Message Testing - Web-based Survey

Form Approved

OMB No. 0920-0840

Expiration Date 01/31/2013

Development of HIV Prevention Decision Support Messages for Men Who Have Sex with Men and Heterosexuals

Web-based Survey

Public reporting burden of this collection of information is estimated to average 30 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 aspect 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, Georgia 30333; Attn: OMB-PRA (0920-0840)

Table of Contents

Section Page

A Background Information 2-5

Demographics 2-5

B Health-Related Items 2-8

HIV Protective Behavioral Intentions 2-8

C High-Risk Behaviors 2-10

Risk of HIV/AIDS—General 2-10

D Knowledge 2-17

E Norms and Attitudes 2-19

F Message Testing 2-21

Informed Decision Making 2-24

Section A: Background Information

Demographics

1. How old are you?

Age__________

1. Refuse to answer

A.2 What is your gender?

1. Male

2. Female

3. Transgender or Transsexual

4. Other [Specify: ] [Terminate]

5. Don’t know [Terminate]

6. Refuse to answer [Terminate]

3. Are you of Hispanic or Latino origin?

1. Yes

2. No

3. Refuse to answer

3. Which of the following best describes your race?

1. [White]

2. [Black or African American]

3. [Asian]

4. [Native Hawaiian or Other Pacific Islander]

5. [American Indian or Alaska Native]

6. Other race [Specify: ]

7. [Prefer not to answer]

3. What is the highest grade or year of school you finished?

1. Never attended school or only attended kindergarten

2. Grades 1 through 8 (elementary)

3. Grades 9 through 11 (some high school)

4. Grade 12 or GED (high school graduate)

5. College 1 year to 3 years (some college or technical school)

6. College 4 years or more (college graduate)

7. Refuse to answer

3. Which best describes your total personal income during the past year?

1. Less than $20,000

2. $21,000 to $30,000

3. $31,000 to $40,000

4. $41,000 to $50,000

5. $51,000 or more

6. Refuse to answer

3. Which do you consider yourself to be?

1. Gay, lesbian, homosexual, or same gender loving

2. Bisexual or two spirited

3. Straight or heterosexual

4. Other [Specify: ]

5. None of the above/unsure

6. Refuse to answer

3. What is your current relationship status? Are you…?

1. [Single]

2. [Married to a man]

3. [Married to a woman]

4. [In a relationship with a man]

5. [In a relationship with a woman]

6. [Divorced or widowed]

7. Refuse to answer

3. At this time, are you living alone or are there others living in your household? Please select one or more.

1. Live alone

2. Live with roommate(s)

3. Live with children

4. Live with family (e.g., mother, father, sister, aunt)

5. Live with partner/significant other

6. Other(s) in household

7. Refuse to answer

3. In what ZIP code do you currently live? _________

4. Before being contacted for this study, had you ever heard of CDC or the Centers for Disease Control and Prevention?

1. Yes

2. No

5. Refuse to answer

A.12 Have you ever been tested for HIV?

1. Yes

2. No

3. Don’t know

4. Decline to answer

A.13 The next question is about the result of your HIV test. We are recruiting people who are positive and negative for the study. With that in mind, what was the result of your most recent HIV test? (Read options.)

1. I tested positive for HIV

2. I tested negative for HIV

3. My results were unclear / Don’t Know

4. I never got my results

5. Decline to answer

13a. [If positive] When did you first test positive? DATE (mm/dd/yy):__________

1. More than 5 years ago

2. 5 or less years ago

3. Don’t Know

4. Decline to answer

13b. [If negative or unknown] When was your last HIV test?

5. Three or more years ago

6. Within the past 12 months

7. Between 1 and 3 years ago

8. Don’t Know

9. Decline to answer

Section B. Health-Related Items

HIV Protective Behavioral Intentions

1. Do you plan to use a condom the next time you have sex?

1. Yes

2. No

5. Refuse to answer

2. If your sexual partner does not want to use a condom, do you plan on insisting that the two of you use a condom?

1. Yes

2. No

5. Refuse to answer

3. The next time you have sex, do you plan on talking about the use of condoms with your partner?

1. Yes

2. No

5. Refuse to answer

4. Because of the information presented in this guide/tool/message, (e.g. here) how likely is it that you will (domain specific example here) the next time you (e.g., specific behavior/sex act here).

1. Very unlikely

2. Unlikely

3. Neither unlikely or likely

4. Likely

5. Very likely

5. Refuse to answer

5. Because of the information presented in this guide/tool/message, (e.g. here) how likely are you to get more information about (domain specific example here).

1. Very unlikely

2. Unlikely

3. Neither unlikely or likely

4. Likely

5. Very likely

5. Refuse to answer

6. How likely are you to (put example preventive action here) the next time you (add specific behavior here/have sex)?

1. Very unlikely

2. Unlikely

3. Neither unlikely or likely

4. Likely

5. Very likely

5. Refuse to answer

Section C: High-Risk Behaviors

Risk of HIV/AIDS—General

C.1 Please tell me if any of the situations apply to you. Have you…

a. Used intravenous drugs in the past year?

b. Been treated for a sexually transmitted or venereal disease in the past year?

c. Given or received money or drugs in exchange for sex in the past year?

d. Had [oral/vaginal/anal] sex without a condom in the past year?

e. [Other behavior]

1. Yes

2. No

3. Refuse to answer

C.2 Do you (insert behavior/action here) every time you have sex?

1. Yes

2. No

5. Refuse to answer

C.3 If your sexual partner does not want to (insert behavior/action here), do you insist that the two of you (insert behavior/action here)?

1. Yes

2. No

5. Refuse to answer

C.4 Do you have sex only with the person with whom you are in a committed relationship?

1. Yes

2. No

5. Refuse to answer

C.5 If you are not in a committed relationship, do you remain abstinent (that is, to not have [vaginal/oral/anal] sex)?

1. Yes

2. No

5. Refuse to answer

STD Testing

C.6 Has a doctor or other health care provider ever suggested that you be tested for any other sexually transmitted diseases besides HIV?

1. Yes

2. No

3. Refuse to answer

C.7 Have you, yourself, ever been tested for any other sexually transmitted disease besides HIV?

1. Yes

2. No

3. Refuse to answer

C.8 What other sexually transmitted diseases besides HIV have you been tested for?

1. Chlamydia

2. Gonorrhea

3. Syphilis

4. Genital herpes

5. Genital warts

6. Human papillomavirus (HPV)

7. Other [Specify: ]

8. Refuse to answer

Sexual Activity

C.9 During the past [INSERT TIME FRAME], how many people did you have sex with?

NUMBER __________________

1. Refuse to answer

C.10 During the past [insert time frame] how many times did you (insert behavior/action here) to reduce your risk of getting HIV?

NUMBER __________

1. Refuse to answer

C.11 How many of your partners in the past [INSERT TIME FRAME] were men?

NUMBER __________________

1. Refuse to answer

C.12 How many of your partners in the past [INSERT TIME FRAME] were women?

NUMBER __________________

1. Refuse to answer

C.13 Did you have [oral/vaginal/anal sex] with any of your [female/male] partner(s) in the past [INSERT TIME FRAME]?

1. Yes

2. No

3. Refuse to answer

C.14 When you had [oral/vaginal/anal] sex with your [female/male] partner(s) in the past [INSERT TIME FRAME], how often did you and your partner use a condom?

1. Never used a condom

2. Occasionally used a condom

3. Usually used a condom

4. Always used a condom

5. Refuse to answer

C.15 In the past [INSERT TIME FRAME], did you ever, even one time, have sex without a condom?

1. Yes

2. No

4. Refuse to answer

Sexual Partners

C.16 Do you currently have a main sex partner—that is, a partner you would call your spouse, significant other, or life partner?

1. Yes

2. No

3. Refuse to answer

C.17 How long have you and your main partner been together?

1. [3 months or less]

2. [4-6 months]

3. [7-11 months]

4. [1-2 years]

5. [More than 2 years to less than 5 years]

6. [5 years or more]

7. Refuse to answer

C.18 Is your main partner male, female, or transgender?

1. Male

2. Female

3. Transgender

4. Refuse to answer

C.19 What is your main partner’s HIV status?

1. My main partner is HIV negative

2. My main partner is HIV positive

3. My main partner has not been tested for HIV

4. My main partner has not told me his or her HIV status

5. Refuse to answer

C.20 Does your main partner know your HIV status?

1. Yes

2. No

3. Refuse to answer

C.21 In the past 12 months, how many non-main partners – that is, somebody who you did not consider to be a spouse, significant other, or life partner – did you have oral, vaginal, or anal sex with?

1. 0

2. 1-5

3. 6-10

4. 11-15

5. 16-20

6. Over 20

7. Refuse to answer

C.22 Did you have unprotected [vaginal/anal] sex with any [female/male] partners in the past 12 months whose HIV status you didn’t know? By unprotected sex, I mean [oral/vaginal/anal] sex when you or your partner didn’t use a condom.

1. Yes

2. No

3. Refuse to answer

C.23 Did you have unprotected [vaginal/anal] sex with any [female/male] partners in the past 12 months who you knew or thought to be HIV positive? By unprotected sex, I mean [oral/vaginal/anal] sex when you or your partner didn’t use a condom.

1. Yes

2. No

3. Refuse to answer

C.24 In the past 3 months, how many of your non-main partners told you their HIV status?

1. 0

2. 1-5

3. 6-10

4. 11-15

5. 16-20

6. Over 20

7. Refuse to answer

C.25 In the past 3 months, how many of your non-main partners did you tell your HIV status to?

1. 0

2. 1-5

3. 6-10

4. 11-15

5. 16-20

6. Over 20

7. Refuse to answer

Drug Use

C.26 Have you ever, even once, injected any drug?

1. Yes

2. No

3. Refuse to answer

C.27 The next question is about injecting, “shooting,” or “skin popping” drugs. This

means injecting drugs with a needle or a syringe yourself or having someone who isn’t a health care provider inject you. Do not include hormones, or drugs that were given or prescribed by a health care professional for things like allergies, diabetes, or HIV medications. Please remember your answer will be kept private. In the past twelve (12) months, have you injected drugs?

1. Yes

2. No

3. Don’t know

3. Refuse to answer

C.28 In the past [INSERT TIME FRAME], on how many days did you inject any drug?

NUMBER OF DAYS ____________________

1. Refuse to answer

C.29 Which of the following drugs have you used in the last [INSERT TIME FRAME]? For each drug mentioned, please tell me how often you used it. How often did you use...

	Used drug Yes or No?	Once a month or less	About once a week	Several times a week	About once a day	Several times a day	Don’t know	Refuse to answer
a. Amphetamine, meth, speed, crystal, crank, ice	1	2	3	4	5	6	7	8
b. Crack	1	2	3	4	5	6	7	8
c. Cocaine	1	2	3	4	5	6	7	8
d. Downers (Valium, Ativan, Xanax)	1	2	3	4	5	6	7	8
e. Painkillers	1	2	3	4	5	6	7	8
f. Hallucinogens such as LSD	1	2	3	4	5	6	7	8
g. Ecstasy	1	2	3	4	5	6	7	8
h. Club drugs such as GHB, ketamine	1	2	3	4	5	6	7	8
i. Heroin (smoke, snorted)	1	2	3	4	5	6	7	8
j. Marijuana	1	2	3	4	5	6	7	8
k. Poppers (amyl nitrite)	1	2	3	4	5	6	7	8
l. Other [Specify: _________________]	1	2	3	4	5	6	7	8

C.30 In the past [INSERT TIME FRAME], have you been high or buzzed on [NAME OF DRUG] during sex?

	No	Yes	Don’t know	Refuse to answer
a. Amphetamine, meth, speed, crystal, crank, ice	1	2	3	4
b. Crack	1	2	3	4
c. Cocaine	1	2	3	4
d. Downers (Valium, Ativan, Xanax)	1	2	3	4
e. Painkillers	1	2	3	4
f. Hallucinogens such as LSD	1	2	3	4
g. Ecstasy	1	2	3	4
h. Club drugs such as GHB, ketamine	1	2	3	4
i. Heroin (smoke, snorted)	1	2	3	4
j. Marijuana	1	2	3	4
k. Poppers (amyl nitrite)	1	2	3	4
l. Other [Specify: ________________________]	1	2	3	4

Alcohol Consumption

C.31 During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage?

1. ___ days per week

2. ___ days in past 30 days

3. No drinks in past 30 days

4. Refuse to answer

C.32 Considering all types of alcoholic beverages, how many times during the past 30 days did you have X [INSERT X = 5 for men, X = 4 for women] or more drinks on an occasion?

1. ___ Number of times

2. None

3. Refuse to answer

C.33 In the past 30 days, have you been drunk [or buzzed from alcohol] during sex?

1. Yes

2. No

3. Refuse to answer

C.34 In the past 30 days, have you used drugs other than alcohol?

1. Yes

2. No

3. Refuse to answer

Section D: PERCEIVED AND ACTUAL Knowledge

D.1 The information provided in this message/tool/booklet was new to me.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.2 I learned new things about [INSERT health behavior] from the message/tool/booklet.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.3 I learned new things about how to [INSERT health behavior] from the message/tool/booklet.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.4 The information in this message/tool/booklet would make HIV-negative [women/men] take [fewer or more]sexual risks.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.5 The information in this message/tool/booklet would make me [more or less] willing to have unprotected sex with someone who is HIV positive.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.6 Because of new treatments for HIV described in this guide, HIV negative [women/men] take more sexual risks.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.7 Because of new treatments for HIV described in this guide, I’m [more or less] willing to have unprotected sex with someone who is HIV positive.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

D.8 Tell me how risky you think each behavior is for [getting or giving] HIV. Use a scale where 0 is lowest risk and 100 is highest risk. Please assign any number in that range to each of the behaviors listed.

1. [Deep kissing]

2. [Receptive anal sex (“bottom”) with a condom]

3. [Receptive anal sex (“bottom”) without a condom]

4. [Mutual masturbation]

5. [Receptive oral sex (“giving a blow job”) with a condom]

6. [Receptive oral sex (“giving a blow job”) without a condom]

7. [Insertive anal sex [(“top”)] with a condom]

8. [Insertive anal sex [(“top”)] without a condom]

9. [Vaginal sex with a condom]

10. [Vaginal sex without a condom]

11. [Other behavior]

12. Refuse to answer

D.9 When should you get an HIV test after having unprotected sex [with a woman/man]?

1. [0–2 months after having unprotected sex]

2. [3–6 months after having unprotected sex]

3. [7–12 months after having unprotected sex]

4. [More than 12 months after having unprotected sex]

5. [When you start to feel sick]

6. Refuse to answer

Section E: Norms and Attitudes

1. Most people who are important to me think I should [insert behavior here]. By important to me, we mean people like friends, family, and anyone else who is an important part of your life.

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

2. Most of my sexual partners [insert behavior here].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

3. Most [gay men/people I know] [insert behavior here].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

4. On a scale from 1 to 6, where 1 is extremely bad and 6 is extremely good, how would you rate [insert behavior here].

1. Extremely bad

2. Bad

3. Neither bad nor good

4. Good

5. Extremely good

6. Refuse to answer

5. On a scale from 1 to 6, where 1 is extremely harmful and 6 is extremely beneficial, how would you rate [insert behavior here] to [prevent HIV]?

1. Extremely harmful

2. Harmful

3. Neither harmful nor beneficial

4. Beneficial

5. Extremely beneficial

6. Refuse to answer

6. Please tell us how much you disagree or agree with the following statements

   1. [insert behavior here] is expensive.

   2. [insert behavior here] is inconvenient.

   3. [insert behavior here] allows me to have unprotected sex with partners who are [HIV negative or HIV positive]

   4. [insert behavior here] [insert descriptor here].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly Agree

6. Refuse to answer

Message Testing

The following questions are about a message/booklet/tool you [saw/heard] [earlier], entitled “_________________.” To refresh your memory of this message/tool/booklet, we would like to play/show it for you again.

[PLAY/SHOW]:

Section F: Message Testing

1. Please indicate how much you agree or disagree with the following statements about this message.

	Strongly disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to answer
a. Overall, I liked this message/tool/booklet.	1	2	3	4	5	6
b. I liked the people in this message/tool/booklet.	1	2	3	4	5	6
c. I liked the voices in this message/tool/booklet.	1	2	3	4	5	6
d. This message/tool/booklet was easy to listen to (to read).	1	2	3	4	5	6
e. I learned something new by listening to (by reading) this message/tool/booklet.	1	2	3	4	5	6
f. I was interested in listening to (reading) this message/tool/booklet.	1	2	3	4	5	6
g. This message/tool/booklet was made (written) for a person like me.	1	2	3	4	5	6
h. This message/tool/booklet was easy to understand.	1	2	3	4	5	6
i. I liked the sound effects in this message/tool/booklet.	1	2	3	4	5	6
j. I would look at (read) this message/tool/booklet if I saw it.	1	2	3	4	5	6
k. I am interested in this message/tool/booklet’s topic.	1	2	3	4	5	6
l. I like the way this message/tool/booklet looks.	1	2	3	4	5	6
m. I liked the colors in this message/tool/booklet.	1	2	3	4	5	6
n. I trust the information in this message/tool/booklet.	1	2	3	4	5	6
o. I can do what this message/tool/booklet suggests.	1	2	3	4	5	6
p. I will do what this message/tool/booklet suggests.	1	2	3	4	5	6
q. I trust the information in this message/tool/booklet.	1	2	3	4	5	6
r. This message/tool/booklet was believable.	1	2	3	4	5	6

2. Please indicate how much you agree or disagree with the following statements about the (INSERT format—television message, radio message, print message, brochure, video, etc.).

	Strongly disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to answer
a. This [INSERT format] was convincing.	1	2	3	4	5	6
b. This [INSERT format] said something important to me.	1	2	3	4	5	6
c. I liked this [INSERT format] overall.	1	2	3	4	5	6
d. This [INSERT format] grabbed my attention.	1	2	3	4	5	6
e. This [INSERT format] told me something I didn’t already know.	1	2	3	4	5	6
f. This [INSERT format] would be helpful in convincing my friends to [INSERT behavior]	1	2	3	4	5	6
g. This message/tool/booklet made me feel confident that I could [INSERT behavior]	1	2	3	4	5	6
h. This [INSERT format] gave me good reasons to [INSERT behavior]..	1	2	3	4	5	6
i. This [INSERT format] was confusing.	1	2	3	4	5	6
j. This [INSERT format] spoke to me.	1	2	3	4	5	6
k. I do not like this [INSERT format].	1	2	3	4	5	6
l. I learned something new from [INSERT format].	1	2	3	4	5	6
m. Real people would act (talk/look) the way the person(s) in this message/tool/booklet [INSERT]	1	2	3	4	5	6
n. The person(s) in this message/tool/booklet were more similar to me than different.	1	2	3	4	5	6
o. I could relate to what the person(s) in this message/tool/booklet were going through.	1	2	3	4	5	6
p. I felt [INSERT emotion] while viewing (listening to) the message/tool/booklet.	1	2	3	4	5	6
q. Visiting the Web site/calling the number listed in the message is a good start to [INSERT behavior].	1	2	3	4	5	6
r. By doing the behaviors suggested by the message, [INSERT outcome].	1	2	3	4	5	6
s. Generally speaking, it is possible to [INSERT activity/behavior].	1	2	3	4	5	6
t. There are many things I can do to [INSERT outcome].	1	2	3	4	5	6
u. The message that I saw about [INSERT topic] was compelling.	1	2	3	4	5	6
v. The message about [INSERT topic] was persuasive.	1	2	3	4	5	6
w. The message was weak.	1	2	3	4	5	6
x. The message was compelling.	1	2	3	4	5	6
y. The message was persuasive.	1	2	3	4	5	6
z. The message was dumb.	1	2	3	4	5	6

3. How much of the [INSERT item] would you read? Please choose all that apply.

• I would only read the headline

• I would only look at the image/s

• I would only read the headline and look at the image/s

• I would read the whole thing

• I wouldn’t read any of it

[Insert other response here]

Informed Decision Making

Please indicate your opinion about the effect of the message/tool/booklet by indicating how much you agree or disagree with each of the following statements.

Did the message/tool/booklet…	Strongly disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to answer
a. Help you recognize that a decision needs to be made about your [sexual health issue]?	1	2	3	4	5	6
b. Prepare you to make a better decision about [sexual health issue]?	1	2	3	4	5	6
c. Help you think about the pros and cons of each option for [INSERT issue here]?	1	2	3	4	5	6
d. Help you think about which pros and cons are most important?	1	2	3	4	5	6
e. Help you know that the decision you make depends on what matters most to you?	1	2	3	4	5	6
f. Help you organize your own thoughts about [insert issue here]/the decision?	1	2	3	4	5	6
g. Help you think about how involved you want to be in[insert issue here]/ this decision?	1	2	3	4	5	6
h. Help you identify the questions you want to ask [your doctor or your partner or other].	1	2	3	4	5	6
i. Prepare you to take to [your doctor or partner or other] about what matters most to you?	1	2	3	4	5	6
j. Prepare you for a follow-up [visit or conversation or other] with [your doctor or partner or other].	1	2	3	4	5	6

Positive Attitudes toward Talking about HIV with Partners, Peers, and Family

4. It is important to talk about [HIV].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly agree

6. Refuse to answer

5. It is important to talk about [HIV] with [INSERT].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly agree

6. Refuse to answer

6. I am confident that I can talk to [INSERT] about [INSERT].

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly agree

6. Refuse to answer

Risk

7. If you don’t change any HIV-related behaviors what is your chance of getting HIV disease in the next (insert time period here)?

1. 0-24% or have little to no chance of getting it

2. 25-49% or have some chance of getting it

3. 50% or have equal chance of getting it or not getting it

4. 51-74% or have a good chance of getting it

5. 75-100% or it is likely that I will get it

6. Refuse to answer

8. I feel at risk for HIV, so I’ll (insert behavior/action here), (insert time period here appropriate to action).

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly agree

6. Refuse to answer

9. I don’t think I will get HIV because I plan to (insert behavior action here), (insert time period here appropriate to action).

1. Strongly disagree

2. Disagree

3. Neither disagree nor agree

4. Agree

5. Strongly agree

6. Refuse to answer

10. What do you think is the risk that you will get HIV if you (insert behavior/action here)?

1. 0-24% or have little to no chance of getting it

2. 25-49% or have some chance of getting it

3. 50% or have equal chance of getting it or not getting it

4. 51-74% or have a good chance of getting it

5. 75-100% or it is likely that I will get it

6. Refuse to answer

11. How much would (insert behavior/action here) reduce your risk of getting HIV?

1. 0-24% or have little to no chance of getting it

2. 25-49% or have some chance of getting it

3. 50% or have equal chance of getting it or not getting it

4. 51-74% or have a good chance of getting it

5. 75-100% or it is likely that I will get it

6. Refuse to answer

12. How likely is it that you will [INSERT behavior here] [INSERT time frame here]?

1. Very unlikely

2. Unlikely

3. Neither unlikely or likely

4. Likely

5. Very likely

6. Refuse to answer

13. How sure are you that you could [insert behavior here] if [insert circumstance here]?

1. Very sure I could not

2. Somewhat sure I could not

3. Slightly sure I could

4. Somewhat sure I could

5. Very sure I could

6. Refuse to answer

14. Thinking about the sex you’ve had over the past (insert time frame), do you consider yourself to be high, medium or low risk for [getting or giving] HIV?

1. Low risk

2. Medium risk

3. High risk

4. Refuse to answer

15. What do you think the chance would be that some time in (insert time frame) you would get HIV? Do you think that it’s likely or that it’s unlikely that you would get HIV in (insert time frame)?

1. Likely

2. Unlikely

3. Refuse to answer

2