FHIR IG analytics| Package | ethiopia.fhir.hiv |
| Resource Type | Questionnaire |
| Id | Questionnaire-IndexCaseSexPartnerQuestionnaire.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/jembi/ethiopia-hiv/Questionnaire-IndexCaseSexPartnerQuestionnaire.html |
| URL | http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseSexPartnerQuestionnaire |
| Version | 1.0.1 |
| Status | active |
| Date | 2026-02-09T05:22:58+00:00 |
| Name | IndexCaseSexPartnerQuestionnaire |
| Title | Questionnaire - Sex Partner Information |
| Description | A questionaire that captures information for index case sex partners. |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire IndexCaseSexPartnerQuestionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  IndexCaseSexPartnerQuestionnaire | A questionaire that captures information for index case sex partners. | Questionnaire | http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseSexPartnerQuestionnaire#1.0.1 | |
  1.1 | Date of last exposure | 0..1 | date | |
 1.2 | Period of exposure if the exact date of exposure is not known | 0..1 | choice | Value Set: Period of HIV Exposure |
 1.3 | Priority category | 0..1 | integer | |
 2 | Intimate Partner Violence Assessment | 0..1 | group | |
 2.1 | Violence Assessment Completed | 0..1 | choice | Value Set: Yes/No Codes |
| 2.2 | Have you been kicked, hit, slapped, or otherwise physically hurt by your partner | 0..1 | choice | Value Set: Yes/No Codes |
| 2.3 | Has you partner ever threatened to hurt you | 0..1 | choice | Value Set: Yes/No Codes |
 2.4 | Has you partner ever forced or coerced you to engage in unwanted sexual activity | 0..1 | choice | Value Set: Yes/No Codes |
| 3 | HIV Status | 0..1 | group | |
| 3.1 | What is the plan for notifying the partner regarding the index case's HIV status | 0..1 | choice | Value Set: Partner Notification Plan |
| 3.2 | Was the partner notified | 0..1 | choice | Value Set: Yes/No Codes |
| 3.3 | Reason for not being notified | 1..1 | choice | Enable When: 3.2 = Value Set: Reason Partner Not Notified |
 3.4 | Other Reason for not being notified | 1..1 | string | Enable When: 3.3 = |
| 3.5 | Date notification offered | 0..1 | date | |
| 3.6 | Date partner contacted | 0..1 | date | |
| 3.7 | Reason partner not contacted | 0..1 | choice | Value Set: Reason Partner Not Contacted |
| 3.8 | Other Reason partner not contacted | 1..1 | string | Enable When: 3.7 = |
| 4 | Previous HIV Testing Services | 0..1 | group | |
| 4.1 | Has the partner been previsouly tested for HIV | 0..1 | choice | Value Set: Yes/No Codes |
| 4.2 | Date of previous HIV test | 1..1 | date | Enable When: 4.1 = |
 4.3 | Previous HIV test result | 1..1 | quantity | Enable When: 4.2 exists |
| 5 | Current HIV Testing Services | 0..1 | group | |
| 5.1 | Will the partner be tested for HIV | 0..1 | choice | Value Set: Yes/No Codes |
| 5.2 | Date of HIV test | 1..1 | date | Enable When: 5.1 = |
| 5.3 | HIV test result | 1..1 | quantity | Enable When: 5.2 exists |
| 6 | Partner Services | 0..1 | group | |
| 6.1 | Is the newly diagnosed partner linked to partner services | 0..1 | choice | Value Set: Yes/No Codes |
| 6.2 | Reason why the newly diagnosed partner is not linked to partner services | 1..1 | choice | Enable When: 6.1 = Value Set: Reason Not Linked to Partner Services |
| 6.3 | Other Reason for not being notified | 1..1 | string | Enable When: 6.2 = |
| 7 | HIV Program | 0..1 | group | |
| 7.1 | Has the partner started ART | 0..1 | choice | Value Set: Yes/No Codes |
 7.2 | Partner identifiers | 0..1 | reference | |
| 8.1 | Case closure status | 0..1 | choice | Value Set: Partner Case Closure Status |
| 8.2 | Other Reason for case closure | 1..1 | string | Enable When: 8.1 = |
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "IndexCaseSexPartnerQuestionnaire",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://moh.gov.et/fhir/hiv/Questionnaire/IndexCaseSexPartnerQuestionnaire",
"version": "1.0.1",
"name": "IndexCaseSexPartnerQuestionnaire",
"title": "Questionnaire - Sex Partner Information",
"status": "active",
"subjectType": [
"Observation"
],
"date": "2026-02-09T05:22:58+00:00",
"publisher": "Jembi Health Systems",
"contact": [
{
"name": "Jembi Health Systems",
"telecom": [
{
"system": "url",
"value": "https://www.jembi.org"
},
{
"system": "email",
"value": "info@jembi.org"
}
]
},
{
"name": "Jembi Health Systems",
"telecom": [
{
"system": "email",
"value": "info@jembi.org",
"use": "work"
}
]
}
],
"description": "A questionaire that captures information for index case sex partners.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "ET",
"display": "Ethiopia"
}
]
}
],
"item": [
{
"linkId": "1.1",
"code": [
{
"system": "http://loinc.org",
"code": "94652-5"
}
],
"text": "Date of last exposure",
"type": "date",
"required": false,
"repeats": false
},
{
"linkId": "1.2",
"code": [
{
"system": "http://loinc.org",
"code": "LP6260-6"
}
],
"text": "Period of exposure if the exact date of exposure is not known",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/period-of-hiv-exposure-value-set"
},
{
"linkId": "1.3",
"code": [
{
"system": "http://loinc.org",
"code": "LA9036-0"
}
],
"text": "Priority category",
"type": "integer",
"required": false,
"repeats": false
},
{
"linkId": "2",
"text": "Intimate Partner Violence Assessment",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "2.1",
"code": [
{
"system": "http://loinc.org",
"code": "LA30873-6"
}
],
"text": "Violence Assessment Completed",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "2.2",
"code": [
{
"system": "http://loinc.org",
"code": "76503-2"
}
],
"text": "Have you been kicked, hit, slapped, or otherwise physically hurt by your partner",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "2.3",
"code": [
{
"system": "http://loinc.org",
"code": "66900-2"
}
],
"text": "Has you partner ever threatened to hurt you",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "2.4",
"code": [
{
"system": "http://loinc.org",
"code": "66905-1"
}
],
"text": "Has you partner ever forced or coerced you to engage in unwanted sexual activity",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
}
]
},
{
"linkId": "3",
"text": "HIV Status",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "3.1",
"code": [
{
"system": "http://snomed.info/sct",
"code": "223454002"
}
],
"text": "What is the plan for notifying the partner regarding the index case's HIV status",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/partner-notification-plan-value-set"
},
{
"linkId": "3.2",
"code": [
{
"system": "http://snomed.info/sct",
"code": "310368009"
}
],
"text": "Was the partner notified",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "3.3",
"code": [
{
"system": "http://snomed.info/sct",
"code": "410666004"
}
],
"text": "Reason for not being notified",
"type": "choice",
"enableWhen": [
{
"question": "3.2",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "false"
}
}
],
"required": true,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/reason-partner-not-notified-value-set"
},
{
"linkId": "3.4",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Other-Reason-Partner-Not-Notified"
}
],
"text": "Other Reason for not being notified",
"type": "string",
"enableWhen": [
{
"question": "3.3",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "3.5",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Date-Notification-Offered"
}
],
"text": "Date notification offered",
"type": "date",
"required": false,
"repeats": false
},
{
"linkId": "3.6",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Date-Partner-Contacted"
}
],
"text": "Date partner contacted",
"type": "date",
"required": false,
"repeats": false
},
{
"linkId": "3.7",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Reason-Partner-Not-Contacted"
}
],
"text": "Reason partner not contacted",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/reason-partner-not-contacted-value-set"
},
{
"linkId": "3.8",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Other-Reason-Partner-Not-Contacted"
}
],
"text": "Other Reason partner not contacted",
"type": "string",
"enableWhen": [
{
"question": "3.7",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true,
"repeats": false
}
]
},
{
"linkId": "4",
"text": "Previous HIV Testing Services",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "4.1",
"code": [
{
"system": "http://snomed.info/sct",
"code": "171121004"
}
],
"text": "Has the partner been previsouly tested for HIV",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "4.2",
"code": [
{
"system": "http://loinc.org",
"code": "67723-7"
}
],
"text": "Date of previous HIV test",
"type": "date",
"enableWhen": [
{
"question": "4.1",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "true"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "4.3",
"code": [
{
"system": "http://snomed.info/sct",
"code": "315124004"
}
],
"text": "Previous HIV test result",
"type": "quantity",
"enableWhen": [
{
"question": "4.2",
"operator": "exists",
"answerBoolean": true
}
],
"required": true,
"repeats": false
}
]
},
{
"linkId": "5",
"text": "Current HIV Testing Services",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "5.1",
"code": [
{
"system": "http://snomed.info/sct",
"code": "171121004"
}
],
"text": "Will the partner be tested for HIV",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "5.2",
"code": [
{
"system": "http://loinc.org",
"code": "67723-7"
}
],
"text": "Date of HIV test",
"type": "date",
"enableWhen": [
{
"question": "5.1",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "true"
}
}
],
"required": true,
"repeats": false
},
{
"linkId": "5.3",
"code": [
{
"system": "http://snomed.info/sct",
"code": "315124004"
}
],
"text": "HIV test result",
"type": "quantity",
"enableWhen": [
{
"question": "5.2",
"operator": "exists",
"answerBoolean": true
}
],
"required": true,
"repeats": false
}
]
},
{
"linkId": "6",
"text": "Partner Services",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "6.1",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Linked-to-Partner-Services"
}
],
"text": "Is the newly diagnosed partner linked to partner services",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "6.2",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Reason-Not-Linked-to-Partner-Services"
}
],
"text": "Reason why the newly diagnosed partner is not linked to partner services",
"type": "choice",
"enableWhen": [
{
"question": "6.1",
"operator": "=",
"answerCoding": {
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/yes-no-code-system",
"code": "false"
}
}
],
"required": true,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/reason-not-linked-to-partner-services-value-set"
},
{
"linkId": "6.3",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Other-Reason-Not-Linked-to-Partner-Services"
}
],
"text": "Other Reason for not being notified",
"type": "string",
"enableWhen": [
{
"question": "6.2",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true,
"repeats": false
}
]
},
{
"linkId": "7",
"text": "HIV Program",
"type": "group",
"required": false,
"repeats": false,
"item": [
{
"linkId": "7.1",
"code": [
{
"system": "http://loinc.org",
"code": "63936-9"
}
],
"text": "Has the partner started ART",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/yes-no-value-set"
},
{
"linkId": "7.2",
"code": [
{
"system": "http://loinc.org",
"code": "94648-3"
}
],
"text": "Partner identifiers",
"type": "reference",
"required": false,
"repeats": false
}
]
},
{
"linkId": "8.1",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Partner-Case-Closure-Status"
}
],
"text": "Case closure status",
"type": "choice",
"required": false,
"repeats": false,
"answerValueSet": "http://moh.gov.et/fhir/hiv/ValueSet/partner-case-closure-status-value-set"
},
{
"linkId": "8.2",
"code": [
{
"system": "http://moh.gov.et/fhir/hiv/CodeSystem/index-case-partner-questionnaire-code-system",
"code": "Other-Reason-Partner-Case-Closure"
}
],
"text": "Other Reason for case closure",
"type": "string",
"enableWhen": [
{
"question": "8.1",
"operator": "=",
"answerCoding": {
"system": "http://loinc.org",
"code": "LA46-8"
}
}
],
"required": true,
"repeats": false
}
]
}