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* 1. Name 

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* 2. Please describe your race/ethnicity.

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* 3. Age

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* 4. Email Address 

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* 5. Phone Number

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* 6. Zip Code 

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* 7. Please list your gender

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* 8. Please list your pronouns

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* 9. Do you identify as any of the following? **Disclaimer: This question is for data collection only and will remain confidential.**

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* 10. You have been invited to participate in a listening session sponsored by NMAC (National Minority AIDS Council) The purpose of this listening session is to collect quantitative and qualitative data on the experiences of PLHIV on Ryan White Planning Bodies.

The information learned in this focus group will be utilized in the future to develop trainings to increase meaningful involvement of PLHIV. 

As part of this study, you will be placed in a group of 6 – 12 individuals. A moderator will ask you several questions while facilitating the discussion. As approved through NMAC’s Training Center to end the Epidemic, this focus group will be audio/video-recorded and a note-taker will be present. However, your responses will remain confidential, and no names will be included in the final report.

You can choose whether or not to participate in the listening session, and you may stop at any time during the course of the study.
Please note that there are no right or wrong answers to questions. NMAC want(s) to hear the many varying viewpoints and would like for everyone to contribute their thoughts. Out of respect, please refrain from interrupting others. However, feel free to be honest even when your responses counter those of other group members.

Benefits and Risks
Your participation may benefit you and other individuals in your community by identifying current challenges to recruitment, on-boarding, involvement, and engagement. However, no risks are anticipated beyond those experienced during an average conversation.

Confidentiality
Should you choose to participate, you will be asked to respect the privacy of other listening session participants by not disclosing any content discussed during the study. Researchers within NMAC will analyze the data, but—as stated above—your responses will remain confidential, and no names will be included in any reports.

Contact
If you have any questions or concerns regarding this study, please contact:

Terrell Parker
Associate Program Manager –NMAC’s Training Center to End the Epidemic tparker@nmac.org or at 202-997-5598

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