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Under age 18

18-29

30-44

45-64

65 or older

3. What is your age range?

Black

White

Hispanic

Native American

Asian

Other

4. What is your race/ethnicity?

Male

Female

2. What is your gender?

1. First of all, how did you find this website?

Married

Widowed

Divorced/Separated

Single

5. What is your relationship status?

Health

Social Services

Youth Organization

Teacher

School Administrator

Other profession involving youth

6. Do you work in any of the following professions? (Check all that apply)

Age 0-4

Age 5-10

Age 11-14

Age 15-17

Age 18 and older

7. Do you have children in any of the following age ranges? (Check all that apply)

Caroline

King George

Stafford

Fredericksburg

Spotsylvania

Other

8. What community do you live in?

Not a problem

A small problem

Very much a problem

Don't know

9. How much of a problem do you think teen pregnancy is in your community?

Not a problem

A small problem

Very much a problem

Don't know

10. How much of a problem do you think sexually transmitted diseases are among teens in your community?

The Rappahannock Teen Abstinence Program is interested in how community members feel about pregnancy prevention programs for teens.

11. When do you think each of the following should start being covered in school?

Please take a moment to fill out the survey below (your answers will be completely confidential)

Yes

No

Don't know

12. Do you think that having sex as a teenager has a negative effect on their future?

Information about STDs

Elementary School Middle School High School Should not be covered in school

Consequences of sex before marriage

Elementary School Middle School High School Should not be covered in school

Differences between love and infatuation

Elementary School Middle School High School Should not be covered in school

Information about pregnancy

Elementary School Middle School High School Should not be covered in school

Peer pressure resistance skills

Elementary School Middle School High School Should not be covered in school

Decision-making skills

Elementary School Middle School High School Should not be covered in school

Anatomy

Elementary School Middle School High School Should not be covered in school

Abstinence from sex

Elementary School Middle School High School Should not be covered in school

Dating violence

Elementary School Middle School High School Should not be covered in school

Abstain (no sex) until marriage

Abstain (no sex) until engaged

Abstain (no sex) until out of high school

Abstain (no sex) until in a committed relationship

Teen sexual activity is acceptable so long as they use birth control

It is acceptable for teens to get pregnant if they are ready for a baby

Other

13. Which of the following statements best fits your beliefs about sexual activity for teens?

14. How often have you discussed the following topics with your children?

There are no barriers

Embarrassment about the topic of sex

I don't know how to discuss the topic of sex with them

My children get this information elsewhere

My children are too young to discuss sex

My children do not want to have a discussion about sex

Other

15. What are the barriers to discussing sex with your children? (Check all that apply)

Your attitudes about teenage sexual activity

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Your children's attitudes about teenage sexual activity

Have not talked about this Talked about this once Talked about this a few times Talked about this often

The consequences of sexual activity

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Information about preventing pregnancy

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Information about preventing STDs

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Rules for dating

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Dating violence

Have not talked about this Talked about this once Talked about this a few times Talked about this often

Resisting peer pressure

Have not talked about this Talked about this once Talked about this a few times Talked about this often

35%

45%

55%

65%

16. Approximately what percentage of high school students in the US have NEVER had sexual intercourse?

HIV/AIDS

Herpes

Gonorrhea

HPV

17. The most common STD is: (CHECK ONLY ONE)

HIV/AIDS

Herpes

Gonorrhea

HPV

18. Which of these STDs can be cured? (Check all that apply)

oral sex

condoms

abstinence

birth control pills

19. Which of the following is a 100% effective way to prevent pregnancy? (Check all that apply)

oral sex

condoms

abstinence

birth control pills

20. Which of the following is a 100% effective way to prevent STDs? (Check all that apply)

Yes

No

21. Do you think that youth should receive the abstinence message?

16

Why or why not?

22. Do you have any other comments about teen pregnancy prevention, STDs or teen sexual activity?

send you information about RappTAP and talking to your youth about sexual activity, please provide your contact information below:

23. If you would like to be entered into the drawing for a $25 Walmart gift certificate or would like us to

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