Case Based Surveillance Implementation Guide - Local Development build (v0.2.1). See the Directory of published versions
Questionnaire: STD-Demo-Questionnaire
| Official URL: http://cbsig.chai.gatech.edu/Questionnaire/STD-Demo-Questionnaire | Version: 0.2.1 | |||
| Draft as of 2022-02-17 | Computable Name: STDQuestionnaire | |||
| LinkId | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  STDQuestionnaire | Questionnaire | Demo questionnaire with a subset of STD questionnaire items. | ||
  STD107 | Had Sex with a Male within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD108 | Had Sex with a Female within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD109 | Had Sex with an Anonymous Partner within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD110 | Had Sex with a Person Known to Him/Her to be an "Intravenous Drug User (IDU)" within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD111 | Had Sex while Intoxicated and/or High on Drugs within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD112 | Exchanged Drugs/Money for Sex within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD113 | Had Sex with a Person Who is Known to Her to Be an MSM within Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD114 | Engaged in Injection Drug use Within Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD117 | Previous STD History | 0..1 | choice | Value Set: YNRD (CDC) |
| STD118 | Been Incarcerated within the Past 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
| STD119 | Have You Met Sex Partners through the Internet in the Last 12 Months | 0..1 | choice | Value Set: YNRD (CDC) |
 STD120 | Total Number of Sex Partners in the Last 12 months | 0..1 | integer | |
 STD999 | Unknown Number of Sex Partners in Last 12 Months | 0..1 | choice | Value Set: Yes/No/Don't Know |
| Documentation for this format | ||||