1 Female Survey

OMB No. 0920-0314

Expiration: 04/30/09

National Survey Family Growth

Cycle 7 Year 2 FEMALE Questionnaire

in CAPI-Lite Format

_____________________________________________________________________________

{THIS ITALICIZED TEXT APPEARS ON SCREEN, IN COMPLIANCE WITH OMB GUIDELINES.

Public reporting burden of this collection of information is estimated to average 80 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, GA 30333; ATTN: PRA (0920-0314)

______________________________________________________________________________

(NOTE: CAPI is Computer-Assisted Personal Interviewing. This is the "CAPI-Lite" version of the NSFG Cycle 7, Year 2 female questionnaire, showing basic question wording and routing. The full specifications, with detailed routing statements and all variants of each question are included in the CAPI Reference Questionnaire ("CRQ") that was used to guide programming of the instrument.)

______________________________________________________________________________

SECTION A

Calendar Instructions; Demographic Characteristics;

Household Roster; Childhood Background

INTRO_1

AA_0. Now we can begin.

I’ll begin with some basic questions about your background.

{ NOTE:

{ FOR EVERY ITEM IN THE QUESTIONNAIRE, RESPONDENTS CAN REFUSE TO ANSWER OR CAN

{ ANSWER AS “DON’T KNOW.” THE INTERVIEWER ENTERS “Control-R” FOR A REFUSAL

{ AND “Control-D” FOR A “DON’T KNOW” RESPONSE.

Age and Date of Birth (AA)

AGE_A

AA-1. (First, I’d like to know your age and date of birth.) How old are you?

ENTER age at last birthday in years __________

BIRTHDAY

AA-2. What is the date of your birth?

ENTER MM/DD/YYYY, with or without dividers ____________

(This is the only date in the interview that is asked for as month/day/year. All others are asked for only as month & year.)

(ASKED IF RESPONDENT DID NOT KNOW OR REFUSED TO PROVIDE AGE AND BIRTHDAY

MISSBRTH

AA-2A. In order to proceed with this interview, we need to know either

your age or your date of birth. I’d like to assure you that all

information collected in this survey will remain confidential and

be used only for statistical tabulations. Would you please give

me your age or date of birth?

Yes ..........1 RETURN TO AGE_A AA-1

No ...........5 GO TO TERMINATION SCRIPT TERMAGE AA-3A.

(IF R IS BETWEEN THE AGES OF 15 and 44, GO TO AB SERIES)

TERMINATION SCRIPTS:

TERMAGE That’s all the questions I have for you. Thank you for your time.

AA-3A.

ENTER [1] TO EXIT INTERVIEW

TERM In this survey we are only interviewing women who are between the

AA-3. ages of 15 and 44. Therefore, that's all the questions I have for you. Thank you for your time.

ENTER [1] TO EXIT INTERVIEW

Marital/Cohabiting Status (AB)

INTROCARD

AB-0. For many questions on this survey, I’ll ask you to look at numbered cards that list answer choices. After you’ve read the choices on the card, you can tell me your answer or, if you prefer, you can just tell me the number next to the answer you choose.

MARSTAT

AB-1. Now I’d like to ask about marital status and living together. Please look at Card 1. What is your current marital or cohabiting status?

Married ...............................................1

Not married but living together with a partner

of the opposite sex .............................2

Widowed ...............................................3

Divorced ..............................................4

Separated, because you and your spouse are

not getting along ...................................5

Never been married ....................................6

{ ASKED IF COHABITING

FMARSTAT

AB-2. What is your formal marital status? That is, are you widowed, divorced, separated, or have you never been married?

Widowed..............................................3

Divorced.............................................4

Separated, because you and your spouse are

not getting along..................................5

Never been married...................................6

Hispanic Origin and Race (AC)

HISP

AC-1. Now I have some questions about your ethnic background and your race. (You may have already told me this, but) Are you Hispanic or Latina, or of Spanish origin?

Yes.....................1

No......................5

{ ASKED IF HISPANIC

HISPGRP

AC-2. Are you Puerto Rican, Cuban, Mexican, Central or South American, or a member of some other group?

Puerto Rican...............................1

Cuban......................................2

Mexican....................................3

Central or South American..................4

Member of some other group.................7

RRACE

AC-3. Which of the groups on Card 2 describe your racial background? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ..........1

Asian......................................2

Native Hawaiian or Other Pacific Islander..3

Black or African American .................4

White .....................................5

{ ASKED ONLY IF MULTIPLE RACE GROUPS MENTIONED

RACEBEST

AC-4. Which of these groups, that is (RACE GROUPS SELECTED ABOVE) would you say best describes your racial background?

(DISPLAY ONLY THOSE GROUPS MENTIONED IN RRACE AC-3)

{ ASKED ONLY IF R REFUSED OR DIDN’T KNOW RACE

OBSERVE

AC-5. ENTER race of respondent by observation

Black............1

White............2

Other............7

Household Roster (AD)

{THE BELOW TABLE WILL BE PRE-FILLED (EXCEPT FOR “Relar” and “RowDone”) WITH INFORMATION ON EACH HOUSEHOLD MEMBER MENTIONED IN THE SCREENER.

{QUESTIONS AD-0 THROUGH AD-6 APPEAR WHEN THE CURSOR IS IN THE CORRESPONDING CELL OF THE TABLE.

{(NOTE: IF THE RESPONDENT HERSELF PROVIDED THE SCREENER INFORMATION, (IS THE “SCREENER INFORMANT”), SHE ONLY PROVIDES RELATIONSHIP (“Relar”) OF EACH PRE-FILLED HOUSEHOLD MEMBER. IF SHE IS NOT THE SCREENER INFORMANT, SHE VERIFIES THE INFORMATION OF EACH PRE-FILLED HOUSEHOLD MEMBER AND PROVIDES RELATIONSHIP.)

	Verify	Name	UsualRes	Sex	Age	Relar	RowDone
HHL[1]
HHL[2]
HHL[3]
HHL[4]
HHL[5]
HHL[6]
HHL[7]
HHL[8]
HHL[9]

{ASKED OF ALL RESPONDENTS:

Verify[X]

AD-0. I would like to get some additional information about the people in this household. / I would like to go over the information that I have about the people in this household.

There’s you and you are [AGE_R] years old. / There’s [Name[X]] and [he/she] is (less than 1 year old/1 year old/[Age[X]] years old). (Is this correct?)

If information is not correct, PROBE if necessary:

(What should be changed?)

{IF THE RESPONDENT HAS GOTTEN TO AN EMPTY ROW (THE END OF THE ROSTER)

Is there anyone else who lives here?

If no, GO TO AD-7 ENDROSTER

If yes, CONTINUE

{ IF THE ROW IS NON-EMPTY, AND IF THE INFORMATION IS CORRECT OR IF RESPONDENT

{ IS THE SCREENER INFORMANT,

{ GO TO AD-5 RELAR

Name[X]

AD-1. Enter name or initials of person who usually lives here.

Name or initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

UsualRes[X]

AD-2. Is this address considered to be (NAME[X])’s usual residence?

  Yes ............1

No .............5

Sex[X]

AD-3. If necessary, ASK: (Is (NAME) a male or female?)

Male ................1

Female ..............2

Age[X]

AD-4. How old is (Name[X])?

If necessary, ASK: (How old was (Name[X]) on (his/her) last birthday?)

Age ____________

Relar[X]

AD-5. Please look at Card (3/4). What is (Name[X])’s relationship to you?

NOTE: If R says “child”, PROBE for whether she means biological child or something else.

If R says ‘foster sister’ or ‘foster brother’, enter [23], ‘Other nonrelative’

(IF HOUSEHOLD MEMBER IS MALE, DISPLAY:)

Husband .............................................1

Male partner ........................................2

Biological son ......................................3

Step-son (son of spouse) ............................4

Adopted son .........................................5

Legal ward ..........................................6

Foster child ........................................7

Partner’s son .......................................8

Grandson ............................................9

Nephew ..............................................10

Biological father ...................................11

Step-father (husband of mother)......................12

Adoptive father .....................................13

Legal guardian ......................................14

Foster parent .......................................15

Your parent’s male partner ..........................16

Grandfather .........................................17

Uncle ...............................................18

Brother .............................................19

Other male relative .................................20

Roommate (male)......................................21

Tenant or boarder (male).............................22

Other male nonrelative ..............................23

(IF HOUSEHOLD MEMBER IS FEMALE, DISPLAY:)

Wife ................................................1

Female partner ......................................2

Biological daughter .................................3

Step-daughter (daughter of spouse) ..................4

Adopted daughter ....................................5

Legal ward ..........................................6

Foster child ........................................7

Partner’s daughter ..................................8

Granddaughter ......................................9

Niece ...............................................10

Biological mother ...................................11

Step-mother (wife of father) ........................12

Adoptive mother .....................................13

Legal guardian ......................................14

Foster parent .......................................15

Your parent’s female partner ........................16

Grandmother .........................................17

Aunt ................................................18

Sister ..............................................19

Other female relative ...............................20

Roommate (female) ...................................21

Tenant or boarder (female) ..........................22

Other female nonrelative ............................23

RowDone[X]

AD-6. ENTER [1] to VERIFY next row or to add additional HH members

ENDROSTER

AD-7. You have reached the end of the roster, ENTER [1] when ready to proceed.

{ASKED IF R IS MARRIED TO A FEMALE

SMSEXMAR

AD-7a. Because this questionnaire was originally designed to capture information on opposite-sex marriages, some of the questions may not pertain to your situation. We would appreciate it if you would answer as many questions as are relevant.

{ASKED IF R IS MARRIED/COHABITING BUT HUSBAND/PARTNER NOT LISTED IN HH ROSTER

HPLOCATN

AD-8. Please look at Card 5. Where is your (husband/partner) currently living?

Friend’s home.............................1

Relative’s home...........................2

College/university........................3

Armed forces..............................4

Employed in another city..................5

Medical institution (hospital,

rehabilitational facility)...............6

Correctional institution (jail, prison)...7

Other ....................................8

{ASKED IF THERE IS A HUSBAND/PARTNER AND CHILD/REN IN HOUSEHOLD

RELMAN[X]

AD-9. I need to find out about [HUSBAND/PARTNER’s NAME]’s relationship to the children who live here. Please look at Card 6. What is [HUSBAND/PARTNER’s NAME]’s relationship to [CHILD’s NAME]?

Biological father .......................1

Stepfather...............................2

Adoptive father .........................3

Uncle, grandfather, or

some other relation ...............4

Foster father or legal guardian..........5

Not related (legally or by blood)........6

Calendar Intro (AE)

CALENDAR_1

AE_1. This is a calendar to help you remember when things happened, when they come up in the interview. At the end of the interview, you can keep it or, if you prefer, I can take it with me and shred it.

We will be talking about dates during the interview, and getting accurate dates is very important. At times I will ask you to enter specific events on the calendar. The boxes are small but you can use abbreviations that are meaningful to you. You may also wish to draw a line between the beginning and end of an event, such as a period of school or a pregnancy.

CALENDAR_2

AE_2. Notice that the calendar's boxes start with January [YEAR OF INTERVIEW - 3]. Some things that I ask about will have happened since then and others will have happened longer ago. The column labeled "Before January [YEAR OF INTERVIEW - 3]" is for you to note things that happened before January [YEAR OF INTERVIEW - 3].

CALENDAR_3

AE_3. Now I’d like you to write your date of birth on the calendar on the line marked “Your Date of Birth”. Then, find the month and year of your last birthday and write your age in the box right underneath it (read if necessary: the row labeled “Your Age”). Now, please write your age under your birth month for the other years on the calendar.

INTERVIEWER: Demonstrate, monitor, and help when needed.

ENTER [1] to continue

CALENDAR_4

AE_4. Sometimes we'll be asking how old you were at a particular event in your life. Remember that your age at the event will depend on whether it happened before or after your birthday in that year. You can use the calendar to help figure that out.

Now let's continue with the interview.

ENTER [1] to continue

Regular school and GED (AF)

GOSCHOL

AF-1. I'd like to talk about your education. I'd like to talk only about regular school. By regular school I mean elementary, junior high or middle school, high school, college, or graduate school.

Are you now going to, or on vacation from, regular school?

ENTER [No] if R says she is taking GED courses now.

Yes ....................1

No .....................5 (GO TO HIGRADE AF-3)

{ ASKED IF R IN SCHOOL

VACA

AF-2. Are you currently on vacation from regular school?

Yes ....................1

No .....................5

HIGRADE

AF-3. Please look at Card 8. What (is the highest grade or year of (regular) school you have ever attended / grade or year of school are you in / were you in before vacation began)?

No formal schooling .............................0

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1 year of college or less .......................13

2 years of college ..............................14

3 years of college ..............................15

4 years of college/grad school ..................16

5 years of college/grad school ..................17

6 years of college/grad school ..................18

7 or more years of college and/or grad school ...19

{IF HIGHEST GRADE ATTENDED IS 0, DON’T KNOW, OR REFUSED, GO TO AF-6 DIPGED

{ASKED IF HIGHEST GRADE ATTENDED IS 1 THROUGH 19

COMPGRD

AF-4. (Did you complete/Have you completed) (that/your highest) (grade/year) of school?

Yes ....................1

No .....................5

{ IF R IS IN SCHOOL AND HIGHEST GRADE <= 12, AND HASN’T COMPLETED 12TH,

{ GO TO AF-8 HISCHGRD.

{ ASKED IF R HAS 12 YRS OF SCHOOLING

DIPGED

AF-6. Do you have either a high school diploma or a GED certificate, or both?

High school diploma only ...1

GED certificate only........2 (GO TO AF-8 HISCHGRD)

Both .......................3

Neither.....................5 (GO TO AF-8 HISCHGRD)

{ ASKED IF R HAS A HIGH SCHOOL DIPLOMA

EARNHS_M, EARNHS_Y

AF-7. In what month and year did you get your high school diploma?

Please record this on your calendar in the row marked "Education", in the box for the month and year that it happened. Remember, if you received your diploma before January [YEAR OF INTERVIEW - 3], please record this in the "Before [YEAR OF INTERVIEW - 3]" space in the "Education" row. You might write “HS” or some other abbreviation that you will recognize later.

{ASKED IF R DOES NOT HAVE A H.S. DIPLOMA AND HIGHEST GRADE IS > 12

HISCHGRD

AF-8. (Not counting your GED classes,) what is the highest grade of elementary, junior high or middle school, or high school you have ever attended?

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade.......................................12

{ ASKED IF R LEFT ELEM/JUNIOR/HIGH SCHOOL BEFORE HIGH SCHOOL GRADUATION

MYSCHOL_M, MYSCHOL_Y

AF-9. In what month and year did you last attend ((HIGHEST H.S. GRADE) grade/regular school)?

Please record this on your calendar in the row marked "Education", in the box for the month and year that it happened. Remember, if you received your diploma before January [YEAR OF INTERVIEW - 3], please record this in the "Before January [YEAR OF INTERVIEW - 3]" space in the "Education" row. You might write “HS” or some other abbreviation that you will recognize later.

ENTER year in 4 digits

If R never attended school, enter year of R’s birth.

_______________________

{ASKED IF HIGHEST GRADE >12

HAVEDEG

AF-10. Do you have any college or university degrees?

If R indicates that she has a trade-school degree, such as cosmetology or truck driving, ENTER [5].

Yes ....................1

No .....................5 (GO TO AG SERIES)

{ASKED IF R HAS A COLLEGE DEGREE

DEGREES

AF-11. Please look at Card 9. What is the highest college or university degree you have?

Associate’s degree ...........1

Bachelor’s degree ............2

Master’s degree ..............3

Doctorate degree .............4

Professional School degree ...5

Childhood Background (AG)

AGINTRO

AG-0. Now I have a few questions about your parents or parent-figures.

{IF R IS UNDER 18 AND HAS NO PARENT OR PARENT-LIKE PEOPLE IN THE HOUSEHOLD, GO TO AG-1 INTACT

{ASKED IF AGE >=18 OR IF (AGE<18 AND R HAS A PARENT OR PARENT-LIKE PERSON IN THE HOUSEHOLD

ONOWN

AG-0a. (Before you turned 18, did you ever live/Have you ever lived) away from your parents or guardians?

Please include times you were away at college or in the Armed Forces. But, do not include times you were away at boarding school for elementary, middle, or high school, or living in an institution or jail or group home.

Yes ...........1

No ............5

{IF R NEVER LIVED AWAY FROM PARENT(S), IS UNDER AGE 18, AND IS LIVING IN NONINTACT FAMILY HH, GO TO PARMARR AG-2

INTACT

AG-1. Between your birth or adoption and (the present time/the time you first started living on your own/your 18th birthday), (have you always lived/did you always live) with both your (biological/adoptive) mother and (biological/adoptive) father?

If R volunteers that she never lived on her own, ask her whether she has always lived with both parents between her birth or adoption and the present time.

Yes........1

No.........5

{ ASKED OF ALL

PARMARR

AG-2. Were your biological parents married to each other at the time you were born?

Yes........1

No.........5

{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP

LVSIT14F

AG-3. Now, think about when you were 14 years old. Looking at Card 9, what female and male parents or parent-figures were you living with at age 14?

ENTER female adult first

No female parent or parent-figure present...1

Biological mother...........................2

Stepmother..................................3

Adoptive mother.............................4

Father's girlfriend.........................5

Foster mother...............................6

Grandmother.................................7

Aunt........................................8

Other female ...............................9

{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP

LVSIT14M

AG-4. Ask if necessary:

Now tell me who was the male parent or parent-figure you were living with when you were 14 years old.

ENTER male adult

No male parent or parent-figure present....1

Biological father..........................2

Stepfather.................................3

Adoptive father............................4

Mother's boyfriend.........................5

Foster father..............................6

Grandfather................................7

Uncle......................................8

Other male ................................9

{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP

WOMRASDU

AG-5. Who, if anyone, do you think of as the woman who mostly raised you when you were growing up?

Biological mother........1

Adoptive mother..........2

Step‑mother..............3

Father's girlfriend......4

Foster mother............5

Grandmother..............6

Other female relative....7

Female non‑relative......8

No such person...........9

Other ..................10

{IF R DID NOT HAVE A MOTHER OR MOTHER-FIGURE, GO TO AG-8 MOMCHILD

MOMDEGRE

AG-6. Please look at Card 11. What is the highest level of education (she/your mother) completed?

PROBE: What is your best guess?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate’s degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school .................6

MOMWORKD

AG-7. During most of the time you were growing up, that is when you were between the ages of 5 and 15, did she usually work full‑time, part‑time or did she not work for pay at all?

Full-time ..................................1

Part-time...................................2

Equal amounts full time and part time.......3

Not at all (for pay)........................4

MOMCHILD

AG-8. (Including yourself/Altogether), how many children did (she/your mother) have who were born alive to her?

Number of children

{ASKED IF R’s MOTHER/MOTHER-FIGURE HAD AT LEAST ONE CHILD

MOMFSTCH

AG-9. How old was she when she had her first child who was born alive?

Age

{ASKED IF R’s MOTHER/MOTHER-FIGURE HAD AT LEAST ONE CHILD AND R DOESN’T KNOW AGE AT FIRST BIRTH

MOM18

AG-10. Was she under 18, 18 to 19, 20 to 24, or 25 or older?

Under 18.... ....1

18‑19 ...........2

20‑24 ...........3

25 or older......4

{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP

MANRASDU

AG-11. Who, if anyone, do you think of as the man who mostly raised you when you were growing up?

Biological father........1

Adoptive father..........2

Step‑father..............3

Mother's boyfriend.......4

Foster father............5

Grandfather..............6

Other male relative......7

Male non‑relative........8

No such person...........9

Other ...................10

{IF R DID NOT HAVE A FATHER OR FATHER-FIGURE, GO TO SECTION B

DADDEGRE

AG-12. Please look at Card 11. What is the highest level of education (he/your father) completed?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate’s degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school..................6

SECTION B

Pregnancy & Birth History; Adoption & Nonbiological Children

BINTRO_1

BA-0. The next section is about your experience with childbearing and pregnancy. First I would like to know when you started having your menstrual periods.

MENARCHE AND CURRENT PREGNANCY (BA)

MENARCHE

BA-1. How old were you when you had your first menstrual period?

Age in years ________

{ IF R HASN’T HAD 1^st MENSTRUAL PERIOD YET AND AGE UNDER 18, GO TO SECTION C.

{ IF R HASN’T HAD 1^st MENSTRUAL PERIOD YET AND AGE 18 OR UP, GO TO BJ SERIES.

{ IF R HAS HAS REACHED MENARCHE OR AGE AT 1^st MENSTRUAL PERIOD IS DK/RF

PREGNOWQ

BA-2. Are you pregnant now?

Yes ........1

No .........5

{ IF R DOESN’T KNOW IF SHE’s CURRENTLY PREGNANT

MAYBPREG

BA-3. Do you think you are probably pregnant or not?

Probably pregnant ...... 1

Probably not pregnant .. 5

{ ALL RESPONDENTS WHO HAVE REACHED MENARCHE

BINTRO_2

BA-4. Next I will be asking you about any pregnancies you have had -- whether they resulted in babies born alive, stillbirth, abortion, miscarriage, or ectopic or tubal pregnancy. We’ll be talking about each of your pregnancies in the order they occurred. This information is some of the most important in this interview because it will help to improve family planning and health services for all women. So please take whatever time you need to answer them as accurately and completely as possible.

NUMBER OF PREGNANCIES (BB)

{ ALL RESPONDENTS WHO HAVE REACHED MENARCHE

NUMPREGS

BB-1. (Including this pregnancy,) how many times have you been pregnant in your life?

Number ________

{ ASKED IF CURRENTLY PREGNANT

{ R CAN ANSWER IN WEEKS OR MONTHS

HOWPREG_N

BB-2. 1 of 2 How many weeks or months pregnant are you now?

If R is less than 1 week pregnant, Enter 0.

Number of weeks or months __________

HOWPREG_P

BB-2. 2 of 2

After R has selected the units, SAY: Please record the month when this pregnancy began using a “P” in the appropriate box on your calendar’s “Pregnancies and Births” row.

Weeks....1

Months...2

{ IF DK HOW MANY MONTHS OR WEEKS PREGNANT

NOWPRGDK

BB-3. Are you in your first trimester, in your second trimester, or in your third trimester?

First trimester ..........1

Second trimester .........2

Third trimester ..........3

{ IF CURRENTLY PREGNANT WITH 1^st PREGNANCY, GO TO BI SERIES.

{ IF ANY COMPLETED PREGNANCIES, CONTINUE WITH BC SERIES.

{ PREGNANCY LOOP BEGINS HERE.

{ THESE QUESTIONS ARE ASKED FOR EACH COMPLETED PREGNANCY.

{ IF PREGNANCY BEING DESCRIBED IS A CURRENT PREGNANCY, GO TO BI SERIES.

PREGNANCY OUTCOME, DATE, AND GESTATIONAL LENGTH -- ALL COMPLETED PREGS (BC)

BINTRO_3

BC-0. Now I'd like to ask some questions specifically about your (PREGFILL) pregnancy. (Remember, we’ll be talking about each of your pregnancies in the order they occurred.)

PREGEND

BC-1. In which of the ways shown on Card 13 did the pregnancy end?

ENTER all that apply.

NOTE: This is a critical item. PROBE if R says DK or RF.

Miscarriage ..........................1

Stillbirth ...........................2

Abortion .............................3

Ectopic or tubal pregnancy ...........4

Live birth by Cesarean section .......5

Live birth by vaginal delivery .......6

{ASKED IF R RESPONDED DK OR REF TO PREGEND

HOWENDDK

BC-1b. I understand that you may not want to answer this question in detail. If you are willing to say, did this pregnancy result in a baby or babies born alive, or did it end in some other way?

Live birth ...............1

Some other way ...........5

{ IF PREGNANCY ENDED IN ANY LIVE BIRTH

NBRNALIV

BC-2. (With your (nth) pregnancy,) How many babies did you have that were born alive? Please include babies that may have died shortly after birth and babies that you placed for adoption.

Number

{ IF MORE THAN 1 LIVEBORN BABY REPORTED FROM THIS PREGNANCY

MULTBRTH

BC-3. Did you have (twins/triplets/all of these babies with this [nth] pregnancy)?

Yes ...........1

No ............5

{ IF ANY LIVEBORN BABY FROM THIS PREGNANCY, GO TO BC-5 GESTASUN.

{ IF THIS PREGNANCY DID NOT RESULT IN LIVEBIRTH

DATPRGEN_M, DATPRGEN_Y

BC-4a. In what month and year did this pregnancy end?

 After R has given the year, say: Please record the pregnancy in the “Birth or Pregnancy Ending Dates” section below the calendar. Then, if the pregnancy ended in January [YEAR OF INTERVIEW - 3] or later, please record “S" for a stillbirth, “M" for miscarriage or ectopic, or “A" for abortion in the appropriate box on the “Births & Other Pregnancies" row of the calendar.

{ IF R REPORTED ONLY A SEASON OR MO/YR = DK/RF

AGEATEND

BC-4b. How old were you when this pregnancy ended?

Age in years ______

{ IF THIS PREGNANCY DID NOT RESULT IN LIVEBIRTH

HPAGEEND

BC-4c. How old was the father when this pregnancy ended?

Age in years _______

{ ASKED FOR EACH COMPLETED PREGNANCY, REGARDLESS OF OUTCOME

GESTASUN_M, GESTASUN_W

BC-5. How many months or weeks had you been pregnant when (the baby was born/the [MULT] were born/that pregnancy ended)?

Number of months/weeks _________

 After R has reported the number of weeks, say:

Please record the month and year when this pregnancy began using a "P" in the appropriate box on your calendar's “Births & Other Pregnancies" row. You may wish to draw a line from the beginning to the ending month of this pregnancy. If pregnancy began before January [YEAR OF INTERVIEW - 3], please record this, including the date, in the box for “Before January [YEAR OF INTERVIEW - 3]”.

{ IF GESTATIONAL LENGTH REPORTED, GO TO BD SERIES.

{ IF GESTATIONAL LENGTH = DK/RF, CONTINUE WITH DK FOLLOW-UP QUESTIONS.

{ IF GESTATIONAL LENGTH = DK/RF AND PREGNANCY ENDED IN STILBIRTH

DK1GEST

BC-6. Was it...

Less than 6 months, or ....1

6 months or more?..........2

{ IF GESTATIONAL LENGTH = DK/RF AND PREGNANCY ENDED IN LIVEBIRTH

DK2GEST

BC-7. A preterm delivery is one that occurs at 36 weeks or earlier in pregnancy. As far as you know, did you have a preterm delivery?

Yes ...............1

No ................5

{ IF GESTATIONAL LENGTH = DK/RF AND PREGNANCY ENDED IN MISCARRIAGE, ABORTION,

{ OR ECTOPIC

DK3GEST

BC-8. Was it...

Less than 3 months, ..........1

3 months or more, but less

than 6 months, or...........2

6 months or more? ............3

{ IF PREGNANCY ENDED IN LIVEBIRTH, CONTINUE WITH BD SERIES.

{ IF PREGNANCY ENDED ONLY IN ABORTION, GO TO BI SERIES.

{ IF PREGNANCY ENDED ONLY IN MISCARR, ECTOPIC, OR STILLBIRTH, GO TO BE SERIES.

DELIVERY INFORMATION -- ALL LIVE BIRTHS, SOME BABY-SPECIFIC QUESTIONS (BD)

BABYNAME

BD-1. What did you name your (baby/[MULT])?

Name or initials __________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE)

{ IF MORE THAN 3 BABIES BORN ALIVE FROM THIS PREGNANCY

BINTRO_4

BD-1b. "In order to save time during the interview, I will only ask you specific questions about the first three babies from this pregnancy."

{ ASKED FOR EACH LIVEBORN BABY FROM THIS PREGNANCY

BABYSEX

BD-2. ASK IF NECESSARY: (Is/Was) (BABYFILL /the [BABYFILL] baby) male or female?

Male ............. 1

Female ........... 2

{ ASKED FOR EACH LIVEBORN BABY FROM THIS PREGNANCY

{ INTERVIEWER ENTERS BOTH POUNDS & OUNCES

BIRTHWGT_LB, BIRTHWGT_OZ

BD-3. How much did (BABYFILL /this (NTH) baby) weigh at birth?

Pounds and ounces _______

{ ASKED FOR EACH LIVEBORN BABY FROM THIS PREGNANCY

{ IF BIRTHWEIGHT IS NOT KNOWN OR REFUSED

LOBTHWGT

BD-4. Did (she/he) weigh 5 1/2 pounds or more, or less than 5 1/2 pounds?

5 1/2 pounds or more ................. 1

Less than 5 1/2 pounds ............... 2

{ IF ALL BABIES FROM THIS PREGNANCY HAVE BEEN DESCRIBED,

{ CONTINUE WITH BD-5 BABYDOB.

{ ELSE RETURN TO BD-1 BABYNAME FOR NEXT BABY FROM THIS PREGNANCY.

{ ASKED FOR THE DELIVERY

BABYDOB_M, BABYDOB_Y

BD-5. IF NUMBER OF BABIES BORN ALIVE IS NOT DK OR RF, ASK:

In what month and year (was she/was he/were the [MULT]) born?

ELSE IF NUMBER OF BABIES BORN ALIVE = DK OR RF, ASK:

In what month and year did this pregnancy end?

 After R has given the year, say: Please write this date in the "Birth or Pregnancy Ending Dates" section below the calendar. Then, if the birth occurred in January [YEAR OF INTERVIEW - 3] or later, please record a "B" in the box for this month and year on the "Births & Other Pregnancies" row of the calendar.

{ ASKED FOR ALL PREGNANCIES RESULTING IN LIVEBIRTH

HPAGELB

BD-6. How old was the father when (he/she/the [MULT]) (was/were) born?

Age _________

{ IF DELIVERY OCCURRED EARLIER THAN January [YEAR OF INTERVIEW - 5], GO TO BG SERIES.

{ IF DELIVERY OCCURRED IN January [YEAR OF INTERVIEW - 5] OR LATER, CONTINUE WITH BD-7 BIRTHPLC.

{ IF DELIVERY OCCURRED IN January [YEAR OF INTERVIEW - 5] OR LATER

BIRTHPLC

BD-7. Where did you give birth? Was it in a hospital, in a birthing center, in your home, or some other place?

In a hospital .........................1

In a birthing center ..................2

In your home ..........................3

Some other place ......................4

PAYBIRTH

BD-8. When ([BABYFILL] was born/your [MULT] were born,) in which of the ways on Card 16 was the delivery bill paid?

ENTER all that apply.

Insurance .....................................1

Co-payment or out-of-pocket payment ...........2

Medicaid ......................................3

No payment required ...........................4

Some other way ................................5

{ IF BABY(IES) BORN FROM THIS PREGNANCY WERE ALL PLACED FOR ADOPTION,

{ GO TO BI SERIES.

{ ELSE IF PREGNANCY ENDED IN January [YEAR OF INTERVIEW - 5] OR LATER, CONTINUE WITH BE SERIES.

{ ELSE IF PREGNANCY ENDED EARLIER THAN January [YEAR OF INTERVIEW - 5], GO TO BG SERIES.

{ Asked if this pregnancy only ended in cesarean live birth delivery and occurred in last 5 years

CSECPRIM

BD-9. Was this your first cesarean delivery, or had you had one before this?

Yes, first cesarean .......1

No, not first cesarean ....5

{ Asked only if this was first cesarean

CSECMED

BD-10. Please look at CARD XX. Which of these medical reasons, if any, were there for this cesarean delivery?

 ENTER all that apply

Labor was taking too long ..................................1

Maternity care provider concerned that baby was too big ....2

Baby was in the wrong position (e.g, breech) ...............3

Maternity care provider concerned about your health ........4

Maternity care provider concerned about your baby’s health .5

Some other medical reason ..................................6

There was no medical reason ................................7

{ Asked only if R has reported no medical reason for the c-section

SP_CSECMED

BD-10sp. What was the main reason for your cesarean delivery?

TYPE: (Enter verbatim response)

{ Asked only if R has reported no medical reason for the c-section

CSECPLAN

BD-11. Was this cesarean the result of your own idea to have a planned cesarean before labor began?

Yes ..........1

No ...........5

SELECTED INFORMATION FOR RECENT PREGNANCIES (SINCE JANUARY OF THE YEAR 5 YEARS BEFORE INTERVIEW) (BE)

KNEWPREG

BE-1. How many weeks pregnant were you when you learned that you were pregnant this (nth) time?

Number of weeks ________

{ IF BE-1 KNEWPREG = DK OR RF AND PREGNANCY LASTED LESS THAN 3 MONTHS,

{ GO TO BI SERIES.

{ ASKED IF BE-1 KNEWPREG = DK OR RF AND PREGNANCY WAS AT LEAST 6 MONTHS LONG

TRIMESTR

BE-2a. Was it less than 3 months, at least 3 months but less than 6 months, or 6 or more months?

Less than 3 months.................1

At least 3 months but less than

6 months.........................2

6 months or more...................3

{ ASKED IF BE-1 KNEWPREG = DK OR RF AND PREGNANCY LASTED 3-6 MONTHS

LTRIMEST

BE-2b. Was it less than 3 months or 3 months or more?

Less than 3 months..............................1

3 months or more................................2

{ ASKED FOR EACH RECENT PREGNANCY

PRIORSMK

BE-3. Please look at Card 17. In the 6 months before you found out you were pregnant this (PREGFILL) time, how many cigarettes did you smoke a day, on average?

None ................................... 0

About one cigarette a day or less ...... 1

Just a few cigarettes a day (2-4) ...... 2

About half a pack a day (5-14) ......... 3

About a pack a day (15-24) ............. 4

About 1 1/2 packs a day (25-34) ........ 5

About 2 packs a day (35-44) ............ 6

More than 2 packs a day (45 or more) ... 7

{ ASKED FOR EACH RECENT PREGNANCY

POSTSMKS

BE-4. After you found out you were pregnant this (nth) time, did you smoke cigarettes at all during the pregnancy?

Yes ........ 1

No ......... 5 (BE-6 GETPRENA)

{ ASKED IF SMOKED AT ALL AFTER LEARNING SHE WAS PREGNANT

NPOSTSMK

BE-5. Looking at Card 18, on average, how many cigarettes did you smoke per day after you found out that you were pregnant this (PREGFILL) time?

About one cigarette a day or less ...... 1

Just a few cigarettes a day (2-4) ...... 2

About half a pack a day (5-14) ......... 3

About a pack a day (15-24) ............. 4

About 1 1/2 packs a day (25-34) ........ 5

About 2 packs a day (35-44) ............ 6

More than 2 packs a day (45 or more) ... 7

{ ASKED FOR EACH RECENT PREGNANCY

GETPRENA

BE-6. During this (PREGFILL) pregnancy, did you ever visit a doctor or other medical care provider for prenatal care, that is, for one or more pregnancy check-ups?

Yes........................1

No.........................5 (GO TO BF SERIES)

{ IF WENT FOR PRENATAL CARE

BGNPRENA

BE-7. How many weeks pregnant were you at the time of your first prenatal care visit?

Number _____________

{ IF BE-7 BGNPRENA = DK OR RF AND PREGNANCY ENDED AT LESS THAN 3 MONTHS,

{ GO TO BI SERIES.

{ ASKED IF BE-7 BGNPRENA = DK OR RF AND PREGNANCY WAS AT LEAST 6 MONTHS LONG

PNCTRIM

BE-8a. Was it less than 3 months, at least 3 months but less than 6 months, or 6 or more months?

Less than 3 months..............................1

At least 3 months but less than 6 months........2

6 or more months .............................3

{ ASKED IF BE-7 BGNPRENA = DK OR RF AND PREGNANCY LASTED 3-6 MONTHS

LPNCTRI

BE-8b. Was it less than 3 months or 3 months or more?

Less than 3 months.........................1

3 or more months...........................2

{ IF PREGNANCY DID NOT END IN LIVE BIRTH JAN 1997 OR LATER, GO TO BG SERIES.

{ ELSE CONTINUE WITH BF SERIES.

MATERNITY LEAVE -- ALL RECENT LIVE BIRTHS (SINCE JANUARY OF THE YEAR 5 YEARS BEFORE INTERVIEW) (BF)

{ IF THIS PREGNANCY RESULTED ONLY IN BABY OR BABIES WHO DIED SHORTLY AFTER

{ BIRTH (AND WERE UNNAMED BY R), GO TO BI SERIES.

{ ELSE IF ANY NAMED BABIES WERE REPORTED, CONTINUE.

{ ASKED FOR EACH DELIVERY RESULTING IN A LIVEBORN, NAMED BABY

WORKPREG

BF-1. At any time while you were pregnant with ([BABYFILL]/this baby/your [MULT]), were you employed at a job for pay?

Yes ...........................................1

No ............................................5 (BG Series)

R volunteers that she worked during pregnancy,

But quit job before delivery ............6 (BG Series)

{ ASKED IF R WAS EMPLOYED DURING PREGNANCY

WORKBORN

BF-2. Maternity leave is any leave, paid or unpaid, due to pregnancy and childbirth that a woman takes from a job to which she expects to return, at least when she starts the leave. Did you ever take maternity leave, paid or unpaid, from a job you held when you were pregnant with ([BABYFILL]/this baby/your[MULT])?

ENTER AYes” if R was already on maternity leave when baby was born.

Yes ...................1 (BF-4 MATWEEKS)

No ....................5 (BF-3 DIDWORK)

DIDWORK

BF-3. Was this because you did not need to take maternity leave, you were not offered or allowed to take leave, or for some other reason?

Did not need to take maternity leave ....................1

Were not offered or allowed to take maternity leave .....2

Some other reason .......................................3

{ IF R DID NOT TAKE MATERNITY LEAVE, GO TO BG SERIES.

{ ASKED IF R TOOK MATERNITY LEAVE

MATWEEKS

BF-4. In total, how many weeks of maternity leave, paid or unpaid, did you take?

Number of weeks ________

{ IF A NUMBER IS REPORTED, GO TO BF-6 MATLEAVE.

{ ASKED IF BF-4 MATWEEKS = DK OR RF

WEEKSDK

BF-5. Did you take 4 weeks or less or longer than 4 weeks?

4 weeks or less,..............1

Longer than 4 weeks...........2

{ ASKED IF R TOOK MATERNITY LEAVE

MATLEAVE

BF-6. Some women receive pay from their jobs during their maternity leave, through vacation pay, sick pay, maternity benefits, and other kinds of paid leave. In total, how many weeks of paid leave did you receive from your job while you were on maternity leave?

Number of weeks _______

{ IF CHILD’s CURRENT AGE IS 18 YEARS OR YOUNGER, CONTINUE WITH BG SERIES.

{ ELSE IF CHILD IS OLDER THAN 18, GO TO BI SERIES.

CURRENT LIVING STATUS OF EACH BABY BORN (if under age 19) (BG)

{ BG SERIES IS ONLY ASKED FOR EACH CHILD BORN FROM THIS PREGNANCY, WHO IS

{ CURRENTLY 18 YEARS OLD OR YOUNGER.

{ ASKED IF NOT ALREADY APPARENT THAT CHILD LIVES WITH R

LIVEHERE

BG-1. Earlier I don't think you mentioned (BABYFILL) when you told me who lives with you. Does (BABYFILL) still live with you?

ENTER “Yes” if child usually lives with R.

Yes .................1 (BH-1 ANYNURSE)

No ..................5

{ ASKED IF CHILD NOT LIVING WITH R

ALIVENOW

BG-2. Is (she/he) still living?

Yes .............. 1

No ............... 5

{ IF CHILD IS STILL LIVING OR DK/RF, GO TO BG-4 WHENLEFT.

{ ASKED IF CHILD IS DECEASED

WHENDIED_M, WHENDIED_Y

BG-3. When did (BABYFILL) die?

 After R has reported year, say: "If you think it might help you in remembering dates of other things later, you can record this on the calendar in the “Births & Other Pregnancies" row."

{ ASKED IF CHILD IS ALIVE BUT NOT LIVING WITH R

WHENLEFT_M, WHENLEFT_Y

BG-4. When did (BABYFILL) stop living with you?

 After R has reported year, say: "If you think it might help you in remembering dates of other things later, you can record this on the calendar in the “Births & Other Pregnancies" row."

{ ASKED IF CHILD IS ALIVE BUT NOT LIVING WITH R

WHERENOW

BG-5. Please look at Card 19. Where does (BABYFILL) now live?

With biologic father .................1

With other relatives .................2

With adoptive family .................3

Away at school/college ...............4

Living on own ........................5

Other ................................6

{ IF CHILD IS LIVING WITH ADOPTIVE FAMILY, AND DID NOT LIVE AT LEAST 2 MONTHS

{ WITH R, GO TO BI SERIES.

{ ELSE IF CHILD IS LIVING WITH ADOPTIVE FAMILY, BUT DID LIVE AT LEAST 2

{ MONTHS WITH R, GO TO BH SERIES.

{ IF CHILD IS AWAY AT SCHOOL, GO BH SERIES.

{ ASKED IF CHILD (18 or under) IS LIVING WITH BIOLOGICAL FATHER

LEGAGREE

BG-6. Do you and (BABYFILL)’s father have a legal agreement about (BABYFILL) regarding child support, alimony, custody, visitation, or where the child lives?

Yes.....1

No......5

{ ASKED IF CHILD (18 or under) IS LIVING WITH BIOLOGICAL FATHER, LIVING WITH

{ OTHER RELATIVES, LIVING ON OWN, OR LIVING IN SOME OTHER PLACE.

PARENEND

BG-7. Are you still the legal mother of (BABYFILL)?

ENTER ANo” if R’s parental rights have been terminated.

Yes ......1

No .......5

BREASTFEEDING SERIES FOR EACH NAMED BABY (BH)

{ BH SERIES ASKED IF CHILD LIVED WITH R FOR AT LEAST 2 MONTHS

{ ASKED FOR EACH CHILD CURRENTLY 18 OR UNDER WHO LIVED WITH R AT LEAST 2 MOS.

ANYNURSE

BH-1. (When (BABYFILL) was an infant,) (Have/did) you breastfeed (him/her) at all?

ENTER “Yes” for any amount of breastfeeding by R. If R only expressed or pumped breastmilk to be fed to the baby, count this as a “yes” as well.

Yes .......... 1

No ........... 5 (GO TO BI SERIES)

{ IF CHILD IS 1 YEAR OR OLDER, GO TO BH-3 FRSTEATD.

{ ASKED IF CHILD IS LESS THAN 1 YEAR OLD

FEDSOLID

BH-2. Besides breastmilk, babies are sometimes given formula, baby food, or other liquid or solid foods. (Did you feed/Have you fed) [BABYFILL] something other than breast milk yet?

Yes ..........................1

No ...........................5 (BI SERIES)

{ IF CHILD WAS EVER FED SOMETHING OTHER THAN BREAST MILK OR

{ IF CHILD OLDER THAN 1 YEAR.

{ ANSWER CAN BE GIVEN IN DAYS, WEEKS, OR MONTHS.

FRSTEATD_N

BH-3. How old was (she/he) when you first fed (her/him) something other than breast milk?

Age in days, weeks, or months _________

{ IF CHILD OLDER THAN 2 YEARS, GO TO BH-5 AGEQTNUR.

{ ASKED IF CHILD AGED 2 YEARS OR YOUNGER

QUITNURS

BH-4. (Have/Had) you stopped breast-feeding (her/him) altogether?

Yes .........................1

No ..........................5 (GO TO BI SERIES)

{ ASKED IF R STOPPED BREASTFEEDING THIS CHILD OR CHILD IS OLDER THAN 2 YEARS.

{ ANSWER CAN BE GIVEN IN DAYS, WEEKS, OR MONTHS.

AGEQTNUR_N

BH-5. How old was (she/he) when you stopped breast-feeding (her/him) altogether?

Use the information already recorded on the calendar to help you remember the date you stopped breast-feeding. You may want to record this on the calendar, but it is not necessary.

Age in days, weeks, or months _________

{ IF MORE BABIES TO DISCUSS FROM THIS PREGNANCY, RETURN TO BG SERIES.

{ ELSE CONTINUE WITH NEXT PREGNANCY, IF THERE IS ONE.

{ IF NO MORE PREGNANCIES TO DISCUSS, GO TO BI SERIES.

CNFMPREG

BH-6. Thank you. Now I would like to confirm some of the important information about this (PREGFILL) pregnancy to make sure I have it right.

IF PREGNANCY ENDED IN A LIVE BIRTH:

This pregnancy ended in the birth of (1 baby (named [BABYFILL])/ [BORNALIV] babies (named [BABYFILL])). This pregnancy lasted (GESTASUN_M) month(s) and (GESTASUN_W) week(s) and ended in (CMPRGEND_FILL).

Is this correct?

IF PREGNANCY DID NOT END IN A LIVE BIRTH:

This pregnancy did not end in a live birth. This pregnancy lasted ((GESTASUN_M) month(s) and (GESTASUN_W) week(s) and ended in (CMPRGEND_FILL).

Is this correct?

Yes ...........1

No ............5

CONFIRMATION OF REPORTED PREGNANCIES (BI)

INTR_ORD

BI-1. Thank you for that information. In addition to the details you just told me, it is also important to make sure that I have listed the pregnancies in the right order. We will use that order for questions later in the interview. As I read a list of your past pregnancies, please let me know if I have them in the order in which they occurred.

CHKORDER

BI-2. (Please let me know if these past pregnancies are listed in the order in which they occurred.)

EXAMPLE:

Your 1^st pregnancy did not end in a live birth. This pregnancy lasted 3 months and 2 weeks and ended in June 2002.

Your 2^nd pregnancy ended in the birth of 1 baby (named George). This pregnancy lasted 9 month(s) and 1 week(s) and ended in December 2004.]

Yes, pregnancies in order/everything is correct..1

No, pregnancies out of order.....................5

IF VOL: No, something else incorrect.............7

{ TABLE APPEARS

PRGVERIF	Outcome	Numlvbrn	Multborn	Gestlen_m	Gestlen_w	Enddate_m	Enddate_y

PRGVERIF[X]

BI-3.

WHEN CURSOR IN FIRST ROW, DISPLAY:

First, let’s correct the information about your pregnancies.

I have that the first pregnancy we talked about [insert pregnancy text from BH-6 except drop “This pregnancy” from the beginning of the first sentence.].

If information is correct, ENTER [1] to go to next pregnancy.

If information is incorrect, ENTER [5] to correct information.

If pregnancy did not occur, ENTER [96] to remove it from list.

WHEN CURSOR IN LAST ROW, DISPLAY:

You have reached the end of the grid.

 After you have completed the grid, say: Please make sure the dates of all births/pregnancies are correct on your calendar as well.

If all pregnancies have been verified, ENTER [1].

If R reports an additional pregnancy, ENTER [5].

ELSE, DISPLAY:

I have that the (PREGFILL) pregnancy we talked about [insert pregnancy text from BH-6 except drop “This pregnancy” from the beginning of the first sentence.].

If information is correct, ENTER [1] to go to next pregnancy.

If information is incorrect, ENTER [5] to correct information.

If pregnancy did not occur, ENTER [96] to remove it from list.

OUTCOME[X]

BI-4. In which of the following ways did this pregnancy end?

Live birth ....................1

Non-live birth.................2

NUMLVBRN[X]

BI-4a. With this pregnancy, how many babies did you have that were born alive? Please include babies that may have died shortly after birth and babies that you placed for adoption.

ENTER number of babies

MULTBORN[X]

BI-4b.IF BI-4a NUMLVBRN[X] = 2, ASK:

Did you have twins?

ELSE IF BI-4a NUMLVBRN[X] = 3, ASK:

Did you have triplets?

ELSE IF BI-4a NUMLVBRN[X] > 3, ASK:

Did you have all of these babies with this [PREGFILL] pregnancy?

Yes ...........1

No ............5

GESTLEN_M[X], GESTLEN_W[X]

BI-5a/b.How many months or weeks had you been pregnant when (the baby was born/the babies were born/that pregnancy ended)?

 After R has reported the number of weeks, say:

Please make sure the month and year when this pregnancy began is correctly recorded on the lines below the calendar and marked with a “P” in the appropriate box on your calendar's “Births & Other Pregnancies" row.

ENDDATE_M[X], ENDDATE_Y[X]

BI-6a/b. In what month and year did this pregnancy end?

PROBE gently for season if DK OR RF month

If R insists she does not know, Enter DK.

[CALENDAR REFERENCE]

1. January 5. May 9. September 13. Winter

2. February 6. June 10. October 14. Spring

3. March 7. July 11. November 15. Summer

4. April 8. August 12. December 16. Fall

After R has given the year, SAY: Please make sure the month and year when this pregnancy began is correctly recorded on the lines below the calendar and marked with an "S" for a stillbirth, "M" for miscarriage or ectopic, or "A" for abortion in the appropriate box on your calendar's “Births & Other Pregnancies" row.

FIXORDER

BI-8. Thank you for that information. Now, we will correct the order of your pregnancies. Please tell me which one was your first pregnancy? (And your next?)

EXITORDR

BI-9. Thank you for your help making sure this pregnancy information is correct. Now let’s move on to some other questions.

OTHER (NON-BIOLOGICAL) CHILDREN CARED FOR SERIES (BJ)

{ BJ SERIES ONLY ASKED IF R IS 18 YEARS OR OLDER.

OTHERKID

BJ-1. (Not counting the child(ren) born to you,) have any children lived with you under your care and responsibility?

Yes .................. 1

No.................... 5 (GO TO BK SERIES)

NOTHRKID

BJ-2. How many children?

Number of children ________

OKDNAME

BJ-3. So that I can refer to (this child/these children) during the interview, what (is/are) the name(s) or initials of the child(ren) who lived with you under your care?

Child’s name/initials __________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

{ BEGIN LOOP TO ASK ABOUT EACH CHILD REPORTED

SEXOTHKD

BJ-4. [ASK IF NECESSARY:] Is (OKDNAME) male or female?

Male ........... 1

Female ......... 2

RELOTHKD

BJ-5. Please look at Card 20. When (OKDNAME) began living with you, how was (she/he/this child) related to you?

Your husband’s child (stepchild) ............. 1

The child of a blood relative ................ 2

The child of a relative by marriage .......... 3

The child of a friend ........................ 4

Your boyfriend or partner's child ............ 5

Related to you in some other way ............. 6

Unrelated to you previously in any way ....... 7

ADPTOTKD

BJ-6. Did you legally adopt (OKDNAME) or become (OKDNAME)’s legal guardian?

ENTER [1] if R both adopted and became legal guardian to this child.

Yes, adopted .............. 1

Yes, became guardian ...... 3

No, neither ............... 5

{ IF R REPORTED ADOPTING THIS CHILD, GO TO BJ-8 STILHERE.

{ ELSE IF R REPORTED BECOMING GUARDIAN TO THIS CHILD, ASK BJ-7a TRYADOPT.

{ ELSE IF R SAID ANEITHER,” GO TO BJ-7b TRYEITHR.

{ ASKED IF R BECAME LEGAL GUARDIAN TO THIS CHILD

TRYADOPT

BJ-7a. Are you in the process of trying to legally adopt [OKDNAME]?

Yes ...........1 (GO TO BJ-8 STILHERE)

No ............5 (GO TO BJ-8 STILHERE)

{ ASKED IF R NEITHER ADOPTED NOR BECAME LEGAL GUARDIAN TO THIS CHILD

TRYEITHR

BJ-7b. Are you in the process of trying to legally adopt [OKDNAME] or to become (his/her/this child’s) legal guardian?

Yes, trying to adopt ................1

Yes, trying to become guardian ......3

No, neither .........................5

{ ASKED IF NOT ALREADY APPARENT THAT CHILD IS LIVING IN WITH R

STILHERE

BJ-8. Is (OKDNAME) still living with you?

Yes ....................... 1

No ........................ 5

{ IF BJ-8 STILHERE = NO OR RF, GO TO BJ-11 OKDDOB.

{ ASKED IF CHILD LIVES WITH R

DATKDCAM_M, DATKDCAM_Y

BJ-9. In what month and year did (she/he/this child) begin living with you?

Use the information already recorded on the calendar to help you remember when this child was living with you. You may want to record this on the calendar, but it is not necessary.

{ IF R IS A STEPCHILD OR PARTNER’s CHILD, GO TO BJ-11 OKDDOB.

{ ASKED IF CHILD LIVES WITH R AND IS NEITHER STEPCHILD NOR PARTNER’s CHILD

OTHKDFOS

BJ-10. Was (OKDNAME) a foster or related child who was placed in your home by a court, child welfare department, or social service agency?

ENTER AYes” for any child for whom R was designated or formally certified as a caregiver (e.g., foster parent, relative foster parent, or custodian) by a court, child welfare department, social service agencies.

Yes .............. 1

No ............... 5

{ IF CHILD DOES NOT LIVE WITH R OR IF CHILD WAS NEVER ADOPTED BY R,

{ GO TO END OF LOOP AND ASK ABOUT NEXT CHILD, IF ANY.

{ ELSE, IF NO MORE CHILDREN TO DISCUSS, GO TO BK SERIES.

{ ASKED IF CHILD IS LIVES WITH R OR WAS ADOPTED BY R

OKDDOB_M, OKDDOB_Y

BJ-11. In what month and year was (OKDNAME) born?

{ IF CHILD IS A “RelATED” CHILD, GO TO END OF LOOP.

{ ASKED IF CHILD IS AUNRELATED” AND LIVING WITH R OR ADOPTED BY R

OTHKDSPN

BJ-12. Is (OKDNAME) Hispanic or Latino, or of Spanish origin?

Yes .......... 1

No ........... 5

OTHKDRAC

BJ-13. Which of the groups on Card 2 describes (OKDNAME's) race? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED IF MORE THAN 1 RACE REPORTED

KDBSTRAC

BJ-14. Which of these groups, that is (RESPONSES FROM BJ-13 OTHKDRAC), would you say best describes (his/her) racial background?

{ Display only those categories reported in BJ-23 OTHKDRAC

{ ASKED IF CHILD IS AUNRELATED” AND LIVING WITH R OR ADOPTED BY R

OKBORNUS

BJ-15. Was (she/he/this child) born in the United States or in another country?

United States ............. 1

Another country ........... 5

{ ASKED IF CHILD IS AUNRELATED” AND LIVING WITH R OR ADOPTED BY R

OKDISABL

BJ-16. Does (OKDNAME) have a physical disability, an emotional disturbance, or mental retardation?

ENTER all that apply

Physical disability ..........1

Emotional disturbance ........2

Mental retardation ...........3

None of the above ............4

{ END OF LOOP ABOUT NONBIOLOGICAL CHILDREN:

{ IF ANOTHER CHILD TO DISCUSS, RETURN TO BJ-4 SEXOTHKD.

{ ELSE, CONTINUE WITH BK SERIES.

CURRENT PLANS TO ADOPT (BK)

{ BK SERIES ASKED IF R IS 18 YEARS OR OLDER

BINTRO_6

BK-0. IF R HAS REPORTED ADOPTING A CHILD, SAY:

The next questions are about any plans you currently have to adopt another child.

ELSE IF R HAS REPORTED THAT SHE IS TRYING TO ADOPT, SAY:

The next questions are about any plans you currently have to adopt a child that has not lived with you. When answering these questions, do not count any children you are currently in the process of adopting.

ELSE SAY:

The next questions are about any plans you currently have to adopt a child.

SEEKADPT

BK-1. (Not counting children who have lived with you or children who live with you now,/At this time,) are you (currently) seeking to adopt a child?

YES ........ 1

NO ......... 5 (GO TO BL SERIES)

CONTAGEM

BK-2. (Not counting things you've done for any children you are currently in the process of adopting,) have you placed a newspaper ad or contacted an adoption agency, a lawyer, a doctor, or other source about adopting (another) child?

YES ........ 1

NO ......... 5 (GO TO BK-4 KNOWADPT)

TRYLONG

BK-3.

(Again, not counting things you've done for any children you have adopted or are currently in the process of adopting,) how long have you been seeking to adopt (a/another) child?

Less than 1 year ........1

1-2 years ...............2

Or longer than 2 years ..3

KNOWADPT

BK-4. Are you seeking to adopt a child whom you know?

Yes ............ 1 (GO TO SECTION C)

No ............. 5

{ ASKED IF R NOT SEEKING TO ADOPT A CHILD SHE KNOWS

CHOSESEX

BK-5. If you could choose exactly the child you wanted, would you prefer to adopt a boy or a girl?

ENTER [3] if R says "it doesn't matter" or "either one."

Boy.................1

Girl................2

Indifferent.........3 (BK-7 CHOSRACE)

{ ASKED IF R SAID SHE PREFERRED A BOY

TYPESEXF

BK-6a. Would you accept a girl?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED A GIRL

TYPESEXM

BK-6b. Would you accept a boy?

Yes .......1

No ........5

{ ASKED IF R NOT SEEKING TO ADOPT A CHILD SHE KNOWS

CHOSRACE

BK-7. If you could choose exactly the child you wanted, would you prefer to adopt a black child, a white child, or a child of some other race?

ENTER [4] if R says "it doesn't matter" or "any one."

Black....................1

White....................2

Some other race..........3

Indifferent..............4 (BK-9 CHOSEAGE)

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN BLACK

TYPRACBK

BK-8a. Would you accept a black child?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN WHITE

TYPRACWH

BK-8b. Would you accept a white child?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN “OTHER RACE”

TYPRACOT

BK-8c. Would you accept a child of some other race, neither black nor white?

Yes .......1

No ........5

{ ASKED IF R NOT SEEKING TO ADOPT A CHILD SHE KNOWS

CHOSEAGE

BK-9. (If you could choose exactly the child you wanted),

Would you prefer to adopt a child younger than 2 years, a child 2 to 5 years old, a child 6 to 12 years old, or a child 13 years old or older?

ENTER [5] if R says "it doesn't matter" or "any one."

A child younger than 2 years ....... 1

A child 2-5 years old .............. 2

A child 6-12 years old ............. 3

A child 13 years old or older....... 4

Indifferent......................... 5 (BK-11 CHOSDISB)

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN AYOUNGER THAN 2"

TYPAGE2M

BK-10a. Would you accept a child younger than 2 years?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN A2-5 YEARS”

TYPAGE5M

BK-10b. Would you accept a child 2 to 5 years old?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN A6-12 YEARS”

TYPAG12M

BK-10c. Would you accept a child 6 to 12 years old?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN A13 OR OLDER"

TYPAG13M

BK-10d. Would you accept a child 13 years old or older?

Yes .......1

No ........5

{ ASKED IF R NOT SEEKING TO ADOPT A CHILD SHE KNOWS

CHOSDISB

BK-11. (If you could choose exactly the child you wanted),

Would you prefer to adopt a child with no disability, a child with a mild disability, or a child with a severe disability?

ENTER [4] if R says "it doesn't matter" or "any one."

A child with no disability.........1

A child with a mild disability.....2

A child with a severe disability...3

Indifferent........................4 (BK-13 CHOSENUM)

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN ANO DISABILITY”

TYPDISBN

BK-12a. Would you accept a child with no disability?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN AMILD DISABILITY”

TYPDISBM

BK-12b. Would you accept a child with a mild disability?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED SOMETHING OTHER THAN ASEVERE DISABILITY”

TYPDISBS

BK-12c. Would you accept a child with a severe disability?

Yes .......1

No ........5

{ ASKED IF R NOT SEEKING TO ADOPT A CHILD SHE KNOWS

CHOSENUM

BK-13. (If you could choose exactly the child you wanted),

Would you prefer to adopt a single child or 2 or more brothers and sisters at once?

ENTER [3] if R says "it doesn't matter" or "any one."

A single child ...................... 1

2 or more brothers and

sisters at once.................... 2

Indifferent...........................3 (Flow Check C-1)

{ ASKED IF R SAID SHE PREFERRED 2 OR MORE SIBS AT ONCE

TYPNUM1M

BK-14a. Would you accept a single child?

Yes .......1

No ........5

{ ASKED IF R SAID SHE PREFERRED A SINGLE CHILD

TYPNUM2M

BK-14b. Would you accept 2 or more brothers and sisters at once?

Yes .......1

No ........5

PREVIOUS PLANS TO ADOPT (BL)

{ IF R IS CURRENTLY SEEKING TO ADOPT, GO TO SECTION C.

EVWNTANO

BL-1. (Not counting any children you are currently in the process of adopting,) have you ever considered adopting (another) child?

Yes ........ 1

No ......... 5 (GO TO SECTION C)

EVCONTAG

BL-2. (Not counting any children you are in the process of adopting,) did you ever contact an adoption agency, a lawyer, a doctor, or other source about adopting (a/another) child?

Yes ......... 1

No .......... 5

TURNDOWN

BL-3. Were you turned down for adoption, unable to find a child to adopt, or did you decide not to pursue adoption any further?

Turned down .............1 (GO TO SECTION C)

Unable to find child ....2 (GO TO SECTION C)

Decided not to pursue ...3

{ ASKED IF R SAID SHE ADECIDED NOT TO PURSUE”

YQUITTRY

BL-4. What were your reasons for deciding not to pursue adoption any further? Were they reasons having to do with the adoption process itself, reasons related to your own situation, or both?

Adoption process only .......1

Own situation only ..........2 (GO TO SECTION C)

Both ........................3

{ ASKED IF “ADOPTION PROCESS” CITED AT ALL

PROCESS

BL-5. Tell me which reasons related to adoption made you decide not to pursue adoption. Was it because the fees were too high, there were not enough children available, or some other reason?

ENTER all that apply

Fees were too high .........................1

There were not enough children available ...2

Some other reason ..........................3

SECTION C

Marital and Relationship History

{ IF R HAS EVER BEEN MARRIED, BEGIN WITH CA SERIES.

{ ELSE IF R HAS NEVER BEEN MARRIED, BUT IS CURRENTLY COHABITING,

{ GO TO CC SERIES.

{ ELSE IF R HAS NEVER BEEN MARRIED AND IS NOT CURRENTLY COHABITING,

{ GO TO CD SERIES.

NUMBER OF MARRIAGES (CA)

{ CA SERIES ASKED IF R HAS EVER BEEN MARRIED.

C_INTRO1

CA-0. The next questions are about your marriages and other relationships.

TIMESMAR

CA-1. (Including your present marriage,) how many times have you been married?

Number ______

{ CA-2, CA-2b, & CA-2c ARE INTENDED TO OBTAIN NAMES OR INITIALS OF HUSBANDS,

{ ONLY FOR PURPOSES OF LOOPING THROUGH CA SERIES.

{ IF R HAS ANSWERED DK/RF FOR # OF TIMES MARRIED, SHE IS LOOPED ONLY ONCE

{ THROUGH CA SERIES.

HUSBNAMEX

CA-2. IF R IS CURRENTLY IN HER 1^st MARRIAGE, ASK:

Please tell me your husband's first name or his initials so that I can refer to him during the interview.

{ OTHER VARIANTS FOR CA-2 ARE BASED ON NUMBER OF TIMES MARRIED AND CURRENT

{ MARITAL STATUS.

{ ASKED IF R HAS BEEN MARRIED MORE THAN ONCE AND SHE IS CURRENTLY MARRIED.

HSBVERIF

CA-2b. And you told me that your current husband is [NAME FROM HH ROSTER]?

Yes ......1 (GO TO CB SERIES)

No .......5 (GO TO CB SERIES)

{ ASKED ONLY IF HUSBAND WAS NOT LISTED IN HH ROSTER BUT R IS CURRENTLY MARRIED

{ OR IF R SAID DK/RF FOR # OF TIMES MARRIED.

CHVERIFY

CA-2c. You may have mentioned this earlier, but what is your (current/ most recent) husband’s name or initials, so that I can refer to him during the interview?

Name or initials __________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

HUSBANDS (CB)

{ CB SERIES IS A LOOP FOR EACH HUSBAND REPORTED

C_INTRO2

CB-0. The next questions are about your (Nth) marriage.

{ ASKED FOR EACH MARRIAGE

WHMARHX_M, WHMARHX_Y

CB-1. In what month and year were you and (HUSBAND) married?

 After R has given the year, say: Please record husband's initials in the box for this month and year on the "Marriages, Cohabs, Partners" row of your calendar. If this happened before January [YEAR OF INTERVIEW - 3], please write the date and his initials in the "Before January [YEAR OF INTERVIEW - 3]" column.

{ ASKED IF MO/YR OF MARRIAGE NOT REPORTED

AGEMARHX

CB-2. How old were you when you got married (this [nth] time)?

Age in years ______

HXAGEMAR

CB-3. How old was (HUSBAND) when you got married?

Age in years ______

DOBHUSBX_M, DOBHUSBX_Y

CB-4. In what month and year was he born?

LVTOGHX

CB-5. Some couples live together without being married. By living together, we mean having a sexual relationship while sharing the same usual address. Did you and (HUSBAND) live together before you got married?

Yes....................1

No.....................5 (CB-8 HISPHX)

{ ASKED IF R COHABITED PREMARITALLY WITH THIS MAN

STRTOGHX_M, STRTOGHX_Y

CB-6. In what month and year did you and he first start living together?

 After R has reported year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ ASKED IF R COHABITED PREMARITALLY WITH THIS MAN

ENGAGHX

CB-7. At the time you began living together, were you and he engaged to be married or have definite plans to get married?

Yes .........1

No ..........5

{ ASKED ONLY FOR R’s 1^ST OR CURRENT/SEPARATED HUSBAND

HISPHX

CB-8. (Is/Was) (HUSBAND) Hispanic or Latino, or of Spanish origin?

Yes.....................1

No......................5

{ ASKED ONLY FOR R’s 1^ST OR CURRENT/SEPARATED HUSBAND

RACEHX

CB-9. Which of the groups on Card 2 describes (HUSBAND)'s racial background? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED ONLY FOR R’s 1^ST OR CURRENT/SEPARATED HUSBAND AND R REPORTED MORE THAN

{ 1 RACE FOR HIM

BSTRACHX

CB-10. Which of these groups, that is (RESPONSES FROM CB-9 RACEHX), would you say best describes his racial background?

{ Display only those categories reported in CB-9 RACEHX

{ ASKED ONLY FOR CURRENT OR SEPARATED HUSBANDS

CHEDMARN

CB-11. Please look at Card 11. What is the highest level of education (HUSBAND) has completed?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate’s degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school .................6

{ ASKED FOR EACH HUSBAND

MARBEFHX

CB-12. At the time you and he were married, had (HUSBAND) been married before?

Yes ................1

No .................5

{ ASKED FOR EACH HUSBAND

KIDSHX

CB-13. When you and he got married, did he have any children, either biological or adopted, from any previous relationships?

Yes ................1

No .................5 (CB-19 MARENDHX)

{ ASKED IF HE HAD ANY CHILDREN

NUMKDSHX

CB-14. How many children did he have?

Number _____

{ ASKED IF HE HAD ANY CHILDREN

KIDLIVHX

CB-15. Did (this child/any of his children from previous relationships) ever live with you and (HUSBAND)?

Yes ..............1

No ...............5

{ ASKED IF HE HAD 1 CHILD AND HE IS R’s CURRENT HUSBAND

CHKID18A

CB-16a. Is this child aged 18 years or younger now?

Yes ........1 (CB-17 WHRCHKDS)

No .........5 (CB-17 WHRCHKDS)

{ ASKED IF HE HAD MORE THAN 1 CHILD AND HE IS R’s CURRENT HUSBAND

CHKID18B

CB-16b. How many, if any, of these [NUMKDSHX_FILL] children are aged 18 years or younger now?

Number ________

{ ASKED IF ANY CHILD IS AGED 18 OR UNDER AND THIS IS R’s CURRENT HUSBAND

WHRCHKDS

CB-17. Where does (this child (aged 18 or younger) / these (CHKID18B) children aged 18 or younger) live now? In this household with you and (CURRENT HUSBAND), with his or her mother, with grandparents or other relatives, or somewhere else?

ENTER all that apply

In this household.....................1

With their mother.....................2

With grandparents or other relatives..3

Somewhere else........................4

{ ASKED IF ANY ANSWER OTHER THAN “in this household” IS GIVEN

SUPPORCH

CB-18. Does (CURRENT HUSBAND) regularly contribute to the financial support of (this child/these children) aged 18 or under?

READ if necessary: Regular child support is financial support provided at specified intervals, such as every week, every other week, or every month.

Yes....................1

No.....................5

{ ASKED IF R HAS EVER HAD A BIOLOGICAL CHILD AND EITHER R IS NOT CURRENTLY MARRIED OR R’s 1st PREGNANCY PRECEDED THE 1st MARRIAGE DATE

BIOHUSBX

CB-18b. (You may have already told me this, but) (Do/Did) you and (CURRENT OR FORMER HUSBAND OR COHABITING PARTNER) have any biological children together? By that, I mean you are the biological mother and he is the biological father.

Yes ........1

No .........5 (GO TO CB-19 MARENDHX)

BIONUMHX

CB-18c. How many biological children (have/did) you and he (had/have) together?

Number _________

{ IF R IS CURRENTLY MARRIED TO THIS HUSBAND, GO TO CC SERIES.

{ ELSE IF R IS SEPARATED FROM THIS HUSBAND, GO TO CB-22 WNSTPHX.

{ ASKED IF R IS NOT MARRIED TO OR SEPARATED FROM THIS HUSBAND

MARENDHX

CB-19. How did your (Nth) marriage end?

Death of husband ................1

Divorce .........................2 (CB-21 DIVDATHX)

Annulment .......................3 (CB-21 DIVDATHX)

{ IF DK/RF FOR MARENDHX, GO TO CB-22 WNSTPHX

{ ASKED IF MARRIAGE ENDED BY DEATH OF HUSBAND

WNDIEHX_M, WNDIEHX_Y

CB-20. In what month and year did (HUSBAND) die?

 After R has given the year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ ASKED IF MARRIAGE ENDED IN DIVORCE OR ANNULMENT

DIVDATHX_M, DIVDATHX_Y

CB-21. In what month and year did your (divorce become final/annulment take place)?

 After R has given the year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ ASKED IF MARRIAGE ENDED IN DIVORCE OR ANNULMENT,

{ OR IF R IS SEPARATED FROM THIS HUSBAND

{ OR IF DK/RF FOR HOW MARRIAGE ENDED

WNSTPHX_M, WNSTPHX_Y

CB-22. In what month and year did you and (HUSBFILL) stop living together (for the last time)?

 After R has reported year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ IF MORE HUSBANDS TO DISCUSS, RETURN TO C-INTRO2.

{ ELSE IF ALL HUSBANDS HAVE BEEN DISCUSSED, CONTINUE WITH CC SERIES.

CURRENT COHABITING PARTNER (CC)

{ IF R HAS REPORTED A CURRENT COHABITING PARTNER (REGARDLESS OF HER FORMAL

{ MARITAL STATUS), CONTINUE WITH CC SERIES.

{ ELSE GO TO CD SERIES.

{ ASKED IF NO CURRENT COHAB PARTNER WAS LISTED IN HH ROSTER, BUT R REPORTED

{ HAVING ONE IN AB-1 MARSTAT

CPNAME

CC-0. Earlier, you told me that you are living with a male partner. Please tell me his first name or initials, so that I can refer to him in the interview.

Name or initials ________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

{ IF CC-0 WAS ASKED, SKIP TO CC-2 WNSTRTCP.

{ ASKED IF CURRENT COHAB PARTNER WAS LISTED IN HH ROSTER.

C_INTRO3

CC-1. Earlier, you told me you and (CURR COHAB PARTNER) are living together. The next questions are about your relationship with him.

WNSTRTCP_M, WNSTRTCP_Y

CC-2. In what month and year did you and (CURR COHAB PARTNER) begin living together?

 After R has given the year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ ASKED IF MO/YR OF COHAB START WAS NOT REPORTED

CPHERAGE

CC-3. How old were you when you began living with (CURR COHAB PARTNER)?

Age in years ___________

{ ASKED FOR ALL WHO ARE CURRENTLY COHABITING

CPHISAGE

CC-4. How old was (CURR COHAB PARTNER) when you began living together?

Age in years ______

WNCPBRN_M, WNCPBRN_Y

CC-5. In what month and year was (CURR COHAB PARTNER) born?

CPENGAG1

CC-6. At the time you began living together, were you and he engaged to be married or have definite plans to get married?

Yes .....1

No ......5

WILLMARR

CC-7. Please look at Card 21. What is the chance that you and [CURR COHAB PARTNER] will marry each other?

No chance ....................1

A little chance ..............2

50-50 chance .................3

A pretty good chance .........4

An almost certain chance .....5

CPHISP

CC-8. Is (CURR COHAB PARTNER) Hispanic or Latino, or of Spanish origin?

YES.....................1

NO......................5

CPRACE

CC-9. Which of the groups on Card 2 describes (CURR COHAB PARTNER)'s racial background? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED IF MORE THAN 1 RACE WAS REPORTED

CPBESTR

CC-10. Which of these groups, that is (RESPONSES FROM CC-9 CPRACE), would you say best describes (CURR COHAB PARTNER)'s racial background?

{ Display only those categories reported in CC-9 CPRACE

CPEDUC

CC-11. Please look at Card 11. What is the highest level of education (CURR COHAB PARTNER) has completed?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate’s degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school .................6

CPMARBEF

CC-12. Has (CURR COHAB PARTNER) ever been married?

YES..................1

NO...................5

CPKIDS

CC-13. When you and (CURR COHAB PARTNER) first began living together, did he have any children, either biological or adopted, from any previous relationships?

Yes......1

No.......5 (GO TO CD SERIES)

{ ASKED IF HE HAD ANY CHILDREN

CPNUMKDS

CC-14. How many children did he have?

Number of children ________

{ ASKED IF HE HAD ANY CHILDREN

CPKIDLIV

CC-15. Did (this child/any of his children) ever live with you and (CURR COHAB PARTNER)?

Yes ..............1

No ...............5

{ ASKED IF ONLY 1 CHILD

CPKID18A

CC-16a. Is this child aged 18 years or younger now?

Yes ........1 (CC-17 WHRCPKDS)

No .........5 (CC-17 WHRCPKDS)

{ ASKED IF MORE THAN 1 CHILD

CPKID18B

CC-16b. How many, if any, of these [CPNUMKDS_FILL] children, are aged 18 years or younger now?

Number of children _________

{ IF NO CHILDREN ARE 18 OR UNDER, GO TO CD SERIES.

{ ASKED IF ANY CHILDREN ARE AGED 18 OR UNDER

WHRCPKDS

CC-17. Where does (this child (aged 18 or younger) / these (CPKID18B) children aged 18 or younger) live now? In this household with you and (CURR COHAB PARTNER), with his or her mother, with grandparents or other relatives, or somewhere else?

ENTER all that apply

In this household.....................1

With their mother.....................2

With grandparents or other relatives..3

Somewhere else........................4

{ ASKED IF ANY RESPONSE OTHER THAN “in this household”

SUPPORCP

CC-18. Does (CURR COHAB PARTNER) regularly contribute to the financial support of (this child/these children)?

READ if necessary: Regular child support is financial support provided at specified intervals, such as every week, every other week, or every month, rather than sporadically.

Yes....................1

No.....................5

{ ASKED IF R HAS EVER HAD A BIOLOGICAL CHILD

BIOCP

CC-19. You may have already told me this, but do you and (CURR COHAB PARTNER) have any biological children together? By that, I mean you are the biological mother and he is the biological father.

Yes ........1

No .........5 (GO TO SECTION CD)

BIONUMCP

CC-20. How many biological children have you and he had together?

Number _________

FORMER (non-current) COHABITING PARTNERS (CD)

{ READ ONLY IF R HAS NEVER BEEN MARRIED AND IS NOT CURRENTLY COHABITING

C_INTRO4

CD-0. Some couples live together without being married. By living together, we mean having a sexual relationship while sharing the same usual address.

LIVEOTH

CD-1. (VARIANTS BASED ON PREVIOUSLY REPORTED MEN)...

Not counting anyone we've already talked about, have you ever lived together with any other man?

NOTE: Do not count "dating" or "sleeping over" as living together. Living together means having a sexual relationship while sharing the same usual address.

Yes................1

No.................5 (GO TO CE SERIES)

{ ASKED IF R EVER LIVED WITH ANY (OTHER) MAN

HMOTHMEN

CD-2. Not counting anyone we’ve already talked about, with how many (other) men have you ever lived?

NOTE: Do not count husbands R lived with prior to marriage. Do not count R's current cohabiting partner.

Number __________ (IF DK/RF, GO TO CE SERIES)

{ ASKED IF R EVER LIVED WITH ANY (OTHER) MAN

OTHMANX

CD-3. IF ONLY IF 1 FORMER COHAB PARTNER, ASK:

Please tell me the first name or the initials of the other man you lived with so that I can refer to him during the interview.

Name or initials _________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

{ OTHER VARIANTS BASED ON NUMBER OF FORMER COHAB PARTNERS

{ BEGIN LOOP FOR ASKING ABOUT EACH FORMER COHABITING PARTNER

{ ASKED FOR EACH FORMER COHAB PARTNER

STRTOTHX_M, STRTOTHX_Y

CD-4. In what month and year did you and (FORMER COHAB PARTNER) begin living together?

 After R has given the year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ ASKED IF MO/YR OF COHAB START WAS NOT REPORTED

HERAGECX

CD-5. How old were you when you began living with (FORMER COHAB PARTNER)?

Age in years ___________

{ ASKED FOR EACH FORMER COHAB PARTNER

HISAGECX

CD-6. How old was he when you began living together?

If R says DK, PROBE for the age difference between R and this husband and have her add to or subtract from her age at the marriage. ENTER this resulting value for age in years.

Age in years ______

WNBRNCX_M, WNBRNCX_Y

CD-7. In what month and year was he born?

ENGAG1CX

CD-8. At the time you began living together in (mo/yr from CD-4), were you and he engaged to be married or have definite plans to get married?

Yes .....1

No ......5

{ IF THIS IS NOT R’s 1^st COHABITING PARTNER, GO TO CD-12 MAREVCX.

{ ASKED ONLY FOR R’s 1^st (former) COHAB PARTNER

HISPCX

CD-9. Was (FORMER COHAB PARTNER) Hispanic or Latino, or of Spanish origin?

Yes ....................1

No .....................5

{ ASKED ONLY FOR R’s 1^st (former) COHAB PARTNER

RACECX

CD-10. Which of the groups on Card 2 describes (FORMER COHAB PARTNER)’s racial background? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED IF MORE THAN 1 RACE REPORTED FOR 1^st (former) COHAB PARTNER

BSTRACCX

CD-11. Which of these groups, that is (RESPONSES FROM CD-10 RACECX), would you say best describes his racial background?

{ Display only those categories reported in CD-10 RACECX

{ ASKED FOR EACH FORMER COHAB PARTNER

MAREVCX

CD-12. When you began living together in (mo/yr from CD-4), had (FORMER COHAB PARTNER) ever been married?

Yes..................1

No...................5

{ ASKED FOR EACH FORMER COHAB PARTNER

CXKIDS

CD-13. When you and he began living together, did he have any children, either biological or adopted, from any previous relationships?

Yes......1

No.......5

{ ASKED IF R HAS EVER HAD A BIOLOGICAL CHILD

BIOFCPX

CD-13b. Did you and (CURR COHAB PARTNER) have any biological children together? By that, I mean you are the biological mother and he is the biological father.

Yes ........1

No .........5 (GO TO CD-14M STPTOGCX_M)

BIONUMCX

CD-13c. How many biological children did you and he have together?

Number _________

{ ASKED FOR EACH FORMER COHAB PARTNER

STPTOGCX_M, STPTOGCX_Y

CD-14. In what month and year did you and (FORMER COHAB PARTNER) stop living together for the last time?

 After R has given the year, say: Please record something in the appropriate box on the "Marriages, Cohabs, Partners" row on your calendar to indicate when this occurred.

{ IF ANY MORE FORMER COHAB PARTNERS TO DISCUSS, RETURN TO CD-4 STRTOTHX.

{ ELSE, CONTINUE WITH CE SERIES.

EVER HAD INTERCOURSE (CE)

{ IF R HAS EVER BEEN MARRIED, EVER COHABITED, OR EVER BEEN PREGNANT,

{ GO TO CE-3 WNFSTSEX.

{ ASKED ONLY IF R HAS NEVER BEEN MARRIED, NEVER COHABITED, AND NEVER BEEN

{ PREGNANT

EVERSEX

CE-1. At any time in your life, have you ever had sexual intercourse with a man, that is, made love, had sex, or gone all the way?

NOTE: Do not count oral sex, anal sex, heavy petting, or other forms of sexual activity that do not involve vaginal penetration. Do not count sex with a female partner.

Yes ........................1 (GO TO CE-3 WNFSTSEX)

No .........................5

{ ASKED IF R HAS NEVER HAD SEX

YNOSEX

CE-2. As you know, some people have had sexual intercourse by your age and others have not. Please look at Card 22 which lists some reasons that people give for not having sexual intercourse.

What would you say is the most important reason why you have not had sexual intercourse up to now?

Against religion or morals............................1

Don’t want to get pregnant............................2

Don’t want to get a sexually transmitted disease......3

Haven’t found the right person yet....................4

In a relationship, but waiting for the right time.....5

Other ................................................6

{ IF R HAS NOT HAD SEX, GO TO CF SERIES.

{ ASKED IF R HAS EVER HAD SEX

WNFSTSEX_M, WNFSTSEX_Y

CE-3. Please look at the calendar and think back to the very first time in your life that you ever had sexual intercourse with a man. In what month and year was that?

 If R refuses, remind her gently of the importance of the question and the confidentiality of her answer. If appropriate say: I understand that this may be a difficult question. However, this question is very important because it tells us when a woman is first exposed to the risk of becoming pregnant. Would you be willing to provide the month and year, or perhaps just the year? If not, we will move on to the next question.

 Sexual intercourse here refers to a sexual encounter between a man and a woman, in which the penis enters the vagina. Do not count oral sex, anal sex, heavy petting, or other forms of sexual activity that do not involve vaginal penetration. Do not count sex with a female partner.

 ENTER [96] if R insists that she has never had sexual intercourse.

{ ASKED IF R HAS EVER HAD SEX

AGEFSTSX

CE-4. That very first time that you had sexual intercourse with a man, how old were you?

Age in years _______

 If R does not want to answer because first sex was not voluntary, allow her to move to the next question that she is comfortable with.

{ IF AGE IN YEARS WAS REPORTED, GO TO CE-8 GRFSTSX.

{ ASKED IF DK/RF ON AGEFSTSX

SEX18

CE-5. Were you less than 18 years old or were you 18 years or older?

Less than 18 years...........1

18 years or older............2

{ IF SEX18 = RF, GO TO CE-18 GRFSTSX.

{ ASKED IF SEX18 = “less than 18 years” or DK

SEX15

CE-6. Were you less than 15 years old or were you 15 or older?

Less than 15 years...........1

15 years or older............2

{ ASKED IF SEX18 = “18 years or older”

SEX20

CE-7. Were you less than 20 years old or were you 20 or older?

Less than 20 years...........1

20 years or older............2

{ ASKED ONLY IF AGE AT 1^st SEX WAS LESS THAN 17 YEARS

GRFSTSX

CE-8. What grade or year of school were you in that first time you had intercourse with a male?

ENTER 96 if R was not in school when she first had intercourse

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1st year of college .............................13

2nd year of college .............................14

3rd year of college .............................15

4th year of college .............................16

Not in school ...................................96

{ ASKED ONLY IF R HAS NEVER BEEN MARRIED AND NEVER COHABITED

SXMTONCE

CE-9. Have you had sexual intercourse more than once?

Yes .........................1

No ..........................5

Sex Communication (CF)

{ CF SERIES IS ONLY ASKED OF 15-24 YEAR OLDS.

{ IF R IS OLDER THAN 24 YEARS, GO TO CG SERIES.

TALKPAR

CF-1. The next questions are about how you learned about sex and birth control. (Before you were 18 years old,) which, if any, of the topics shown on Card 23 (did you ever talk/have you ever talked) with a parent or guardian about?

ENTER all that apply.

How to say no to sex ............1

Methods of birth control ........2

Where to get birth control ......3

Sexually transmitted diseases ...4

How to prevent HIV/AIDS..........5

How to use a condom .............6

None of the above ...............7

SEDNO

CF-2. Now I’m interested in knowing about formal sex education you may have had. (Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about how to say no to sex?

Yes............1

No.............5 (CF-5 SEDBC)

{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC

SEDNOG

CF-3. What grade were you in when you first received instruction on how to say no to sex?

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1st year of college .............................13

2nd year of college .............................14

3rd year of college .............................15

4th year of college .............................16

Not in school when received instruction .........96

{ IF R HAS NEVER HAD SEX, GO TO CF-5 SEDBC.

{ ELSE IF IT IS APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex),

{ GO TO CF-5 SEDBC.

{ ASKED ONLY IF NOT APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex)

SEDNOSX

CF-4. Did you receive instruction about how to say no to sex before or after the first time you had sex?

Before..........1

After...........2

SEDBC

CF-5. (Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about methods of birth control?

Yes............1

No.............5 (CF-8 SEDSTD)

{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC

SEDBCG

CF-6. What grade were you in when you first received instruction on methods of birth control?

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1st year of college .............................13

2nd year of college .............................14

3rd year of college .............................15

4th year of college .............................16

Not in school when received instruction .........96

{ IF R HAS NEVER HAD SEX, GO TO CF-8 SEDSTD.

{ ELSE IF IT IS APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex),

{ GO TO CF-8 SEDSTD.

{ ASKED ONLY IF NOT APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex)

SEDBCSX

CF-7. Did you receive instruction about methods of birth control before or after the first time you had sex?

Before..........1

After...........2

SEDSTD

CF-8. IF AGE_R GE 18, ASK:

Before you were 18, did you ever have any formal instruction at school, church, a community center or some other place about sexually transmitted diseases?

ELSE IF AGE_R LT 18, ASK:

Have you ever had any formal instruction at school, church, a community center or some other place about sexually transmitted diseases?

Yes............1

No.............5 (CF-11 SEDHIV)

SEDSTDG

CF-9. What grade were you in when you first received instruction on sexually transmitted diseases?

ENTER 96 if R was not in school when she received the instruction

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1st year of college .............................13

2nd year of college .............................14

3rd year of college .............................15

4th year of college .............................16

Not in school when received instruction .........96

{ IF R HAS NEVER HAD SEX, GO TO CF-11 SEDHIV.

{ ELSE IF IT IS APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex),

{ GO TO CF-11 SEDHIV.

{ ASKED ONLY IF NOT APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex)

SEDSTDSX

CF-10.Did you receive instruction about sexually transmitted diseases before or after the first time you had sex?

Before..........1

After...........2

SEDHIV

CF-11.IF AGE_R GE 18, ASK:

Before you were 18, did you ever have any formal instruction at school, church, a community center or some other place about how to prevent HIV/AIDS?

ELSE IF AGE_R LT 18, ASK:

Have you ever had any formal instruction at school, church, a community center or some other place about to prevent HIV/AIDS?

Yes............1

No.............5 (CF-14 PLEDGE)

SEDHIVG

CF-12.What grade were you in when you first received instruction on how to prevent HIV/AIDS?

ENTER 96 if R was not in school when she received the instruction

1st grade .......................................1

2nd grade .......................................2

3rd grade .......................................3

4th grade .......................................4

5th grade .......................................5

6th grade .......................................6

7th grade .......................................7

8th grade .......................................8

9th grade .......................................9

10th grade ......................................10

11th grade ......................................11

12th grade ......................................12

1st year of college .............................13

2nd year of college .............................14

3rd year of college .............................15

4th year of college .............................16

Not in school when received instruction .........96

{ IF R HAS NEVER HAD SEX, GO TO CF-14 PLEDGE.

{ ELSE IF IT IS APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex),

{ GO TO CF-14 PLEDGE.

{ ASKED ONLY IF NOT APPARENT WHICH CAME FIRST (this sex ed or R’s 1^st sex)

SEDSHIVX

CF-13.Did you receive instruction about to prevent HIV/AIDS before or after the first time you had sex?

Before..........1

After...........2

PLEDGE

CF-14. IF R HAS EVER BEEN MARRIED, ASK:

Did you ever take a public or written pledge to remain a virgin until marriage?

ELSE IF R HAS NEVER BEEN MARRIED, ASK:

Have you ever taken a public or written pledge to remain a virgin until marriage?

Yes ............1

No .............5

{ IF R HAS NEVER HAD SEX, GO TO SECTION D.

{ REMAINDER OF SECTION C IS ONLY ASKED FOR R’s WHO HAVE HAD SEX.

FIRST INTERCOURSE PARTNER (CG)

FRSTPART

CG-1. I have some questions about your first male partner ever. Please tell me the first name or the initials of your first sexual partner so that I can refer to him in these questions.

Name/initials _______________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)

{ IF R HAS NEVER BEEN MARRIED AND NEVER COHABITED, GO TO CG-4 FPAGE.

{ ASKED ONLY IF R HAS EVER BEEN MARRIED OR EVER COHABITED

SAMEMAN

CG-2. (A SUMMARY SCREEN IS DISPLAYED TO HELP DETERMINE IF R’s 1^st SEXUAL PARTNER WAS A MAN PREVIOUSLY DISCUSSED AS A HUSBAND OR COHABITING PARTNER.)

Please look at this screen. Is (FIRST PARTNER) someone we talked about earlier? That is, was he someone you’ve been married to or lived with?

YES................1

NO.................5 (CG-4 FPAGE)

{ ASKED IF R'S FIRST PARTNER WAS ALSO A COHABITING PARTNER OR SPOUSE

WHOFSTPR

CG-3. Which of these men listed on the screen was your first sexual partner? Was he ...

(Respondent identifies him based on initials or name)

{ ASKED ONLY IF R IS 18 YEARS OR OLDER

FPAGE

CG-4. How old was (FIRST PARTNER) when you had sexual intercourse with him that first time?

Age in years __________ (IF AGE REPORTED, GO TO CG-5 KNOWFP)

{ ASKED ONLY IF R IS 18 YEARS OR OLDER AND FPAGE = DK/RF

FPRELAGE

CG-4b. Was he older than you, younger than you, or the same age?

Older ............1

Younger ..........2

Same age .........3 (CG-5 KNOWFP)

{ ASKED ONLY IF R IS 18 YEARS OR OLDER AND FPRELAGE = “older” or “younger”

FPRELYRS

CG-4c. By how many years?

1-2 years.............1

3-5 years.............2

6-10 years............3

More than 10 years....4

KNOWFP

CG-5. Please look at Card 24. At the time you first had sexual intercourse with (FIRST PARTNER), how would you describe your relationship with him?

Married to him ...............................................1

Engaged to him ...............................................2

Living together in a sexual relationship, but not engaged ....3

Going with him or going steady ...............................4

Going out with him once in a while ...........................5

Just friends .................................................6

Had just met him .............................................7

Something else ...............................................8

{ ASKED ONLY IF R IS NOT CURRENTLY MARRIED OR COHABITING

STILFPSX

CG-6. Do you consider him to be a current sexual partner?

Yes .......................1

No ........................5

{ ASKED FOR ALL “1^st partners” EVEN IF HE IS R’s CURRENT H/P

LSTSEXFP_M, LSTSEXFP_Y

CG-7. When was the last time you had sexual intercourse with him, that is, in what month and year?

ENTER 96 for MONTH if R only had sex once with this partner

 After R has given the year, say: Please record this partner and date in the appropriate box on the calendar in the "Marriages, Cohabs, Partners" row. You might use “LSEX” and his initials or some other abbreviation that you will recognize later.

{ ASKED IF FIRST PARTNER IS CURRENT, BUT NOT A COHABITING OR MARITAL PARTNER

FPEDUC

CG-7b. Please look at Card 11. What is the highest level of education (FRSTPART_FILL) has completed?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate's degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school .................6

{ ASKED IF FIRST PARTNER IS CURRENT, BUT NOT A COHABITING OR MARITAL PARTNER

FPHISP

CG-7c. Is (FRSTPART_FILL) Hispanic or Latino, or of Spanish origin?

Yes.....................1

No......................5

{ ASKED IF FIRST PARTNER IS CURRENT, BUT NOT A COHABITING OR MARITAL PARTNER

FPRACE

CG-7d. Which of the groups on Card 2 describes (FRSTPART_FILL)'s racial background? Please select one or more groups.

ENTER all that apply

NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED IF FIRST PARTNER IS CURRENT, BUT NOT A COHABITING OR MARITAL PARTNER,

{ AND R REPORTED MORE THAN ONE RACE

FPRACEB

CG-7e. Which of these groups, that is (RESPONSES FROM FPRACE), would you say best describes his racial background?

{ ASKED IF FIRST PARTNER IS CURRENT, BUT NOT A COHABITING OR MARITAL PARTNER

FPRN

CG-7f. Please look at Card xx. How would you describe your current relationship with (FRSTPART_FILL)?

Engaged to him ...............................................2

Going with him or going steady ...............................4

Going out with him once in a while ...........................5

Just friends .................................................6

Had just met him .............................................7

Something else ...............................................8

{ IF R HAS NOT YET REACHED MENARCHE OR IF HER AGE AT 1^st SEX IS OLDER

{ THAN HER AGE AT 1^st MENSTRUAL PERIOD, GO TO CH SERIES.

{ READ IF R’s AGE AT FIRST SEX IS LESS THAN OR EQUAL TO AGE AT 1^st PERIOD

C_INTRO6

CG-7g. IF AGE AT 1^st SEX = AGE AT 1^st MENSTRUAL PERIOD, SAY:

You told me that you were [AGEFSTSX] years old the first time you had sexual intercourse, the same age you were when you had your first menstrual period. It is important for this study to know whether your first sexual intercourse was before or after your first menstrual period so we know something about your risk of pregnancy.

ELSE IF AGE AT 1^st SEX IS YOUNGER THAN AGE AT 1^st MENSTRUAL PERIOD, SAY:

You told me that you were [AGEFSTSX] years old the first time you had sexual intercourse, and that you were [MENARCHE] years old when you had your first menstrual period. It is important for this study to know when you first had sexual intercourse after your first menstrual period so we know something about your risk of pregnancy.

{ ASKED IF 2 AGES WERE THE SAME

WHICH1ST

CG-8. Which came first, your first sexual intercourse or your first menstrual period?

Sexual intercourse .............1

Menstrual period ...............2 (GO TO CH SERIES)

{ ASKED IF R HAS NEVER BEEN MARRIED, NEVER BEEN PREGNANT, AND NEVER COHABITED

SEXAFMEN

CG-9. Since your first menstrual period, have you had sexual intercourse?

NOTE: Do not count oral sex, anal sex, heavy petting, or other forms of sexual activity that do not involve vaginal penetration.

Yes ....................1

No .....................5 (CH-1 LIFEPRT)

WNSEXAFM_M, WNSEXAFM_Y

CG-10. Thinking back, after your first menstrual period, in what month and year did you have sexual intercourse for the first time?

ENTER 96 if R insists that she has not had sexual intercourse since her first menstrual period.

 After R has given the year, say: Please record this event in the appropriate box in the “Marriages, Cohabs, Partners" row of your calendar. You can use any abbreviation that you will recognize later.

AGESXAFM

CG-11. Thinking back after your first menstrual period, how old were you when you had sexual intercourse for the first time?

Age in years ____________

{ IF AGESXAFM = RF OR AGE IS REPORTED, GO TO CH SERIES.

{ ASKED IF AGESXAFM = DK OR RF

AFMEN18

CG-12. Were you less than 18 years old or were you 18 years or older?

Less than 18 years...........1

18 years or older............2

{ IF AFMEN18 = RF, GO TO CH SERIES

{ ASKED IF AFMEN18 = DK OR “less than 18 years”

AFMEN15

CG-13. Were you less than 15 years old or were you 15 or older?

Less than 15 years...........1 (GO TO CH SERIES)

15 years or older............2 (GO TO CH SERIES)

{ ASKED IF AFMEN18 = “18 years or older”

AFMEN20

CG-14. Were you less than 20 years old or were you 20 or older?

Less than 20 years...........1

20 years or older............2

NUMBERS OF SEXUAL PARTNERS (CH)

LIFEPRT

CH-1. Counting all your male sexual partners, even those you had intercourse with only once, how many men have you had sexual intercourse with in your life?

Number __________

{ IF NUMBER WAS REPORTED, GO TO CH-2 PTSB4MAR

{ ASKED IF LIFEPRT = DK OR RF

LIFEPRT_LO

CH-1b. ENTER LOWER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS IN LIFETIME.

Number ____________

{ ASKED IF LIFEPRT = DK OR RF

LIFEPRT_HI

CH-1c. ENTER UPPER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS IN LIFETIME.

Number ____________

{ ASKED IF R HAS EVER BEEN MARRIED

PTSB4MAR

CH-2. How many male sexual partners did you have before you got married in [DATE OF FIRST MARRIAGE]? Please count your [first/former] husband, if you had sex with him before the marriage.

Number ___________

{ ASKED IF PTSB4MAR = DK OR RF

PTSB4MAR_LO

CH-2b. (ENTER LOWER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS BEFORE MARRIAGE.)

Number ____________

{ ASKED IF PTSB4MAR = DK OR RF

PTSB4MAR_HI

CH-2c. (ENTER UPPER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS BEFORE MARRIAGE.)

Number ____________

MON12PRT

CH-3. During the last 12 months, that is, since (INTERVIEW MONTH, 2001), how many men, if any, have you had sexual intercourse with? Please count every male sexual partner, even those you had sex with only once.

Number ___________

{ IF NUMBER WAS REPORTED, GO TO CH-3 PTSB4MAR

{ ASKED IF MON12PRT = DK OR RF

MON12PRT_LO

CH-3b. (ENTER LOWER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS IN LAST 12 MONTHS.)

Number ____________

{ ASKED IF MON12PRT = DK OR RF

MON12PRT_HI

CH-3c. (ENTER UPPER BOUND OF RANGE FOR NUMBER OF MALE PARTNERS IN LAST 12 MONTHS.)

Number ____________

SEXUAL PARTNERS IN LAST 12 MONTHS (UP TO 3) AND LAST PARTNER (CI)

{ IF R HAS ONLY HAD ONE PARTNER AND IT WAS

{ HER FIRST SEXUAL PARTNER EVER, AND SHE MARRIED OR COHABITED WITH THIS

{ MAN, GO TO SECTION D.

{ (ALL INFORMATION FOR THIS ONE PARTNER HAS ALREADY BEEN OBTAINED)

{ ELSE IF R HAS HAD ONLY ONE PARTNER AND SHE NEVER MARRIED OR COHABITED

{ WITH HIM,

{ OR IF R HAS HAD MORE THAN ONE PARTNER EVER,

{ PROCEED THROUGH CI SERIES AS APPLICABLE.

{ (WILL COLLECT ADDITIONAL DETAIL IF FIRST PARTNER IS STILL “CURRENT” -- specifically education, race, and Hispanic origin)

{ ASKED IF R HAD ONLY 1 PARTNER IN LAST 12 MONTHS AND R IS CURRENTLY

{ MARRIED OR COHABITING

WHOSNC1Y

CI-1. You mentioned that you have had one sexual partner since (INTERVIEW MONTH, 2005). Is that (CURRENT H/P)?

YES................1

NO.................5

P3INTRO

CI-2. In order to save time during the interview, I’ll only ask you about your 3 most recent partners in the past 12 months. Let’s start with your most recent partner.

PXNAME

CI-3. Please tell me the name or initials of the male with whom you (had sex most recently/ had sex before (PREVIOUSLY NAMED PARTNER).

ENTER Name ____________

{ ASKED IF FIRST SEX WAS WITHIN PAST 12 MONTHS

MATCHFPX

CI-4. Is (PARTNER'S NAME) the man you told us was your first partner ever?

YES................1

NO.................5

{ ASKED IF R HAS EVER COHABITED OR BEEN MARRIED

MATCHHPX

CI-5. Is (PARTNER'S NAME) any of the following husbands or partners we’ve already talked about?

[Screen displays names or initials of all reported husbands and partners, along with start & end dates of marriage/cohabitation.]

(If he is in the list, R identifies him based on initials or name)

P1YLSEX_MX, P1YLSEX_YX

CI-6. In what month and year did you last have sexual intercourse with (PARTNER'S NAME)?

 After R has given the year, say: Please record this partner and date in the appropriate box on the calendar in the "Marriages, Cohabs, Partners" row. You might use LSEX and his initials or some other abbreviation that you will recognize later.

{ IF PARTNER BEING DESCRIBED IS R’s CURRENT H/P OR

{ IF CI-1 WHOSNC1Y = YES, GO TO CI-10 P1YLSEX.

{ ASKED IF R IS NOT MARRIED TO, SEPARATED FROM, OR COHABITING WITH THIS

{ PARTNER. ALSO NOT ASKED IF THIS PARTNER WAS 1ST PARTNER

P1YCURRPX

CI-7. Do you consider (PARTNER'S NAME) to be a current sexual partner?

[HELP AVAILABLE]

Yes ................1

No .................5

{ ASKED IF R IS NOT MARRIED TO, SEPARATED FROM, OR COHABITING WITH THIS

{ PARTNER. ALSO NOT ASKED IF THIS PARTNER WAS 1ST PARTNER

P1YRAGEX

CI-9. Thinking now of (PARTNER'S NAME), how old were you when you first had sexual intercourse with him?

Age in years _______

{ ASKED IF R IS NOT MARRIED TO, SEPARATED FROM, OR COHABITING WITH THIS

{ PARTNER. ALSO NOT ASKED IF THIS PARTNER WAS 1ST PARTNER

{ ASKED ONLY IF R IS 18 YEARS OR OLDER

P1YHSAGE

CI-10. And how old was he when you first had sexual intercourse with him?

Age in years _______

{ ASKED IF R IS NOT MARRIED TO, SEPARATED FROM, OR COHABITING WITH THIS

{ PARTNER. ALSO NOT ASKED IF THIS PARTNER WAS 1ST PARTNER

P1YRF

CI-11. Please look at Card 24. At the time you first had sexual intercourse with (PARTNER'S NAME), how would you describe your relationship with him?

Married to him ...............................................1

Engaged to him ...............................................2

Living together in a sexual relationship, but not engaged ....3

Going with him or going steady ...............................4

Going out with him once in a while ...........................5

Just friends .................................................6

Had just met him .............................................7

Something else ...............................................8

{ ASKED IF R IS NOT MARRIED TO, SEPARATED FROM, OR COHABITING WITH THIS

{ PARTNER. ALSO NOT ASKED IF THIS PARTNER WAS 1ST PARTNER

P1YFSEX_MX, P1YFSEX_YX

CI-12. In what month and year did you have sexual intercourse with him for the first time?

ENTER 96 if R only had sex once with this partner

 After R has given the year, say: Please record this event in the appropriate box in the “Marriages, Cohabs, Partners" row of your calendar. You can use any abbreviation that you will recognize later.

{ ASKED IF THIS IS A CURRENT SEXUAL PARTNER, BUT NOT R’s CURRENT H/P

{ NOR FIRST PARTNER

P1YEDUCX

CI-13. Please look at Card 11. What is the highest level of education he has completed?

Less than high school ...........................1

High school graduate or GED .....................2

Some college but no degree ......................3

2-year college degree (e.g., Associate’s degree).4

4-year college graduate (e.g., BA, BS) ..........5

Graduate or professional school .................6

{ ASKED IF THIS IS A CURRENT SEXUAL PARTNER, BUT NOT R’s CURRENT H/P

{ NOR FIRST PARTNER

P1YHISPX

CI-14. Is (PARTNER'S NAME) Hispanic or Latino, or of Spanish origin?

YES.....................1

NO......................5

{ ASKED IF THIS IS A CURRENT SEXUAL PARTNER, BUT NOT R’s CURRENT H/P

{ NOR FIRST PARTNER

P1YRACEX

CI-15. Which of the groups on Card 2 describes (PARTNER'S NAME)'s racial background? Please select one or more groups.

American Indian or Alaska Native ...............1

Asian ..........................................2

Native Hawaiian or Other Pacific Islander ......3

Black or African American ......................4

White ..........................................5

{ ASKED IF THIS IS A CURRENT SEXUAL PARTNER, BUT NOT R’s CURRENT H/P

{ NOR FIRST PARTNER, AND R REPORTED MORE THAN ONE RACE

P1YRACEBX

CI-16. Which of these groups, that is (RESPONSES FROM P1YRACEX), would you say best describes his racial background?

{ Display only those categories reported in CI-15 P1YRACEX

{ ASKED IF THIS IS A CURRENT SEXUAL PARTNER, BUT NOT R’s CURRENT H/P OR R’s

{ FIRST PARTNER, AND RELATIONSHIP HAS LASTED LONGER THAN 1 MONTH

P1YRNX

CI-17. Please look at Card XX. How would you describe your current relationship with (PARTNER'S NAME)?

Engaged to him ...............................................1

Going with him or going steady ...............................2

Going out with him once in a while ...........................3

Just friends .................................................4

Had just met him .............................................5

Something else ...............................................6

{ IF ANY OTHER RECENT PARTNER TO DESCRIBE (MAXIMUM OF 3),

{ RETURN TO CI-5 P1YRAGE.

{ OTHERWISE GO TO SECTION D.

SECTION D

Sterilizing Operations and Impaired Fecundity

STERILIZATION OPERATIONS (DA)

INTRO_D1

INTRO-D1. The next questions are about your physical ability to have (a/another) baby.

EVERTUBS

DA-1. Have you ever had both of your tubes tied, cut, or removed? This procedure is often called a tubal ligation or tubal sterilization.

YES..................................1

IF VOL: Operation failed ............3

IF VOL: Had ESSURE procedure.........4

NO...................................5

IF VOL: Operation already reversed ..6

ESSURE

DA-1b. If DA-1 EVERTUBS= 3 or 5 or DK or RF, THEN ASK:

Have you ever had a tubal sterilization procedure called “Essure”? This is not generally considered an operation, but makes it impossible for you to have a baby.

YES..........1

NO...........5

{ ASKED IF R IS NOT CURRENTLY PREGNANT

EVERHYST

DA-2. Have you ever had a hysterectomy, that is, surgery to remove your uterus?

Yes ..................1

No ...................5

{ ASKED IF R IS NOT CURRENTLY PREGNANT

EVEROVRS

DA-3. Have you ever had both of your ovaries removed?

Yes ...................1

No ....................5

{ ASKED FOR ALL

EVEROTHR

DA-4. Have you ever had any other operation that makes it impossible for you to have (a/another) baby?

Yes .................1

No ..................5 (GO TO DA-8 ANYOPSMN)

{ ASKED IF EVEROTHR = YES

WHTOOPRS

DA-5. What operation did you have that makes it impossible for you to have (a/another) baby? If you do not know its name, please describe the operation.

RECORD answer verbatim

{ INTERVIEWER CODES IF EVEROTHR = YES AND R VOLUNTEERS ANY OF THESE

WHTOOPRC

DA-5a. INTERVIEWER: CODE If any of the following mentioned:

OPERATION AFFECTS ONLY ONE TUBE...1

OPERATION AFFECTS ONLY ONE OVARY..2

SOME OTHER OPERATION..............3

OTHER STERILIZING OPERATION.......4

{ IF “SOME OTHER OPERATION” GO TO DA-7 DFNLSTRL.

{ ELSE IF “OTHER STERILIZING OPERATION” GO TO DA-8 ANYOPSMN.

{ ASKED IF R MENTIONS THAT ONLY 1 TUBE OR OVARY WAS AFFECTED

ONOTFUNC

DA-6. Many women who have only one (tube tied/ovary removed) can still have babies because they are not completely sterile. As far as you know, are you completely sterile from this operation, that is, does it make it impossible for you to have a baby in the future?

Yes ..............1 (DA-8 ANYOPSMN)

No ...............5 (DA-8 ANYOPSMN)

{ ASKED IF WHTOOPRC = 3 (SOME OTHER OPERATION)

DFNLSTRL

DA-7. As far as you know, are you completely sterile from this operation, that is, does it make it impossible for you to have a baby in the future?

Yes....1

No.....5

{ IF R IS NOT CURRENTLY MARRIED OR COHABITING, GO TO DB SERIES.

{ ASKED IF R IS CURRENTLY MARRIED OR COHABITING

ANYOPSMN

DA-8. Has (HUSBAND/PARTNER) ever had a vasectomy or any other operation that would make it impossible for him to father a baby in the future?

Yes ...............1

No ................5 (DB SERIES)

WHATOPSM

DA-9. What type of operation did (HUSBAND/PARTNER) have?

Vasectomy ................................1 (DB SERIES)

Other operation ..........................2

IF VOL: Operation failed .................5 (DB SERIES)

IF VOL: Operation already reversed .......6 (DB SERIES)

{ ASKED IF “OTHER OPERATION” MENTIONED IN WHATOPSM

DFNLSTRM

DA-10. As far as you know, is he completely sterile from this operation, that is, does it make it impossible for him to father a baby in the future?

Yes......1

No.......5

OPERATION BY OPERATION SERIES (DB)

{ LOOP FOR FEMALE OPERATIONS GOES FROM DB-1 DATFEMOP THROUGH DB-6 MINCDNNR.

{ ASK DB SERIES FOR EACH FEMALE OPERATION REPORTED (could be up to 4)

{ ASK DB SERIES FOR SINGLE MALE OPERATION (vasectomy or “other”)

{ ASKED FOR EACH FEMALE STERILIZING OPERATION REPORTED

DATFEMOP_M, DATFEMOP_Y

DB-1. When did you have your [OPERATION]?

 After R has given the year, say: Please record this operation in the box for this month and year on the "Birth Control Methods" row of your calendar. You might use "TS" or some other abbreviation that you will recognize later. If this happened before January [YEAR OF INTERVIEW - 3], please record it in the box for "before January [YEAR OF INTERVIEW - 3]".

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

PLCFEMOP

DB-2. Looking at Card 25, please tell me where this operation was performed.

Private doctor's office..............................1

HMO facility ........................................2

Community health clinic, community clinic,

public health clinic .............................3

Family planning or Planned Parenthood clinic ........4

Employer or company clinic ..........................5

School or school-based clinic .......................6

Hospital outpatient clinic ..........................7

Hospital emergency room .............................8

Hospital regular room ...............................9

Urgent care center, urgi-care, or walk-in facility ..10

Some other place ....................................20

{ ASKED FOR EACH TUBAL STERILIZATION OCCURRING WITHIN LAST 5 YEARS

INPATIEN

DB-2a. When you had your tubal sterilization, did you stay overnight in the hospital?

Yes ...............1

No ................5

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

PAYRSTER

DB-2b. Looking at Card 16, please tell me all of the ways in which the bill for this operation was paid.

ENTER all that apply

Insurance .....................................1

Co-payment or out-of-pocket payment ...........2

Medicaid ......................................3

No payment required ...........................4

Some other way ................................5

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

RHADALL

DB-3a. At the time you had your (OPERATION) in (mo/yr), had you, yourself, had all the children you wanted?

Yes .........1

No ..........5

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

HHADALL

DB-3b. And what about your (husband/partner/husband or partner) (at the time)? At the time you had your (OPERATION) in (mo/yr), had he had all the children he wanted?

Yes ..........................................1

No ...........................................5

IF VOL: R was not in a relationship with

a man at the time she had this operation ....6

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

FMEDREAS

DB-4. Please look at Card 26. Did you have any of these medical reasons for having your (OPERATION)?

ENTER all that apply

Medical problems with your female organs..........1

Pregnancy would be dangerous to your health.......2

You would probably lose a pregnancy...............3

You would probably have an unhealthy child........4

Some other medical reason ........................5

No medical reason for operation ..................6

{ ASKED FOR EACH FEMALE OPERATION OCCURRING WITHIN LAST 5 YEARS

BCREAS

DB-5a. IF R DID NOT VOLUNTEER (IN HHADALL) THAT SHE WAS NOT IN A RELATIONSHIP WITH A MAN AT THE TIME OF THE OPERATION, ASK:

At the time you had your (OPERATION), had you or your (husband/partner/husband or partner) been having problems with your method or methods of birth control?

ELSE IF R DID VOLUNTEER (IN HHADALL) THAT SHE WAS NOT IN A RELATIONSHIP WITH A MAN AT THE TIME OF THE OPERATION, ASK:

At the time you had your (OPERATION), had you been having problems with your method or methods of birth control?

Yes .....................................1

No ......................................5 (DB-6 MINCDNNR)

No, not using any method at the time ....6 (DB-6 MINCDNNR)

{ ASKED IF R REPORTED PROBLEMS WITH BIRTH CONTROL

BCWHYF

DB-5b. Was there a health or medical problem with the method of birth control you or your partner was using, or did you not like the method for some other reason?

Health or medical problem ...............1

Some other reason .......................2

Both ....................................3

{ IF R REPORTED ONLY 1 REASON FOR THIS OPERATION, GO TO NEXT OPERATION.

{ IF NO MORE OPERATIONS TO DESCRIBE, GO TO DB-6b OPERSAME.

{ ASKED IF R REPORTED MORE THAN 1 REASON FOR THIS OPERATION

MINCDNNR

DB-6. You mentioned that the reasons for your [OPERATION] were that... [ONLY DISPLAY REASONS THAT R REPORTED ABOVE]. Which one of these was the main reason that you had your [OPERATION]?

ENTER 3 if any medical reasons reported as her main reason.

ENTER 5 if R reports that her main reason was something other than a reason she reported previously.

You had all the children you wanted ....................1

Your husband or partner had all the children he wanted .2

Medical reasons ........................................3

Problems with other methods of birth control ...........4

Some other reason not mentioned above ..................5

{ RETURN TO DB-1 DATFEMOP TO ASK ABOUT NEXT OPERATION.

{ IF NO MORE OPERATIONS TO DESCRIBE, GO TO DB-6b OPERSAME.

{ ASKED IF 2 OR MORE OPERATIONS OCCURRED IN SAME M0/YR

OPERSAME

DB-6b. Did you have the (OPERATIONS OCCURRING IN SAME MO/YR) in the same operation in (mo/yr), or were these separate operations?

Same operation ...............1

Separate operations ..........5

{ IF NO MALE OPERATION REPORTED, GO TO DC SERIES.

{ ASKED FOR MALE OPERATION

DATEOPMN_M, DATEOPMN_Y

DB-7. When did [HUSBAND/PARTNER] have his [OPERATION]?

 After R has given the year, say: Please record this operation in the box for this month and year on the "Birth Control Methods" row of your calendar. You might use "V" or some other abbreviation that you will recognize later. If this happened before January [YEAR OF INTERVIEW - 3], please record it in the box for "before January [YEAR OF INTERVIEW - 3]"

{ IF OPERATION OCCURRED MORE THAN 5 YEARS AGO, GO TO DC SERIES.

{ IF OPERATION OCCURRED AFTER MO/YR WHEN R MARRIED HER CURRENT HUSBAND, AND

{ OCCURRED WITHIN THE LAST 5 YEARS, GO TO DB-9 PLACOPMN.

{ IF OPERATION OCCURRED BEFORE MARRIAGE DATE OR R IS COHABITING WITH THIS MAN,

{ AND OPERATION OCCURRED WITHIN THE LAST 5 YEARS

WITHIMOP

DB-8. You may have already told me this, but were you in a relationship with him at the time he had his [OPERATION]?

Yes ................. 1

No .................. 5 (DC Series)

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

PLACOPMN

DB-9. Looking at Card 25, please tell me where this operation was performed.

Private doctor's office..............................1

HMO facility ........................................2

Community health clinic, community clinic,

public health clinic .............................3

Family planning or Planned Parenthood clinic ........4

Employer or company clinic ..........................5

School or school-based clinic .......................6

Hospital outpatient clinic ..........................7

Hospital emergency room .............................8

Hospital regular room ...............................9

Urgent care center, urgi-care, or walk-in facility ..10

Some other place ....................................20

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

PAYMSTER

DB-10. Looking at Card 16, please tell me all of the ways in which the bill for [HUSBAND/PARTNER]'s operation was paid.

ENTER all that apply

Insurance .....................................1

Co-payment or out-of-pocket payment ...........2

Medicaid ......................................3

No payment required ...........................4

Some other way ................................5

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

RHADALLM

DB-11a. At the time [HUSBAND/PARTNER] had his [OPERATION] in (MO/YR), had you, yourself, had all the children you wanted?

Yes .........1

No ..........5

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

HHADALLM

DB-11b. And what about him? At the time he had his [OPERATION], had he had all the children he wanted?

Yes .........1

No ..........5

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

MEDREAS

DB-12. Please look at Card 27. Did he have any of these medical reasons for having his (OPERATION)?

ENTER all that apply

Pregnancy would be dangerous to your health......1

You would probably lose a pregnancy .............2

You would probably have an unhealthy child.......3

He had health problem that required the

operation......................................4

Some other medical reason .......................5

No medical reason for operation .................6

6, DK, OR RF CANNOT BE ENTERED WITH CODES 1-5

{ ASKED FOR MALE OPERATIONS OCCURRING WITHIN THE LAST 5 YEARS AND OCCURRING

{ DURING THEIR RELATIONSHIP

BCREASM

DB-13a. At the time he had his [OPERATION], had you or [HUSBAND/PARTNER] been having problems with your method or methods of birth control?

Yes .....................................1

No ......................................5 (DB-14 MINCDNMN)

No, not using any method at the time ....6 (DB-14 MINCDNMN)

{ ASKED IF BIRTH CONTROL PROBLEMS REPORTED

BCWHYM

DB-13b. Was there a health or medical problem with the method of birth control you or he was using, or did you not like the method for some other reason?

Health or medical problem ...............1

Some other reason .......................2

Both ....................................3

{ IF ONLY 1 REASON REPORTED FOR THE MALE OPERATION, GO TO DC SERIES.

{ ASKED IF MORE THAN 1 REASON REPORTED FOR THE MALE OPERATION

MINCDNMN

DB-14. You mentioned that the reasons that [HUSBAND/PARTNER] had [OPERATION] were that... [ONLY DISPLAY THOSE REASONS THAT R REPORTED FOR HUSBAND/PARTNER ABOVE]. Which one of these was the main reason that he had [OPERATION]?

ENTER 3 if any medical reasons reported as main reason.

ENTER 5 if R reports that his main reason was something other than a reason she reported previously.

You had all the children you wanted ....................1

Your husband or partner had all the children he wanted .2

Medical reasons ........................................3

Problems with other methods of birth control ...........4

Some other reason not mentioned above ..................5

REVERSAL OF TUBAL LIGATION OR VASECTOMY (DC)

{ IF TUBAL LIGATION NOT REPORTED, GO TO DC-3 REVSVASX.

{ ASKED IF TUBAL LIGATION OR ESSURE PROCEDURE WAS REPORTED

REVSTUBL

DC-1. IF NO REVERSAL OPERATION PREVIOUSLY REPORTED, ASK:

Have you ever had surgery to reverse your tubal sterilization?

ELSE IF REVERSAL OPERATION WAS ALREADY REPORTED, ASK:

Earlier you mentioned that you had your tubal sterilization reversed. Is this correct?

Yes .................1

No ..................5 (GO TO DC-3 REVSVASX)

{ ASKED IF R HAD REVERSAL OF TUBAL STERILIZATION

DATRVSTB_M, DATRVSTB_Y

DC-2. In what month and year did you have your tubal sterilization reversed?

If R cannot recall month and year, REFER her to the life history calendar.

 After R has given the year, say: Please record this operation in the box for this month and year on the "Birth Control Methods" row of your calendar. You might use "REV" or some other abbreviation that you will recognize later. If this happened before January [YEAR OF INTERVIEW - 3], please record it in the box for "before January [YEAR OF INTERVIEW - 3]".

{ IF R DID NOT REPORT A VASECTOMY FOR HER CURRENT H/P, GO TO DC-5 RWANTRVT.

{ ASKED IF R REPORTED THAT HER CURRENT H/P HAD A VASECTOMY

REVSVASX

DC-3. IF NO VASECTOMY REVERSAL WAS PREVIOUSLY REPORTED, ASK:

Has [HUSBAND/PARTNER] ever had surgery to reverse his vasectomy?

ELSE IF VASECTOMY REVERSAL WAS PREVIOUSLY REPORTED, ASK:

Earlier you mentioned that [HUSBAND/PARTNER] has had his vasectomy reversed. Is this correct?

Yes ................1

No .................5 (GO TO DC-5 RWANTRVT)

{ ASKED IF R REPORTED THAT HER CURRENT H/P HAD A VASECTOMY REVERSAL

DATRVVEX_M, DATRVVEX_Y

DC-4. In what month and year did [HUSBAND/PARTNER] have the reversal?

If R cannot recall month and year, REFER her to the life history calendar.

 After R has given the year, say: Please record this operation in the box for this month and year on the "Birth Control Methods" row of your calendar. You might use "REV" or some other abbreviation that you will recognize later. If this happened before January [YEAR OF INTERVIEW - 3], please record it in the box for "before January [YEAR OF INTERVIEW - 3]".

{ IF R HAD ANY OPERATION BESIDES TUBAL STERILIZATION OR HER CURRENT H/P HAD AN

{ OPERATION OTHER THAN VASECTOMY, GO TO DE SERIES.

{ THE REMAINING ITEMS IN THE DC SERIES ARE ASKED IF R’s (OR COUPLE’s) ONLY

{ STERILIZATION OPERATIONS ARE A TUBAL OR A VASECTOMY.

{ ASKED IF R REPORTED AN UNREVERSED TUBAL

RWANTRVT

DC-5. As things look to you now, if your tubal sterilization could be reversed safely, would you want to have it reversed? Would you say definitely yes, probably yes, probably no, or definitely no?

Definitely yes ..........1

Probably yes ............2

Probably no .............3

Definitely no ...........4

{ ASKED IF R IS CURRENTLY MARRIED OR COHABITING

MANWANTT

DC-6. Would [HUSBAND/PARTNER] like you to have your tubal sterilization reversed? Would you say definitely yes, probably yes, probably no, or definitely no?

Definitely yes..........1

Probably yes............2

Probably no.. ..........3

Definitely no...........4

{ IF NO VASECTOMY REPORTED, GO TO DD SERIES.

{ ASKED IF R REPORTED AN UNREVERSED VASECTOMY FOR HER CURRENT H/P

RWANTREV

DC-7. As things look to you now, if [HUSBAND/PARTNER]'s vasectomy could be reversed safely, would you want to have it reversed? Would you say definitely yes, probably yes, probably no, or definitely no?

Definitely yes ..........1

Probably yes ............2

Probably no .............3

Definitely no ...........4

MANWANTR

DC-8. Would [HUSBAND/PARTNER] like to have his vasectomy reversed? Would you say definitely yes, probably yes, probably no, or definitely no?

Definitely yes ..........1

Probably yes ............2

Probably no .............3

Definitely no ...........4

NON-SURGICAL STERILITY (DE)

{ IF R IS SURGICALLY STERILE, GO TO SECTION E.

{ ELSE IF R IS CURRENTLY PREGNANT, GO TO DF-1 CANHAVER.

{ ASKED IF R IS NEITHER SURGICALLY STERILE NOR PREGNANT.

POSIBLPG

DE-1. Now I have a few more questions about your physical ability to have (a/another) baby at some time in the future.

Some women are not physically able to have children. As far as you know, is it physically possible for you, yourself, to have (a/another) baby?

Yes .....................1

No ......................5

{ IF PHYSICALLY POSSIBLE, GO TO DE-3 POSIBLMN.

{ ASKED IF NOT PHYSICALLY POSSIBLE

REASIMPR

DE-2. What is the main reason it is impossible for you to have a baby in the future? Is it ...

Impossible due to an accident or illness ............1

Impossible due to menopause .........................2

Impossible for some other reason ....................3

Impossible for you to have a baby,

for unknown reasons ...........................4

{ ASKED IF R REPORTED SOME OTHER REASON FOR DE-2 REASIMPR

REASIMPR_SP

DE-2b. (What is the other reason it is impossible?)

RECORD ANSWER VERBATIM:

_____________________________________________________

{ ASKED IF R HAS A CURRENT H/P AND HE IS NOT SURGICALLY STERILE.

POSIBLMN

DE-3. What about [HUSBAND/PARTNER]? As far as you know, is it physically possible for him to father a baby in the future?

Yes .....................1

No ......................5

{ASKED IF PHYSICALLY IMPOSSIBLE FOR HIM

REASIMPP

DE-4. What is the main reason it is impossible for [HUSBAND/PARTNER] to father a baby in the future?

Impossible due to an accident or illness ............1

Impossible for some other reason ....................2

Impossible for him to father a baby,

for unknown reasons .........................3

{ ASKED IF R REPORTED SOME OTHER REASON FOR DE-4 REASIMPP

REASIMPP_SP

DE-4b. (What is the other reason it is impossible?)

RECORD ANSWER VERBATIM:

______________________________________________________

{ IF PHYSICALLY IMPOSSIBLE FOR R TO HAVE A BABY, GO TO DF-3 CANHAVEM.

PREGNANCY DIFFICULTY SERIES (DF)

{ ASKED IF PHYSICALLY POSSIBLE FOR R TO HAVE A BABY

CANHAVER

DF-1. Some women are physically able to have (a/another) baby, but have difficulty getting pregnant or carrying the baby to term. As far as you know, would you, yourself, have any difficulty getting pregnant (again) or carrying (a/another) baby (after this pregnancy)?

Yes ............1

No .............5 (GO TO DF-3 CANHAVEM)

{ ASKED IF R HAS DIFFICULTY

REASDIFF

DF-2. Please look at Card 28. What is the reason that it would be difficult for you to have (a/another) baby?

ENTER all that apply

You have difficulty getting pregnant............1

You have difficulty carrying baby to term.......2

Pregnancy is dangerous to your health...........3

You are likely to have an unhealthy baby .......4

Or some other reason ...........................5

{ ASKED IF R HAS A CURRENT H/P WHO IS PHYSICALLY ABLE TO FATHER A CHILD

CANHAVEM

DF-3. As far as you know, does [HUSBAND/PARTNER] have any difficulty fathering a baby?

Yes .................1

No ..................5

{ ASKED IF PHYSICALLY POSSIBLE FOR R TO HAVE A BABY

PREGNONO

DF-4. At any time has a medical doctor ever advised you never to become pregnant (again)?

Yes .................1

No ..................5 (GO TO SECTION E)

{ ASKED IF PREGNONO = YES

REASNONO

DF-5. Please look at Card 29 and tell me why the doctor advised you not to become pregnant?

ENTER all that apply

Dangerous for you ..................1

Dangerous for your baby ............2

Some other reason ..................3

SECTION E

Contraceptive History and Pregnancy Wantedness

CONTRACEPTIVE METHODS EVER USED (EA)

INTR-EA1

EA-0. Card 30 lists methods that some people use to prevent pregnancy or to prevent sexually transmitted disease. As I read a method from the list, please tell me if you have ever used it for any reason. Just give me a "yes" or "no" answer. Please answer yes even if you have only used the method once.

PILL

EA-1. Have you ever used birth control pills?

If R volunteers she never used a method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

{IF R HAS NEVER HAD SEX GO TO DEPOPROV EA-4

CONDOM

EA-2. Have you ever used condoms or rubbers with a partner?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

VASECTMY

EA-3. Have you ever had sex with a partner who had a vasectomy?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

DEPOPROV

EA-4. (Have you ever used) Depo-Provera, an injectable (or shot) given once every three months?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

LUNELLE

EA-5. (Have you ever used) Lunelle, a once-a-month injection?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

{ IF R HAS NEVER HAD SEX, GO TO PATCH EA-9

WIDRAWAL

EA-6. Have you ever had sex with a partner who used withdrawal or "pulling out"?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

RHYTHM

EA-7. Have you ever used rhythm or safe period by calendar to prevent pregnancy?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

TEMPSAFE

EA-8. (Have you ever used) Natural family planning or safe period by temperature or cervical mucus test to prevent pregnancy?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

PATCH

EA-9. (Have you ever used) The contraceptive patch?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

RING

EA-10. (Have you ever used) The vaginal contraceptive ring (or “NuvaRing”)?

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes............................1

No.............................5

{ IF R HAS NEVER HAD SEX, GO TO OTHRMETH EA-14

MORNPILL

EA-11. (Have you ever used) Emergency contraception, also known as “Plan B” or “Preven”, or "morning after pills”?

Read if necessary: This is a series of regular birth control pills taken within 72 hours after unprotected sex to help a woman avoid pregnancy.

If R volunteers she never used a (another) method, probe to make sure R has read the entire card and is sure of her answer.

Yes.............................1

No..............................5

{IF R HAS NEVER USED EMERGENCY CONTRACEPTION GO TO EA-14 OTHRMETH

ECTIMESX

EA-12. How many different times have you used emergency contraception?

Number _________

ECREASON

EA-13. Did you use emergency contraception because you were worried your birth control method would not work, you didn’t use birth control that time, or for some other reason?

ENTER all that apply

You were worried your birth control method would

not work.................................1

You didn’t use birth control that time.....2

Some other reason..........................3

ECWHERE

EA-13a. (The last time you used it,) where did you get the emergency contraception?

Private doctor’s office............................................1

HMO facility.......................................................2

Community health clinic, Community clinic, Public health clinic....3

Family planning or Planned Parenthood Clinic.......................4

Employer or company clinic.........................................5

School or school-based clinic......................................6

Hospital outpatient clinic.........................................7

Hospital emergency room............................................8

Hospital regular room..............................................9

Urgent care center, urgi-care or walk-in facility.................10

Friend............................................................11

Partner or spouse.................................................12

Drug store........................................................13

Mail order/Internet...............................................14

Some other place..................................................20

ECWHEN

EA-13b. (The last time you used it,) was that within the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?

Yes.............................1

No..............................5

OTHRMETH

EA-14. Card 33 lists some other methods of birth control. Which, if any, of the methods listed on that card have you ever used? Please tell me the method even if you have only used it once.

ENTER all that apply

Birth control pills.........................3

Condom......................................4

Partner’s vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy............6

Withdrawal, pulling out.....................7

Depo-Provera, injectables (shots)...........8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Other method...............................21

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

No other methods ever used.................95

{ASKED IF R USED AN “OTHER” METHOD OF CONTRACEPTION

SP_OTHRMETH

EA-15. (Have you used any other methods?)

Specify

{IF R HAS NEVER USED A METHOD, GO TO EC SERIES

METHDISS

EA-16. Some people try a method and then don’t use it again, or stop using it, because they are not satisfied with the method. Did you ever stop using a method because you were not satisfied with it in some way?

Do not count stopping a method for reasons other than dissatisfaction, for example, stopped to get pregnant or because not having intercourse

Yes.............................1

No..............................5

{ASKED IF R EVER STOPPED USING A METHOD DUE TO DISSATISFACTION

METHSTOP

EA-17. Please look at Card 31. What method or methods did you stop because you were not satisfied?

ENTER all that apply

Birth control pills.........................3

Condom......................................4

Partner’s vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy............6

Withdrawal, pulling out.....................7

Depo-Provera, injectables (shots)...........8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Other method...............................21

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{ ASKED IF R EVER STOPPED USING BIRTH CONTROL PILLS DUE TO DISSATISFACTION

REASPILL

EA-18. Looking at Card 32, What was the reason or reasons you were not satisfied with the Pill?

ENTER all that apply

Too expensive..........................................1

Insurance did not cover it.............................2

Too difficult to use...................................3

Too messy..............................................4

Your partner did not like it...........................5

You had side effects...................................6

You were worried you might have side effects...........7

You worried the method would not work..................8

The method failed, you became pregnant.................9

The method did not protect against disease............10

Because of other health problems, a doctor

told you that you should not use the method again....11

The method decreased your sexual pleasure.............12

Too difficult to obtain the method....................13

Did not like the changes to your menstrual cycle......14

Other.................................................15

{ ASKED IF REASPILL = 15 (OTHER REASON)

SP_REASPILL

EA-18b. (Looking at Card 32, What was the reason or reasons you were not satisfied with the Pill?)

Specify

{ ASKED IF R EVER STOPPED USING THE CONDOM DUE TO DISSATISFACTION

REASCOND

EA-19. Looking at Card 32, What was the reason or reasons you were not satisfied with the condom?

ENTER all that apply.

Too expensive..........................................1

Insurance did not cover it.............................2

Too difficult to use...................................3

Too messy..............................................4

Your partner did not like it...........................5

You had side effects...................................6

You were worried you might have side effects...........7

You worried the method would not work..................8

The method failed, you became pregnant.................9

The method did not protect against disease............10

Because of other health problems, a doctor

told you that you should not use the method again....11

The method decreased your sexual pleasure.............12

Too difficult to obtain the method....................13

Did not like the changes to your menstrual cycle......14

Other.................................................15

{ ASKED IF REASCOND = 15 (OTHER REASON)

SP_REASCOND

EA-19b. (Looking at Card 32, What was the reason or reasons you were not satisfied with the condom?)

Specify

{ ASKED IF R EVER STOPPED USING DEPO-PROVERA DUE TO DISSATISFACTION

REASDEPO

EA-20. Looking at Card 32, What was the reason or reasons you were not satisfied with Depo-Provera?

ENTER all that apply.

Too expensive..........................................1

Insurance did not cover it.............................2

Too difficult to use...................................3

Too messy..............................................4

Your partner did not like it...........................5

You had side effects...................................6

You were worried you might have side effects...........7

You worried the method would not work..................8

The method failed, you became pregnant.................9

The method did not protect against disease............10

Because of other health problems, a doctor

told you that you should not use the method again....11

The method decreased your sexual pleasure.............12

Too difficult to obtain the method....................13

Did not like the changes to your menstrual cycle......14

Other.................................................15

{ ASKED IF REASDEPO = 15 (OTHER REASON)

SP_REASDEPO

EA-20b. (Looking at Card 32, What was the reason or reasons you were not satisfied with the Depo-Provera?)

Specify

{ ASKED IF R EVER STOPPED USING LUNELLE INJECTIBLE DUE TO DISSATISFACTION

REASLUNL

EA-21. Looking at Card 32, What was the reason or reasons you were not satisfied with Lunelle injectible?

ENTER all that apply.

Too expensive..........................................1

Insurance did not cover it.............................2

Too difficult to use...................................3

Too messy..............................................4

Your partner did not like it...........................5

You had side effects...................................6

You were worried you might have side effects...........7

You worried the method would not work..................8

The method failed, you became pregnant.................9

The method did not protect against disease............10

Because of other health problems, a doctor

told you that you should not use the method again....11

The method decreased your sexual pleasure.............12

Too difficult to obtain the method....................13

Did not like the changes to your menstrual cycle......14

Other.................................................15

{ ASKED IF REASLUNL = 15 (OTHER REASON)

SP_REASLUNL

EA-21b. (Looking at Card 32, What was the reason or reasons you were not satisfied with the Lunelle injectible?)

Specify

{ ASKED IF R EVER STOPPED USING THE CONTRACEPTIVE PATCH DUE TO DISSATISFACTION

REASPTCH

EA-22. Looking at Card 32, What was the reason or reasons you were not satisfied with the contraceptive patch?

ENTER all that apply.

Too expensive..........................................1

Insurance did not cover it.............................2

Too difficult to use...................................3

Too messy..............................................4

Your partner did not like it...........................5

You had side effects...................................6

You were worried you might have side effects...........7

You worried the method would not work..................8

The method failed, you became pregnant.................9

The method did not protect against disease............10

Because of other health problems, a doctor

told you that you should not use the method again....11

The method decreased your sexual pleasure.............12

Too difficult to obtain the method....................13

Did not like the changes to your menstrual cycle......14

Other.................................................15

{ ASKED IF REASPTCH = 15 (OTHER REASON)

SP_REASPTCH

EA-22b. (Looking at Card 32, What was the reason or reasons you were not satisfied with the contraceptive patch?)

Specify

{IF R HAS NEVER USED A CONTRACEPTIVE METHOD, BUT HAS HAD SEX, GO TO EC SERIES. {IF R HAS NEVER USED A CONTRACEPTIVE METHOD AND HAS NEVER HAD SEX, GO TO SECTION F

FIRST METHOD SERIES (EB)

INTR-EB1

EB-0. Now I need to ask a few questions about the very first time in your life that you used a birth control method for any reason.

FIRSMETH

EB-1. What was the first birth control method you ever used for any reason? If you used more than one method, please tell me about each one. Please refer to Card 33.

ENTER all that apply

If R spontaneously mentions she was sterile (aside from sterilizing operation listed among categories), ENTER 22.

If R spontaneously mentions her partner was sterile (aside from vasectomy listed in categories), ENTER 23.

Birth control pills.........................3

Condom......................................4

Partner's vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy...........6

Withdrawal, pulling out.....................7

Depo-Provera, injectables...................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

[JA 4/10/07: check if this change was actually made]

Other method ..............................21

Respondent was sterile.....................22

Respondent’s partner was sterile...........23

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{ASKED IF FIRST METHOD USED WAS “OTHER”

SP_FIRSMETH

EB-1. (What was the first birth control method you ever used for any reason? If you used more than one method, please tell me about each one. Please refer to Card 33.)

Specify

{IF R HAS NEVER HAD SEX, GO TO EB-3 WNFSTUSE_MO

{ASKED IF R’s FIRST METHOD WAS NOT A CONTINUOUS METHOD

FIRSTIME1

EB-2. Please look at Card 34. Thinking again of the very first time you ever used a method of birth control, when was it? Was it the first time you had intercourse, less than a month after your first intercourse, one to three months after your first intercourse, four to twelve months after your first intercourse, or more than twelve months after your first intercourse?

The first time you had

intercourse...................2

Less than a month after

your first intercourse........3

One to three months after

first intercourse.............4

Four to twelve months after

first intercourse.............5

More than twelve months after

first intercourse.............6

{ASKED IF R’s FIRST METHOD WAS A CONTINUOUS METHOD

FIRSTIME2

EB_2. Please look at Card 35. Thinking again of the very first time you ever used a method of birth control, when was it? Was it before your first intercourse, the first time you had intercourse, less than a month after your first intercourse, one to three months after your first intercourse, four to twelve months after your first intercourse, or more than twelve months after your first intercourse?

Before your first

intercourse...................1

The first time you had

intercourse ..................2

Less than a month after

your first intercourse........3

One to three months after

first intercourse.............4

Four to twelve months after

first intercourse.............5

More than twelve months after

first intercourse.............6

{ ASKED IF FIRST METHOD USE WAS AFTER FIRST SEX

NOMETH

EB-2a. Including your first sex, how many times did you have sexual intercourse before you used a method of birth control?

Number ___________

If R used a method at second sex, response should be “1”.

{ ASKED IF FIRST METHOD USE WAS NOT AT FIRST SEX

WNFSTUSE_M/WNFSTUSE_Y

EB-3. Now, please look at your calendar, and tell me in what month and year you first used a method (for any reason).

Display if R HAS EVER HAD SEX:

If respondent needs help, remind her of the date of her first intercourse which was in [DATE].

w After R has given the year, say: Please write this on your calendar on the “Birth Control Methods” row, in the box for this month and year. You can use an abbreviation for the method, or anything that you will recognize later. If this date is before January [YEAR OF INTERVIEW - 3], write the date and method in the “Before January [YEAR OF INTERVIEW - 3]” box.

{ ASKED IF FIRST METHOD USE WAS NOT AT FIRST SEX

AGEFSTUS

EB-4. How old were you the first time you used a method for any reason?

Age in years ____________

{ ASKED IF AGE IS 15-24 AND FIRST METHOD USED WAS A DRUG OR DEVICE

PLACGOTF

EB-5. Please look at Card 36. Where did you get the [FIRST METHOD USED]?

Private doctor’s office............................................1

HMO facility.......................................................2

Community health clinic, Community clinic, Public health clinic....3

Family planning or Planned Parenthood Clinic.......................4

Employer or company clinic.........................................5

School or school-based clinic......................................6

Hospital outpatient clinic.........................................7

Hospital emergency room............................................8

Hospital regular room..............................................9

Urgent care center, urgi-care or walk-in facility.................10

Friend............................................................11

Partner or spouse.................................................12

Drug store........................................................13

Mail order/Internet...............................................14

Some other place..................................................20

{IF FIRST METHOD USE WAS AT OR AFTER FIRST INTERCOURSE, GO TO EC SERIES

{ASKED IF FIRST METHOD USE WAS BEFORE FIRST INTERCOURSE

USEFRSTS

EB-6. Did you use any birth control method the first time you had intercourse?

Yes...............1 (GO TO MTHFRSTS EB-8)

No................5

{ASKED IF FIRST METHOD USE WAS BEFORE FIRST INTERCOURSE AND NO METHOD USED AT FIRST INTERCOURSE

NOMETH2

EB-7. Including your first sex, how many times did you have sexual intercourse before you used a method of birth control during sexual intercourse?

Number _________

If R used a method at second sex, response should be “1”.

{ASKED IF FIRST METHOD USE WAS BEFORE FIRST INTERCOURSE AND A METHOD WAS ALSO USED AT FIRST INTERCOURSE

MTHFRSTS

EB-8. Which method did you use the first time you had intercourse? The methods are listed on Card 33. If you used more than one method at the same time, please tell me about that.

ENTER all that apply

If R spontaneously mentions she was sterile (aside from sterilizing operation listed in categories), ENTER 22.

If R spontaneously mentions her partner was sterile (aside from vasectomy listed in categories), ENTER 23.

Birth control pills.........................3

Condom......................................4

Partner's vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy...........6

Withdrawal, pulling out.....................7

Depo-Provera, injectables...................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

Other method (Specify).....................21

Respondent was sterile.....................22

Respondent’s partner was sterile...........23

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{ASKED IF METHOD USED AT FIRST SEX WAS “OTHER”

SP_MTHFRSTS

EB-8. (Which method did you use the first time you had intercourse? The methods are listed on Card 33. If you used more than one method at the same time, please tell me about that. )

Specify

PERIODS OF NON INTERCOURSE (EC)

{IF R NEVER HAD SEX, GO TO ED SERIES

{IF R’s FIRST SEX WAS THE MONTH OF INTERVIEW, ASSIGN “YES” TO INTERCOURSE IN CURRENT MONTH, AND GO TO ED SERIES

INTR-EC1

EC-1. Many women have times when they are not having intercourse at all, for example, because of pregnancy, separation, not dating anyone, illness, or other reasons. I’d like to know the months since (the first time you had intercourse, which was in [DATE OF FIRST SEX]/ January [YEAR OF INTERVIEW - 3]] that you did not have intercourse at all for the entire month. First, let’s make sure you have other information on your calendar.

{INFORMATION ABOUT PREGNANCIES, IF ANY, APPEARS ON SCREEN THAT RESPONDENT HAS PROVIDED IN PRIOR SECTIONS, AS AN AID FOR ENTERING THE CURRENT INFORMATION

INTR-EC2

EC-2. (Many women have times when they are not having intercourse at all, for example, because of pregnancy, separation, not dating anyone, illness, or other reasons. I’d like to know the months since (the first time you had intercourse, which was in [DATE OF FIRST SEX]/ January [YEAR OF INTERVIEW - 3]] that you did not have intercourse at all for the entire month. First, let’s make sure you have other information on your calendar.)

{INFORMATION ABOUT DATES OF SEXUAL PARTNERS IF ANY, APPEARS ON SCREEN THAT RESPONDENT HAS PROVIDED IN PRIOR SECTIONS, AS AN AID FOR ENTERING THE CURRENT INFORMATION

INTR-EC3

EC-3. Since ([DATE OF FIRST SEX]/ January [YEAR OF INTERVIEW - 3]], have there been any times when you were not having intercourse at all for one month or more?

Remember,

'Yes' means the respondent had at least one month of no intercourse, and

'No' means R had intercourse every month.

Yes...................1

No....................5

{IF R HAD INTERCOURSE EVERY MONTH, GO TO ED SERIES

INTR-EC4

EC-4. Start with the current month, [MONTH OF INTERVIEW], and think about each month one at a time, going back to (January [YEAR OF INTERVIEW - 3]/[DATE OF FIRST SEX]). On the row labeled “Intercourse”, please mark an “x” in the box for each month during which you had intercourse at least once. So the boxes in this row that are blank will be the ones during which you did not have intercourse at all for the whole month.

{IF R’s DATE OF FIRST SEX WAS ON OR AFTER January [INTERVIEW YEAR], GO TO INTR-EC7

INTR-EC5

EC-5. Now think about last year, [YEAR OF INTERVIEW- 1]. Start with December, and think about each month one at a time, going back to (January [YEAR OF INTERVIEW - 1])/[DATE OF FIRST SEX]). Please mark an “x” in the box for each month during which you had intercourse at least once.

{IF R’s DATE OF FIRST SEX WAS ON OR AFTER January [YEAR OF INTERVIEW - 1], GO TO INTR-EC7

INTR-EC6

EC-6. Finally, start with December [YEAR OF INTERVIEW - 2], and think about each month one at a time, going back to January [YEAR OF INTERVIEW - 3]/[DATE OF FIRST SEX]). Please mark an “x” in the box for each month during which you had intercourse at least once.

INTR-EC7

EC-7. Now I need to enter those months into the computer. Would you prefer that I look at your calendar, or would you rather tell me the months?

If Respondent is reading the months:

Please tell me the months that you had intercourse, starting with [January [YEAR OF INTERVIEW - 3]/DATE OF FIRST SEX].

MAKE SURE you know whether she is telling you the months she did NOT have intercourse or the months she DID have intercourse.

MONSX

EC-8. [HEADER: DATE CORRESPONDING TO WHERE THE CURSOR IS IN THE GRID]

ENTER 1 if the Respondent marked an X in this month or mentions it as a month that intercourse occurred. Otherwise,

PRESS [Enter] to continue.

CONTRACEPTIVE METHOD HISTORY (ED)

{IF R HAS NEVER USED A CONTRACEPTIVE METHOD, GO TO EG SERIES

INTR-ED1

ED-1. Before we begin this next section on your birth control use, I need to make sure all of the information we need is on your calendar.

{INFORMATION ABOUT PREGNANCIES, IF ANY, APPEARS ON SCREEN THAT RESPONDENT HAS PROVIDED IN PRIOR SECTIONS, AS AN AID FOR ENTERING THE CURRENT INFORMATION

INTR-ED2

ED-2. (Before we begin this next section on your birth control use, I need to make sure all of the information we need is on your calendar.)

{MONTHS OF NONINTERCOURSE, IF ANY, APPEAR ON SCREEN THAT RESPONDENT HAS PROVIDED IN PRIOR SERIES, AS AN AID FOR ENTERING THE CURRENT INFORMATION

INTR-ED3

ED-3. (Before we begin this next section on your birth control use, I need to make sure all of the information we need is on your calendar.)

{INFORMATION ON STERILIZING OPERATIONS, IF ANY, APPEAR ON SCREEN THAT RESPONDENT HAS PROVIDED IN PRIOR SECTION, AS AN AID FOR ENTERING THE CURRENT INFORMATION

Once R has entered all information and/or verified that it is correct, continue.

{ ASKED IF DATE OF R’S HYSTERECOMY IS PRIOR TO STARTING MONTH OF METHOD

{ CALENDAR, ELSE GO TO ED-4b

INTR-ED4a

ED-4a. The next questions are about birth control methods you may have used between (START DATE OF METHOD CALENDAR) and (CMENDMC_FILL). Remember that this also refers to methods men use, such as condoms, vasectomy, and withdrawal.

As we discussed earlier, you had a hysterectomy in (DATE OF HYSTERECTOMY). Since (START DATE OF METHOD CALENDAR), have you used any other birth control methods for any reasons, such as preventing disease?

Yes.............1

No..............5

{ IF R HAS USED OTHER BIRTH CONTROL METHODS SINCE STARTING MONTH OF METHOD

{ CALENDAR OR IF R HAS NOT HAD A HYSTERECTOMY, CONTINUE WITH ED-4b.

INTR-ED4b

ED-4b. I need to find out about the birth control methods you used each month between (DATE OF FIRST METHOD USE) and January [YEAR OF INTERVIEW - 3]. Remember to include methods men use -- such as condoms, vasectomy, and withdrawal -- in your answer.

Mark method history start and end dates on calendar for R.

Looking at the methods on Card 37, please write the methods you used each month on the calendar. I need to know about all the methods you used, so if you used more than one method in a month, please record all the methods you used that month.

To do this, on the “Birth Control Methods” row, write the name of the method in each month that you used a method, going back to (DATE OF FIRST METHOD USE). You can use an abbreviation for the method if you wish.

{IF R HAS HAD A STERILIZING OPERATION

Even though we’ve marked the month that your sterilization began, if you used any methods after that time, please mark an “x” on the appropriate row, in the months you used them.

INTR-ED5

ED-5. Take your time.

Help her record methods on calendar.

When R has recorded all methods on the calendar, SAY:

Now I need to enter the methods in the computer. It is important that we get these methods correct. If you notice that I have entered something incorrectly, please let me know.

Have R read methods to you if possible. Verify methods with R as you enter them.

METHHIST

ED-6. METHHIST is recorded for each method used in each month of the calendar. Up to 4 different methods may be recorded for each month.

No method used................................1

Same as previous month........................2

Birth control pills...........................3

Condom........................................4

Partner's vasectomy...........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy.............6

Withdrawal, pulling out.......................7

Depo-Provera, injectables.....................8

Hormonal implants (Norplant or Implanon)......9

Rhythm or safe period by calendar............10

Safe period by temperature or cervical mucus

test, natural family planning..............11

Diaphragm....................................12

Female condom, vaginal pouch.................13

Foam.........................................14

Jelly or cream...............................15

Cervical cap.................................16

Suppository, insert..........................17

Today^tm sponge................................18

IUD, coil, loop..............................19

Emergency contraception......................20

Other method.................................21

Respondent sterile...........................22

Respondent’s partner sterile.................23

Same method used through the end of the year.55

Lunelle injectable (monthly shot)............24

Contraceptive patch..........................25

Vaginal contraceptive ring...................26

{ASKED IF METHOD WAS “OTHER”

SP_METHHIST

ED-7. (ENTER method(s) used in (MONTH OF METHOD CALENDAR):)

Specify

{ASKED IF R SAID SHE USED THE SAME METHOD FOR THE WHOLE YEAR

SAMEAllYear

ED-8. I’m about to enter that you used [METHOD] every month from [THIS MONTH] through [DECEMBER OF THAT YEAR or INTERVIEW MONTH if this is the interview year]. Is that correct?

Yes..........1

No...........5

{ ASKED IF R REPORTED 1 OR MORE METHODS IN THE FIRST MONTH OF THE METHOD CALENDAR, January [YEAR OF INTERVIEW - 3])

DATBEGIN_M/DATBEGIN_Y

ED-9. IF ONLY ONE METHOD REPORTED IN 1ST MONTH OF MC, ASK:

When did you start using (this method/that method combination)? If you used (this method/that method combination) on and off before (DATE OF START OF CALENDAR), please tell me when you started using the method (combination) most recently before January [YEAR OF INTERVIEW - 3].

{IF MORE THAN ONE METHOD IN THE MONTH, AND ONE IS THE PILL, SAY:

If you used the methods at different times during that month, please tell me when you started using the pill most recently before January [YEAR OF INTERVIEW - 3].

{IF R USED ONLY ONE METHOD IN FIRST MONTH OF CALENDAR, GO BACK TO ED-1 METHHIST UNTIL THERE ARE NO MORE MONTHS OF METHOD CALENDAR

{ASKED IF R USED TWO METHODS IN ONE MONTH OF CALENDAR

SIMSEQ

ED-10. Did you use those methods together, that is, at the same time, or did you use them at different times during the month?

Same time...........1

Different times.....2

{ASKED IF R USED THREE OR MORE METHODS IN ONE MONTH OF CALENDAR

MTHUSIMX

ED-11. During that month, which (of those methods/other methods), if any, did you use at the same time?

Select next set of methods used simultaneously. Code all that apply.

None.......................................1

Office use only............................2

Birth control pills........................3

Condom.....................................4

Partner's vasectomy........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy...........6

Withdrawal, pulling out....................7

Depo-Provera, injectables..................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

Other method (Display specified response)..21

R’s sterility..............................22

R’s partner’s sterility....................23

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{IF THERE ARE MONTHS REMAINING IN THE METHOD CALENDAR TO RECORD, GO BACK TO ED-1 METHHIST.

{IF R HAS NEVER HAD SEX:

AND CURRENT METHOD IS PILL, GO TO EJ SERIES

AND CURRENT METHOD IS NOT PILL, GO TO SECTION F

METHOD USE AT LAST (AND FIRST) SEX WITH UP TO 3 PARTNERS IN THE PAST 12 MONTHS (EF)

{IF R HAS NOT HAD SEX IN THE PAST 12 MONTHS, GO TO EG SERIES

INTRBC12

EF_0. Now I have some questions about your use of birth control with your sexual partner(s) within the past year, that is, since (CMLSTYR_FILL). It will be helpful to look at your calendar for any information on sexual partners, months you did not have intercourse, and birth control methods you used.

{ASKED FOR UP TO 3 PARTNERS IN THE PAST 12 MONTHS UNLESS ALREADY KNOWN (FROM FIRST METHOD USE SERIES)

USELSTP

EF-1. Looking at Card 33, the (last) time you had intercourse with [PARTNER] in [DATE], did you or he use any method?

Yes....................................1

No.....................................5

{ASKED IF USED A METHOD AT LAST INTERCOURSE WITH PARTNER

LSTMTHP

EF-2. Which method or methods on Card 33 did you or he use?

Birth control pills.........................3

Condom......................................4

Partner's vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization or hysterectomy.............6

Withdrawal, pulling out.....................7

Depo-Provera, injectables...................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

Other method...............................21

Respondent was sterile.....................22

Respondent’s partner was sterile...........23

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{ASKED FOR EACH PARTNER IN THE PAST 12 MONTHS UNLESS ALREADY KNOWN (FROM FIRST METHOD USE SERIES) OR UNLESS ONLY HAD SEX WITH HIM ONCE

USEFSTP

EF-3. Looking at Card 33, the first time you had intercourse with [PARTNER] in [DATE], did you or he use any method?

Yes.....................................1

No......................................5

{ASKED IF USED A METHOD AT FIRST INTERCOURSE WITH PARTNER

FSTMTHP

EF-4. Which method or methods on Card 33 did you or he use?

Birth control pills.........................3

Condom......................................4

Partner's vasectomy.........................5

Female sterilizing operation, such as tubal

sterilization or hysterectomy.............6

Withdrawal, pulling out.....................7

Depo-Provera, injectables...................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

Other method...............................21

Respondent was sterile.....................22

Respondent’s partner was sterile...........23

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{GO TO BEGINNING OF LOOP (EF-1 USELSTFP) FOR NEXT PARTNER IF ANY

{IF R HAS HAD NO PREGNANCIES GO TO SECTION EH

CONDITIONS SURROUNDING R’s PREGNANCIES:

WANTEDNESS; PARTNER(S); MOTIVATION; REASONS (EG)

{REPEAT INTR_EG1 THROUGH WHYNOUSE EG-24 FOR EACH PREGNANCY

INTR-EG1

INTR_EG1. Now let's talk about the period of time from (your first intercourse/[BABY NAME]s birth in [DATE]/your nth pregnancy which ended in [DATE]) until you became pregnant (this time/with your (Nth+1) pregnancy (which ended in [DATE])).

{ASKED IF PREGNANCY BEGAN BEFORE January [YEAR OF INTERVIEW - 3] AND WE DON’T ALREADY KNOW THIS FROM DATE OF FIRST METHOD USE

EVUSEINT

EG-1. Did you ever use any method of birth control between (your first intercourse/[BABY NAME’s] birth in [DATE]/your [Nth] pregnancy which ended in [DATE]) and (DATE OF Nth pregnancy)/[BABY NAME’s] birth)? Remember to include methods men use--that is condoms, vasectomy, and withdrawal--in your answer.

Yes................... 1

No.................... 5 (GO TO EG-5 RESNOUSE)

{ASKED IF R WAS USING A METHOD IN MONTH PREGNANCY BEGAN BUT DID NOT USE ONE IN THE MONTH AFTER PREGNANCY BEGAN OR IF R WAS USING A METHOD IN MONTH PREGNANCY BEGAN AND IN THE MONTH AFTER PREGNANCY BEGAN AND THEY WERE DIFFERENT METHODS

STOPDUSE

EG-2. Before you became pregnant with your (NTH) pregnancy which ended in (DATE), had you stopped using all methods of birth control?

Yes................1

No.................5 (GO TO EG-4 WHATMETH)

{ASKED IF STOPPED USING METHOD(S) IN MONTH PREGNANCY BEGAN

WHYSTOPD

EG-3. Was the reason you stopped using all methods of birth control because you yourself wanted to become pregnant?

Yes................1 (GO TO EG-10 TIMINGOK)

No.................5 (GO TO INTR-EG2)

{ASKED IF R WAS USING A METHOD IN MONTH PREGNANCY BEGAN AND MONTH AFTER PREGNANCY BEGAN AND THEY WERE THE SAME METHOD

WHATMETH

EG-4. You may have already told me, but looking at Card 38, what methods were you using at the time you became pregnant (with your (NTH) pregnancy which ended in (DATE)/this time)?

If R spontaneously mentions “thought I was sterile” or “thought partner was sterile”, ascertain whether any above methods were used. If not, code “none” (1)

None.......................................1

Office use only............................2

Birth control pills........................3

Condom.....................................4

Partner's vasectomy........................5

Female sterilizing operation, such as tubal

sterilization and hysterectomy...........6

Withdrawal, pulling out....................7

Depo-Provera, injectables..................8

Hormonal implants (Norplant or Implanon)....9

Rhythm or safe period by calendar..........10

Safe period by temperature or cervical mucus

test, natural family planning............11

Diaphragm..................................12

Female condom, vaginal pouch...............13

Foam.......................................14

Jelly or cream.............................15

Cervical cap...............................16

Suppository, insert........................17

Today^tm sponge..............................18

IUD, coil, loop............................19

Emergency contraception....................20

Other method...............................21

Lunelle injectable (monthly shot)..........24

Contraceptive patch........................25

Vaginal contraceptive ring.................26

{ ASKED IF NEVER USED A METHOD OR IF R DID NOT USE A METHOD IN MONTH PREGNANCY

BEGAN

RESNOUSE

EG-5.

Before you became pregnant (with your (NTH) pregnancy which ended in (DATE)/this time), was the reason you did not use any birth control methods because you, yourself, wanted to become pregnant?

(IF USED A METHOD BETWEEN FIRST SEX/LAST PREGNANCY AND THIS ONE)

You told me you had stopped using a birth control method before you became pregnant (with your (NTH) pregnancy which ended in (DATE)/this time). Was the reason you had stopped using any methods because you yourself wanted to become pregnant?

(IF DID NOT USE A METHOD BETWEEN FIRST SEX/LAST PREGNANCY AND THIS ONE)

You did not use any method of birth control from (your first intercourse/[BABY NAME’s] birth in [DATE]/your [Nth] pregnancy which ended in [DATE]) until you became pregnant (with your (NTH) pregnancy which ended in (DATE)/this time). Was the reason you were not using any methods because you yourself wanted to become pregnant?

Yes.......... 1 (GO TO EG-10 TIMINGOK)

No........... 5

{READ ONLY THE FIRST TIME THROUGH THIS LOOP, IN OTHER WORDS, FOR THE FIRST PREGNANCY ONLY

INTR-EG2

INTR_EG2. The next few questions are important. They are about how you felt right before you became pregnant (with your pregnancy which ended in (DATE)/this time).

WANTBOLD

EG-6. Right before you became pregnant (with your (NTH) pregnancy which ended in (DATE)/this time), did you yourself want to have a(nother) baby at any time in the future?

Yes........................1 (GO TO TIMINGOK EG-10)

No.........................5 (GO TO CNFRMNO EG-8)

Not sure, don’t know.......6

PROBBABE

EG-7. It is sometimes difficult to recall these things but, right before (this/that) pregnancy began, would you say you probably wanted a(nother) baby at some time in the future or probably not?

Probably yes..... 1 (GO TO TIMINGOK EG-10)

Probably not..... 5

Didn't care...... 6 (GO TO TIMINGOK EG-10)

(IF R IS AGE 20 OR OLDER, GO TO INTROWTH)

CNFRMNO

EG-8. So right before you became pregnant (this time/that time), you thought you did not want to have (any children/a Nth child) at any time in the future, is that correct?

Correct....................1 (GO TO INTROWTH)

Incorrect..................5

INCORTXT

EGINCO_1. I must have gotten something wrong. Let me ask this question again.

WANTBLD2

EG-9. Right before you became pregnant (with your (Nth) pregnancy (which ended in (DATE)/this time), did you yourself want to have a(nother) baby at any time in the future?

Yes......................1

No.......................5 (GO TO INTROWTH)

Not sure, don’t know.....6 (GO TO INTROWTH)

Didn’t care..............7 (GO TO INTROWTH)

{ASKED IF R WANTED TO HAVE A(NOTHER) BABY IN THE FUTURE

TIMINGOK

EG-10. So would you say you became pregnant too soon, at about the right time, or later than you wanted?

Too soon.......... 1

Right time.........2

Later..............3

Didn't care........4

{ASKED IF TOO SOON

{R CAN ANSWER IN MONTHS OR YEARS

TOOSOONQ

EG-11. How much sooner than you wanted did you become pregnant?

Month/years __________

INTROWTH

INTROWTH_1. Sometimes how people feel about having a baby in general can be different from how they feel about having a baby with a certain partner.

{ASKED IF R BECAME PREGNANT AT THE RIGHT TIME OR LATER THAN SHE WANTED

WTHPART1

EG-12a. Right before (the/this/that) pregnancy, did you want to have a(nother) baby with that partner?

Definitely yes............1

Probably yes..............2

Probably no...............3

Definitely no.............4

{GO TO FEELINPG EG-13

{ASKED IF PREGNANCY CAME TOO SOON OR WHEN R WANTED NO FUTURE BIRTHS

WTHPART2

EG-12b. Right before (the/this/that) pregnancy, did you think you might ever want to have a(nother) baby with that partner?

Definitely yes............1

Probably yes..............2

Probably no...............3

Definitely no.............4

{IF PREGNANCY ENDED BEFORE January [YEAR OF INTERVIEW - 3], GO TO HPWNOLD EG-16

FEELINPG

EG-13. Please look at the scale on Card 39. On this scale, a one means that you were very unhappy to be pregnant and a ten means that you were very happy to be pregnant. Tell me which number on the card best describes how you felt when you found out you were pregnant.

Number __________

HPWNOLD

EG-16. Right before you became pregnant (this time/that (Nth) time,) did the father want you to have a(nother) baby at any time in the future?

Yes.............................1

No..............................5

Not sure, don't know............6

{ASKED IF R REPORTED "YES" TO ABOVE QUESTION

TIMOKHP

EG-17. So would you say you became pregnant sooner than he wanted, at about the right time, or later than he wanted?

Sooner................ 1

Right time.............2

Later................. 3

Didn't care........... 4

{ ASKED IF R IS NOT CURRENTLY MARRIED, OR MARRIED MORE THAN ONCE, OR TIMES MARRIED UNKNOWN, OR CENTURY MONTH MARRIED GREATER THAN CENTURY MONTH PREGNANCY ENDED, OR CENTURY MONTH MARRIED UNKNOWN, OR CENTURY MONTH PREGNANCY ENDED UNKNOWN

COHPBEG

EG-18a. Were you living with the father of (the pregnancy/this pregnancy/your (Nth) pregnancy which ended in (DATE)) at the beginning of the pregnancy?

Yes.......................1

No........................5

{ASKED IF PREGNANCY IS NOT CURRENT

COHPEND

EG-18b. Were you living with the father of (the/that) pregnancy when ([BABY NAME] was born/the pregnancy ended)?

Yes.......................1

No........................5

{IF R HAD A LIVE BIRTH AND WAS LIVING WITH THE BABY’s FATHER AT THE TIME OF BIRTH, GO TO EG-21 TRYSCALE

TELLFATH

EG-19. Did you tell the father of (the pregnancy/that (Nth) pregnancy/your current pregnancy) that you (were/are) pregnant?

Yes.......................1

No........................5

{IF R IS CURRENTLY PREGNANT, GO TO TRYSCALE EG-21

WHENTELL

EG-20. When did you tell him that you were pregnant B during the pregnancy or after the baby was born/after the pregnancy ended?

(IF NON-LIVE BIRTH)

During the pregnancy..........1

After the pregnancy ended.....2

(IF LIVE BIRTH)

During the pregnancy..........1

After the baby was born.......2

{IF PREGNANCY ENDED BEFORE January [YEAR OF INTERVIEW - 3], GO TO EH SERIES

TRYSCALE

EG-21. Look at the scale on Card 40, where a 0 means trying hard not to get pregnant, and a 10 means trying hard to get pregnant. If you had to rate how much you were trying to get pregnant or avoid pregnancy right before you got pregnant (this time/that time), how would you rate yourself?

Number ________

WANTSCAL

EG-22. Look at the scale on Card 41, where a 0 means you wanted to avoid a pregnancy and a 10 means you wanted to get pregnant. If you had to rate how much you wanted or didn’t want a pregnancy right before you got pregnant (this time/that time), how would you rate yourself?

Number ________

{IF PREGNANCY OCCURRED AT THE RIGHT TIME OR LATER THAN R WANTED, OR R DIDN’T CARE ABOUT TIMING:

GO BACK TO EGINTR_1 IF THERE ARE MORE PREGNANCIES TO DISCUSS, OTHERWISE GO TO EH SERIES

{ASK THE NEXT TWO QUESTIONS FOR MISTIMED OR UNWANTED PREGNANCIES

{ASK IF R USED A METHOD IN MONTH PREGNANCY BEGAN

WHYPRG

EG-23. (IF PREGNANCY OCCURRED TOO SOON)

Please look at Card 42. Earlier you told me your pregnancy occurred too soon. Which of the following statements applies to you right before you became pregnant (this time/that time (that is, with the pregnancy that ended in DATE)?

(IF PREGNANCY OCCURRED WHEN R WANTED NO FUTURE BIRTHS)

Please look at Card 42. Earlier you told me that your pregnancy occurred at a time when you wanted no future pregnancies. Which of the following statements applies to you right before you became pregnant (this time/that time (that is, with the pregnancy that ended in DATE)?

ENTER all that apply

If Respondent volunteers she wasn’t using a method, ENTER 3

Your birth control method failed...............1

You did not use your birth control

method properly..............................2

Respondent wasn’t using a method...............3

{GO TO EH SERIES

{ASKED IF R DID NOT USE A METHOD IN MONTH PREGNANCY BEGAN

WHYNOUSE

EG-24. (IF PREGNANCY OCCURRED TOO SOON)

Please look at Card 43. Earlier you told me your pregnancy occurred at a time when you wanted no future pregnancies. Which of the following statements applies to you right before you became pregnant (this time/that time (that is, with the pregnancy that ended in DATE)? You did not use birth control because...

(IF PREGNANCY OCCURRED WHEN R WANTED NO FUTURE BIRTHS)

Please look at Card 43. Earlier you told me that your pregnancy occurred at a time when you wanted no future pregnancies. Which of the following statements applies to you right before you became pregnant (this time/that time (that is, with the pregnancy that ended in DATE)? You did not use birth control because...

ENTER all that apply

If Respondent volunteers sex was forced, code 1.

If Respondent volunteers she was using a method, ENTER 7

You did not expect to have sex.............................1

You did not think you could get pregnant...................2

You didn’t really mind if you got pregnant.................3

You were worried about the side effects of birth control...4

Your male partner did not want you to use a birth

control method...........................................5

Your male partner did not want to use a birth

control method...........................................6

Respondent was using a method..............................7

{GO TO BEGINNING OF LOOP (INTR-EG1) FOR NEXT PREGNANCY IF ANY

OPEN INTERVAL QUESTIONS (EH)

{IF R IS CURRENTLY PREGNANT GO TO EJ SERIES

{IF R DID NOT HAVE SEX IN CURRENT MONTH, OR IS SURGICALLY OR NONSURGICALLY STERILE (NOT AT RISK OF PREGNANCY) GO TO EJ SERIES

INTR-EH1

INTR_EH1. Now, I have a few more questions about birth control.

{IF R USED NO METHODS IN THE CURRENT MONTH, GO TO PLACCUR1

WYNOTUSE

EH-1. Is the reason you are not using a method of birth control now because you, yourself, want to become pregnant as soon as possible?

Yes...................1

No....................5

HPPREGQ

EH-2. And your partner, does he want you to become pregnant as soon as possible?

Yes...................................1

No....................................5

(if volunteered) no current partner...6

{ASKED IF R IS TRYING TO BECOME PREGNANT

{R CAN SUPPLY EITHER MONTHS OR YEARS

DURTRY

EH-2a. How long have you been trying to become pregnant?

Months/Years ____________

If R has been trying for less than a month ENTER 1

If R says she is / they are not trying, ENTER 95

{IF R WAS NOT USING A METHOD IN THE MONTH PRIOR TO INTERVIEW, OR

IF R WAS USING A METHOD BUT IT WAS NOT A DRUG OR DEVICE,

GO TO YUSEPILL EJ-1

{ASKED IF R WAS USING A METHOD IN MONTH PRIOR TO INTERVIEW AND IT WAS DRUG OR DEVICE

PLACCUR

EH-3. Please look at Card 36. You may have already told me, but where did you get the [METHOD] you used last month?

Private doctor’s office............................................1

HMO facility.......................................................2

Community health clinic, community clinic, public health clinic....3

Family planning or Planned Parenthood Clinic.......................4

Employer or company clinic.........................................5

School or school-based clinic......................................6

Hospital outpatient clinic.........................................7

Hospital emergency room............................................8

Hospital regular room..............................................9

Urgent care center, urgi-care or walk-in facility.................10

Friend............................................................11

Partner or spouse.................................................12

Drug store........................................................13

Mail order/ Internet..............................................14

Some other place..................................................20

{GO TO EH-3 STATE_NAME

{IF R DID NOT OBTAIN A METHOD AT A CLINIC GO TO SECTION EJ

State_name

EH-3. What is the name and address of the place where you received [METHOD]?

What state is the place in?

Either press <BackSpace> to see the lookup table or start typing the name of the state.

CLINFST

EH-3. What is the name and address of the place where you received [METHOD]?

Either press <BackSpace> to see the lookup table or start typing the name of the city where the clinic is located.

1) TYPE OR SELECT A CITY NAME

2) SELECT A CLINIC BY SCROLLING UP OR DOWN

3) PRESS ENTER

CityName

ClinicName

ClinicCode

Confirm

I have found a clinic (by that name/in that city) at:

(Name and address of clinic)

Is this correct?

Yes..........................1

No...........................5

Clinic not in database.......6

{ASKED IF CLINIC WAS NOT FOUND IN DATABASE

CLINFSTN

EH-3b. ENTER name and address of clinic you were unable to find in database

If necessary: (REFER R to personal records or area phone books to obtain clinic name and address. If R is unable to provide the full address, record as much information as she can provide.)

PILL FOR HEALTH REASONS (EJ)

{ASKED IF R USED THE PILL IN CURRENT MONTH OR IN PRIOR MONTH

YUSEPILL

EJ-1. Now I would like to know all of the reasons for your recent pill use. Have you used it for birth control, cramps or pain during menstrual period, treatment for acne, treatment for endometriosis, or for some other reason?

ENTER all that apply

Birth control..............................1

Cramps, or pain during menstrual periods...2

Treatment for acne.........................3

Treatment for endometriosis................4

Other reasons..............................5

To regulate your menstrual periods.........6

{ASKED IF R USED THE PILL IN CURRENT MONTH OR IN EITHER OF 2 MONTHS PRIOR TO CURRENT

TYPEPILL

EJ-2. This chart shows types of oral contraceptive pills that are available for women today. Please tell me the number next to the type that you are currently using or used most recently.

Pill number _________

If pill is not on chart, ask R to specify type or brand

CONDOM CONSISTENCY: PAST 4 WEEKS & PAST 12 MONTHS (EL)

{ ASKED IF R HAD SEXUAL INTERCOURSE IN THE PAST 12 MONTHS

PST4WKSX

EL-1. Now please think about the last four weeks. How many times have you had sexual intercourse with a male in the last four weeks?

If R says “not at all” or “none”, ENTER 0

Number _________

{ ASKED IF R EVER USED THE CONDOM AND HAD SEXUAL INTERCOURSE ONLY ONCE IN

{ THE PAST 4 WKS

{ IF R NEVER USED THE CONDOM OR ANSWERED DK/RF, SKIP TO SECTION F

PSWKCOND1

EL-2. Did you use a condom?

Yes........1 (GO TO EL-4 P12MOCON)

No.........5 (GO TO EL-4 P12MOCON)

{ ASKED IF R EVER USED THE CONDOM AND HAD SEXUAL INTERCOURSE MORE THAN ONCE IN

{ THE PAST 4 WKS

PSWKCOND2

EL-3. How many of those times did you use a condom?

If R says “every time”, enter number that was reported in PST4WKSX

If R says “not at all” or “never”, enter 0

Number __________

{ ASKED IF R EVER USED THE CONDOM AND HAD SEXUAL INTERCOURSE IN THE PAST

{ 12 MONTHS

P12MOCON

EL-4. Please look at the Card 48. Thinking back over the past 12 months, that is, since (DATE OF INTERVIEW MINUS 12 MONS), would you say you used a condom with your partner for sexual intercourse every time, most of the time, about half of the time, some of the time, or none of the time?

Every time......................1

Most of the time................2

About half of the time..........3

Some of the time................4

None of the time................5

SECTION F

Family Planning and Medical Services

INTRSVC

FA-0. We have already asked you a few questions about sterilizing operations. The questions in this section are about your medical visits for these and other types of birth control, pregnancy, and health care services for women.

Birth Control and Medical Services in Past 12 Months (FA)

INTRO_FA

FA-1. You may have already told me this, but in the past 12 months, that is since [INTERVIEW MONTH, INTERVIEW YEAR – 1] have you received any of the following birth control services shown on card 49 from a doctor or other medical care provider?

{ SHOW CARD 49 IS DISPLAYED FOR FA-1b through FA-1h

BTHCON12

FA-1b. (In the past 12 months, have you received) A method of birth control or a prescription for a method?

Yes.........1

No..........5

MEDTST12

FA-1c. (In the past 12 months, have you received) A check-up or medical test related to using a birth control method?

Yes.........1

No..........5

BCCNS12

FA-1d. (In the past 12 months, have you received) Counseling or information about birth control?

Yes.........1

No..........5

STEROP12

FA-1e. (In the past 12 months, have you received) a sterilizing operation?

Yes.........1

No..........5

STCNS12

FA-1f. (In the past 12 months, have you received) Counseling or information about getting sterilized?

Yes.........1

No..........5

{ IF R REPORTED EVER USING EMERGENCY CONTRACEPTION PREVIOUSLY

EMCON12

FA-1g. (In the past 12 months, have you received) Emergency contraception, also known as “Plan B” or “Preven”, or the “Morning-after pill,” or a prescription for it?

Yes.........1

No..........5

ECCNS12

FA-1h. (In the past 12 months, have you received) Counseling or information about Emergency contraception, also known as “Plan B” or “Preven”, or the “Morning-after pill?”

Yes.........1

No..........5

{ IF R REPORTED NOT RECEIVING ANY SERVICES IN PAST 12 MONTHS, BUT REPORTED

{ EARLIER SHE USED A DRUG OR DEVICE METHOD IN THE PAST 12 MONTHS

FOLLOW12

FA-2. {IF R REPORTED ONE METHOD IN SECTION E’S METHOD HISTORY

In the last 12 months, that is, since [INTERVIEW MONTH, INTERVIEW YEAR – 1] have you visited a doctor or medical care provider about the following method which you used in that period: [METHOD REPORTED IN SECTION E].

{IF R REPORTED TWO OR MORE METHODS IN SECTION E’S METHOD HISTORY

Earlier you mentioned you have used [METHOD(S) FROM SECTION E] in the past 12 months. Did you receive any of these at a visit to a doctor or medical care provider within the past 12 months?

Yes........................................................1

No.........................................................5

Didn’t use the medical method(s) in 12 months after all

as reported in section E.............................3

INTR_MED

FA-3. We’re also interested in where women go to get other kinds of reproductive health care. Please look at Card 50.

In the past 12 months, that is, since [INTERVIEW MONTH, INTERVIEW YEAR – 1], have you received any of the following medical services from a doctor or other medical care provider:

{ SHOW CARD 50 IS DISPLAYED FOR FA-3a through FA-3g

{IF R EVER HAD SEX

PRGTST12

FA-3a. (You may have already told me, but/In the past 12 months have you received) A pregnancy test?

Yes...........1

No............5

{IF R EVER HAD SEX

ABORT12

FA-3b. (In the past 12 months have you received) An abortion?

Yes...........1

No............5

PAP12

FA-3c. (In the past 12 months have you received) A Pap smear?

Yes...........1

No............5

PELVIC12

FA-3d. (In the past 12 months have you received) A pelvic exam?

Yes...........1

No............5

{ IF R HAD A PREGNANCY ENDING WITHIN THE LAST 12 MONTHS

PRENAT12

FA-3e You may have told me this already, but in the past 12 months, have your received prenatal care?

Yes..........1

No...........5

{ IF R’S MOST WITHIN THE LAST 12 MONTHS

PARTUM12

FA-3f. (In the past 12 months have you received) Post-pregnancy care?

Yes...........1

No............5

STDSVC12

FA-3g. In the past 12 months, have you received counseling for, or been tested or treated for a sexually transmitted disease?

Yes...........1

No............5

{ IF R HAD NO BIRTH CONTROL OR MEDICAL SERVICES IN THE PAST 12 MONTHS,

{ GO TO FB SERIES.

{ IF MORE THAN 1 SERVICE RECEIVED IN THE PAST 12 MONTHS)

NUMBCVIS

FA-4. You said that in the past 12 months you received the following services: (DISPLAY ABBREVIATED LIST OF SERVICES REPORTED IN BTHCON12 THROUGH ECCNS12 AND PRGTST12 THROUGH STDSVC12). Did you receive those services during a single visit, or in more than one visit?

Single visit...........1

More than one visit....5

{ ASKED FOR EACH SERVICE RECEIVED IF HAD MORE THAN ONE VISIT IN PAST 12 MONTHS

BC12PLCX

FA-5. Please look at Card 25. During the past 12 months, that is since [INTERVIEW MONTH, INTERVIEW YEAR – 1], where did you receive (DISPLAY (Nth) SERVICE(S) REPORTED IN BTHCON12 THROUGH ECCNS12 AND PRGTST12 THROUGH STDSVC12)?

Private doctor’s office.........................................1

HMO facility,...................................................2

Community health clinic, community clinic, public health clinic.3

Family Planning or Planned Parenthood...........................4

Employer or company clinic ........ ............................5

School or School-based clinic...................................6

Hospital outpatient clinic......................................7

Hospital emergency room.........................................8

Hospital regular room...........................................9

Urgent care center, urgi-care or walk-in facility..............10

Some other place...............................................20

{ IF R RECEIVED A PREGNANCY TEST FROM A MEDICAL PROVIDER IN LAST 12 MONTHS

PGTSTBC2

FA-5a. During your visit in the past 12 months when you received a pregnancy test, did a doctor or medical provider talk to you about using birth control?

Yes.........1

No..........5

{ IF R RECEIVED A PAP SMEAR OR PELVIC EXAM IN LAST 12 MONTHS

PAPPLBC2

FA-5b. (During your visit in the past 12 months) when you received a Pap test or a pelvic exam, did a doctor or medical provider talk to you about using birth control?

Yes.........1

No..........5

PAPPELEC

FA-5c. (During your visit in the past 12 months) when you received a Pap test or a pelvic exam, did a doctor or medical provider talk to you about using emergency contraception, also known as “Plan B” or “Preven”, or the “morning after pill”?

Yes.........1

No..........5

STDTSCON

{ ASKED IF R RECEIVED STD TESTING/TREATMENT IN LAST 12 MONTHS)

FA-5d. (During your visit in the past 12 months) when you received STD testing or treatment, did a doctor or medical provider talk to you about using condoms to prevent disease?

Yes.........1

No..........5

{ ASKED FOR EACH SERVICE RECEIVED IN LAST 12 MONTHS

BC12PAYX

FA-6. Looking at Card 16, please tell me all of the ways in which the bill for [Nth SERVICE IN PAST 12 MONTHS REPORTED IN BTHCON12 THROUGH ECCNS12 AND PRGTST12 THROUGH STDSVC12] was paid.

ENTER all that apply

Insurance,................................1

Co-payment, or out-of-pocket payment,.....2

Medicaid..................................3

No payment required.......................4

Some other way............................5

{ FA-8 STATE_NAME THROUGH FA-9 REGCAR12 ASKED FOR EACH SERVICE RECEIVED IN THE LAST 12 MONTHS AT A CLINIC

STATE_NAME

FA-8. What is the name and address of the clinic where you received (DISPLAY (ALL SERVICES/Nth SERVICE) REPORTED IN BTHCON12 THROUGH ECCNS12 AND PRGTST12 THROUGH STDSVC12 THAT WERE RECEIVED AT A CLINIC)?

CLINIC12

FA-8a. What is the name and address of the place where you received (DISPLAY ALL SERVICES REPORTED)

CONFIRM

I found a clinic (by that name/in that city) at (LIST CLINIC SELECTED).

Is this correct?

Yes...............................1

No................................5

Clinic not in database............6

{ IF CLINIC NOT FOUND IN DATABASE

ADCLIN12

FA-8a. Interviewer: record name and address of clinic you were unable to find in database.

___________________________________

___________________________________

{ IF CLINIC MENTIONED IN FA-8 IS DIFFERENT FROM CLINICS MENTIONED BEFORE

REGCAR12

FA-9. Is this clinic your regular place for medical care, or do you usually go somewhere else for medical care?

Regular place..........................................1

Regular place, but go to more than 1 place regularly...2

Usually go somewhere else..............................3

No usual place.........................................4

{ IF R REPORTED A CLINIC IN LAST 12 MONTHS

INTR_CLN

In the past 12 months, have you received any of the following from a clinic:

FCONDOM

FA-13a. (In the past 12 months, have you received)

Free condoms (from a clinic)?

Yes......................1

No.......................5

FFOAM

FA-13b. (In the past 12 months, have you received)

Free foam or jelly (from a clinic)?

Yes......................1

No.......................5

FORAL

FA-13c. (In the past 12 months, have you received)

Free oral contraceptive pills (from a clinic)?

Yes......................1

No.......................5

RORAL

FA-13d. (In the past 12 months, have you received)

Reduced-price oral contraceptive pills (from a clinic)?

Yes......................1

No.......................5

{ IF PAYMENT FOR FIRST OR PAST 12 MONTHS SERVICES WAS CO-PAYMENT OR OUT OF

{ POCKET PAYMENT

SLSCSRV

FA-14. In the past 12 months, have you paid for any clinic services on a sliding scale based on your income?

Yes.......................1

No........................5

First Service Ever Received (FB)

{ IF YOUNGER THAN 25 AND MEDICAL SERVICES REPORTED IN LAST 12 MONTHS

FSTSVC12

FB-1. You told me that in the last 12 months you received a birth control service from a doctor or medical care provider. (Were any of these services/Was this) the first birth control service you ever received in your life?

Yes....................1

No.....................5

{IF YOUNGER THAN 25 AND ONE OR MORE DRUG/DEVICE BIRTH CONTROL METHOD EVER USED {OR USED A SERVICE IN LAST 12 MONTHS

WNFSTSVC_M, WNFSTSVC_Y

FB-2. Now I’d like to know about the very first time you received a birth control service from a doctor or medical care provider. In what month and year did you receive your first birth control service?

{ IF ANSWER CANNOT BE DETERMINED BASED ON REPORTED DATES OR ONE OF THE DATES

{ IS MISSING

B4AFSTIN

FB-4. Was it before or after the first time you had intercourse (in [DATE OF FIRST INTERCOURSE])?

Before..................1 (GO TO FSTSERV FB-6)

After...................2

{ IF FIRST TIME RECEIVED BIRTH CONTROL SERVICE WAS AFTER FIRST INTERCOURSE

TMAFTIN

FB-5. How long after your first intercourse did you receive your first birth control service? Was it...

Less than a month after your first intercourse......1

One to three months after your first intercourse....2

Four to twelve months after your first intercourse..3

More than a year after your first intercourse.......4

{IF YOUNGER THAN 25 AND ONE OR MORE DRUG/DEVICE BIRTH CONTROL METHOD EVER USED OR USED A SERVICE IN LAST 12 MONTHS

FSTSERV

FB-6. Which service or services did you get that first time? Did you get…

A method of birth control or prescription for a method...............1

A check-up or medical test related to using a birth control method...2

Counseling or information about birth control........................3

Counseling or information about getting sterilized...................4

Emergency contraception or a prescription for EC.....................5

Counseling or information about Emergency contraception..............6

A sterilizing operation..............................................7

[Only show option 7, a sterilizing operation if female sterilization reported earlier.]

{IF YOUNGER THAN 25 AND ONE OR MORE DRUG/DEVICE BIRTH CONTROL METHOD EVER USED OR USED A SERVICE IN LAST 12 MONTHS

BCPLCFST

FB-7. Please look at Card 25. Where did you receive your first birth control service(s)?

Private doctor’s office...............................................1

HMO facility..........................................................2

Community health clinic, Community clinic, Public Health clinic.......3

Family planning or Planned Parenthood Clinic..........................4

Employer or company clinic............................................5

School or school-based clinic.........................................6

Hospital outpatient clinic............................................7

Hospital emergency room...............................................8

Hospital regular room.................................................9

Urgent care center, urgi-care or walk-in facility....................10

Some other place.....................................................20

Clinic Series (FC)

{ IF R IS 25 OR OLDER, GO TO SECTION G.

{ IF R RECEIVED ANY SERVICES (FIRST OR PAST 12 MONTHS) AT A CLINIC, GO TO

{ SECTION G.

EVERFPC

FC-1. Since your first menstrual period (when you were (AGE AT MENARCHE)), have you ever visited a clinic for any kind of medical or birth control service?

Yes..............1

No...............2 (GO TO SECTION G)

KNDMDHLP

FC-2. What kind of medical help did you receive at the clinic?

A method of birth control (or prescription)....................1

Birth control counseling.......................................2

Emergency contraception........................................3

Counseling about emergency contraception.......................4

A check-up or test for birth control...........................5

Pregnancy test.................................................6

An abortion....................................................7

A pap smear or pelvic exam.....................................8

Post-natal care................................................9

STD or HIV testing/treatment/counseling.......................10

Other.........................................................20

SECTION G

Birth Desires and Intentions

Birth Desires (GA)

GAINTRO1

GA-0. Now, I would like to know your feelings about having (a/nother) baby, whether or not you are able to, or plan to have one.

RWANT

GA-1. (Looking to the future, do/If it were possible would) you, yourself, want to have (a/nother) baby at some time (after this pregnancy is over/in the future)?

Yes .......................1

No ........................5

{ IF R SAID >DON’T KNOW= FOR WANTING TO HAVE A/NOTHER BABY

PROBWANT

GA-1a. (Do you think you probably want or probably do not want/If it were possible do you think you would probably want or probably not want) to have (a/nother) baby at some time (after this pregnancy is over/in the future)?

Probably want ................1

Probably do not want .........5

{ IF R IS CURRENTLY MARRIED OR COHABITING

PWANT

GA-2. (If it were possible, would/Looking to the future, does/Does) (HUSBAND/PARTNER) want to have (a/nother) baby at some time (after this pregnancy is over/in the future)? Would you say...

Definitely yes.................1

Probably yes...................2

Probably no....................3

Definitely no..................4

Joint Birth Intentions (Married/Cohabiting) (GB)

{ SECTION GB IS ASKED IF R IS CURRENTLY MARRIED OR COHABITING AND BOTH PARTNERS ARE PHYSICALLY ABLE TO HAVE CHILDREN}

GBINTRO1

GB-0. Sometimes what people want and what they intend are different because they are not able to do what they want. The next questions are about your and [husband/partner]’s intentions for (a/nother) baby in the future.

JINTEND

GB-1. Do you and (HUSBAND/PARTNER) intend to have (a/nother) baby at some time in the future (after this pregnancy is over)?

IF NECESSARY SAY: "Intend" refers to what R and her husband are actually going to try to do. Do not count intended adoptions or stepchildren.

Yes...................1

No....................5

[IF R RESPONDS “DON’T KNOW”, GO TO GB-4 JEXPECTL

IF R RESPONDS “REFUSED”, GO TO SECTION GC]

JSUREINT

GB-2. Of course, sometimes things do not work out exactly as we intend them to, or something makes us change our minds. In your case, how sure are you that you and (HUSBAND/PARTNER) will (not) have (a/nother) baby (after this pregnancy is over)? Would you say...

Very sure.............1

Somewhat sure.........2

Not at all sure.......3

{IF INTEND NO BABIES (GB-1 JINTEND=NO), GO TO GD SERIES

JINTENDN

GB-3. (Not counting your current pregnancy,) How many (more) babies do you and (HUSBAND/PARTNER) intend to have?

IF NECESSARY SAY: "Intend" refers to what R and her husband are actually going to try to do. Do not count intended adoptions or stepchildren.

Number of babies _________

{ IF DON’T KNOW HOW MANY (MORE) BABIES INTENDED

JEXPECTL

GB-4. Many people aren't sure, but still have some idea about the future. As you expect things to work out for you and (HUSBAND/PARTNER), what is the largest number of (additional) babies you and he expect to have (after this pregnancy is over)?

Number of babies __________ (IF 0, GO TO SECTION H)

{ IF NUMBER OF (ADDITIONAL) BABIES EXPECTED IS > ZERO

JEXPECTS

GB-5. What is the smallest number of (additional) babies you and he expect to have (after this pregnancy is over)?

Number of babies ________________

Individual Intentions Series (GC)

{SECTION GC IS ASKED IF R IS NOT MARRIED OR COHABITING AND PHYSICALLY ABLE TO HAVE CHILDREN AND WANTS A/NOTHER BABY}

GCINTRO1

GC-0. Sometimes what people want and what they intend are different because they are not able to do what they want. The next questions are about your intentions for (a/nother) baby in the future.

INTEND

GC-1. Looking to the future, do you intend to have (a/nother) baby at some time (after this pregnancy is over)?

If necessary, say: "Intend" refers to what the R is actually going to try to do. Do not count intended adoptions or stepchildren.

Yes...................1

No....................5

[IF R RESPONDS “DON’T KNOW”, GO TO GC-4 EXPECTL

IF R RESPONDS “REFUSED”, GO TO SECTION H]

SUREINT

GC-2. Of course, sometimes things do not work out exactly as we intend them to, or something makes us change our minds. In your case, how sure are you that you will (not) have (a/nother) baby (after this pregnancy is over)? Would you say ...

Very sure.............1

Somewhat sure.........2

Not at all sure.......3

{IF INTEND NO BABIES (GC-1 INTEND=NO), GO TO SECTION H

INTENDN

GC-3. (Not counting your current pregnancy,) How many (more) babies do you intend to have?

IF NECESSARY, SAY "Intend" refers to what the R is actually going to try to do. Do not count intended adoptions or stepchildren.

Number of babies __________

{ ASKED IF R DOESN’T KNOW IF SHE INTENDS TO HAVE A/NOTHER BABY OR DOESN’T KNOW THE NUMBER SHE INTENDS TO HAVE

EXPECTL

GC-4. Many people aren't sure, but still have some idea about the future. As you expect things to work out for you, what is the largest number of (additional) babies you, yourself, expect to have (after this pregnancy is over)?

Number of babies ___________

{IF THE LARGEST NUMBER OF BABIES R EXPECTS = ZERO, GO TO SECTION H}

EXPECTS

GC-5. What is the smallest number of (additional) babies you, yourself, expect to have (after this pregnancy is over)?

Number of babies ___________

SECTION H

Infertility Services and Reproductive Health

{ IF R HAS NOT HAD SEX WITH A MALE AND SHE IS UNDER 18, GO TO HB-5 INTRO_H3.

{ SAID FOR ALL WHO HAVE HAD SEX WITH A MALE OR WHO ARE 18 YEARS OR OLDER

INTRO_H1

HA-0. The next questions are about any infertility services you may have ever received. This includes medical help to become pregnant or to prevent miscarriage. I will ask you about each type of help separately.

EVER RECEIVED MEDICAL HELP TO GET PREGNANT (HA)

HLPPRG

HA-1. IF R HAS EVER BEEN MARRIED AND HAS ONLY 1 MALE SEXUAL PARTNER IN LIFETIME, ASK:

(Have/Did) you or your husband ever been to a doctor or other medical care provider to talk about ways to help you become pregnant?

ELSE IF R HAS NEVER BEEN MARRIED AND HAS NEVER HAD A MALE SEXUAL PARTNER, ASK:

Have you ever been to a doctor or other medical care provider to talk about ways to help you become pregnant?

ELSE ASK:

(During any of your relationships,) have you or your (husband or) partner at the time ever been to a doctor or other medical care provider to talk about ways to help you become pregnant?

Yes ............1

No .............5 (GO TO HB SERIES)

{ IF R HAS HAD ONLY 1 MALE SEXUAL PARTNER IN LIFETIME, GO TO HA-5 TYPALLPG.

{ ASKED IF R HAS HAD MORE THAN 1 SEXUAL PARTNER IN LIFETIME

HOWMANYR

HA-2. In how many of your relationships did you seek medical help in order to become pregnant?

One.............1

More than one...5

{ IF R IS NOT CURRENTLY MARRIED, COHABITING, OR SEPARATED, GO TO HA-5 TYPALLPG

{ ASKED IF R IS MARRIED, COHABITING, OR SEPARATED, AND HOWMANYR = 1

SEEKWHO1

HA-3. IF R IS MARRIED OR SEPARATED, ASK:

Was that with your current husband or another partner?

Current husband..............1

Another partner..............5

ELSE IF R IS COHABITING, ASK:

Was that with your current partner or another partner?

Current partner..............1

Another partner..............5

{ IF HA-3 SEEKWHO1 WAS ASKED, GO TO HA-5 TYPALLPG.

{ ASKED IF R IS MARRIED, COHABITING, OR SEPARATED, AND HOWMANYR NE 1

SEEKWHO2

HA-4. Have you sought help with your current (husband/partner)?

Yes .............1

No ..............5

{ ASKED IF R REPORTED SEEKING ANY MEDICAL HELP TO GET PREGNANT

TYPALLPG

HA-5. IF R HAS ONLY HAD 1 LIFETIME PARTNER OR IF R ONLY SOUGHT MEDICAL HELP IN ONE RELATIONSHIP, ASK:

Which of the services shown on Card 52 (have/did) you or your (husband/partner/previous partner (had/have) to help you become pregnant?

ELSE IF R SOUGHT MEDICAL HELP IN MORE THAN ONE RELATIONSHIP, ASK:

Think about all of the medical help you or your partners have ever received to help you become pregnant. Which of the services shown on Card 54 have you or they had (to help you become pregnant)?

ENTER all that apply

Advice ..............................1

Infertility testing .................2

Drugs to improve your ovulation .....3

Surgery to correct blocked tubes ....4

Artificial insemination .............5

Other types of medical help .........6

{ ASKED IF INFERTILITY TESTING MENTIONED

WHOTEST

HA-5a. Who was it that had infertility testing? Was it you, him, or both of you?

You ...........................1

Him ...........................3

Both of you ...................5

{ ASKED IF ARTIFICIAL INSEMINATION MENTIONED

WHARTIN

HA-5b. Were you inseminated with sperm from your husband or partner only, from some other donor only, or from both?

Husband or partner.........................1

Donor......................................3

Both husband or partner and donor..........5

{ ASKED IF “OTHER TYPES OF MEDICAL HELP” MENTIONED

OTMEDHEP

HA-5c. Which of these other types of medical help listed on Card 53 did either of you receive for becoming pregnant?

ENTER all that apply

Surgery or drug treatment for endometriosis .....1

In vitro fertilization (IVF) ....................2

Surgery or drug treatment for uterine fibroids ..3

Some other female pelvic surgery ................4

Other medical help ..............................5

{ ASKED IF R REPORTED SEEKING ANY MEDICAL HELP TO GET PREGNANT

INSCOVPG

HA-6. Did either of you have private health insurance to cover any of the costs of medical help for becoming pregnant?

Yes ............ 1

No ............. 5

{ ASKED IF R REPORTED SEEKING ANY MEDICAL HELP TO GET PREGNANT

FSTHLPPG_M, FSTHLPPG_Y

HA-7. Please look at the calendar to help you remember when you (or your (husband/partner)) made your first visit to seek medical help for becoming pregnant. In what month and year was that?

{ ASKED IF R REPORTED SEEKING ANY MEDICAL HELP TO GET PREGNANT

{ R can answer in months or years

TRYLONG

HA-8. When you first went for medical help (in mo/yr from HA-7), how many months or years had you (and your (husband/partner)) been trying to become pregnant?

Number of months/years _________

{ ASKED IF R REPORTED SEEKING ANY MEDICAL HELP TO GET PREGNANT AND IS NOT CURRENTLY PREGNANT

HLPPGNOW

HA-9. Are you currently pursuing medical help to become pregnant?

Yes .............1

No ..............5

RCNTPGH_M, RCNTPGH_Y

HA-10. Again, please look at your calendar to help you remember. In what month and year was your (most recent/last) visit for help to become pregnant?

{ IF NEITHER DATE (1^st or most recent/last visit) IS WITHIN LAST 12 MONTHS,

{ GO TO HB SERIES.

{ IF EITHER DATE (1^st or most recent/last visit) IS WITHIN LAST 12 MONTHS

NUMVSTPG

HA-11. During the last 12 months, that is, since (INTERVIEW MONTH, 2001), how many visits have you (or your (husband/partner)) made to a doctor or other medical care provider to help you get pregnant?

Number of visits ______

EVER RECEIVED MEDICAL HELP TO PREVENT MISCARRIAGE (HB)

{ ASKED FOR ALL

INTRO_H2

HB-0. Now there are a few questions about medical help you may have received to prevent miscarriage or pregnancy loss.

HLPMC

HB-1. (Not counting routine check-ups, prenatal care, or advice about a pregnancy,) have you ever been to a doctor or other medical care provider to talk about ways to help you prevent miscarriage or pregnancy loss?

Yes ....... 1

No ........ 5 (GO TO HB-4 INFRTPRB)

{ ASKED IF R REPORTED MISCARRIAGE SERVICES

TYPALLMC

HB-2. Which of the services shown on Card 54 have you ever received to help you prevent miscarriage or pregnancy loss?

ENTER all that apply.

Instructions to take complete bed rest ...........1

Instructions to limit your physical activity .....2

Testing to diagnose problems related to

miscarriage ....................................3

Drugs to prevent miscarriage, such as

progesterone suppositories .....................4

Stitches in your cervix, also known as the

"purse-string" procedure .......................5

Other types of medical help ..................... 6

{ ASKED IF R REPORTED MISCARRIAGE SERVICES

MISCNUM

HB-3. When you first went for medical help for preventing miscarriage, how many pregnancies had you lost, if any?

INCLUDE any spontaneous pregnancy losses -- miscarriages, ectopic pregnancies, stillbirths.

Number ______

{ IF R REPORTED NEITHER INFERTILITY NOR MISCARRIAGE SERVICES, GO TO INTRO-H3.

{ ASKED IF R REPORTED MEDICAL HELP TO GET PREGNANT OR TO PREVENT MISCARRIAGE

INFRTPRB

HB-4. Looking at Card 55, when you went for medical help to (become pregnant/ prevent miscarriage/ to become pregnant and prevent miscarriage), were you ever told that you or your husband or partner had any of the following infertility problems shown on the card?

ENTER all that apply

Problems with ovulation ....................1

Blocked tubes ..............................2

Other tube or pelvic problems ..............3

Endometriosis ..............................4

Semen or sperm problems ....................5

Any other infertility problems .............6

None of these problems......................7

{ ASKED FOR ALL

INTRO_H3

HB-5. The remaining questions in this section will ask about a variety of things that can affect a woman's health and her ability to have children.

VAGINAL DOUCHING (HC)

DUCHFREQ

HC-1. Some women douche after intercourse or at other times, while other women do not. Looking at Card 56, during the past 12 months, that is, since (INTERVIEW MONTH, 2001), how often, if at all, did you douche?

Never..................................1 (HD-1 PID)

Once a month or less...................2

2-3 times a month .....................3

Once a week ...........................4

2-3 times a week ......................5

4-6 times a week ......................6

Or every day...........................7

{ ASKED IF R REPORTED ANY DOUCHING

DUCHWHEN

HC-2. When you douched in the past 12 months, was it only after sexual intercourse, only at other times, or both?

Only after sexual intercourse .....1

Only at other times ...............2

Both ..............................3

PID AND OTHER HEALTH PROBLEMS RELATED TO CHILDBEARING (HD)

{ ASKED FOR ALL

PID

HD-1. Have you ever been treated for an infection in your fallopian tubes, womb, or ovaries, also called a pelvic infection, pelvic inflammatory disease, or P.I.D.?

If don’t know, PROBE: AThis is a female infection that sometimes causes abdominal pain or lower stomach cramps.”

Yes ........... 1

No ............ 5

{ IF PID = NO OR RF, GO TO HD-5 DIABETES.

{ ASKED IF PID = YES OR DK

PIDSYMPT

HD-2. Were you having any symptoms, such as pain or vaginal discharge or bleeding, that caused you to go for treatment?

Yes ........... 1

No ............ 5

{ IF HD-1 PID = DK, GO TO HD-5 DIABETES

{ ASKED ONLY IF PID = YES

PIDTX

HD-3. How many different times have you been treated for a pelvic infection or P.I.D.?

Number __________

{ ASKED ONLY IF PID = YES

LSTPIDTX_M, LSTPIDTX_Y

HD-4. In what month and year did you last receive treatment for a pelvic infection or P.I.D.?

{ ASKED FOR ALL

DIABETES

HD-5. Has a doctor or other medical care provider ever told you that you had diabetes or Asugar”?

Yes ...........1

No ............5 (HD-7 OVACYST)

{ ASKED IF R WAS EVER PREGNANT AND REPORTED DIABETES

GESTDIAB

HD-6. Were you ever told you had diabetes when you were not pregnant?

Yes ...........1

No ............5

{ ASKED FOR ALL

OVACYST

HD-7. (You may have already told me this, but) has a doctor or other medical care provider ever told you had an ovarian cyst?

Yes ...........1

No ............5

UF

HD-8. (You may have already told me this, but) has a doctor or other medical care provider ever told you had fibroid tumors or myomas in your uterus?

Yes ...........1

No ............5

ENDO

HD-9. (You may have already told me this, but) has a doctor or other medical care provider ever told you had endometriosis?

Yes ...........1

No ............5

OVUPROB

HD-10. (You may have already told me this, but) has a doctor or other medical care provider ever told you had problems with ovulation or menstruation?

Yes ...........1

No ............5

LIMITED

HD-11. The following 2 questions are about other health problems or impairments you may have.

Are you limited in any way in any activities because of physical, mental, or emotional problems?

Yes .............1

No ..............5

EQUIPMNT

HD-12. Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?

NOTE: Include occasional use or use in certain circumstances.

Yes .............1

No ..............5

HIV TESTING AND AIDS KNOWLEDGE/COUNSELING (HE)

INTRO_H4

HE-0. Now I would like to ask you about testing for HIV, the virus that causes AIDS.

DONBLD85

HE-1. First, I’ll ask you about blood donations you may have made to the Red Cross or other blood banks because all blood donated in recent years has been routinely tested for HIV before it can be used. Since March 1985, have you (ever) donated blood at the Red Cross, at a bloodmobile, at a blood drive, or at other blood banks?

Yes ........... 1

No ............ 5

HIVTEST

HE-2. (Not counting tests you may have had as part of blood donations,) have you ever been tested for HIV?

Yes ...................... 1

No ....................... 5 (HE-8 RETROVIR)

{ ASKED IF R REPORTED ANY HIV TESTING APART FROM BLOOD DONATION

WHENHIV_M, WHENHIV_Y

HE-3. (Not including blood donations,) in what month and year was your last test for HIV, the virus that causes AIDS?

{ ASKED IF R DOES NOT REPORT SPECIFIC MONTH AND YEAR

HIVTSTYR

HE-3b. Did you have this last HIV test since [INTERVIEW MONTH, INTERVIEW YEAR-1]?

Yes.......... 1

No........... 5

{ ASKED IF R REPORTED ANY HIV TESTING APART FROM BLOOD DONATION

RAPIDHIV

HE-3c. When you had this last test for HIV (in [INTERVIEW MONTH, INTERVIEW YEAR-1]), was it a rapid test where you could get your results in a couple of hours or less?

Yes............1

No.............5

HIVSOON

HE-3d. How soon after your last test for HIV did you receive your results? Was it ...

Within 1 day, .....................................1

Within 1 week but longer than 1 day, ...............2

Longer than 1 week, ...............................3

Or did you never receive the test results? ........4

HIVKIND

HE-3e. Did this test use a swab from your mouth, blood from your finger, or blood from your arm?

Swab from mouth ....................1

Blood from finger ..................2

Blood from arm .....................3

Other ..............................4

PLCHIV

HE-4. Please look at Card 72. (Not including your blood donations,) where did you have that last test for HIV?

Private doctor's office..............................1

HMO facility ........................................2

Community health clinic, community clinic,

public health clinic .............................3

Family planning or Planned Parenthood clinic ........4

Employer or company clinic ..........................5

School or school-based clinic .......................6

Hospital outpatient clinic ..........................7

Hospital emergency room .............................8

Hospital regular room ...............................9

Urgent care center, urgi-care, or walk-in facility...10

Your worksite .......................................11

Your home ...........................................12

Military induction or military service site .........13

Sexually transmitted disease (STD) clinic............14

Laboratory or blood bank ............................15

Some other place ....................................20

{ ASKED IF R REPORTED SOME OTHER PLACE FOR HE-4 PLCHIV)

SP_PLCHIV

HE-4sp. Where was this other place that you had your last HIV test?

_______________________________________________

{ ASKED IF R RECEIVED AN HIV TEST IN THE LAST 12 MONTHS AT A CLINIC SITE

STATE_NAME

HE-4a. What is the name and address of the place where you received your last HIV test?

What state is the place in?

CLINICHIV

HE-4b. (What is the name and address of the place where you received your last HIV test?)

Confirm

HE-4h. I have found a clinic (by that name/in that city) at (LIST CLINIC SELECTED):

Is this correct?

Yes..........................1

No...........................5

Clinic not in database.......6

{ASKED IF CLINIC NOT IDENTIFIED IN THE DATABASE

ADCLINHIV

HE-4i (What is the name and address of the place where you received your last HIV test?)

 INTERVIEWER: ENTER name and address of clinic you were unable to find in database

{ ASKED IF R REPORTED ANY HIV TESTING APART FROM BLOOD DONATION

HIVTST

HE-5. Please look at Card 73a. I am going to show you a list of reasons why some people have been tested for HIV, the virus that causes AIDS.

(Not including your blood donations), which of these would you say was the main reason for your last HIV test?

Part of a medical checkup or surgical procedure......1

For health or life insurance coverage................2

Wanted to find out if infected or not................3

Someone suggested you should be tested...............4

For marriage license or to get married...............5

Because you were pregnant or because it was

part of prenatal care..........................6

You might have been exposed through sex or drug use..7

Some other reason ..................................20

{ ASKED IF R REPORTED SOMEONE SUGGESTED YOU SHOULD BE TESTED FOR HE-5 HIVTST

WHOSUGG

HE-5b. Who suggested you should be tested –- a doctor or other medical care provider, a sexual partner, or someone else?

Doctor or medical care provider.....1

Sexual partner......................2

Someone else........................3

{ ASKED IF R REPORTED SOME OTHER REASON FOR HE-5 HIVTST

SP_HIVTST

HE-5sp. What was the main reason for your last HIV test?

_________________________________________________

TALKDOCT

HE-6. Did a doctor or other medical care provider talk with you about AIDS after you had this last HIV test (outside of blood donation)?

Yes ..............1

No ...............5 (HE-8 RETROVIR)

{ IF R REPORTED TALKING WITH A DOCTOR OR MEDICAL CARE PROVIDER

AIDSTALK

HE-7. Looking at Card 74, what topics related to HIV or AIDS were covered in the discussion you had with the doctor or other health professional?

ENTER all that apply

How HIV/AIDS is transmitted .....................1

Other sexually transmitted diseases like

gonorrhea, herpes, or Hepatitis C .........2

The correct use of condoms ......................3

Needle cleaning/using clean needles .............4

Dangers of needle sharing .......................5

Abstinence from sex (not having sex) ............6

Reducing your number of sexual partners..........7

Condom use to prevent HIV or STD transmission....8

“Safe sex” practices (abstinence,

condom use, etc)...............9

Other ..........................................20

{ ASKED IF R RESPONDED “OTHER” TO HE-7 AIDSTALK

SP_AIDSTALK

HE-7sp. What was the other topic covered in your discussion with the doctor or health care professional after this HIV test?

________________________________________

{ ASKED FOR ALL

RETROVIR

HE-8. Please tell me if you think the following statement is definitely true, probably true, probably false, or definitely false, or if you don’t know whether it is true or false.

“There is a treatment available for pregnant women who are infected with the HIV virus to prevent passing the virus to their baby.”

Definitely true ...............1

Probably true .................2

Probably false ................3

Definitely false ..............4

Don’t know if true or false ...5

{ IF R HAS NEVER BEEN PREGNANT OR HER LAST PREGNANCY ENDED MORE THAN 12 MONTHS

{ AGO, GO TO SECTION I.

{ ASKED IF R’s LAST COMPLETED PREGNANCY WAS WITHIN LAST 12 MONTHS

PREGHIV

HE-9.

The last time you were pregnant (before you became pregnant this time), were you tested for the HIV virus when you visited the doctor for prenatal care?

Yes ............................1

No .............................5

Never went for prenatal care ...6

HUMAN PAPILLOMA VIRUS (HPV) Series (HF)

{ Asked for all Rs

HPVKNOW

HF-1. Have you ever heard of Human Papillomavirus or HPV? This is different from Human Immunodeficiency virus or HIV, which we were just talking about.

Yes ............................1

No .............................5

{ Asked for all Rs

VACCKNOW

HF-2. HPV is a common sexually transmitted virus that can cause genital warts and cervical cancer in women. A vaccine to prevent the HPV infections most commonly associated with warts and cervical cancer is available for women 9-26 years of age and is sometimes called the cervical cancer vaccine, HPV shot, or Gardasil.

Before today, have you ever heard of the cervical cancer vaccine, HPV shot, or Gardasil?

Yes ............................1

No .............................5

{ Asked if screener age < 25 and R has ever heard of Gardasil.

EVERVACC

HF-3. Have you received the cervical cancer vaccine, also known as the HPV shot or Gardasil?

 CODE 1 if R volunteers that she has had any of the 3 shots or doses that comprise HPV vaccination.

Yes ............................1

No .............................5

{ Asked if R has not had the vaccine

VACCPROB

HF-4. How likely is it that you will receive the HPV shot in the next 12 months?

Very likely ...............1

Somewhat likely ...........2

Not too likely ............3

Not likely at all .........4

{ Asked if R says “not too likely” or “not likely at all”

WHYNOVAC

HF-5. Please look at Card XXX. What is the main reason you are not likely to get the HPV shot in the next 12 months?

I don’t know enough about HPV ...............................1

I don’t know enough about the HPV vaccine ...................2

My provider has not recommended it ..........................3

I am not at risk for HPV and don’t need the vaccine .........4

I am too old for the vaccine ................................5

I am concerned about safety or side-effects .................6

The vaccine is not effective ................................7

The vaccine costs too much/ is not covered by insurance .....8

The vaccine is not available in my provider’s office ........9

Other – specify .............................................20

SP_WHYNOVAC

HF-5sp. IF HF-5 WHYNOVAC=20 THEN ASK AND RECORD VERBATIM:

What is the reason you are not likely to get the HPV shot in the next 12 months?

{ Asked if R lives with at least 1 bio or adopted daughter aged 9-18 and R has ever heard of Gardasil.

DAUGHTVAC

HF-6. Now I have a few questions about your (youngest) daughter who is currently between the ages of 9 and 18. Has she received the cervical cancer vaccine, also known as the HPV shot or Gardasil?

 CODE 1 if R volunteers that she has had any of the 3 shots that comprise HPV vaccination.

Yes ............................1

No .............................5

{ Asked if R’s (youngest) daughter 9-18 has not had the vaccine

DAUGHTPRB

HF-7. How likely is it that she will receive the HPV shot in the next 12 months?

Very likely ...............1

Somewhat likely ...........2

Not too likely ............3

Not likely at all .........4

{ Asked if R said “not too likely” or “not likely at all” about daughter getting HPV vaccine.

DAUGHTWHY

HF-8. Please look at Card YYY. What is the main reason your (youngest) daughter who is currently 9 to 18 years old is not likely to get the HPV shot in the next 12 months?

I don’t know enough about HPV ...............................1

I don’t know enough about the HPV vaccine ...................2

My provider has not recommended it for her ..................3

She is not at risk for HPV and doesn’t need the vaccine .....4

She is too young for the vaccine ............................5

I am concerned about safety or side-effects .................6

The vaccine is not effective ................................7

The vaccine costs too much/ is not covered by insurance .....8

The vaccine is not available in my provider’s office ........9

I am concerned about the HPV vaccine leading to sexual

activity ....................................................10

Other – specify .............................................20

SP_DAUGHTWHY

HF-8sp. IF HF-8 DAUGHTWHY=20 THEN ASK AND RECORD VERBATIM:

What is the reason she is not likely to get the HPV shot in the next 12 months?

SECTION I

Insurance; Residence and Place of Birth; Religion;

Past and Current Work (R and Current H/P); Child Care; Attitudes

Insurance (IA)

COVER12

IA-1. Now I have some questions about health insurance and coverage of medical expenses in the past year.

Card 75 lists some examples of types of health care coverage. In the past 12 months, that is, since [INTERVIEW MONTH, INTERVIEW YEAR – 1], was there any time that you did not have any health insurance or coverage?

Yes .............1

No ..............5 (GO TO IA-3 COVERHOW)

(IF IA-1 COVER12=DK/RF GO TO IA-3 COVERHOW)

NUMNOCOV

IA-2. In how many of the past 12 months were you without coverage?

Number of months _________(IF 12, GO TO IB-1 SAMEADD)

{ASKED IF HAD INSURANCE COVERAGE IN ANY OF PAST 12 MONTHS

COVERHOW

IA-3. Card 76 shows different types of health care coverage. In the past 12 months, that is since [INTERVIEW MONTH, INTERVIEW YEAR – 1], which of these were you covered by?

ENTER all that apply

A private health insurance plan (from employer or

workplace; purchased directly; through a state or

local government program or community program) .......1

Medicaid—Additional name(s) for Medicaid in this state:

[DISPLAY STATE PROGRAM NAME(S)].......................2

Medicare....................................................3

Medi-Gap....................................................4

Military health care, including: the VA, CHAMPUS /

TRICARE / CHAMP-VA....................................5

Indian Health Service ......................................6

CHIP (Children’s Health Insurance Program)--Additional

name(s) for CHIP in this state: [DISPLAY STATE CHIP

PROGRAM NAME(S)] .....................................7

Single-service plan (eg. dental, vision, prescriptions) ....8

State-sponsored health plan (called [DISPLAY STATE PLAN

NAME] in this state)..................................9

Other government health care...............................10

{ASKED IF LACKED COVERAGE AT ANY TIME IN THE LAST 12 MONTHS OR R HAS MORE THAN ONE TYPE OF COVERAGE

NOWCOVER

IA-4. Which of these, if any, are you covered by now?

ENTER all that apply

[DISPLAY RESPONSES FROM IA-3 COVERHOW (OR ALL RESPONSE CHOICES FROM IA-3 COVERHOW IF R SKIPPED IA-3 COVERHOW OR IF IA-3 COVERHOW=DK/RF)]

Not covered by any insurance..........11

Residence and Place of birth (IB)

SAMEADD

IB-1. Now I have some questions about where you live.

Were you living at this same address on April 1, 2000?

Yes................1 (GO TO IB-8 BRNOUT)

No.................5

CNTRY00

IB-2. Were you living in the United States on April 1, 2000?

Yes................1

No.................5 (GO TO IB-8 BRNOUT)

ASTREET

IB-3. Please tell me the address where you were living on April 1, 2000.

Street number and street name _________________

ACITY

IB-4. (Please tell me the address where you were living on April 1, 2000.)

City________________________

ASTATE

IB-5. (Please tell me the address where you were living on April 1, 2000.)

[LINK STATE DATABASE]

State_______________________

AZIP

IB-6. (Please tell me the address where you were living on April 1, 2000.)

Zip code____________________

CNTY2000

IB-7. What county did you live in then?

County _____________________

BRNOUT

IB-8. Were you born outside of the United States?

Yes .........1

No ..........5 (GO TO IB-10 PAYDU)

{ASKED IF R WAS BORN OUTSIDE THE U.S.

STRUS_M/STRUS_Y

IB-9. In what month and year did you come to the United States to stay?

PAYDU

IB-10. This next question is about your residence. Are your current living quarters owned or being bought by you or someone in your household, rented for cash, or occupied without payment of cash rent?

Owned or being bought by you or

someone in your household......................1

Rented for cash..................................2

Occupied without payment of cash rent............3

R lives in a dormitory ..........................4

Religion (IC)

RELRSD

IC-1. Now I have a few questions about religion. Please look at Card 77. In what religion were you raised, if any?

If R says Protestant, ASK “What is the complete name of the denomination?” If necessary, ENTER [11].

ENTER [1] if R was raised "atheist" or "agnostic"

None......................................................1

Catholic..................................................2

Jewish....................................................3

Southern Baptist..........................................4

Baptist...................................................5

Methodist or African Methodist............................6

Lutheran..................................................7

Presbyterian..............................................8

Episcopal or Anglican.....................................9

Church of Jesus Christ of Latter Day Saints (LDS/Mormon).10

Other ...................................................11

{ ASKED IF R’s RELIGION RAISED WAS “OTHER”

RELRSD1

IC-2. Please look at Card 78. In what religion were you raised?

Assemblies of God....................................12

Church of Nazarene...................................13

The Church of God....................................14

The Church of God (Cleveland, TN)....................15

The Church of God in Christ..........................16

7^th Day Adventist.....................................17

United Pentecostal Church............................18

Pentecostal Assemblies...............................19

Jehovah’s Witness....................................20

Christian, another denomination not listed...........21

Christian, no specific denomination..................22

Unitarian-Universalist...............................23

Greek Orthodox.......................................24

Other Orthodox ......................................25

Muslim...............................................26

Buddhist.............................................27

Hindu................................................28

Other (specify)......................................29

{ ASKED IF R REPORTED “OTHER” (RELRSD1 IC-2=29)

OTHRLRSD

IC-3. Please tell me the name of the religion in which you were raised.

________________________________

{ASKED IF R IS UNDER AGE 25

ATTND14

IC-4. Please look at Card 79. When you were 14, about how often did you usually attend religious services?

More than once a week...............................1

Once a week.........................................2

2-3 times a month...................................3

Once a month (about 12 times a year)................4

3-11 times a year...................................5

Once or twice a year................................6

Never...............................................7

RELNOW

IC-5. Please look at Card 77. What religion are you now, if any?

If R says Protestant, ASK: (What is the complete name of the denomination?) If necessary, ENTER [11].

ENTER [1] if R was raised "atheist" or "agnostic"

None......................................................1

Catholic..................................................2

Jewish....................................................3

Southern Baptist..........................................4

Baptist...................................................5

Methodist or African Methodist............................6

Lutheran..................................................7

Presbyterian..............................................8

Episcopal or Anglican.....................................9

Church of Jesus Christ of Latter Day Saints (LDS/Mormon).10

Other ...................................................11

{ ASKED IF R ANSWERS “OTHER” RELIGION (IC-5 RELNOW=11)

RELNOW1

IC-6. Please look at Card 78. What religion are you now?

Assemblies of God....................................12

Church of Nazarene...................................13

The Church of God....................................14

The Church of God (Cleveland, TN)....................15

The Church of God in Christ..........................16

7^th Day Adventist.....................................17

United Pentecostal Church............................18

Pentecostal Assemblies...............................19

Jehovah’s Witness....................................20

Christian, another denomination not listed...........21

Christian, no specific denomination..................22

Unitarian-Universalist...............................23

Greek Orthodox.......................................24

Other Orthodox ......................................25

Muslim...............................................26

Buddhist.............................................27

Hindu................................................28

Other (specify)......................................29

{ ASKED IF R REPORTED OTHER FOR RELNOW1 IC-6.

OTHRLNOW

IC-7. Please tell me the name of the religion you are now.

________________________________

{ IF R’s RELIGION IS JEWISH OR MUSLIM OR DON’T KNOW OR REFUSE,

{ GO TO IC-9 RELDLIFE

{ ELSE IF R’s RELIGION IS NONE, GO TO IC-10 ATTNDNOW

FUNDAM

IC-8. Please look at Card 80. Which of these do you consider yourself to be, if any?

ENTER all that apply.

A born again Christian..........1

A charismatic...................2

An evangelical..................3

A fundamentalist ...............4

None of the above...............5

RELDLIFE

IC-9. Currently, how important is religion in your daily life? Would you say it is very important, somewhat important, or not important?

Very important...................1

Somewhat important...............2

Not important....................3

ATTNDNOW

IC-10. Please look at Card 79. About how often do you attend religious

services?

More than once a week...............................1

Once a week.........................................2

2-3 times a month...................................3

Once a month (about 12 times a year)................4

3-11 times a year...................................5

Once or twice a year................................6

Never...............................................7

Work (ID)

EVWRK6MO

ID-1. Now I’m interested in knowing if you’ve ever worked full-time, for 6 months or longer. By full-time I mean 35 or more hours per week. If you’ve ever taken leave from work, such as family leave, vacations, disability leave, strikes, and temporary layoffs, that counts as still working, as long as you were still officially employed.

Have you ever worked for pay, full-time, for six months or longer?

Yes.............1

No..............5 (GO TO ID-4 WRK12MOS)

BEGFSTWK_M/BEGFSTWK_Y

ID-2. When, in what month and year, did you start your first period of full-time work that lasted 6 months or longer altogether?

EVRNTWRK

ID-3. Since you started that first period of work, has there ever been a time lasting 6 months or longer when you weren’t working full-time?

IF Necessary, SAY: “Remember, family leave, disability leave, strikes, temporary layoffs, paternity leave, and similar situations count as working if your employer considered you as still employed there.”

Yes.............1

No..............5

WRK12MOS

ID-4. Now I’d like to ask about your work experience in the last 12 months. By work, I mean any job for pay that was regularly scheduled, for which you were expected to perform. Please include full-time, part-time, and temporary or summer jobs.

In the last 12 months, that is since [INTERVIEW MONTH, INTERVIEW YEAR – 1], for how many months did you have any job for pay?

Number of months (IF ZERO, DK, RF, GO TO IE SERIES)

FPT12MOS

ID-5. In the last 12 months, did you work all full-time, all part-time or some of each?

Full-time............1

Part time............2

Some of each.........3

Current/last job series (IE)

DOLASTWK

IE-1. Please look at Card 81. Last week, what were you doing? Were you working, keeping house, going to school, or something else?

ENTER all that apply

Working....................................... 1

Not working at job due to temporary illness,

vacation, strike, etc....................... 2

On maternity or family leave from job......... 3

Unemployed, laid off, or looking for work..... 4

Keeping house................................. 5

Taking care of family .........................6

Going to school............................... 7

On permanent disability....................... 8

Something else ............................... 9

{ IF R IS CURRENTLY EMPLOYED OR EVER WORKED, GO TO IE-3 RNUMJOB.

{ ASKED IF R NEVER WORKED FULL-TIME AND DIDN’T WORK IN THE LAST 12 MONTHS

{ AND WASN’T WORKING LAST WEEK

RPAYJOB

IE-2. Did you ever work at a job or business for pay on a regular basis?

Yes.....................1

No......................5 (GO TO IF SERIES)

(IF DON’T KNOW OR REFUSED, GO TO IF SERIES)

RNUMJOB

IE-3. How many jobs did you work (last week / during the last week you worked)?

Number of jobs __________

RFTPTX

IE-4. (Please think about the last week you worked on your (primary) job. Did / At your primary job, do/ Do) you work part-time or full-time, or some of each? By full-time I mean 35 or more hours a week.

Full time...............1

Part time...............2

Some of each............3

Spouse/partner’s current/last job series (IF)

{ IF R IS NOT CURRENTLY MARRIED OR COHABITING, GO TO IG SERIES

SPLSTWK

IF-1. Please look at Card 82. Last week, what was (HUSBAND/PARTNER) doing? Was he working, keeping house, going to school, or something else?

ENTER all that apply

Working....................................... 1

Not working at job due to temporary illness,

vacation, strike, etc....................... 2

On paternity or family leave from job......... 3

Unemployed, laid off, or looking for work..... 4

Keeping house................................. 5

Taking care of family .........................6

Going to school............................... 7

On permanent disability....................... 8

Something else ................................9

{IF HUSBAND/PARTNER WORKED OR WAS EMPLOYED LAST WEEK, GO TO IF-3 SPNUMJOB

{ASKED IF HUSBAND/PARTNER NOT EMPLOYED/WORKING LAST WEEK

SPPAYJOB

IF-2. Did he ever work at a job or business for pay on a regular basis?

Yes.....................1

No......................5 (GO TO IG SERIES)

SPNUMJOB

IF-3. How many jobs did he work (last week/ during the last week he worked)?

Number of jobs __________

SPFTPTX

IF-4. (Please think about the last week he worked on his (primary) job.  Did / At his primary job, does / Does) he work part time or full time, or some of each? By full time I mean 35 or more hours a week.

Full-time...............1

Part time...............2

Some of each............3

Child care (IG)

{IF R HAS NO CHILDREN UNDER 13 IN THE HOUSEHOLD (includes bio child, step-child, adopted child, legal ward, foster child, partner’s child) GO TO IH/II SERIES

INTROCHC

IG-0. The next questions are about child care for children aged 12 or under who live with you.

CHCARANY

IG-1. In the past four weeks (has this child/have any of these children, aged 12 or under,) been cared for in any regular arrangement such as a day care, nursery school, play group, babysitter, after school care, relative, or some other child care arrangement?

READ if necessary: “By “regular” I mean at least once a week for a month or more.”

Yes...............1

No................5 (GO TO IH/II SERIES)

CHCARTYP

IG-2. Please look at Card 83. Which of these, if any, have you used for (any of these children/this child) in the past four weeks?

ENTER all that apply

Child's other parent/stepparent......1

child's brother/sister 13+...........2

child's brother/sister under 13......3

child's grandparent..................4

Other relative.......................5

Nonrelative or babysitter............6

Day care center......................7

Nursery/preschool/pre-k/

pre-kindergarten...............8

Family day care......................9

Federally-funded Head Start program.10

Kindergarten/school (grades 1-12)...11

Before or after school care.........12

Child cares for self................13

Other...............................14

Attitudes towards Sex, Contraception, Marriage, Gender, and Parenthood (IH/II)

IHINTRO1

IH-0. Please look at Card 84. Next, I would like to get your opinion on some matters concerning family life. I will read you some statements, and I would like you to tell me if you strongly agree, agree, disagree, or strongly disagree. The first is:

BETTER

IH-1. It is better for a person to get married than to go through life being single. Do you strongly agree, agree, disagree, or strongly disagree?

Strongly agree ..................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree ...............................4

IF R INSISTS: Neither agree nor disagree ........5

STAYTOG

IH-2. Divorce is usually the best solution when a couple can’t seem to work out their marriage problems.

Strongly agree ..................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree ...............................4

IF R INSISTS: Neither agree nor disagree ........5

SAMESEX

IH-3. Sexual relations between two adults of the same sex are all right.

Strongly agree ..................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree ...............................4

IF R INSISTS: Neither agree nor disagree ........5

ANYACT

IH-4. Any sexual act between two consenting adults is all right.

Strongly agree ..................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

SXOK18

IH-5. It is all right for unmarried 18 year olds to have sexual intercourse if they have strong affection for each other.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

SXOK16

IH-6. It is all right for unmarried 16 year olds to have sexual intercourse if they have strong affection for each other.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

CHUNLESS

IH-6a. People can’t be really happy unless they have children.

Strongly agree 1

Agree 2

Disagree 3

Strongly disagree 4

If R insists: Neither agree nor disagree 5

CHREWARD

IH-7. The rewards of being a parent are worth it, despite the cost and the work it takes.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

CHSUPPOR

IH-8. It is okay for an unmarried female to have a child.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

GAYADOPT

IH-9. Gay or lesbian adults should have the right to adopt children.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

OKCOHAB

IH-10. A young couple should not live together unless they are married.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

WARM

IH-11. A working mother can establish just as warm and secure a relationship with her children as a mother who does not work.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

ACHIEVE

IH-12. It is much better for everyone if the man earns the main living and the woman takes care of the home and family.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

FAMILY

IH-13. It is more important for a man to spend a lot of time with his family than to be successful at his career.

Strongly agree...................................1

Agree ...........................................2

Disagree ........................................3

Strongly disagree................................4

IF R INSISTS: Neither agree nor disagree ........5

{ ASKED IF R IS UNDER 20 YEARS OF AGE.

REACTSLF

IH-14. If you got pregnant now how would you feel? Would you be very upset, a little upset, a little pleased, or very pleased?

Very upset ......................1

A little upset ..................2

A little pleased ................3

Very pleased ....................4

IF R INSISTS: She wouldn’t care..5

{ ASKED IF R HAS NOT HAD ANY BIOLOGICAL OR ADOPTED CHILDREN

CHBOTHER

IH-15. If it turns out that you do not have any children, would that bother you a great deal, some, a little, or not at all?

A great deal ....................1

Some ............................2

A little ........................3

Not at all ......................4

{ IF R IS 25 OR OLDER, GO TO II-6 ACASILANG.

IIINTRO1

II-1. The next question is about what might happen if you had sex and your partner used a condom. (Even if you have never had sex or used a condom, you can think about what might happen if you did.)

LESSPLSR

II-2. Please look at Card 21. What is the chance that if your partner used a condom during sex, you would feel less physical pleasure?

No chance..........................1

A little chance....................2

A 50-50 chance.....................3

A pretty good chance...............4

An almost certain chance...........5

IIINTRO2

II-3. IF NOT CURRENTLY MARRIED OR COHABITING, SAY:

Now think about what might happen if you are with a person with whom you are about to have sexual intercourse for the first time.

ELSE IF CURRENTLY MARRIED OR COHABITING, SAY:

Now imagine that you are no longer in your current relationship, for whatever reason, and you are with a person with whom you are about to have sexual intercourse for the first time.

EMBARRAS

II-4. Please look at Card 21. What is the chance that it would be embarrassing for you and a new partner to discuss using a condom?

No chance..........................1

A little chance....................2

A 50-50 chance.....................3

A pretty good chance...............4

An almost certain chance...........5

APPREC1

II-5. Please look at Card 21. What is the chance that if a new partner used a condom, you would appreciate it?

No chance..........................1

A little chance....................2

A 50-50 chance.....................3

A pretty good chance...............4

An almost certain chance...........5

{ Question only intended for interviewer.

ACASILANG

II-6. Interviewer: Should ACASI be conducted in English or Spanish?

English............................1

Spanish............................2

SECTION J

Audio CASI

{ READ BY INTERVIEWER FROM THE SCREEN.

INTRO_J1

INTRO-J1. For this last part of the interview, I’ll turn the computer over to you so that you can enter your answers yourself. We have these headphones so that you can listen to the questions in privacy, and you can also read the questions on the computer screen. I will not be able to hear the questions or see the answers you type into the computer. After I explain a few of the keys that you’ll be using, I’ll help you with the first few practice questions, just to get you started. Then I’ll leave you on your own to answer the rest of the questions in privacy.

When you are done with this section, a screen will come up that will tell you how to lock away your responses so that no one can see how you answered the questions. Then you can return the computer to me.

INTRO_J1b

INTRO-J1b. INTERVIEWER: Explain the following things to R:

Connect the headphones to the laptop.

Give the computer to Respondent.

Show Respondent where to find number keys, Enter, Backspace, F11, F12, and Hyphen keys.

Show Respondent the Aid Card.

Explain how to adjust the volume.

Explain that you will be doing an unrelated task while Respondent completes Audio CASI, but Respondent should feel free to interrupt with questions.

The next screen is for the Respondent.

A-CASI PRACTICE QUESTIONS (JA)

{ MACHINE AUDIO BEGINS HERE.

INTRO_J2

INTRO-J2. These questions are just for practice. The interviewer is going to help you do this.

Press the [BACKSPACE] key to erase an answer you want to change or when the computer asks you to correct an answer.

Please press the large [Enter] key on the right side of the keyboard to see the first question.

PRACYEAR

JA-1. In what year were you born?

Please enter the 4-digit year you were born and press the [Enter] key.

Year ________

PRACMNTH

JA-2. In what month in [PRACYEAR] were you born?

Please enter the number for the month.

January ........1

February .......2

March ..........3

April ..........4

May ............5

June ...........6

July ...........7

August .........8

September ......9

October ........10

November .......11

December .......12

PRACCNFM

JA-3. The computer has recorded that you were born in [PRACMNTH, PRACYEAR]. Is this correct?

Yes .......1 (JA-3a INTROJ3a)

No ........5 (RETURN TO CORRECT INFORMATION AS NEEDED)

INTROJ3a

JA-3a. Thank you. Now we will go over a few keystrokes which will help you complete the survey.

Please press [Enter] to continue

INTROJ3ab

JA-3ab. If you want to replay the audio, press the [F11] key. It is located near the top right side of the keyboard.

Please press [Enter] to continue.

INTROJ3b

JA-3b. If you want to hide the question, press the [F12] key. To make the question reappear, simply press [F12] again. The [F12] key is located near the [F11] key on the top right side of the keyboard.

Please press [Enter] to continue

INTROJ3c

JA-3c. If you do not know the answer to a question, press the [CTRL] and [D] keys at the same time.

The [CTRL] key is at the bottom left of the keyboard. It is labeled “Ctrl”.

Please press [Enter] to continue

INTROJ3d

JA-3d. If you do not wish to answer a particular question, press the [CTRL] and [R] keys at the same time.

Please press [Enter] to continue

INTROJ3e

JA-3e. If you have any questions about how to use the computer, please ask your interviewer now. Otherwise, please press the [Enter] key to continue on your own.

INTRO_J4

INTRO-J4. These first questions are about your general health.

Please press [Enter] to continue

GENHEALT

JA-4. In general, how is your health? Would you say it is...

Excellent .....................1

Very good .....................2

Good ..........................3

Fair ..........................4

Poor ..........................5

{ ASKED IF R NOT CURRENTLY PREGNANT

RHEIGHT_FT

JA-5. How tall are you?

First, please select the number of feet, then press [Enter].

3 feet ..........3

4 feet ..........4

5 feet ..........5

6 feet ..........6

7 feet ..........7

{ IF RHEIGHT = DK OR RF, GO TO JA-6 RWEIGHT.

RHEIGHT_IN

JA-5. Now please select the number of inches and then press [Enter].

0 inches .......0

1 inch .........1

2 inches .......2

3 inches .......3

4 inches .......4

5 inches .......5

6 inches .......6

7 inches .......7

8 inches .......8

9 inches ......9

10 inches ......10

11 inches ......11

{ ASKED IF R NOT CURRENTLY PREGNANT

RWEIGHT

JA-6. How much do you weigh?

Please answer in pounds and then press [Enter].

Pounds ________

PREGNANCY REPORTING (JB)

INTRO_J5

INTRO-J5. The information you provide about the outcome of any pregnancies you may have had is very important for this study. Sometimes women who take part in the study are reluctant to tell an interviewer about some of their pregnancies, especially those pregnancies that ended in abortion or with babies they no longer live with.

Please press [Enter] to continue.

CASIBIRTH

JB-1. Between January (year of interview -5) and December (year of interview

-1), how many pregnancies did you have that resulted in live birth, that

is, a baby born alive?

Having twins or triplets should be counted as 1 pregnancy.

Number _____

CASILOSS

JB-2. Between January (year of interview -5) and December (year of interview

-1), how many pregnancies did you have that ended in miscarriage, stillbirth, or ectopic pregnancy?

Number _____

CASIABOR

JB-3. Between January (year of interview -5) and December (year of interview

-1), how many pregnancies did you have that ended in abortion?

Number _____

CASIADOP

JB-4. Have you ever placed a child you gave birth to for adoption?

Yes.............1

No..............5

Suspension/Expulsion; Substance Use (JC)

INTRO_J6

JC_0. IF AGESCRN GE 25, SAY:

These next questions are about your use of cigarettes, alcohol, and other substances.

Please press [Enter] to continue.

{ Asked only if R is 15-24 years old at screener

EVSUSPEN

JC-0a. Next, I have a couple of questions about your school experience. Have you ever been suspended or expelled from school?

Yes ............1

No .............5 (GO TO JC-1 SMK100)

{ Asked if R has reported ever being suspended or expelled from school

GRADSUSP

JC-0b.What grade were you in when you were suspended or expelled from school? If you were suspended or expelled more than once, please enter the grade you were in the most recent time.

Grade _________

{ Asked for all Rs

SMK100

JC-1. IF R IS 15-24 YEARS OLD, ASK:

These next questions are about your use of cigarettes, alcohol, and other substances.

IF R IS 25+ YEARS OLD, ASK:

In your entire life, have you smoked at least 100 cigarettes?

100 cigarettes is about 5 packs.

Yes.......................1

No........................5

{ ASKED IF SMOKED AT LEAST 100 CIGARETTES IN LIFETIME

AGESMK

JC-2. How old were you when you first started smoking fairly regularly?

Please enter your age in years.

If you never smoked regularly, enter 0.

Age in years ______

{ ASKED IF SMOKED AT LEAST 100 CIGARETTES IN LIFETIME

SMOKE12

JC-3. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), how many cigarettes did you smoke a day, on average?

None..................................0

About one cigarette a day or less.....1

Just a few cigarettes a day (2-4).....2

About half a pack a day (5-14)........3

About a pack a day (15-24)............4

More than a pack a day (25 or more)...5

DRINK12

JC-4. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), how often have you had beer, wine, hard liquor, or other alcoholic beverages?

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month ...................4

About once a week ....................5

About once a day .....................6

{ ASKED IF R REPORTED ANY AMOUNT OF DRINKING IN LAST YEAR OR SAID DK

BINGE12

JC-5. During the last 12 months, how often did you have 5 or more drinks within a couple of hours?

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month ...................4

About once a week ....................5

About once a day .....................6

POT12

JC-6. During the last 12 months, how often have you smoked marijuana?

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month ...................4

About once a week ....................5

About once a day or more..............6

COC12

JC-7. During the last 12 months, how often have you used cocaine?

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month or more............4

CRACK12

JC-8. During the last 12 months, how often have you used crack?

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month or more............4

CRYSTMTH

JC-8a.During the last 12 months, how often have you used Crystal or meth, also known as tina, crank, or ice? 

Never ................................1            
      Once or twice during the year ........2
      Several times during the year ........3
      About once a month or more ...........4

INJECT12

JC-9. During the last 12 months, how often have you shot up or injected drugs other than those prescribed to you? By shooting up, we mean anytime you might have used drugs with a needle, by mainlining, skin-popping, or muscling.

Never ................................1

Once or twice during the year ........2

Several times during the year ........3

About once a month or more............4

{ ASKED IF R HAS NEVER SHOT UP OR INJECTED DRUGS IN THE LAST 12 MONTHS

OR IF JC-9 = DK/RF

EVRINJECT

JC-10. At any time in your life, have you ever shot up or injected drugs other than those prescribed for you?

Yes.............1

No..............5 (GO TO INTRO_J7)

EVRSHARE

JC-11. At any time in your life, have you ever shot up or injected drugs with a needle that someone else had used before you?

Yes .............1

No ..............5

Sex with Males (JD)

INTRO_J7

INTRO-J7. The next questions are about sexual experiences you may have had with a male.

Please press [Enter] to continue.

INTRO_J8

INTRO-J8. Here are some things you may have done with a male. If you have ever done this at least one time with a male, answer yes. If you have never done this, answer no.

Please press [Enter] to continue.

{ ASKED IF R HAS NEVER MARRIED, NEVER COHABITED, NEVER BEEN PREGNANT (BASED ON CAPI OR ACASI)

VAGSEX

JD-1. Has a male ever put his penis in your vagina (also known as vaginal intercourse)?

Yes ............1

No .............5 (JD-6 GETORALM)

AGEVAGR

JD-2. The first time this occurred, how old were you?

Age in years _________

AGEVAGM

JD-3. The first time this occurred, how old was he?

Age in years __________

{ ASKED FOR ALL WHO REPORTED EVER HAVING VAGINAL INTERCOURSE

CONDVAG

JD-4. Was a condom used the last time you had vaginal intercourse with a male?

Yes ............1

No .............5 (JD-6 GETORALM)

WHYCONDL

JD-5. The last time you had vaginal intercourse with a male, did you use the condom to...

To prevent pregnancy, ..................................1

To prevent diseases like syphilis, gonorrhea or AIDS, ..2

For both reasons, ......................................3

Or for some other reason ...............................4

GETORALM

JD-6. The next few questions are about oral sex. By oral sex, we mean stimulating the genitals with the mouth. Has a male ever performed oral sex on you?

Yes ............1

No .............5

GIVORALM

JD-7. Have you ever performed oral sex on a male? That is, have you ever stimulated his penis with your mouth?

Yes ............1

No .............5 (JD-9 ANALSEX)

CONDFELL

JD-8. Was a condom used the last time you performed oral sex on a male?

Yes ............1

No .............5

{ASKED IF R IS 15-24 AT SCREENER AND HAS EVER HAD ORAL SEX AND VAGINAL INTERCOURSE

TIMING

JD-8b. Thinking back to when you had oral sex with a male for the first time, was it before, after, or on the same occasion as your first vaginal intercourse with a male?

Before first vaginal intercourse .......1

After first vaginal intercourse ........3

            Same occasion...........................5

ANALSEX

JD-9. Has a male ever put his penis in your rectum or butt (also known as anal sex)?

Yes ............1

No .............5 (JD-11 CONDSEXL)

CONDANAL

JD-10. Was a condom used the last time you had anal sex with a male?

Yes ............1

No .............5

{ ASKED IF R REPORTED MORE THAN 1 FORM OF MALE-GENITAL-INVOLVING SEX

CONDSEXL

JD-11. The very last time you had any type of sex -- that is, vaginal intercourse or anal sex or oral sex -- with a male partner, was a condom used?

Yes ............1

No .............5

{ IF R IS 18 OR OLDER, CONTINUE WITH JE SERIES.

{ ELSE IF R IS YOUNGER THAN 18, GO TO JF SERIES.

Non Voluntary Intercourse: Male - Female (JE)

{ JE SERIES ONLY ASKED FOR R’s AGED 18 YEARS OR OLDER

{ IF R DID NOT REPORT HAVING VAGINAL SEX (IN AUDIO CASI), GO TO JE-5 EVRFORCD

{ ASKED IF R REPORTED EVER HAVING VAGINAL SEX

WANTSEX1

JE-1. Think back to the very first time you had vaginal intercourse with a male. Which would you say comes closest to describing how much you wanted that first vaginal intercourse to happen?

I really didn’t want it to happen at the time ..........1

I had mixed feelings -- part of me wanted it to

happen at the time and part of me didn’t .........2

I really wanted it to happen at the time ...............3

VOLSEX1

JE-2. Would you say then that this first vaginal intercourse was voluntary or not voluntary, that is, did you choose to have sex of your own free will or not?

Voluntary.....................1

Not voluntary.................5

HOWOLD

JE-3. How old were you when this first vaginal intercourse happened?

Age in years _______

{IF R’s FIRST VAGINAL SEX WAS WANTED AND VOLUNTARY, GO TO JF-5 EVRFORCD

{ ASKED ONLY IF R REPORTED HER 1^st VAGINAL SEX AS “Not voluntary”

{ OR DIDN’T WANT IT TO HAPPEN OR HAD MIXED FEELINGS (WANTSEX1 = 1 or 2)

INTRO-J9

INTRO-J9. Were any of these kinds of force used?

Please press [Enter] to continue.

{ JE-4a THROUGH JE-4g ASKED ONLY IF R REPORTED HER 1^st VAGINAL SEX AS “Not

{ voluntary” OR DIDN’T WANT IT TO HAPPEN OR HAD MIXED FEELINGS (WANTSEX1 = 1

{ or 2)

GIVNDRUG

JE-4a. Were you given alcohol or drugs?

Yes.........1

No..........5

HEBIGOLD

JE-4b. Did you do what he said because he was bigger than you or a grown-up, and you were young?

Yes.........1

No..........5

ENDRELAT

JE-4c. Were you told that the relationship would end if you didn’t have sex?

Yes.........1

No..........5

WORDPRES

JE-4d. Were you pressured into it by his words or actions, but without threats of harm?

Yes.........1

No..........5

THRTPHYS

JE-4e. Were you threatened with physical hurt or injury?

Yes.........1

No..........5

PHYSHURT

JE-4f. Were you physically hurt or injured?

Yes.........1

No..........5

HELDDOWN

JE-4g. Were you physically held down?

Yes.........1

No..........5

EVRFORCD

JE-5. (Besides the time you already reported,) have you ever been forced by a male to have vaginal intercourse against your will?

Yes...............1

No................5 (GO TO JF SERIES)

AGEFORC1

JE-6. (After the time you already reported, when you were age (JE-3 HOWOLD),) how old were you the next time you were forced by a male to have vaginal intercourse against your will?

Age in years _______

{ IF R’s 1^st VAGINAL SEX WAS “not voluntary” GO TO JF SERIES.

{ REMAINDER OF JE SERIES ASKED ONLY IF R’s 1^st VAGINAL SEX WAS VOLUNTARY BUT

{ SHE REPORTED HAVING EVER BEEN FORCED AT ANOTHER TIME BY A MALE TO HAVE

{ VAGINAL SEX OR R’S 1^ST VAGINAL SEX WAS REALLY NOT WANTED AT THE TIME OR

{ R HAD MIXED FEELINGS AT THE TIME (WANTSEX1=1 OR 2)

INTROJ10

INTROJ10. Were any of these kinds of force used?

Please press [Enter] to continue.

GIVNDRG2

JE-7a. Were you given alcohol or drugs?

Yes.........1

No..........5

HEBIGOL2

JE-7b. Did you do what he said because he was bigger than you or a grown-up, and you were young?

Yes.........1

No..........5

ENDRELA2

JE-7c. Were you told that the relationship would end if you didn’t have sex?

Yes.........1

No..........5

WRDPRES2

JE-7d. Were you pressured into it by his words or actions, but without threats of harm?

Yes.........1

No..........5

THRTPHY2

JE-7e. Were you threatened with physical hurt or injury?

Yes.........1

No..........5

PHYSHRT2

JE-7f. Were you physically hurt or injured?

Yes.........1

No..........5

HELDDWN2

JE-7g. Were you physically held down?

Yes.........1

No..........5

STD/HIV Risk Behaviors (JF)

{ IF R DID NOT REPORT (IN A-CASI) ANY VAGINAL, ORAL, OR ANAL SEX WITH A MALE,

{ GO TO JG SERIES.

INTROJ11

INTROJ11. This next section is also about your male sex partners. This time, think about any male with whom you have had vaginal intercourse, oral sex, or anal sex -- any of these.

Please press [Enter] to continue.

PARTSLIF

JF-1. Thinking about your entire life, how many male sex partners have you had? Please count every partner, even those you had sex with only once.

Number _______

PARTS12M

JF-2. Thinking about the last 12 months, how many male sex partners have you had in the 12 months since (INTERVIEW MONTH)? Please count every partner, even those you had sex with only once in those 12 months.

Number _______

{NEWYEAR AND NEWLIFE ASKED IF R REPORTS MORE MALE PARTNERS IN LAST 12 MONTHS THAN IN LIFETIME

NEWYEAR

JF-2YR. Earlier you reported having more male partners in the last 12 months than you have had in your life. One or both of these numbers appear to be entered incorrectly, so those questions will be asked again. Your previous answers are displayed below:

DISPLAY: ___ male partners in last 12 months

___ male partners in lifetime

How many male partners did you have in the last 12 months?

Enter number _________

{ Asked if R has ever had vaginal intercourse

VAGNUM12

JF-2YRa. Your number of male partners in the last 12 months is displayed below. Thinking of your male partners in the last 12 months, with how many of them did you have vaginal intercourse?

DISPLAY: ___ male partners in last 12 months

{ Asked if R has ever had oral sex with a male

ORALNUM12

JF-2YRb. (Your number of male partners in the last 12 months is displayed below.) Thinking of your male partners in the last 12 months, with how many of them did you have oral sex, either giving or receiving?

DISPLAY: ___ male partners in last 12 months

{ Asked if R has ever had anal sex

ANALNUM12

JF-2YRc. (Your number of male partners in the last 12 months is displayed below.) Thinking of your male partners in the last 12 months, with how many of them did you have anal sex?

DISPLAY: ___ male partners in last 12 months

NEWLIFE

JF-2LF. How many male partners did you have in your lifetime?

Enter number ___________

{ IF R IS UNDER AGE 18 AND HAS 1 OR MORE CURRENT SEXUAL PARTNER, CONTINUE.

{ ELSE IF R REPORTED 0 MALE PARTNERS IN LAST 12 MONTHS, GO TO JG SERIES.

{ ELSE GO TO JF-3 BISEXPRT.

INTROJ12

INTROJ12. You indicated in the interview that you have (NUMBER) current sexual partner(s). Here is an additional question about (him/ those partners/some of those partners).

Please press [Enter] to continue.

{ SCREEN WILL DISPLAY UP TO 3 CURRENT SEXUAL PARTNERS FOR R’s UNDER 18 YEARS.

{ R WILL BE LOOPED FROM CURRPAGE THROUGH HOWMUCH as applicable.

CURRPAGE

JF-2a. Earlier you reported that you last had sexual intercourse with the (blank/first/second/third) person shown on the screen in (mo/yr). How old was he at that time?

Age in years _________

{ IF AGE REPORTED OR RF, GO TO NEXT PARTNER IF THERE IS ONE.

{ ELSE GO TO JF-3 BISEXPRT.

{ ASKED IF CURRPAGE = DK

RELAGE

JF-2b. Is he older than you, younger than you or the same age?

Older ................1

Younger ..............2

Same age .............3

{ IF R SAID “same age” GO TO NEXT PARTNER IF THERE IS ONE.

{ IF NO MORE PARTNERS TO LOOP THROUGH, GO TO JF-3 BISEXPRT.

{ ASKED IF RELAGE = older or younger

HOWMUCH

JF-2c. By how many years?

1-2 years ..............1

3-5 years ..............2

6-10 years .............3

More than 10 years .....4

{ IF ANY MORE CURRENT PARTNERS, RETURN TO CURRPAGE.

{ IF R REPORTED 0 MALE PARTNERS IN LAST 12 MONTHS, GO TO JG SERIES.

{ REMAINDER OF JF SERIES ASKED IF R REPORTED ANY MALE PARTNERS IN LAST 12

{ MONTHS OR SAID DK

BISEXPRT

JF-3. (Now please think about all of your male sexual partners in the last 12 months, that is since (INTERVIEW MONTH, INTERVIEW YEAR - 1).)

Have any of your male partners in the last 12 months ever had sex with other males?

Yes ...........1

No ............5

NONMONOG

JF-4. In the last 12 months, did you have sex with any males who were also having sex with other people at around the same time?

Yes ...........1

No ............5

MALSHT12

JF-6. In the last 12 months, have you had sex with a male who takes or shoots street drugs using a needle?

Yes ...........1

No ............5

PROSTFRQ

JF-7. In the last 12 months, has a male given you money or drugs to have sex with him?

Yes ...........1

No ............5

JOHNFREQ

JF-8. In the last 12 months, have you given a male money or drugs to have sex with you?

Yes ...........1

No ............5

HIVMAL12

JF-9. In the last 12 months, have you had sex with a male who you knew was infected with the AIDS virus?

Yes ...........1

No ............5

Sex with Females (JG)

{ ASKED FOR ALL

GIVORALF

JG-1a. The next questions ask about sexual experiences you may had with another female. Have you ever performed oral sex on another female?

Yes............1

No.............5

GETORALF

JG-1b. Has another female ever performed oral sex on you?

Yes............1

No.............5

{ ASKED IF R HAS NOT ALREADY REPORTED ORAL SEX WITH A FEMALE

FEMSEX

JG-1c. Have you ever had any sexual experience of any kind with another female?

Yes............1

No.............5

{ ASKED IF R HAS HAD ANY SEXUAL EXPERIENCE WITH A FEMALE PARTNER. IF R HAS NOT HAD ANY SEXUAL EXPERIENCE WITH A FEMALE PARTNER, GO TO JH SERIES.

FEMPARTS

JG-2. Thinking about your entire life, how many female sex partners have you had?

Number _________

FEMPRT12

JG-3. Thinking about the last 12 months, how many female sex partners have you had in the 12 months since (INTERVIEW MONTH)? Please count every partner, even those you had sex with only once in those 12 months.

Number _________

Sexual Attraction, Orientation, & Experience with STDs (JH)

{ ASKED ONLY IF R REPORTED HAVING SEX WITH BOTH MALES & FEMALES

MFLASTP

JH-1. The very last time you had any type of sex -- that is vaginal intercourse or anal sex or oral sex -- was that last sexual partner male or female?

Male ........1

Female ......2

{ ASKED FOR ALL

ATTRACT

JH-2. People are different in their sexual attraction to other people. Which best describes your feelings? Are you...

Only attracted to males .............................1

Mostly attracted to males ...........................2

Equally attracted to males and females ..............3

Mostly attracted to females .........................4

Only attracted to females ...........................5

Not sure ............................................6

{ ASKED FOR ALL

ORIENT

JH-3. Do you think of yourself as ...

Heterosexual or straight, ........1

Homosexual, gay, or lesbian,......2

Bisexual, ........................3

Or something else? ...............4

{ ASKED IF ORIENT = 4. ELSE GO TO INTROJ13

SP_ORIENT

JH-3. When you say “something else,” what do you mean?

_________________________________

INTROJ13

INTROJ13. The next questions are about your sexual and reproductive health.

Please press [Enter] to continue.

CHLAMTST

JH-4.   In the last 12 months, that is, since [INTERVIEW MONTH, INTERVIEW YEAR – 1], have you been tested for chlamydia?

Yes ............1                              
No .............5

STDTRT12

JH-5. In the last 12 months, have you been treated or received medication from a doctor or other medical care provider for a sexually transmitted disease like gonorrhea, chlamydia, herpes, or syphilis?

Yes ............1

No .............5 (JH-8 HERPES)

{ ASKED ONLY IF R WAS TREATED FOR STD IN LAST 12 MONTHS

GON

JH-6. In the last 12 months, have you been told by a doctor or other medical care provider that you had gonorrhea?

Yes ............1

No .............5

{ ASKED ONLY IF R WAS TREATED FOR STD IN LAST 12 MONTHS

CHLAM

JH-7. In the last 12 months, have you been told by a doctor or other medical care provider that you had chlamydia?

Yes ............1

No .............5

{ ASKED FOR ALL

HERPES

JH-8. At any time in your life, have you ever been told by a doctor or other medical care provider that you had genital herpes?

Yes ............1

No .............5

{ ASKED FOR ALL

GENWARTS

JH-9. At any time in your life, have you ever been told by a doctor or other medical care provider that you had genital warts or human papillomavirus also called HPV?

Yes ............1

No .............5

{ ASKED FOR ALL

SYPHILIS

JH-10. At any time in your life, have you ever been told by a doctor or other medical care provider that you had syphilis?

Yes ............1

No .............5

Individual Earnings and Family Income and Public Assistance (JI)

INTROJ14

INTROJ14. Income is important in analyzing the information we collect. For example, this information helps us to learn whether persons in each income group get the health services they need.

Please press [Enter] to continue.

{IF R HAS NEVER WORKED GO TO JI-1 INTROJ15

EARNTYPE

JI-0a. Next, I need to know your total earnings before taxes (on your last job). Will it be easier for you to tell me your total weekly, monthly, or yearly earnings?

Week..............1

Month.............2

Year..............3

EARN

JI-0b. Which category represents your total (weekly/monthly/yearly) earnings before taxes (on your last job)? (READ CATEGORIES IF NECESSARY.)

(WEEKLY INCOME CATEGORIES)

WEEKLY INCOME

UNDER $96.............................1

$ 96-143..............................2

$ 144-191.............................3

$ 192-239.............................4

$ 240-288.............................5

$ 289-384.............................6

$ 385-480.............................7

$ 481-576.............................8

$ 577-672.............................9

$ 673-768.............................10

$ 769-961.............................11

$ 962-1,153...........................12

$1,154-1,441..........................13

$1,442 or more........................14

(MONTHLY INCOME CATEGORIES)

MONTHLY INCOME

UNDER $417............................1

$ 417-624............................2

$ 625-832............................3

$ 833-1041...........................4

$1,042-1,249..........................5

$1,250-1,666..........................6

$1,667-2,082..........................7

$2,083-2,499..........................8

$2,500-2,916..........................9

$2,917-3,332..........................10

$3,333-4,166..........................11

$4,167-4,999..........................12

$5,000-6,249..........................13

$6,250 or more........................14

(YEARLY INCOME CATEGORIES)

YEARLY INCOME

UNDER $5,000..........................1

$ 5,000-7,499.........................2

$ 7,500-9,999.........................3

$10,000-12,499........................4

$12,500-14,999........................5

$15,000-19,999........................6

$20,000-24,999........................7

$25,000-29,999........................8

$30,000-34,999........................9

$35,000-39,999........................10

$40,000-49,999........................11

$50,000-59,999........................12

$60,000-74,999........................13

$75,000 or more.......................14

{ASKED IF R RESPONDED DK OR R TO EARN

EARNDK1

JI-0c. Was it $20,000 or more per year?

Yes..........1

No...........5 (GO TO JI-1 INTROJ15)

EARNDK2

JI-0d. Was it $50,000 or more per year?

Yes..........1

No...........5 (GO TO JI-1 INTROJ15)

EARNDK3

JI-0e. Was it $75,000 or more per year?

Yes..........1

No...........5

{ READ IF HOUSEHOLD INCLUDES MORE THAN JUST R.

INTROJ15

INTROJ15. IF R IS MARRIED AND HOUSEHOLD SIZE > 2, SAY:

The next questions are about your combined family income last year, that is, in the (year of interview -1). When answering these questions, please remember that "combined family income" means your income plus your husband’s income, income from any of your family members that live here, and income from any of your husband’s family members that live here, before taxes.

{THERE ARE OTHER WORDING VARIANTS, DETERMINED BY HOUSEHOLD SIZE & COMPOSITION

Please press [Enter] to continue.

WAGE

JI-1a. In the (year of interview -1), did you (or any members of your family living here) receive any wages and salaries, including tips, bonuses and overtime?

Wages and salaries (including tips, bonuses, and overtime) are paid by employers in compensation for work performed by the employee. This includes wages to armed forces personnel.

Yes.....1

No......5

SELFINC

JI-1b. In the (year of interview -1), did you (or any members of your family living here) receive any income from self employment including business and farm income?

Self employment means being a full or part owner in a business or farm.

Yes.....1

No......5

SOCSEC

JI-1c. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from Social Security or Railroad Retirement?

Railroad Retirement benefits are administered by the Railroad Retirement Board and are paid to retired railroad workers and their families

Yes.....1

No......5

DISABIL

JI-1d. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from any disability pension (other than Social Security or Railroad Retirement)?

Yes.....1

No......5

RETIRE

JI-1e. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from any retirement or survivor pension (other than Social Security or Railroad Retirement)?

Yes.....1

No......5

SSI

JI-1f. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from Supplemental Security Income (SSI)?

Supplemental Security Income is paid to persons aged 65 and over and to blind or disabled persons with incomes below specified levels. The benefits are administered by the Social Security Administration.

Yes....1

No.....5

UNEMP

JI-1g. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from unemployment compensation?

Unemployment compensation is payment made by states to involuntarily unemployed workers who are able to work, available to work, and meet other state requirements.

Yes.....1

No......5

CHLDSUPP

JI-1h. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from child support?

Yes.....1

No......5

INTEREST

JI-1i. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from interest from savings or other bank accounts?

Yes.....1

No......5

DIVIDEND

JI-1j. (In the (year of interview -1), did you (or any members of your family living here) receive...)

Any income from dividends received from stocks or mutual funds, or net rental income from property, royalties, estates or trusts?

Yes.....1

No......5

OTHINC

JI-1k. In the (year of interview -1), did you (or any members of your family living here) receive any income from any other source, such as alimony, contributions from family or others, Veteran's Administration (VA) payments, or Worker's Compensation?

Any other source could include alimony, VA payments, worker's compensation, foster care payments, and other retirement income. Also include cash awards, education stipends, trust funds from other relatives, and anything else adding to family income.

Yes.....1

No......5

TOTINCWMY

JI-2. The next question will ask about (your total income/ the total combined income of your family) in the (year of interview -1).

Remember, this item is important and your answers will be kept confidential. Will it be easier for you to report the total income per week, per month, or per year?

Week..............1

Month.............2

Year..............3

TOTINC

JI-3. Which category on represents (your total (weekly/monthly/yearly) income/ the total combined (weekly/monthly/yearly) income of your family) in the (year of interview -1), including income from all the sources you just went through, such as wages, salaries, Social Security or retirement benefits, help from relatives, and so forth? Please enter the amount before taxes.

{ ONSCREEN NOTES REMIND R OF WHOSE INCOME TO INCLUDE

(WEEKLY INCOME CATEGORIES)

WEEKLY INCOME

UNDER $96.............................1

$ 96-143..............................2

$ 144-191.............................3

$ 192-239.............................4

$ 240-288.............................5

$ 289-384.............................6

$ 385-480.............................7

$ 481-576.............................8

$ 577-672.............................9

$ 673-768.............................10

$ 769-961.............................11

$ 962-1,153...........................12

$1,154-1,441..........................13

$1,442 or more........................14

(MONTHLY INCOME CATEGORIES)

MONTHLY INCOME

UNDER $417............................1

$ 417-624............................2

$ 625-832............................3

$ 833-1041...........................4

$1,042-1,249..........................5

$1,250-1,666..........................6

$1,667-2,082..........................7

$2,083-2,499..........................8

$2,500-2,916..........................9

$2,917-3,332..........................10

$3,333-4,166..........................11

$4,167-4,999..........................12

$5,000-6,249..........................13

$6,250 or more........................14

(YEARLY INCOME CATEGORIES)

YEARLY INCOME

UNDER $5,000..........................1

$ 5,000-7,499.........................2

$ 7,500-9,999.........................3

$10,000-12,499........................4

$12,500-14,999........................5

$15,000-19,999........................6

$20,000-24,999........................7

$25,000-29,999........................8

$30,000-34,999........................9

$35,000-39,999........................10

$40,000-49,999........................11

$50,000-59,999........................12

$60,000-74,999........................13

$75,000 or more.......................14

{ IF TOTINC IS REPORTED, GO TO JI-5 PUBASST.

{ ASKED IF TOTINC = DK OR RF

FMINCDK1

JI-3a. Was it $20,000 or more last year?

Yes..........1

No...........5 (GO TO JI-4 PUBASST)

{ ASKED IF TOTAL INCOME WAS $20,000 OR MORE

FMINCDK2

JI-3b. Was it $50,000 or more last year?

Yes..........1

No...........5 (GO TO JI-4 PUBASST)

FMINCDK3

JI-3c. Was it $75,000 or more last year?

Yes..........1

No...........5

{ ASKED FOR ALL

PUBASST

JI-4. At any time in the (year of interview -1), even for one month, did you or any members of your family living here receive any CASH assistance from a state or county welfare program, such as (DISPLAY STATE PROGRAM NAME(S))?

Do not include Food Stamps, SSI, Energy Assistance, WIC, School Meals, or Transportation, Child Care, Rental or Education Assistance.

Yes ............1

No .............5 (JI-6 FOODSTMP)

{ ASKED IF ANY GOVT PAYMENTS WERE REPORTED

PUBASTYP

JI-5. From what type of program did you or any members of your family living here receive the CASH assistance? Was it a welfare or welfare-to-work program such as (DISPLAY STATE PROGRAM NAME(S)), General Assistance, Emergency Assistance, or some other program?

Please enter all that apply.

To enter multiple answers, enter the number of the first answer, press the space bar, enter the number of the next answer, and so forth. The space bar is the long key at the bottom of the keyboard, in the middle. Press [Enter] once you're finished entering all your answers.

(STATE PROGRAM NAME(S))/welfare/AFDC........................1

General assistance..........................................2

Emergency Assistance/short-term cash assistance.............3

Some other program..........................................4

{ ASKED FOR ALL

FOODSTMP

JI-6. In the (year of interview -1), did you or any members of your family living here receive food stamps?

Yes ............1

No .............5

{ ASKED FOR ALL

WIC

JI-7. In the (year of interview -1), did you or any members of your family living here receive WIC, the Women, Infants, and Children Nutrition Program?

Yes ............1

No .............5

{ ASKED FOR ALL

HLPTRANS

JI-8a. In the (year of interview -1), did you or any members of your family living here receive the following type of government assistance because your income was low...

Transportation assistance, such as gas vouchers, bus passes, or help registering, repairing, or insuring a car?

Yes............1

No.............5

{ ASKED FOR ALL

HLPCHLDC

JI-8b. (In the (year of interview -1), did you or any members of your family living here receive the following type of government assistance because your income was low...)

Any child care services or assistance so you or they could go to work or school or training?

Yes............1

No.............5

{ ASKED FOR ALL

HLPJOB

JI-8c. (In the (year of interview -1), did you or any members of your family living here receive the following type of government assistance because your income was low...)

A social services or Welfare office’s help with job training, a Job Club, a job search program, or anything else to help you or anyone in the household try to find a job?

Yes............1

No.............5

Lock

The responses you have given in this section will now be locked away to maintain your privacy. In order to activate the lock, please enter a number between 1 and 100 and press [Enter].

CONCLUSN

CONCLUSN. Thank you again for your participation in this study. Your responses to this special section have been successfully locked away. Please turn the computer back to the interviewer.

INTVCLOSE

INTVCLOSE. INTERVIEWER: PLEASE ENTER [1] TO END THE INTERVIEW.

2655801

Page 60