Date _____________________ Municipality _______________ Respondent code ___________________ Form ____________________________ Gender Male Female School code _______________

Age___________

Evaluation to fulfill objective 1 1. Is sex education part of your school's curriculum? (Please tick one) YES 2. What are STD's? Socially transmitted diseases Sexually transmitted diseases School transmitted diseases None of the above I don't know 3. How are STD's transmitted? (Please tick one) air schools sex water I don't know 4. In a scale of one to ten, how likely do you think a virgin is to contracting an STD? (Tick where appropriate) 1 very unlikely 2 3 4 5 6 7 8 9 very likely 10 NO

5. What is the most obvious action that precedes the conception of a baby? (Please tick one) Shopping Buying Sex Going to church I don't know

Evaluation to fulfill objective 1 6. When was the last time you had sex? (Please tick one) Less than three months ago Less than a year ago less than three years ago More than three years ago Never 7. Had you started learning sex education then and did you understand the risks involved? (Please tick one) Yes, I was learning and I understood the risks yes, I was learning but I didn't understand the risks No, I hadn't started learning 8. did you choose to use protection and if so, which one? (Please tick one) Yes, I chose to use condoms Yes I chose contraceptives No, I didn't choose, I allowed my partner to choose what was best for us No, I didn't have a choice 9. At your current position, if you had the perfect opportunity with the perfect partner, would you have sex today with him or her? (Please tick one) YES Condoms Contraceptives None I would abstain NO 10. What form of protection would you use? (Please tick one)

Evaluation to fulfill objective 1 11. How do you feel when matters of sex are discussed either socially or in the media? (Please tick one) Very embarrassed A little embarrassed Nothing I feel good I feel aroused 12. In your opinion, for two people in love, when is the right time for a person start engaging in sex? (Please tick one) In primary school In secondary school After circumcision for men As long as they have protection As long as they are of the same HIV status As long as they have done sex education and passed As long as they have cleared school As long as they are adults Anytime After marriage 13. Has sex education improved your ability to consult a responsible adult (e.g. A parent, teacher, counselor, pastor etc.) regarding sex. (Please tick one) YES NO

14. In a scale of 1 to 10, how has sex education helped you in making the right choices in matters regarding sex? (Tick where appropriate) 1 Very little 2 3 4 5 6 7 8 9 Very much 10

Questionnaire for the headteacher or a senior teacher with access to discipline and perfomance data and statistics. Evaluation to fulfill objective 1 15. What was the annual sex-related student dropout in the school before the introduction of sex education?_________ 16. What is the annual sex-related student dropout in the school since the introduction of sex education?_________ 17. According to the statistics, what direction has sexual promiscuity taken since the introduction of sex education. Sexual promiscuity has increased Sexual promiscuity has decreased 19. Has student performance since the introduction of sex-education improved or deteriorated? Student performance has improved Student performance has deteriorated 20. in your opinion, in a scale of 1 to 10, how has sex education contributed to the results above? (Tick where appropriate) 1 Very little 2 3 4 5 6 7 8 9 10 Very much