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APPENDIX A <br />Survey Questions <br />i. Where do you usually get HIV or STD services? <br />a. 17th Street Clinic <br />b. APAIT <br />c. Kaiser <br />d. LGBT Center <br />e. Planned Parenthood <br />f. Radiant Health Centers/RADAR <br />g. Other HIV/STD provider in Orange County (please specify provider): <br />h. Other HIV/STD provider in another county (please specify county and provider): <br />i. I do not have a health care provider that I go to for HIV or STD services (Go to <br />Question 3. in the Personal Needs and Resources section) <br />2. On a scale from i to 5 (1 is Strongly Agree and 5 is Strongly Disagree), how would you <br />rate your satisfaction with your HIV/STD services provider. <br />a. Staff look like me/reflect me <br />b. Staff are welcoming <br />c. Staff are helpful <br />d. Staff are bi-lingual and communicate with me in Spanish, if preferred <br />e. Staff are sensitive to my needs and referto me using my name and preferred <br />pronouns <br />f. Services meet my needs <br />g. Hours of operation meet my needs <br />h. Office environment is welcoming and inclusive, including patient materials <br />3. The following area list of possible reasons why you may not get the HIV/STD health <br />care you need. Based on your own situation, please rate your agreement or <br />disagreement (i is Strongly Agree and 5 is Strongly Disagree). <br />a. Lack of personal resources <br />b. Service providers having fear about or dislike of TGNC people <br />c. Lack of health professionals adequately trained to deliver healthcare to TGNC <br />people <br />d. Long distances to TGNC sensitive medical care facilities <br />e. Doctors and other healthcare workers who refuse to provide services to TGNC <br />people 1 <br />f. Fearthat if medical personnel find out I'm TGNC, they will treat me different 1 <br />g. Lack of transportation to get to services I need <br />�i <br />28 <br />a <br />