status
1 2 3 4 5
9. How much do you fear the future? 1 2 3 4 5
10. How much do you worry about death? 1 2 3 4 5
Not at all A little A moderate amount Very much Extremel y
11. How well are you able to concentrate? 1 2 3 4 5
12. How safe do you feel in your daily life? 1 2 3 4 5
13. How healthy is your physical
environment?
1 2 3 4 5