Needs Assessment for Gay Men 40+

Understanding the Needs of Gay Men 40+ Living with HIV/AIDS

Your voice counts! PWA is introducing a Gay Men’s 40+ needs assessment to help us understand how we are meeting the needs of Gay Men 40+ living with HIV/AIDS, what you feel we are doing well, and what improvements you would like to see at PWA.

Question Title

* 1. How long have you been a Community Member at PWA?

Less than one year

1-2 years

2-5 years

5-10 years

Over 10 years

Question Title

* 2. Which race/ethnicity best describes you? (Please choose only one.)

African, Caribbean, Black

East Asian

Indigenous, Metis, Inuit

Latino, Latinx

Middle Eastern

South Asian

White / Caucasian

Multiple ethnicity / Other (please specify)

Question Title

* 3. What is your age?

17 or younger

18-29

30-39

40-49

50-59

60 or older

Question Title

* 4. How do you identify?

Bisexual

Gay

Heterosexual or straight

Pansexual

Queer

Other (please specify)

Question Title

* 5. What is your gender identity?

Man

Transman

Genderqueer

Non-binary

Transgender

Agender

Other, please describe

Question Title

* 6. Overall, how helpful are the following programs and services in supporting you to meet your needs?

If you have not accessed the program in the past one year, please select "Not applicable."

If you have never accessed the program, please also select "Not applicable."

	Very helpful	Helpful	Somewhat helpful	Not helpful	Not applicable
Essentials Market	Essentials Market Very helpful	Essentials Market Helpful	Essentials Market Somewhat helpful	Essentials Market Not helpful	Essentials Market Not applicable
Food Delivery	Food Delivery Very helpful	Food Delivery Helpful	Food Delivery Somewhat helpful	Food Delivery Not helpful	Food Delivery Not applicable
Financial Assistance	Financial Assistance Very helpful	Financial Assistance Helpful	Financial Assistance Somewhat helpful	Financial Assistance Not helpful	Financial Assistance Not applicable
Case Worker	Case Worker Very helpful	Case Worker Helpful	Case Worker Somewhat helpful	Case Worker Not helpful	Case Worker Not applicable
Massage, Acupuncture	Massage, Acupuncture Very helpful	Massage, Acupuncture Helpful	Massage, Acupuncture Somewhat helpful	Massage, Acupuncture Not helpful	Massage, Acupuncture Not applicable
Dental Hygienist	Dental Hygienist Very helpful	Dental Hygienist Helpful	Dental Hygienist Somewhat helpful	Dental Hygienist Not helpful	Dental Hygienist Not applicable
Ear clinic	Ear clinic Very helpful	Ear clinic Helpful	Ear clinic Somewhat helpful	Ear clinic Not helpful	Ear clinic Not applicable
Eye Clinic	Eye Clinic Very helpful	Eye Clinic Helpful	Eye Clinic Somewhat helpful	Eye Clinic Not helpful	Eye Clinic Not applicable
Help with Accessing Medication	Help with Accessing Medication Very helpful	Help with Accessing Medication Helpful	Help with Accessing Medication Somewhat helpful	Help with Accessing Medication Not helpful	Help with Accessing Medication Not applicable
Holiday Bags	Holiday Bags Very helpful	Holiday Bags Helpful	Holiday Bags Somewhat helpful	Holiday Bags Not helpful	Holiday Bags Not applicable
Starry Nite holiday party	Starry Nite holiday party Very helpful	Starry Nite holiday party Helpful	Starry Nite holiday party Somewhat helpful	Starry Nite holiday party Not helpful	Starry Nite holiday party Not applicable
Art Programs(Open studio, Expressive Arts, Art Therapy)	Art Programs(Open studio, Expressive Arts, Art Therapy) Very helpful	Art Programs(Open studio, Expressive Arts, Art Therapy) Helpful	Art Programs(Open studio, Expressive Arts, Art Therapy) Somewhat helpful	Art Programs(Open studio, Expressive Arts, Art Therapy) Not helpful	Art Programs(Open studio, Expressive Arts, Art Therapy) Not applicable
Pet Program	Pet Program Very helpful	Pet Program Helpful	Pet Program Somewhat helpful	Pet Program Not helpful	Pet Program Not applicable
Boutique	Boutique Very helpful	Boutique Helpful	Boutique Somewhat helpful	Boutique Not helpful	Boutique Not applicable
Hair cuts	Hair cuts Very helpful	Hair cuts Helpful	Hair cuts Somewhat helpful	Hair cuts Not helpful	Hair cuts Not applicable
Volunteering	Volunteering Very helpful	Volunteering Helpful	Volunteering Somewhat helpful	Volunteering Not helpful	Volunteering Not applicable
Peer Support	Peer Support Very helpful	Peer Support Helpful	Peer Support Somewhat helpful	Peer Support Not helpful	Peer Support Not applicable

Question Title

* 7. Overall, how satisfied are you with the range of programs PWA offers?

Very satisfied

Satisfied

Neither satisfied

Dissatisfied

Very Dissatisfied

Question Title

* 8. Are there any programs or services that you would like to see offered at PWA?

Question Title

* 9. Please tell us how much you agree with the following Statements.

	Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly Disagree
I feel welcome at PWA	I feel welcome at PWA Strongly agree	I feel welcome at PWA Agree	I feel welcome at PWA Neither agree nor disagree	I feel welcome at PWA Disagree	I feel welcome at PWA Strongly Disagree
I feel safe at PWA	I feel safe at PWA Strongly agree	I feel safe at PWA Agree	I feel safe at PWA Neither agree nor disagree	I feel safe at PWA Disagree	I feel safe at PWA Strongly Disagree
I feel confident that PWA keeps my personal information private	I feel confident that PWA keeps my personal information private Strongly agree	I feel confident that PWA keeps my personal information private Agree	I feel confident that PWA keeps my personal information private Neither agree nor disagree	I feel confident that PWA keeps my personal information private Disagree	I feel confident that PWA keeps my personal information private Strongly Disagree
I feel a sense of Community at PWA	I feel a sense of Community at PWA Strongly agree	I feel a sense of Community at PWA Agree	I feel a sense of Community at PWA Neither agree nor disagree	I feel a sense of Community at PWA Disagree	I feel a sense of Community at PWA Strongly Disagree
My ability to connect with other people living with HIV at PWA is important to me	My ability to connect with other people living with HIV at PWA is important to me Strongly agree	My ability to connect with other people living with HIV at PWA is important to me Agree	My ability to connect with other people living with HIV at PWA is important to me Neither agree nor disagree	My ability to connect with other people living with HIV at PWA is important to me Disagree	My ability to connect with other people living with HIV at PWA is important to me Strongly Disagree
When I come to PWA, I can access services from other agencies I need the most	When I come to PWA, I can access services from other agencies I need the most Strongly agree	When I come to PWA, I can access services from other agencies I need the most Agree	When I come to PWA, I can access services from other agencies I need the most Neither agree nor disagree	When I come to PWA, I can access services from other agencies I need the most Disagree	When I come to PWA, I can access services from other agencies I need the most Strongly Disagree
PWA is a place I can learn and gain new skills	PWA is a place I can learn and gain new skills Strongly agree	PWA is a place I can learn and gain new skills Agree	PWA is a place I can learn and gain new skills Neither agree nor disagree	PWA is a place I can learn and gain new skills Disagree	PWA is a place I can learn and gain new skills Strongly Disagree
I feel that I can get involved in PWA programs if I want to	I feel that I can get involved in PWA programs if I want to Strongly agree	I feel that I can get involved in PWA programs if I want to Agree	I feel that I can get involved in PWA programs if I want to Neither agree nor disagree	I feel that I can get involved in PWA programs if I want to Disagree	I feel that I can get involved in PWA programs if I want to Strongly Disagree
PWA programs and services strengthen my ability to take care of myself	PWA programs and services strengthen my ability to take care of myself Strongly agree	PWA programs and services strengthen my ability to take care of myself Agree	PWA programs and services strengthen my ability to take care of myself Neither agree nor disagree	PWA programs and services strengthen my ability to take care of myself Disagree	PWA programs and services strengthen my ability to take care of myself Strongly Disagree
PWA programs and services strengthen my ability to support my health	PWA programs and services strengthen my ability to support my health Strongly agree	PWA programs and services strengthen my ability to support my health Agree	PWA programs and services strengthen my ability to support my health Neither agree nor disagree	PWA programs and services strengthen my ability to support my health Disagree	PWA programs and services strengthen my ability to support my health Strongly Disagree
I feel like I am heard when I give give feedback or share ideas at PWA	I feel like I am heard when I give give feedback or share ideas at PWA Strongly agree	I feel like I am heard when I give give feedback or share ideas at PWA Agree	I feel like I am heard when I give give feedback or share ideas at PWA Neither agree nor disagree	I feel like I am heard when I give give feedback or share ideas at PWA Disagree	I feel like I am heard when I give give feedback or share ideas at PWA Strongly Disagree
I feel comfortable asking PWA staff for support if I need it	I feel comfortable asking PWA staff for support if I need it Strongly agree	I feel comfortable asking PWA staff for support if I need it Agree	I feel comfortable asking PWA staff for support if I need it Neither agree nor disagree	I feel comfortable asking PWA staff for support if I need it Disagree	I feel comfortable asking PWA staff for support if I need it Strongly Disagree

Question Title

* 10. What do you like about coming to PWA?

Question Title

* 11. If PWA was to have a regular men's group would you be interested in attending any of the following: (Rate by 1 being most likely , 10 being less likely)

Question Title

* 12. What do you think PWA is doing well?

Question Title

* 13. Is there anything you would like to see PWA do differently?

Question Title

* 14. Do you have any final comments or feedback you would like to share?

Question Title

* 15. There are times where it is helpful to us to be able to use anonymous quotes and stories to talk about the work that PWA does, show how it impacts our Community Members, and to provide examples of some of the key issues faced by people living with HIV/AIDS.

Examples of how these quotes and stories might be used include presentations that we give in the community, meetings with community partners, government, and health care providers, applications for funding and our annual report.

Any quotes we use are completely anonymous and there is no way to identify the person who provided the information.

Do we have your permission to use exact quotes taken from your responses to this survey?

Yes, PWA may use exact quotes taken from my responses to this survey, if they are anonymous

No, please do not use exact quotes from my responses to this survey

Needs Assessment for Gay Men 40+

Understanding the Needs of Gay Men 40+ Living with HIV/AIDS

Question Title

* 1. How long have you been a Community Member at PWA?

Question Title

* 2. Which race/ethnicity best describes you? (Please choose only one.)

Question Title

* 3. What is your age?

Question Title

* 4. How do you identify?

Question Title

* 5. What is your gender identity?

Question Title

* 6. Overall, how helpful are the following programs and services in supporting you to meet your needs?If you have not accessed the program in the past one year, please select "Not applicable."If you have never accessed the program, please also select "Not applicable."

Question Title

* 7. Overall, how satisfied are you with the range of programs PWA offers?

Question Title

* 8. Are there any programs or services that you would like to see offered at PWA?

Question Title

* 9. Please tell us how much you agree with the following Statements.

Question Title

* 10. What do you like about coming to PWA?

Question Title

* 11. If PWA was to have a regular men's group would you be interested in attending any of the following: (Rate by 1 being most likely , 10 being less likely)

Question Title

* 12. What do you think PWA is doing well?

Question Title

* 13. Is there anything you would like to see PWA do differently?

Question Title

* 14. Do you have any final comments or feedback you would like to share?

Question Title

* 6. Overall, how helpful are the following programs and services in supporting you to meet your needs?

If you have not accessed the program in the past one year, please select "Not applicable."

If you have never accessed the program, please also select "Not applicable."