Administrative Forms:
- Data Set Transmission Form
Acrobat
MS Word
(Single /
Multiple files)
WordPerfect
(Single /
Multiple files)
Use this form to send data to CAMACS or centers.
- Collaboration Concept Sheet *
MS Word
WordPerfect
This form is intended for use for all
collaborations, whether the initiative is to combine data from both MACS and WIHS
or for just the MACS study. Click here
to see the MACS Publication Policy.
* If lymphoblastic cell lines are requested, the NIH AIDS
Research and
Reference Reagent Program requires all investigators to be registered prior
to receiving samples. Registration materials and instructions can be found
on the
Reagent Program web site.
- Restricted Use of MACS Specimens
Acrobat
MS Word
WordPerfect
This form is to be completed for MACS
participants that have
refused consent for stored specimens to be used to establish a cell line,
for possible commercial value, or for other reasons that may evolve over
the
course of the study.
Data Collection Forms:
Effective January 18, 2011, the variable visit
number suffix was changed from 2 digits (i.e., VARIABLE_54)
to a 3 digit suffix (i.e., VARIABLE_054) and affects ALL visit
questionnaire variables from the first visit onward,
excluding NP Waves 1 - 10.
- Visit: Baseline
( Acrobat Reader required )
- Visit 1: Original Cohort
April 1, 1984 - April 8, 1985
-
Physical Exam /
w/variables
-
Section 2 & 3: demographics & psychosocial /
w/variables
-
Section 4 :
behavior, medical history, health services
/
w/variables
- Visit 707 (Visit 75): First New Recruit
April 1, 1987 - March 16, 1995
-
Physical Exam /
w/variables
-
Section 2 & 3: demographics & psychosocial /
w/variables
-
Section 4:
behavior, medical history, health services
/
w/variables
- Visit 736 (Visit 76): Second New Recruit
October 1, 2001 - August 8, 2003
- Screening Form:
(Guidelines)
English /
Spanish
-
Retrospective Medical Record Abstraction
(Guidelines)
- Eligibility Form
- Physical Exam/Lipodystrophy:
English /
w/variables /
Spanish
- Section 2 & 3: demographics & psychosocial
English /
w/variables /
Spanish
- Section 4 : behavior, medical history, health services
English /
w/variables /
Spanish
(Guidelines)
- Drug Form 1: antivirals
English /
w/variables /
Spanish
(Guidelines)
- Drug Form 2: non-antivirals
English /
w/variables /
Spanish
(Guidelines)
- Antiviral Medication Adherence: antiviral medication adherence (same as Visit 36 form)
English /
w/variables /
Spanish
(Guidelines)
- 36-Item Health Survey: quality of life (same form used all visits)
English /
w/variables
- NP Forms:
- Visit: Follow-up
( Acrobat Reader required )
- Physical Exam/Lipodystrophy (Lipodystrophy section introduced at Visit 31)
-
Timed Walking and Hand Grip Assessments
(introduced at Visit 44)
- Section 2 & 3
: demographics & psychosocial
- Section 4
: behavior, medical history, health services
- Drug Form 1
: anti-virals (introduced at Visit 13)
- Drug Form 2
: non-antivirals (Visit 13 through Visit 50)
-
Form 20: patient with AIDS short telephone interview
(introduced at Visit 16 and discontinued at Visit 44)
- NP Forms:
- Form 07: Background information (NP Exam,
Visit 1 only)
- Form 08: Neuropsychological screening battery -
psychological tests (Rey Auditory Verbal Learning test,
Rey-Osterreith Complex Figure, Stroop Task,
Grooved Pegboard Test)
- Form 09: Neuropsychological screening battery -
psychological tests (Rey Auditory Verbal Learning test,
Rey-Osterreith Complex Figure, Stroop Task,
Grooved Pegboard Test) - discontinued at Visit 15
- Form 10: Neurological Assessment
- Form 18: Trail-Making Task and Symbol Digit Task
- 36-Item Health Survey: quality of life (introduced at Visit 21)
Full:
English /
w/variables /
Spanish
Abbreviated: (introduced at Visit 55)
English /
w/variables /
Spanish
-
Antiviral Medication Adherence: antiviral medication adherence
(introduced at Visit 30)
-
Men's Attitude Survey: (Visit 31, 35, 39, 43, 47, 51, & 55 only)
-
Instrumental Activities of Daily Living (IADL):
: (introduced at Visit 55)
-
International Physical Activity Questionnaire (IPAQ):
(Visit 53 and Visit 54)
Questionnaire w/variables:
Visit 53 /
Visit 54
- Family History of Hip Fractures: (Visit 55)
English /
w/variables /
Spanish
-
Visit Guidelines (starting at Visit 34)
Event
( Acrobat Reader required )
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