Document 13015796

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Section B: Lab Stage
TIME THIS SECTION BEGINS RECORDED HERE
TSST03B
B1.
Has your blood been tested for a “T-cell lymphocyte,” “helper cell,” or “CD4 count?”
(Circle One)
YES ............................................... 1
B03B01
NO ................................................ 2 → SKIP TO C1
B2.
When did you get your first CD4 or T-cell count?
YEAR: ___________________
B03B02
B3.
What was your first CD4 or T-cell count?
FIRST COUNT: __________________
B03B03
B4a. Of all your CD4 tests, what was your lowest count?:
B03B04A
LOWEST COUNT: ___________________ → SKIP TO B4b
OR
B03B04S
SAME AS FIRST TEST ............................. 1 → SKIP TO B4b
DON'T KNOW ............................................ 2 → ASK B4a1
NOTE: B4a1 - B4a3 were added as of baseline version 11, and are asked only if
response to B4a is DON'T KNOW.
B4a1.
Was it less than 500?
(Circle One)
B03B04A1
YES ............................................... 1
NO ................................................ 2 → SKIP TO B4b
REFUSED ...................................... -1 → SKIP TO B4b
B4a2.
Was it less than 200?
(Circle One)
B03B04A2
YES ............................................... 1
NO ................................................ 2 → SKIP TO B4b
REFUSED ...................................... -1 → SKIP TO B4b
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B4a3.
Was it less than 50?
(Circle One)
YES ............................................... 1
B03B04A3
NO ................................................ 2
B4b.
When was that (lowest count)?
B03B04B
B5a.
YEAR: ____________
OR
What was your latest (most recent) CD4 or T-cell count?
LATEST COUNT: ________________
B03B05A
OR
B5b.
SAME AS FIRST TEST ................... 1
SAME AS FIRST TEST .................... 1
When was that (latest count)?
MONTH: ___________
B03B05BM
OR
B03B05BY
YEAR: ____________
SAME AS FIRST TEST .................... 1
VERSIONS 6 - 10:
B6.
CAPI CHECK B4a
(Circle One)
B4a IS BETWEEN 0 AND 49 ...................................... 1
B4a IS BETWEEN 50 AND 199 .................................. 2
B4a IS BETWEEN 200 AND 499 ................................ 3
B4a IS 500 OR MORE ................................................. 4
VERSIONS 11 - 13:
B6.
CAPI CHECK B4a
(Circle One)
B4a IS BETWEEN 0 AND 49 OR B4a3 = 1 ....................................................... 1
B4a IS BETWEEN 50 AND 199 OR B4a2 = 1 AND B4a3 NOT 1 ...................... 2
B4a IS BETWEEN 200 AND 499 OR B4a1 = 1 AND B4a2 NOT 1 ................... 3
B4a IS 500 OR MORE OR B4a1 NOT = 1 ......................................................... 4
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B7.
CAPI CHECK B3 AND B6:
(Circle One)
B3 IS > 50 AND B6 IS CODED 1 .............. 1
B3 IS > 200 AND B6 IS CODED 2 ............ 2 → SKIP TO B8b
B3 IS > 500 AND B6 IS CODED 3 ............ 3 → SKIP TO B8c
ALL OTHERS ............................................ 4 → SKIP TO C1
B8a. When did your CD4 or T-cell count first drop below 50?
B03B08A
YEAR: ____________________
SKIP TO C1
B8b. When did your CD4 or T-cell count first drop below 200?
B03B08B
YEAR: ____________________
SKIP TO C1
B8c. When did your CD4 or T-cell count first drop below 500?
B03B08C
YEAR: ____________________
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