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Indicators Tracking Form

Please use this form to report HIV CTRS activities related to the National Youth Advocacy Coalition's "You Know Different" youth HIV testing initiative.

INDICATORS
2 weeks pre-campaign
Campaign week 1
Campaign week 2
2 weeks post-campaign
Number of calls by youth to agency phone number
Number of calls to schedule HIV antibody testing
Number of walk-in visits by youth for HIV antibody testing
Number of HIV antibody tests performed on youth
Percentage of youth tested during this time who return to receive HIV antibody test results
Percentage of HIV antibody tests performed among youth during this time that are positive
Demographics of youth (ages 13-24) tested
Number of Males youth tested
Number of Females youth tested
Number of Transgender youth tested
Number of African-American/black youth tested
Number of Latino/a youth tested
Number of Anglo/white youth tested
Number of other (race/ethnicity) youth tested

Your Name:

Organization Name:

City:

 
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