Form Id: FRM-APSS-FACTOR
ENGLISH FRANÇAIS PORTUGUÊS ITALIANO| Refusal positive result: | |
| Feeling too sick: | |
| Does not believe in ART: | |
| There are a lot of pills: | |
| Feel better: | |
| Lack of nutrition: | |
| Lack of family support: | |
| Signs of depression/anxiety: | |
| Difficulty revealing the partner/family: | |
| Toxicity/ Fear of side effects: | |
| Lost/Forgot/Shared pills: | |
| Stigma/Discrimination: | |
| Transportation Problems: | |
| Gender-based violence: | |
| Cultural and Traditional Aspects: | |
| Abuse of alcohol or drugs: | |
| Risk assessment: (automatic evaluation not working in preview) | |
| Score Result: | RESULT: SCORE |
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