Behavioral Assessment

Attachment 5B: Behavioral Assessment Instrument

Behavioral Assessment Component of the Behavioral

Assessment and Rapid Testing (BART) Project

October 28, 2010

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Division of HIV/AIDS Prevention

Behavioral and Clinical Surveillance Branch

Centers for Disease Control and Prevention

1600 Clifton Road NE, Mailstop E-46

Atlanta, GA 30333.

Peter Thomas, PhD, MPH

Project Officer
Email: [email protected]

Voice: (404) 639-6266

Fax: (404) 639-8640

ATTACHMENT 5B: BEHAVIORAL ASSESSMENT INSTRUMENT

Note to Reviewers: - This instrument consists of several sections. Some sections will be asked of all participants. Different questions from the remaining sections will be asked based on the place of recruitment and on the risk group of the respondent.

All of the questions will be programmed electronically and asked by the trained interviewer. The respondent will not see the response options, except where audio visuals are indicated. “No response” and “don’t know” will not be offered to the respondent but will be available options for most questions that are asked.

Public reporting burden of this collection of information is estimated to average 10 to 15 minutes per response. 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/ASDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-XXX)

Form Approved OMB No. 0920-XXXX Expiration date XX.XX.20XX Behavioral Assessment INSTRUMENT B-1. Device ID #: __ __ __ __ B-2. Subject ID #: __ __ __ __ B-3. Event Type: __ Gay Pride (Group 1) __ Minority Gay Pride (Group 2) __ Black Spring Break (Group 3) __ Social or Cultural Events Attracting African Americans (Group 4) B-4. Date of interview: __ __/ __ __ / __ __ __ __ (M M / D D / Y Y Y Y ) B-5. Respondent’s Sex: __ (1) Male __ (2) Female
SAY: Thanks again for taking part in this survey. Remember that all the information you give me will be private and your name will not appear anywhere on this interview. First, I would like to ask you some questions about your background.
SECTION 1.0: Demographics (All Groups)
1		What state do you currently live in? [Do not read choices. Choose matching response]
				1		Alabama
				2		Alaska
				3		Arizona
				4		Arkansas
				5		California
				6		Colorado
				7		Connecticut
				8		Delaware
				9		Florida
				10		Georgia
				11		Hawaii
				12		Idaho
				13		Illinois
				14		Indiana
				15		Iowa
				16		Kansas
				17		Kentucky
				18		Louisiana
				19		Maine
				20		Maryland
				21		Massachusetts
				22		Michigan
				23		Minnesota
				24		Mississippi
				25		Missouri
				26		Montana
				27		Nebraska
				28		Nevada
				29		New Hampshire
				30		New Jersey
				31		New Mexico
				32		New York
				33		North Carolina
				34		North Dakota
				35		Ohio
				36		Oklahoma
				37		Oregon
				38		Pennsylvania
				39		Puerto Rico
				40		Rhode Island
				41		South Carolina
				42		South Dakota
				43		Tennessee
				44		Texas
				45		Utah
				46		Vermont
				47		Virginia
				48		Washington D.C.
				49		Washington State
				50		West Virginia
				51		Wisconsin
				52		Wyoming
				53		Outside of the U.S.
				77		Refuse to answer
				99		Don’t know
2		What is the ZIP code where you currently live?			_ _ _ _ _
2a		Do you live in [B-6] county?
			No ……………….....……..……………..……………………….…… 0
			Yes………………………..…..…...……………..…………...………. 1
			Refuse to answer……...……..……………………………………...… 7
			Don’t know……………….…………………………………….…...... 9
3		What is the highest grade in school you completed? [Do not read choices. Choose option that matches response]
			Grade 1-8............................................................................................... 1
			Grade 9-11……………………………………………………………. 2
			Grade 12 or GED……………..……………...............................…….. 3
			Some college, associate’s degree, technical school………………....... 4
			Bachelor’s degree....…………………...……. ………………....…..… 5
			Any post-graduate studies.……………….………………….……...… 6
			Refuse to answer………………..……………………….…..…….….. 7
			Don’t know……..………………..…………………………………………. 9
4		Are you currently: [Read all choices. Choose one]
			A full-time student ………...............…..……………………...……… 1
			A part-time student...………...……………………………….....……. 2
			Not a student….……….…………………………………………..….. 3				 skip to 6
			Refuse to answer…….……………………………………………....... 7				 skip to 6
			Don’t know……..………………..…………………………………………. 9
5		Where do you currently live while attending school? [Read all choices. Choose one]
			On campus student housing...………………………...…………...….. 1
			Off campus student housing……………………………….……..…… 2
			Off campus private apartment or house……………………………..... 3
			Other...................…..…..…………………………............................... 4
			Refuse to answer…..…..…………………………………...………..... 7
			Don’t know……..………………..…………………………………………. 9
6		Do you have any health insurance or coverage?
			No ……………….....……..……………..……………………….…… 0
			Yes………………………..…..…...……………..…………...………. 1
			Refuse to answer……...……..……………………………………...… 7
			Don’t know……………….…………………………………….…...... 9
7		Are you currently employed?
			No ………………...…………………..…………………………….… 0
			Yes……………………………...……………………………..……… 1
			Refuse to answer……………..………………............................…..… 7
			Don’t know……………..…………………….…………………......... 9
8		Thinking of the past 12 months, what was your usual monthly “take home” income from all sources, including public assistance? [Show placard and ask them for the letter that applies to their income range.]
		A	$0 - $499 per month ..........................…….…….................................. 1
		B	$500 - $999 per month…….……………………………….……......... 2
		C	$1000 - $2999 per month……………..…………………….……….... 3
		D	$3000 - $4999 per month.…………..………………………….…...… 4
		E	$5000 - $6999 per month………………………………….…..……… 5
		F	$7,000 - $8999 per month.…..……………...………………….....…... 6
		G	$9,000 or more per month.…………..……............................…....…...7
			Refuse to answer…..…..…..……………………………….……….... 77
			Don’t know...………..………….………...………………….………. 99
			(card will have conversion to annual rates )
9			Including yourself, how many people depended on this income? ______
			Refuse to answer…..………………………………………….…….... 77
			Not applicable .............................................................................. …... 88
			Don’t know...………..…………………...………………….……….. 99
10		In the past 12 months, have you been homeless at any time? By homeless, I mean you were living on the street, in a shelter, a Single Room Occupancy hotel (SRO), temporarily staying with friends or relatives, or living in a car.
			No ………………........………………..………………………….…... 0
			Yes………...………..…...……...………………………………..…… 1
			Refuse to answer…...……………...……………………………....….. 7
			Don’t know……………..…………………………………….…......... 9
11a		Which of the following best describes your present relationship status? [Read all choices. Choose one]
			Single .................................………………………………..…………. 1				 skip to 12
			Married …………..………………………………………..…………. 2
			Separated or divorced…………..……………..………………..…….. 3				 skip to 12
			Widowed………………………………………………………..…….. 4				 skip to 12
			Long term relationship....………...……………………………...…..... 5
			Refuse to answer……………..…………………..…………………… 7				 skip to 12
			Don’t know……………..……………………………………..…........ 9				 skip to 12
			[Interviewer read]:
11b			To or with a man …………………………………………………......  1
			To or with a woman ………...…………………………………..……. 2
12		Do you consider yourself to be straight (heterosexual), gay (homosexual), bisexual, or something else? [Choose one]
			Straight or heterosexual…………………...........................………..… 1
			Bisexual………………………...…………………………….…..…… 2
			Gay or homosexual..…………………..……………………………… 3
			Something else.……………........……..……………………………… 4
			Refuse to answer……….……………………………………….…...... 7
			Don’t know…………..…………………...………………………....…9

SECTION 2.0: Sexual Behaviors (All Groups)
SAY: Next, I'm going to ask you some questions about sex. Remember that the answers you give me will be private. For these questions, “having sex” means vaginal or anal sex. Vaginal sex means penis in the vagina and anal sex means penis in the anus (butt). I need to ask you all the questions, even if some may not apply to your situation. [Use your discretion in using slang terms for the following sexual behavior questions]
S0a	In the past 12 months were your sexual partners: [Read all choices. Choose one]
			Only female……………………… ….…………………..…………… 1								If B-5 = 1 skip to S1
			Mostly female…………………....….………………………….…….. 2
			Equally female and male…………….………………………..……..... 3
			Mostly male…………….……………………………….…................. 4
			Only male………………………………………………….…….…..... 5								If B-5 = 2 skip to S1
			Refuse to answer……….……………………………...………............ 7								 skip to section 2.1
			Not applicable (No partners in the past 12 months)………………….. 8								If B-3 = 1 or 2 skip to section 2.4 If B-3 = 3 or 4 skip to section 4.0
			Don’t know…………..…………………...……................................…9								 skip to section 2.1
If B-3 = 1 or 2 skip to S1 If B-5 = 1  insert “men” in S0b question If B-5 = 2  insert “women” in S0b question
S0b	Have you told any of the following people that you are attracted to or have sex with other [men/women]? [Read all choices. Check all that apply]
			Gay, lesbian, or bisexual friends………….......…………………...….. 1
			Heterosexual friends…………..….……………………………..……. 2
			Friends in my religious community…....…….………………….....…. 3
			Friends at school or work….………………..…………………...……. 4
			Friends in my racial or ethnic community…......…………………..…. 5
			Family members……………….…………………………………..…. 6
			Spouse or partner…………………………….……………………...…7
			Health care providers………….….………………………………..…. 8
			Not told anyone...................................................................................... 9
			Refuse to answer………..….…………………………………...……. 77
			Don’t know………………………..………………………...…......… 99
SECTION 2.1: Sexual Behaviors – With Males (All Groups)
If B-5 = 1  questions S1 – S4, S7, use “anal” and not “vaginal or anal”
S1	In the past 12 months, [If B-3 = 3  add “prior to coming to this event,”] with how many different men did you have [vaginal or anal] sex? [Record number of partners 0-7500. If number of partners > 7500, enter 7500. If respondent can not remember, ask them to make their best guess].
			[Refuse to answer = 7777, Don’t know = 9999]				__ __ __ __				If 0, 7777 or 9999  skip to S10 If > 1  skip to S3
If S1 > 1  questions S20, S21, S22 should read partners not partner
If S1 = 0  alert to interviewer should read “Earlier you reported [response to S0a] sexual partners in the past 12 months, is that correct?” If there is a discrepancy, the response to S1 or S0a should be adjusted as necessary
S2	Did you have [vaginal or anal] sex with this man without using a condom?
			No ………………...……………..…..…………………………...…… 0								 skip to S7a
			Yes………...………………...….….……………………..……..……. 1								 skip to S5
			Refuse to answer……..………..…...…..................................….…..… 7
			Don’t know…………........……………………………………..…..… 9
S3	Of the [response to S1] men you had vaginal or anal sex with in the past 12 months, with how many did you have [vaginal or anal] sex without a condom?
			[Refuse to answer = 7777, Don’t know = 9999]			__ __ __ __					If 1  skip to S5 If 0  skip to S7a
If S3 > S1 alert to interviewer should read “Earlier you reported [Response S1] sexual partners in the past 12 months is that correct?” If there is a discrepancy, the respondent should be informed that S3 cannot exceed the number of partners and the response to S1 or S3 should be adjusted as necessary
S4	Of the [response to S3] men with whom you did not use a condom during [vaginal or anal] sex, did you ask the HIV status of none of them, One or more of them, or all of them before having sex?
			None of them ..........…………………………………..……………..... 1								 skip to S7a
			One or more of them…...…...…………...……………………..…… 2								 skip to S6a
			All of them….......……………......………..………………………..… 3								 skip to S6a
			Refuse to answer………...………...…………………………...…...… 7								 skip to S7a
			Don’t know…………...………………………………………...…...... 9								 skip to S7a
S5	Did you ask this man his HIV status before you had sex without a condom? [Do not read choices. If respondent says yes, ask what the status of this male partner was.]
			No, we didn’t discuss HIV status...……...……..…………………...…1								 skip to S7a
			Yes, and he said he was HIV positive..…………………...…..….........2								 skip to S7a
			Yes, and he said he was HIV negative.……………………….....….… 3								 skip to S7a
			Yes, but he didn’t know his HIV status……………………......……... 4								 skip to S7a
			Refuse to answer………...………...…………………………..…....… 7								 skip to S7a
			Don’t know if we discussed his HIC status…………..…………….………………………......…....... 9								 skip to S7a
S6	Of the male sex partners with whom you did not use a condom but asked about HIV status, how many were HIV-positive? Would you say . . .
			None were HIV positive..……………..……………………...……..... 1
			one or more was HIV positive.....………………………...……...…… 2
			All were HIV positive……...………..……………………….…......… 3
			Refuse to answer………...………...…………………………...…...… 7
			Don’t know…………..…………….………...……………………...... 9
S7a	During the past 12 months, where did you meet any new male [vaginal or anal] sex partner(s)? [Do not read from list. Check all that apply]
			Internet……………………………….................................….………. 1
			Phone or chat line….…...………………………………………..……. 2
			With/through friends or family.............................................................. 3
			Public or private social, meeting, or hook-up spot………………….... 4								 S7b
			Work..................…………………………………………...……..…... 5
			In school/on campus……….………………………………...……..… 6
			While traveling away from my home/community..................................7
			At this festival/event or an event like this one …………………….......8
			Other..................……………………………….……………………....9
			Refuse to answer………...……..…....………………………..........… 77
			Not applicable……......………….……...……………………….…… 88
			Don’t know……...…..…………......................................................… 99
S7b	Drop Down from (4)
			Church, social, or cultural group……………………………….….… 50
			Bar/club………………………………………………...………...….. 51
			Cruising area including adult bookstore, theater etc………………… 52
			Bath house, sex party, or sex resort……...............................…………53
			Gym or place for recreational activity…..…………………………… 54
			Shooting gallery/crack house…………………………………..…….. 55
			Private party (circuit party, rave, college, friend’s)………………….. 56
			Public area (hotel, park, restaurant, shopping mall)…………………. 57
			Other…………………………………………………………………. 58
SECTION 2.2: Sexual Behaviors – With Females (All Groups)
S10		In the past 12 months, [If B-3 = 3  add “prior to coming to this event,”] with how many different women did you have [vaginal or anal] sex? [Record number of partners 0-7500. If number of partners > 7500, enter 7500. If respondent can not remember, ask them to make their best guess].
			[Refuse to answer = 7777, Don’t know = 9999]					__ __ __ __			If 0, 7777, or 9999  skip to S18

If B-5 (S-ID) = 2 S17

S1 + S10 = TSP (Total Sex Partners)
If TSP = 0  alert to interviewer should read “You’ve indicated no male or female partners in the past 12 months, is that correct?" If 0 partners in the past 12 months  skip to section 2.4.1. If there is an error, go back to correct previous entry(ies).
If S10 > 1  skip to S12
S11	Did you have [vaginal or anal] sex with this woman without using a condom?
		No …………….........………………..…...………………………...…. 0					 skip to S16a
		Yes………...…...…………..............…………………………………. 1					 skip to S14
		Refuse to answer……........………...…………………………………. 7
		Don’t know…………...…..……………………………………..……. 9
S12	Of the [response to S10] women you had vaginal or anal sex with in the past 12 months, with how many did you have [vaginal or anal] sex without a condom?
		[Refuse to answer = 7777, Don’t know = 9999]			__ __ __ __		If 0, 7777, or 9999  skip to S16a
							If 1  skip to S14
If S12 > S10  alert to interviewer should read “The number of women with whom no condom was used is too high. Please correct this number.”
S13	Of the [response to S12] women with whom you did not use a condom, during [vaginal or anal] sex, did you ask the HIV status of none of them, One or more of them, or all of them before having sex?
		None of them ..........…………………..…..…………………………... 1					 skip to S16a
		One or more of them…..……...………………………………...…...… 2					 skip to S15
		All of them….......……………...……………………………………… 3					 skip to S15
		Refuse to answer………..………...…………..……………………..… 7					 skip to S16a
		Don’t know……………..…..…………………………………..…..…. 9					 skip to S16a
S14	Did you ask this woman her HIV status before you had sex without a condom? [Do not read choices. If respondent says yes, ask what the status of this female partner was.]
		No, we didn’t discuss HIV status...…..…...........…………………...…1					 skip to S16a
		Yes, and she said she was HIV positive..…...........................................2					 skip to S16a
		Yes, and she said she was HIV negative.….....………………….....… 3					 skip to S16a
		Yes, but she didn’t know her HIV status………………………………4					 skip to S16a
		Refuse to answer………...………...……………...............................…7					 skip to S16a
		Don’t know.............................................................................................9					 skip to S16a
S15	Of the female sex partners with whom you did not use a condom but asked about HIV status, how many were HIV-positive? Would you say . . .
		None were HIV positive..……………..……..…………………...…... 1
		One or more was HIV positive..………….…....…………………...… 2
		All were HIV positive……...……………..…...................................… 3
		Refuse to answer……..………….....………………………….........… 7
		Don’t know……………..…………………………………....……...... 9
S16a	During the past 12 months, where did you meet any new female [vaginal or anal] sex partner(s)? [Do not read from list. Check all that apply]
		Internet………………………………...…………………………...…. 1
		Phone or chat line……...……………………………………………... 2
		With/ through friends or family............................................................. 3
		Public or private social, meeting, or hook-up spot………………….... 4					 S16b
		Work.................………………………………………………...…...... 5
		In school/on campus…………………………………………...…...… 6
		While traveling away from my home/community................................ 7
		At this festival/event or an event like this one ……………………..... 8
		Other.................……………………………………………….….…... 9
		Refuse to answer………...……..…...………………………...........… 77
		Not applicable ..........…….………………………………………..… 88
		Don’t know………..…….……........................................................… 99
S16b	Drop Down from (4)
		Church, social or cultural group……..…………………….......…...... 50
		Bar/club……………………………………...………..…………...… 51
		Cruising area including adult bookstore, theater etc………………… 52
		Bath house, sex party, or sex resort…………………………………...53
		Gym or place for recreational activity.......……………………..….… 54
		Shooting gallery/crack house………………….……………………... 55
		Private party (circuit party, rave, college, friend’s)………………….. 56
		Public area (hotel, park, restaurant, shopping mall)…………………. 57
		Other............................................……...…...…………………………58
If B-5 = 1 skip to S18
S17	In the past 12 months have you had vaginal or anal sex with a man that you know had sex with another man? [Question should be asked of women only]
		No ………………...………………..…………………………...…...... 0
		Yes………...…………...……...……………………………...…..……1
		Refuse to answer………………...………………………………....…. 7
		Don’t know……………..……………….……………………..……... 9
SECTION 2.3: Sexual Behaviors – All Persons (All Groups)
If TSP = 1  skip to S19
S18	How often would you say that your sex partners in the past 12 months knew each other? Would you say always, usually, sometimes, rarely, or never?
		Always….…………...……………………………………..…………. 1
		Usually….....……………………...………………………..…....……. 2
		Sometimes…………………………………………………………….. 3
		Rarely………………………………………………………..…..……. 4
		Never…………………………………………………………..…..….. 5
		Refuse to answer……..……………...………….……………..…....… 7
		Don’t know…………...…..………………………….....................….. 9
S19	In the past 12 months, was there ever a time when you had a sexual partner while you were also in a sexual relationship with someone else?
		No.…………………...…..………………..………………………..…. 0
		Yes………...……………...……...……………………………...……. 1
		Refuse to answer…………..……...……...........................................… 7
		Don’t know…………...…..……………………………………..…..... 9
If S19 = 1 and TSP = 1  alert to interviewer should read “Please verify that during the past 12 months you had only 1 vaginal or anal sex partner.” If there is a discrepancy, correct S1 or S10 as needed.

SAY: I’m now going to ask you to describe your sex partners as either main or casual partners. By main partners, I mean partners that you have an emotional bond with and have sex with and feel committed to above anyone else, such as a boyfriend, girlfriend, or spouse. By casual partners, I mean those people who you may have sex with every now and then, but do not feel committed to or may not know very well, including one-night stands.

S20	Would you say that your sex partner or partners in the past 12 months have been only main, only casual or both main and casual partners?
		Main partner(s) only…………………………………..………..……...1
		Casual partner(s) only………………………………………..….....…..2				 skip to S22
		Both casual and main partner(s) ...…………………………..….....…..3
		Refuse to answer…………….……...…………………………..…..… 7				 skip to S23
		Don’t know……………………………………………. ……...………....... 9				 skip to S23
S21	In the past 12 months, when you had vaginal or anal sex with your main partner(s), how often was a condom used? Would you say . . . [Read all choices. Choose one]
		Always…..….……………………………………..………………...… 1
		Usually...………………………………………………..…………..… 2
		Sometimes..…………...………………………………..…………..…. 3
		Rarely……........…………………………………………..………..…. 4
		Never.………………………………...……………………..……....… 5
		Refuse to answer…………..………...………….………………......… 7
		Don’t know…………...…..………………………………….……….. 9
If S20 = 1  skip to S23
S22	In the past 12 months, when you had vaginal or anal sex with your casual partner(s), how often was a condom used? Would you say . . . [Read all choices. Choose one]
		Always…..….………………………………………….……………… 1
		Usually...………………………………..…………………………..… 2
		Sometimes..…………...………………..…………………………..…. 3
		Rarely……........…………………………..………………………..…. 4
		Never.………………………………...…..………………………....… 5
		Refuse to answer…………………...………………………..….…..… 7
		Don’t know…………...…..………………………………….……….. 9
S23	In the past 12 months, have you given money, drugs or things like food, housing or transportation to someone in exchange for sex?
		No…….…..….…………….…………………………………..……… 0
		Yes……...………………….…………………………………….….… 1
		Refuse to answer……....……………...………….………………....… 7
		Don’t know…………......…..…………………………………...…….. 9
S24	In the past 12 months, has anyone given you money, drugs or things like food, housing or transportation in exchange for sex?
		No…….…..….…………….………………………..………………… 0				If S23 = 7 or 9 and S24 = 0  skip to S26
		Yes……...………………….…………………………………..……… 1
		Refuse to answer……..……...………...………………………..…..… 7
		Don’t know…………......…..…………..………………………….….. 9
S25	When you exchanged sex for money or things, how often was a condom used? Would you say always, usually, sometimes, rarely, or never [Read all choices. Choose one]
			Always….…………...……………………………….………….……. 1
			Usually….....……………………...……………..……………...….…. 2
			Sometimes……………………………………………………...…….. 3
			Rarely…………………………………………………………...……. 4
			Never…………………………………………………………...…….. 5
			Refuse to answer…………......……...………………………….…..… 7
			Don’t know…………...…..……………………….………………….. 9
If B-5 = 1 and S1 ≠ 0  skip to S27
S26	In the past 12 months, have you had unprotected anal sex (anal sex without a condom)?
		No…….…..….…………….………………………………………..… 0
		Yes……...………………….………………………………………..… 1
		Refuse to answer……..……………...………….………………..…… 7
		Don’t know…………......…..……………………………………...….. 9
If B-5 = 1 and S11 = 1 or S12 > 0 and S26 = 0  S27 should automatically be programmed as 1 and then skip to S28
If B-5 = 1 and S10 = 0  skip to S28
S27	In the past 12 months, have you had unprotected vaginal sex (vaginal sex without a condom)?
		No…….…..….…………….………………………………..………… 0
		Yes……...………………….………………………………………..… 1
		Refuse to answer……..……………...…………...………………....… 7
		Don’t know…......…..……………………………………………...….. 9
Now, please tell me whether you have done the following in the past 12 months:
S28	Had sex with a person who uses injection drugs?
		No…….…..….…………….………………………………..………… 0
		Yes……...………………….…………………………………..……… 1
		Refuse to answer……..……………...……………………..…...…..… 7
		Don’t know…......…..………………………………………..……….. 9
S29	Had vaginal or anal sex with someone whom you had just met or did not really know?
		No…….…..….…………….…………………………………..……… 0
		Yes……...………………….………………………………………..… 1
		Refuse to answer……..……………...………….........................…..… 7
		Don’t know…......…..……………………………………...………….. 9
S30	Had vaginal or anal sex with a person who is transgender
		No…….…..….…………….………………………..………………… 0
		Yes……...………………….……………………………………….… 1
		Refuse to answer……..……………...…………...………………....… 7
		Don’t know…......…..……………………………………………...….. 9

Options:

If B-3 = 1 or 2 section 2.4

If B-3 = 3  skip to section 2.5

If B-3 = 4  skip to section 2.6

SECTION 2.4: Sexual Behaviors, Groups 1 and 2

SAY: Next, I'm going to ask you some more questions about sex. Remember that the answers you give me will be private. and that “having sex” means vaginal or anal sex. I need to ask you all the questions, even if some may not apply to your situation. [Use your discretion in using slang terms for the following sexual behavior questions.]

SECTION 2.4.1: Last Male Sex Partner

LS1

When was the last time you had anal sex with a man?

Never had sex with a man.......................…............................…..….… 1

If S10 > 0  skip to LS13 Else  skip to section 4.0

Within the past 12 months..............…...……………………............… 2

More than 12 months but less than 2 years ago..................................... 3

More than 2 years but less than 5 years ago.......…...........................… 4

More than 5 years ago…......………………..…..…………………..… 5

Refuse to answer ……...…............….…………..…………………......7

Don’t know …….............…..………....……………………………….9

LS2

When you had sex that last time with a man, did you have insertive anal sex, meaning were you the top?

No ………………...…………………..……………………….…….... 0

 skip to LS4

Yes………...…………...……...………………..…………………..… 1

Refuse to answer………….……...……………………….……......…. 7

 skip to LS4

Don’t know……………..…………………………………………...... 9

 skip to LS4

LS3

That last time that you were the top, did you use a condom all of the time?

No..................... …..…………………..…………………………….… 0

Yes........................……………...………………………………..…… 1

Refuse to answer...……………..……………………………….…...... 7

Don’t know...........…..………….………...………………….….…..…9

LS4

When you had sex that last time with a man, did you have receptive anal sex, meaning were you the bottom?

No ………………...…………………..…….…………………….…... 0

 skip to LS7

Yes………...…………...…….....………………..…………………… 1

Refuse to answer…………………...……………………………....…. 7

 skip to LS7

Don’t know……………..…...………………………………………... 9

 skip to LS7

If LS2 and LS4 = 0  alert to interviewer should read “You reported neither insertive nor receptive anal sex with your last sex partner. Please revise one response.”

LS5

That last time that you were the bottom, did your partner use a condom all of the time?

No..................... …..…………………..………………….…………… 0

Yes........................……………...………………………………..…… 1

Refuse to answer...……………..…..………………………………..... 7

Don’t know...........…..………….………...........................…..……..…9

SAY: Now I will ask you about your relationship with your last male sex partner. Remember, I want you to consider that a main partner is someone you feel committed to above anyone else and a casual partner is someone you do not feel committed to above anyone else,

LS7

Would you describe the last man you had sex with as a main partner, or a casual partner [Choose one]

Main partner..……..…………………..………….…………………… 1

Casual partner.......……………...………………..…………………… 2

Refuse to answer...……………..………………..…………………..... 7

 skip to section 2.4.2

Don’t know...........…..………….………...……………………..…..…9

 skip to section 2.4.2

LS8

The last time you had sex with this [response to LS7] partner, what was his HIV status? [Choose one]

HIV negative…........…………………..……………………...….…… 1

HIV positive…......……………...………………………………..…… 2

Uncertain .......………...……………….…...…………………...…..… 3

Refuse to answer....…………..…..……………………………...…..... 7

Don’t know............…..……..…….………...…………………...…..…9

LS9

As far as you know, when you were having a sexual relationship with this partner, did he have sex with other people? Would you say he . . . [Read all choices. Choose one]

Definitely did not.....…………………..……………………………… 1

Probably did not....……………...………………………………..…… 2

Probably did...………...…………………...………………………..… 3

Definitely did………...……………………………………………….. 4

Refuse to answer...……………..………………………………..…..... 7

Don’t know...........…..………….………...………………….……...…9

LS10

At the time you were having sex with this [response to LS7] partner, were you also in a sexual relationship with any other persons?

No ………………...…………………..…………………….…….…... 0

 skip to LS13

Yes………...…………...……...……………………………………… 1

Refuse to answer………………...……………...............................….. 7

 skip to LS13

Don’t know……………..………………………….............................. 9

 skip to LS13

LS11

When you had sex with other people during this period, who were you having sex with? Were they. . . [Read all choices. Choose one]

Male partners.………………………………………………………… 1

Female partners.....……………………………………………….…… 2

Male and female partners……………..…………………….………… 3

Other partners.....……...………………….………………….………... 4

Refuse to answer………….………...…….…………………….…..… 7

Don’t know…………...…..…………………………………….…….. 9

If LS11 = 2 and S10 = 0  alert to interviewer should read “You reported 0 female partners during the past 12 months, is that correct?” If there is a discrepancy, correct LS11 or S10 as needed.

SAY: You mentioned a time when you had at least one sex partner while you were also in a sexual relationship with someone else

LS12

When you had vaginal or anal sex with these [response to LS11] during this period, was a condom used always, usually, sometimes, rarely, or never? [Read all choices. Choose one]

Always….…………...…………………..…………………….……….1

Usually….....…………………...……...…………………….…..……. 2

Sometimes…………………………...……………………………….. 3

Rarely……………………………………………………….………… 4

Never……….....……………………………..……………………….. 5

Refuse to answer…..………………...……………………………...… 7

Don’t know……….…...…..……………………………………….…. 9

SECTION 2.4.2: Last Female Sex Partner

If S10 > 0  complete LS13 and LS14; If not  skip to LS17 If S26 and S27 = 0  skip to LS14

LS13

When you last had vaginal or anal sex with a female, was a condom used always, usually, sometimes, rarely, or never? [Read all choices. Choose one]

Always….…………...…….……………..…………………………….1

Usually….....………………............……...………………….……….. 2

Sometimes…………………………...……………………………….. 3

Rarely……………………………………………………………….… 4

Never……………………….………………..……………………….. 5

Refuse to answer…………..………...……………………………..… 7

Don’t know…………...…...………………………………….………. 9

LS14

As far as you know, when you were having a sexual relationship with your last female partner, did she have sex with other people? Would you say she: [Read all choices. Choose one]

Definitely did not.....…………………………………..……………… 1

Probably did not....……………...………………..…………………… 2

Probably did...………...…………………...………………………..… 3

Definitely did………...……………………………………………….. 4

Refuse to answer...…....…..….......…...……………………………..... 7

Don’t know...........…..…..………...……...…………………..……..…9

If TSP = 2 and either LS11 = 2 or LS1 = 0  skip to section 2.4.3

LS15

At the time you were having sex with your last female partner, were you also in a sexual relationship with any other persons?

No ………………...…………………..…….………………….……... 0

 skip to section 3.0

Yes………...…………...……...……………..…..…………………… 1

Refuse to answer………………...……………………………........…. 7

 skip to section 3.0

Don’t know……………..…………………………………………….. 9

 skip to section 3.0

SECTION 2.4.3: Race/Ethnicity of Sexual Partner

LS17

In general, how would you describe the race and ethnicity of your male sex partners in the past 12 months? Would you say that your male partners were . . . [Read all choices. Choose one]

Always the same race or ethnicity as yourself.....………………..…… 1

Usually the same race or ethnicity as yourself…..….........................… 2

Sometimes the same race or ethnicity as yourself.........................….... 3

Never the same race or ethnicity as yourself.…................................… 4

Refuse to answer………...…………....………………..…................…7

Not applicable………..…………...……...…….......………………..…8

Don’t know………..………...……...................................................… 9

Options: If B-3 = 3  section 2.5 If B-3 = 1 or 2  skip to section 3.0 If B-3 = 4  skip to section 2.6

SECTION 2.5: Sexual Behaviors, Group 3

SAY: Next, I'm going to ask you some questions about having sex at this event. Please do not consider any sex prior to this event in your responses. Remember that the answers you give me will be private. For these questions, “having sex” means vaginal sex (penis in the vagina) or anal sex (penis in the anus or butt). I need to ask you all the questions, even if some may not apply to your situation. [Use your discretion in using slang terms for the following sexual behavior questions.]

If B-5 = 1  question format in 2.5.1 will be “anal sex”

If B-5 = 2  question format in 2.5.1 will be “vaginal or anal sex”

SECTION 2.5.1: Male Sex Partners at Current Event

If S0a = 1  skip to section 2.5.2

CE0

How many days have you been at this event?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

CE1

During this event, with how many different men have you had [vaginal or anal] sex?

[Record number of partners 0-999. If number of partners > 999, enter 999]

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

If = 0  skip to CE12 if >1  skip to CE3

CE2

Did you have [vaginal or anal] sex with this man at the current event without using a condom at any time?

No.…………………...…………………..……………………………. 0

Yes………...……………………...……………..……………………. 1

Refuse to answer…………………...…………...…………………..… 7

Don’t know…………...…..…………………….…………………….. 9

CE3

Of the [response to CE1] [man/men] you had sex with at the current event, with how many did you have [vaginal or anal] sex without a condom?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

CE4

How would you classify the [man/men] you had [vaginal or anal] sex with at the current event: [Read all choices. Choose one]

Student(s) only……………………...……………………….….…..… 1

Non-students(s) only………………...………………………….…..… 2

Both student(s) and non-student(s)…………......…………………..… 3

Refuse to answer…………………...…………...…………………..… 7

Don’t know…………...…..…………………….…………………….. 9

CE5

[Was/were] the [man/men] you had [vaginal or anal] sex with at the current event: [Read all choices. Choose one]

Younger than you................................................................................... 1

The same age or a few years older than you..…………………..…..… 2

3 to 5 years older than you ….………………………………….…..… 3

More than 5 years older than you......................................................… 4

Some older or the same age as you and some younger……………….. 5

Refuse to answer…………………...………….……………………… 7

Don’t know…………...…..………………….……………………….. 9

If CE1 >1  skip to CE8

SECTION 2.5.2: First-time Male Sex Partners at Current Event

SAY: I will now ask you about your first-time male [vaginal or anal] sex partners during this event. This includes partners you met for the first time during the event and partners you already knew but had sex with for the first time during this event.

CE6

With regard to the male partner you had sex with during this event, was this the first time you had sex with him?

No.…………………...…………………..…………………….……. 0

 skip to CE11

Yes………...……………………...……………………..……..……. 1

Refuse to answer……………..……...………………………..…..… 7

Don’t know…..………………..………………………………………….. 9

CE7a

Did you meet him for the first time during this event?

No.…………………...…………………..………………….………. 0

 skip to CE11

Yes………...………………………………….....……………..……. 1

Refuse to answer…………………...…………………….….…....… 7

Don’t know……..………………..……………………………………….. 9

CE7b

Did you discuss both your HIV status and your partner’s HIV status before you had sex?

No.…………………...…………………..………………….………. 0

 skip to CE11

Yes………...……………………...……………..………………..…. 1

 skip to CE11

Refuse to answer…………………...………..………………..…..… 7

 skip to CE11

Don’t know…………......…..………………..…………………..….. 9

 skip to CE11

CE8

Of the [response to CE1] men you had [vaginal or anal] sex with during this event, with how many did you have sex for the first time during this event?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

CE9

How many of your [response to CE8] new male sex partners did you meet for the first time during this event?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

If CE8 = 0  skip to section 2.5.2

CE10

With how many of your [response to CE8] first-time male sex partners at this event did you discuss both your HIV status and your partner’s HIV status before you had sex?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

If 0 skip to section 2.5.2

CE11

What was the HIV status of your first-time male sex partner(s) at this event? [Choose only one)]

None were HIV positive…………………………………………..… 1

At least one was HIV-positive………………..………………….…. 2

All were HIV positive...………………………………………..…… 3

If B-5 (S-ID) = 2 S17

Refuse to answer………………………………………………..…... 7

Don’t know………………………….………….………………..….. 9

SECTION 2.5.3: Female Sex Partners at Current Event

If B-5 = 2 and CE1 > 0  skip to CE23

CE12

During this event, with how many different women have you had [vaginal or anal] sex?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

If > 1 skip to CE14

If CE12 = 0 and CE1 > 0  skip to CE23

If CE1 + CE12 = 0,  skip to section 3.0

CE13

Did you have [vaginal or anal] sex with this woman at the current event without using a condom?

No.…………………...…………………..……………………….…. 0

 skip to CE15

Yes………...……………………...……………..………………..…. 1

 skip to CE15

Refuse to answer…………………...………….……………….....… 7

 skip to CE15

Don’t know…………...…..…………………………………..….….. 9

 skip to CE15

CE14

Of the [response to CE12] women you had sex with at this event, with how many did you have [vaginal or anal] sex without a condom?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

CE15

[Was/Were] the [woman/women] you had [vaginal or anal] sex with at the current event . . . [Read all choices. Choose one]

Student(s) only……………………...……….………………..…..… 1

Non-students(s) only………………...………………………..…..… 2

Both student(s) and non-student(s)…..…….………………....…..… 3

Refuse to answer…………………........................………..….…..… 7

Don’t know…………...…..……………….……………………..….. 9

CE16

[Was/Were] the [woman/women] you had [vaginal or anal] sex with at the current event . . . [Read all choices. Choose one]

Younger than you................................................................................ 1

The same age or a few years older than you..….………………....… 2

3 to 5 years older than you ….………………………………..…..… 3

More than 5 years older than you................................................... … 4

Some older or the same age as you and some younger……………... 5

Refuse to answer…………………...………….………………...….. 7

Don’t know…………...…..……………………………………...….. 9

If CE12 > 1  skip to CE19

SECTION 2.5.4: First-time Female Sex Partners at Current Event
SAY: I will now ask you about your first-time female [vaginal or anal] sex partners during this event. This includes partners you met for the first time during the event and partners you already knew but hadn’t had sex with for the first time during this event.
CE17		With regard to the female partner you had sex with during this event, was this the first time you had sex with her?
				No.…………………...…………………..……………………….…. 0					 skip to CE22
				Yes………...……………………...……………..………………….. 1
				Refuse to answer…………………...………….….........................… 7
				Don’t know……..………………..………………………………………. 9
CE18a		Did you meet her for the first time during this event?
				No.…………………...…………………..……………….…………. 0					 skip to CE22
				Yes………...……………………...…………………….……..……. 1
				Refuse to answer…………………...…………………….….…....… 7
				Don’t know……..………………..………………………………………. 9
CE18b			Did you discuss both your HIV status and your partner’s HIV status before you had sex?
				No.…………………...…………………..………………………….. 0					 skip to CE22
				Yes………...……………………...……………..………………….. 1					 skip to CE22
				Refuse to answer…………………...………..….…..………………. 7					 skip to CE22
				Don’t know...........………………...………...….…..………………. 9					 skip to CE22
CE19	Of the [response to CE12] women you had [vaginal or anal] sex with during this event, with how many did you have [vaginal or anal] sex for the first time during this event?
				[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __
CE20	How many of your [response to CE19] new female [vaginal or anal] sex partners did you meet for the first time during this event?
				[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __
CE21	With how many of your [response to CE19] first-time female [vaginal or anal] sex partners at this event did you discuss both your HIV status and your partner’s HIV status before you had sex?
				[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __					If 0  skip to options box after CE23
CE22	What was the HIV status of your first-time female [vaginal or anal] sex partners at this event? [Choose only one,]
				None were HIV positive………………………………………….… 1
				At least one was HIV-positive………………..………………….…. 2
				All were HIV positive...…………………………………………..… 3
				Partner(s) didn’t know HIV status...….………………………………..…… 4
				Refuse to answer………………………………………………..…... 7
				Don’t know………………………….………….……………….….. 9
SECTION 2.5.5: Impulsive Sex
CE23	Did you have [vaginal or anal] sex with anyone at this event on impulse or on the spur of the moment?
				No.…………………...…………………..……………….…………. 0
				Yes………...……………………...…………………………...……. 1
				Refused to answer…………………...………………….…….…..… 7
				Don’t know…………...…..…………………….……………….….. 9

Options:

If B-3 = 4  section 2.6

If B-3 = 1, 2, or 3  skip to section 3.0

SECTION 2.6: Sexual Behaviors, Group 4
SAY: Next, I'm going to ask you some more questions about having vaginal or anal sex. Remember that the answers you give me will be private. For these questions, “having sex” means vaginal or anal sex. I need to ask you all the questions, even if some may not apply to your situation. [Use your discretion in using slang terms for the following sexual behavior questions.]
If S20 = 2  skip to SAY box before AS15 If TSP = 1 and S20 = 1  skip to AS3b

SECTION 2.6.1: Respondents with Main Sex Partners
AS1	SAY: Earlier you said you had [TSP] partners in the past 12 months. Of the [TSP] partners you had vaginal or anal sex with, how many were main sex partners? Remember, by main partners we mean partners that you have an emotional bond with and have sex with and feel committed to above anyone else, such as a boyfriend, girlfriend or spouse [Record number of partners 0-7500. If number of partners > 7500, enter 7500. If respondent can not remember, ask them to make their best guess.]
		[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __	If 0, 7777, or 9999,  skip to AS15
If AS1 > TSP alert to interviewer should read “Earlier you said you had [TSP] partners in the past 12 months. Please give me a number less than [TSP].”

SAY: Now I’m going to ask you about the last main sex partner that you had vaginal or anal sex with.

AS2

Was the last main sex partner that you had sex with a male, female, or transgender?

Male………………….………………………………………..…….....1

Female…………………………………………………………..……..2

Transgender………….………………………………………..….........3

Refuse to answer….………….……...…………………………....……7

 skip to AS5

Don’t know……..……...…..…………………………..........................9

 skip to AS5

If AS2 = 1  use “him”; If AS2 = 2  use “her”; If AS2 = 3, 7, or 9 use “them” in AS8, AS9, AS12

AS3

Are you still sexually active with this [response to AS2] sex partner?

No.…………………...…………………..……………...………….…. 0

Use past tense for AS4, AS11, and AS12

Yes………...……………………...……………..……………..……... 1

Use present tense for AS4, AS11, and AS12

Refuse to answer…………………...………….……………..…......… 7

 skip to AS7

Don’t know…………...…..…………………….…...………………... 9

 skip to AS7

AS4

For how long [were you / have you been] sexually involved with this main partner? [Do not read choices. Choose option that best matches response.]

Less than 1 week.……....…………………………..…...………….…. 1

≥ 1 week but < 1 month…………...…………………………..…...…. 2

≥1 month but < 4 months………….…………………...……..………. 3

≥ 4 months but < 1year....……………………..……………..……...... 4

≥1 year but < 3 years………………..……………………………..…. 5

3 years or more…….………………………………………………..… 6

Refuse to answer……...……………...………….……………......…... 7

 skip to AS7

Don’t know…………...…..………………………………...……….... 9

 skip to AS5

AS5

During the past 12 months, how often did you have sex with this main partner? [If respondent can’t remember, ask them to make their best guess. Do not read choices. Choose option that best matches response.]

If respondent gives only a number ……….……………………...…… 1

 AS6

One or more times a day……….………………………………...…… 2

 skip to AS7

3 to 4 times a week…...….…………………...…………….……....… 3

 skip to AS7

1 to 2 times a week………………………..……………….....……..… 4

 skip to AS7

1 to 3 times a month……….…………...…….……………...……...… 5

 skip to AS7

A few times a year……………………...…….…………………….… 6

 skip to AS7

Refuse to answer…………………......……….………………….....… 7

 skip to AS7

Don’t know……..……...…..……………………………………...….. 9

 skip to AS7

AS6

Write number of sex intercourse events here __ __ __ __

IF TSP = 1  skip to AS9 or if S26 = 0  skip to AS8

AS7

During the past 12 months, have you had unprotected vaginal sex, unprotected anal sex, or both unprotected anal and vaginal sex with this main partner?

No.…………………...……….......……..……..…...…………………. 0

Yes………...……………………...……........…………...…..…….…. 1

Refuse to answer…………………...…............……………....…….… 7

Don’t know…………...…..…………………………………..…...….. 9

AS8

Did you ask this last main partner their HIV status before you had sex with [him/her/them] the first time?

No.…………………...……….......……..……..……………...…....…. 0

Yes………...……………………...……........………..…………....…. 1

Refuse to answer…………………...…............……….…………....… 7

Don’t know…………...…..……………...………………………..….. 9

AS9

Did this main partner ask you about your HIV status before you had sex with [him/her/them] the first time?

No.…………………...……….......……..……………..…………..…. 0

Yes………...……………………...……........................……..…....…. 1

Refuse to answer…………………...…............……………….…....… 7

Don’t know…………...…..……………...………………………..….. 9

AS10

When you last had vaginal or anal sex with this main partner was a condom used none of the time, some of the time, or the whole time? [Choose one]

None of the time……………………….......…………..…………..…. 1

Some of the time………………………………........…..…………..… 2

The whole time……………………………….........…………….....… 3

Refuse to answer…………….........……...………….…………......… 7

Don’t know…………...…..……………………………….............….. 9

AS11

As far as you know, when you were having a sexual relationship with this main sex partner, did [they have/have they had] sex with other people? Would you say they . . . [Read all choices. Choose one]

Definitely did not.....…………………..……………………………… 1

 skip to AS13

Probably did not....……………...………………..………………....… 2

 skip to AS13

Probably did...………...…………………...………………….…….… 3

Definitely did………...……………………………………….…..…... 4

Refuse to answer..…………………..…...…………………...……..… 7

Don’t know ……...……………..…………………….……..…..…..... 9

AS12

Since you first started having sex with this main partner [did you ask/ have you asked] [him/her/them] to be tested for HIV?

No.…………………...……………………………..…………………. 0

Yes………...……………………...................……………..…..…..…. 1

Refuse to answer………………….....................…………………...… 7

Don’t know ………………….....…...…………….…………..…….... 9

If S19 = 0  skip to SAY box before AS15 If TSP = 1  skip to end of section 2.6.1

AS13

At the time you were having sex with this main partner, were you also in a sexual relationship with anyone else?

No.…………………...…………….......……..………...……………... 0

 skip to section 2.6.2

Yes……….……………………...…..………………...……................ 1

Refuse to answer…………………...…………………..….…...….….. 7

 skip to section 2.6.2

Don’t know…………...…..……..........………………………...…….. 9

 skip to section 2.6.2

AS14

When you were having vaginal or anal sex with this “someone else” who was not your main partner, was a condom used none of the time, some of the time, or the whole time? [Choose one]

None of the time..........................………………………………...…… 1

Some of the time……….........…………………………………….….. 2

The whole time……………….........……………………………...….. 3

Refuse to answer……….........…………...……...….…………….…... 7

Don’t know…………...…..……..........……….……………………… 9

SECTION 2.6.2: Respondents with Casual Sex Partners

If S20 ≠ 1  section 2.6.2 If S20 = 1  skip to section 3.0

SAY: Now we are still talking about behavior that took place during the past 12 months, but I will now ask you about the last casual partner you had vaginal or anal sex with. By casual partners, I mean those people who you have sex with, but do not feel committed to or may not know very well, including one-night stands. Also please remember that we are defining vaginal sex as penis in the vagina and anal sex as penis in the anus (butt).

If TSP = 1 and S20 = 2  skip to AS17

AS15

Of the [TSP] partners you had vaginal or anal sex with in the past 12 months, how many would you describe as casual sex partners? [Record number of partners 0-7500. If number of partners > 7500, enter 7500. If respondent can not remember, ask them to make their best guess.]

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

If 0, 7777, or 9999,  skip to section 3.0

If AS15 + AS1 > TSP alert to interviewer should read “Earlier you said you had [TSP] partners in the past 12 months. Please give me a number less than [TSP – AS1].”

SAY: The next few questions are about your last casual sex partner

AS16

Was the last casual sex partner that you had vaginal or anal sex with a male, female, or transgender?

Male…………………………………………..……………...……....1

Female………………………………………..…...……………...….2

Transgender………………………………………………...…..…....3

Refuse to answer…………….……...……………………………..…7

Don’t know…………...…..……………………………………..….. 9

If AS16 = 1  use “him”; If AS16 = 2  use “her”; If AS16 = 3, 7, or 9 use “them” in AS28

AS17

Are you still sexually active with your last casual sex partner?

No.…...………………...………………..………..…………………. 0

 use past tense for AS27 and AS28

Yes………...……………………...………....................……………. 1

 use present tense for AS27 and AS28

Refuse to answer…………………...…...…….…..………………… 7

Don’t know…………...…..…………………………………………. 9

AS18

For how long [were you /have you been] sexually involved with this casual partner? [Do not read choices. Choose option that best matches response]

Less than 1 week.……....…………………………………...………. 1

≥ 1 week but < 1 month…………...………………………………… 2

≥1 month but < 4 months………….…………………………...…… 3

≥ 4 months but < 1year....………………………….....……………... 4

≥1 year but < 3 years………………..………………………………. 5

3 years or more…….………………………………...……………… 6

Refuse to answer……...……………...……………………....….….. 7

Don’t know…………......…..……………………………………….. 9

AS19

During the past 12 months, how often did you have sex with this casual partner? [If respondent can’t remember, ask them to make their best guess. Do not read choices. Choose option that best matches response.]

If respondent gives only a number ……….….…………………...… 1

 AS20

One or more times a day……….……………………………..…..… 2

 skip to AS21

3 to 4 times a week………………………………………………..… 3

 skip to AS21

1 to 2 times a week………………………………………..….…..… 4

 skip to AS21

1 to 3 times a month………….………………………..………….… 5

 skip to AS21

A few times a year………………………………….…...………..… 6

 skip to AS21

Refuse to answer…………………………………...……………..… 7

 skip to AS21

Don’t know………………………………………….………..…….. 9

 skip to AS21

AS20

Write number of sex intercourse events here __ __ __ __

AS21

Did you meet and have sex with this last casual partner for the first time within the past 12 months?

No.…………………...…………………..………….………………. 0

Yes…...….....……………………..…………………………...……. 1

Refuse to answer…………………...…….…………………...…..… 7

Don’t know…………...…..……………………………………........ 9

If TSP = 1  skip to AS23

AS22

Where did you meet this last casual sex partner? [Do not read choices. Choose one]

Internet………………………………...……................................…. 1

Phone or chat line……...…………………………………….…..…. 2

With/ through friends or family.......................................................... 3

Public or private social, meeting, or hook-up spot………………..... 4

 to AS22b

Work.................……………………………………………….…..... 5

In school/on campus…………...…………………........................… 6

While traveling away from my home/community...............................7

Related to or at a festival /event..........................................................8

Other.................……………………………………………….….... 66

Refuse to answer………...……..…....……..................................… 77

Not applicable……...………….……...…….………………..…..… 88

Don’t know………..…………......................................................… 99

AS22b

Drop Down from (4)

Church, social or cultural group……….………….……………..… 50

Bar/club…………………………………………....…………….… 51

Cruising area including adult bookstore, theater etc……………..... 52

Bath house/sex party/sex resort…………...……….……………..…53

Gym or place for recreational activity…………………………...… 54

Shooting gallery/crack house……………………..……………....... 55

Private party (circuit party, rave, college, friend’s)……………....... 56

Public area (hotel, park, restaurant, shopping mall)…………….…. 57

If TSP = 1  skip to AS25 Or If S26 = 0  skip to AS24

AS23

Have you had unprotected anal intercourse (sex with no condom) with this last casual partner in the past 12 months?

No.…………………...…………………….…..………………...…. 0

Yes………...……………………...………….…….………….……. 1

Refuse to answer…………………...……………………..….…..… 7

Don’t know…………...…..…………………………………......….. 9

AS24

Did you ask this last casual partner about their HIV status before you had sex with them the first time?

No.…………………...………………………...… ………………. 0

Yes……….……………………...…………….……................……. 1

Refuse to answer…………………...………………….……….....… 7

Don’t know…………...…..……………...……………………...….. 9

AS25

Did this last casual partner ask you about your HIV status before you had sex the first time?

No.…………………...………………………......…………………. 0

Yes………...……………………...……………………………...…. 1

Refuse to answer…………………...………….………………....… 7

Don’t know…………...…..………………………...……………..... 9

AS26

When you last had vaginal or anal sex with this last casual partner was a condom used none of the time, some of the time, or the whole time? [Choose one]

None of the time……………………….........…………………...…. 1

Some of the time……………………………..…........…………...… 2

The whole time………………………….…….........………...…..… 3

Refuse to answer…………….........………..……………………..… 7

Don’t know…………...…..……………….……….....................….. 9

AS27

As far as you know, during your sexual relationship with this last casual sex partner, [did they have/have they had] sex with other people? Would you say they . . . [Read all choices. Choose one]

Definitely did not.....………………………....…………………...… 1

Probably did not....……………...……………….……………..…… 2

Probably did...………...………………………....………………..… 3

Definitely did………...………………………….….…………...….. 4

Refuse to answer..…………………..……………..……………...… 7

Don’t know ……...……………..……………………………...….... 9

AS28

Since you first started having sex with this last casual partner [did you ask/have you asked] [him/her/them] to be tested for HIV?

No.…………………...………………………...……………………. 0

Yes………...……………………...………………..………….……. 1

Refuse to answer…………………...……………………………..… 7

Don’t know…………...…..…………………………………......….. 9

If S19 = 0 or TSP = 1  SKIP to section 3.0

AS29

During the time you were having a sexual relationship with this last casual partner, did you have sex with anyone else?

No.…………………...……………....................……..……………. 0

Yes……….……………………...…..………….……..………......... 1

Refused to answer…………………...…………………….……...… 7

Don’t know…………...…..…………..………………….……...….. 9

SECTION 3.0: Drug Use (All Groups)

If S0a = 6 or TSP = 0  skip to SAY Box before D9

SAY: The next questions are about drug use [If B-3 = 3 add “prior to coming to this event”]. Please remember that your name is not attached to this and what you tell me is confidential.

If TSP = 1 then use “partner” in D1, otherwise use “partners.”

D1

In the past 12 months, [If B-3 = 3 add “again, not including the time here at this event”], before or during sex with your partner(s) did you use . . . [Read all choices. Choose one]

Alcohol only...……...……..…………...…..……..................……... 1

Drugs only.....…………...……...…………...........…………...…… 2

 skip to D3

Both alcohol and drugs……………...........……..……………...….. 3

Neither alcohol nor drugs…….........………….………………........ 4

 skip to options box after D13

Refuse to answer…….............…..……….....…………...............…. 7

 skip to options box after D13

Don’t know…………..…..……............…….……………………... 9

 skip to options box after D13

D2

In the past 12 months, how often did you drink alcohol right before or during sex? [Read all choices. Choose one]

Always….…………...…………………..……………………..…….1

Usually….....…………………...……...………..……………….…. 2

Sometimes…....………………………...…………………………... 3

Rarely……………....…………………………………………….… 4

Never………………………………………..………………..…….. 5

Refuse to answer…………………...………………………...…..… 7

Don’t know…………...…..………………………………..………. 9

If D1 = 1  skip to D4

SAY: Now I'm going to ask you about recreational drugs (or drugs that were not prescribed for you) that you may have used but did not inject. I'll refer to these as non-injection drugs. Please remember that your answers are confidential.

D3

In the past 12 months, did you use marijuana right before or during sex?

No ………………...……………………………...…………….…... 0

Yes………...…………...……...……………………..……..…….… 1

Refuse to answer………………...……………………...…..........…. 7

Don’t know……………..……………………………..…………..... 9

D4

In the past 12 months how often did you use Viagra, Cialis, or Levitra right before or during [vaginal or anal] sex? [Read all Choices. Choose one]

Always….…………...…………………..……………………….….1

Usually….....…………………...……...………..……………….…. 2

Sometimes………...…………………...………………………..….. 3

Rarely ……………………...…………………………………….… 4

Never………………………………………..…………………..….. 5

Refuse to answer…………………...………………………...…..… 7

Don’t know…………...…..……………………………………..…. 9

If D1 = 1  skip to SAY box before T1

D5

In the past 12 months, did you use any other non-injection drugs?

No ………………...…………………..…………………………..... 0

 skip to SAY box after D8

Yes………...…………...……...…………………………..…...…… 1

Refuse to answer………………...………………………….........…. 7

 skip to SAY box after D8

Don’t know……………..……………………………………....…... 9

 skip to SAY box after D8

D6

In the past 12 months, did you use any of the following non-injection drugs right before or during sex? [Read all choices. Choose all that apply]

Crystal meth (tina, crank, or ice) …..……………………….......…...1

Powdered cocaine ……………..…………………..………..…..…...2

Crack cocaine …………….………………................................……3

Heroin ………………...…………………….…..………….........….4

Speedballs [explain if needed]…...………………...…...……...……5

Oxycontin …………..………............................………...……...…...6

None of the above………………………......…………………....…..0

D7

In the past 12 months, did you use any other drug right before or during sex?

No ………………...…………………..………………..…………... 0

Yes………...…………...……...…………………………….....…… 1

Refuse to answer…..……………...……………...........................…. 7

 skip to SAY box after D8

Don’t know……….……..…………………….………………..…... 9

 skip to SAY box after D8

D8

What is the name of this or any other drug?

Drug name: ____________________________________

SAY: The next few questions are about shooting up or injecting drugs in the past 12 months. [If B-3 = 3  add “prior to coming to this event.”]

D9

In the past 12 months have you injected any drugs that were not prescribed for you?

No ………………...…………………..……………………......…... 0

 skip to options box after D14

Yes………...…………...……...……………………………..…...… 1

Refuse to answer………………...…………….............................…. 7

 skip to options box after D14

Don’t know……………..……………………………………..…..... 9

 skip to options box after D14

D10

In the past 12 months, did you inject any of the following drugs? [Read all choices. Choose all that apply]

Crystal meth (tina, crank, or ice) …..…...….………………..……... 1

Powdered cocaine ……………..……………..…..……………….....2

Crack cocaine …………….………………................................……3

Heroin ………………...…………..…………..............................….4

Speedballs [explain if needed]…...……...……..........................……5

Oxycontin ……………..…..…………………………………...…... 6

None of the above…….....……………………………………..…....0

D11

In the past 12 months, did you inject any other drug?

No ………………...…………………..……………………...……... 0

 skip to D13

Yes………...……….…...……...……………………………....…… 1

Refuse to answer…..……………...……………………………...…. 7

 skip to D13

Don’t know……….……..…………………………………..….…... 9

 skip to D13

D12

What is the name of this and any other drug?

Drug name: ____________________________________

Refuse to answer…..……………...….………………..………....…. 7

Don’t know……….……..…………………………...……………... 9

D13

When you injected drugs in the past 12 months, how often did you use a needle or syringe that someone else had already used? [Read all choices. ]

Always….…………...…………………..…………..…………………1

Usually….....…………………...……...………..………………..…… 2

Sometimes………....………………...……………………………...... 3

Rarely……………....……………………………….…………….…... 4

Never………………………………………..…………………..……. 5

 skip to options box after D14

Refuse to answer…………………...………………………...……...... 7

 skip to options box after D14

Don’t know…………...…..………………………...………………… 9

 skip to options box after D14

D14

In the past 12 months When you injected drugs using a needle or syringe that someone else had already used, how often did you use bleach to clean the needle? [Read all choices. Choose one]

Always….…………...…………………..…………………..…………1

Usually….....…………………...……...……….……………...……… 2

Sometimes………....………………...…………….…………………. 3

Rarely……………....………………………………………….….….. 4

Never………………………………………..………………………... 5

Refuse to answer…………………...……………...……………...….. 7

Don’t know…………...…..………………………..…………….…… 9

Options:

If B-3 = 1 or 2 skip to section 4.0

If B-3 = 3 section 3.1

If B-3 = 4 skip to section 4.0

If CE1 + CE12 = 0  skip to section 4.0

SECTION 3.1: Drug Use During Spring Break Event (Group 3)
SAY: The next questions are about alcohol and drug use during this event that took place before or during vaginal or anal sex. When I say drugs, I mean recreational drugs or substances that were not prescribed for you, including steroids and hormones.
BD1	Before or during sex with your sex partner(s) at this event, did you use . . . [Read all choices. Choose one]
		Alcohol only...……...………………..………………………….…... 1
		Drugs only.....…………...……...…………….......……………….… 2
		Both alcohol and drugs………………………………………….….. 3
		Neither alcohol nor drugs………………………………………....... 4		 skip to section 4.0
		Refuse to answer………..………...…………...............................…. 7		 skip to section 4.0
		Don’t know…………..…..………………………............................. 9		 skip to section 4.0
SAY: The next few questions are about recreational drugs you may have used but did not inject. This includes poppers. I'll refer to these as non-injection drugs.
BD2	During this event, how often did you use Viagra, Cialis, or Levitra right before or during [vaginal or anal] sex? [Read all choices.]
		Always…………………………………………………….……...… 1
		Usually.............…………………………..………………….….…... 2
		Sometimes.................……………………………………….…...….. 3
		Rarely or occasionally..…………………..….……………….…....... 4
		Never……………………………………..…….………………........ 5
		Refuse to answer..…………………..…….………………................ 7
		Don’t know..………………...…………..…………………..…........ 9
If BD1 = 1  skip to SAY Box before T1
BD3	At this event, did you use any other non-injection drugs right before or during sex?
		No ………………...…………………..……………………………... 0		 skip to BD7
		Yes………...…………...……...………………………………..…… 1
		Refused to answer………………...……………………………....…. 7		 skip to BD7
		Don’t know..………………...…………..…………………..…......... 9		 skip to BD7
BD4	At this event, did you use any of the following drugs right before or during sex?
		Crystal meth (tina, crank, or ice) …..………………………..…….... 1
		Speedballs ………...…………...…………………………...…..…… 2
		Heroin ………………...…………..……………………………...…. 3
		Powdered cocaine ……………..………………………………..…... 4
		Crack cocaine ……………..………………………………………..  5
		Oxycontin …………...…..…………………………………………... 6
		None of the above...……..…………………………………………...10
BD5	At this event, did you use any other drug right before or during sex?
		No ………………...……………..…………………………………... 0		 skip to BD7
		Yes………...…………...……...………………..…………………… 1
		Refused to answer………………...……………………………....…. 7		 skip to BD7
		Don’t know...........………………...……………………...……....…. 9		 skip to BD7
BD6	What is the name of this other drug?
		Drug name: ____________________________________
		Refuse to answer…..……………...….…………...........................…. 7
		Don’t know……….……..…………….……………………...……... 9
BD7	At this event, did you inject any drug right before or during sex?
		No ………………...……………..…………………………………... 0		 skip to section 4.0
		Yes………...…………...……...………………..…………………… 1
		Refused to answer………………...……………………………....…. 7		 skip to section 4.0
		Don’t know...........………………...……………………...……....…. 9		 skip to section 4.0
BD8	What is the name of this drug?
		Drug name: ____________________________________
		Refuse to answer…..……………...….…………...........................…. 7
		Don’t know……….……..…………….……………………...……... 9

SECTION 4.0: STD/HIV Testing and Diagnosis (All Groups)

SAY: Now I am going to ask you some questions about testing for sexually transmitted diseases including HIV, the virus which causes AIDS.

T1

Have you visited a doctor, nurse or other health care provider in the past 12 months?

No ………………...…………………..………………………..….... 0

 skip to T3

Yes………...…………...……...……………………………….……. 1

Refuse to answer………………...…………………………….....…. 7

 skip to T3

Don’t know……………..…………………………………………... 9

 skip to T3

T2

When you visited a health care provider in the past year, did you receive an HIV test?

No ………………...…………………..………………...……...…... 0

Yes………...…………...……...…….………………………....…… 1

 skip to T4

Refuse to answer………………...…..…………...........................…. 7

Don’t know……………..…………………………………………... 9

T3

Have you ever been tested for HIV?

No…………………………...………………………………….…... 0

 skip to T8

Yes………………..……………………………………………….... 1

Refuse to answer………………...…...…………..........................…. 7

 skip to T8

Don’t know……………..…………..………………………….….... 9

 skip to T8

T4

In the past two years, how many times have you been tested for HIV?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

T5

And in the past 12 months, how many times have you been tested for HIV?

[Refuse to answer = 7777, Don’t know = 9999] __ __ __ __

T6

When were you most recently tested for HIV? [Do not read choices. If necessary, assist respondent to identify a category]

Less than 3 months ago……….……..................……………………1

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

At least 6 months but less than 1 year ago.…..................................... 3

At least a year but less than 2 years ago.…........................................ 4

Two or more years ago....................................................................... 5

Refuse to answer……......…………………………………….…..… 7

Don’t know….…..…………...………………………………..…..... 9

T7

What was the result of your most recent HIV test? [Do not read choices. Choose one]

Negative………………….…………………………………….…… 1

Positive…………………………………………...……………….... 2

 skip to T10

Indeterminate……………………………..…………………….…... 3

Didn’t get the result of the last test…….……………………….…... 4

Refuse to answer……….………………………………………....… 7

Don’t know…...………………...……………………………..…..... 9

T8

What do you think your chances are of getting infected with HIV, would you say they are . . . [Read all choices. Choose one]

High…………..……...…………………..……………………….…. 1

Medium…....……………………...…………………………...……. 2

Low......................…………………...………………………..…..… 3

None............…………...…..……………………………….……….. 4

Refuse to answer........................….....…………………….….…..… 7

Don’t know..........…………………...……………………..……..… 9

If T6 > 0  skip to T12

If T7 = 1, 2, 3, 7, or 9  skip to T12

T9

What is the main reason you have not been tested for HIV? [Do not read choices. Probe with additional questions if necessary. Select up to 2 responses]

No risky behaviors / thought I was HIV negative............................... 1

Afraid of finding out if I have HIV......…..…………………...…….. 2

Worried who would know results (family/job/insurance)…………...3

Worried people would think I’m gay/sick/infected............................ 4

Don’t like needles………………………......…………………...….. 5

Didn’t know where to get tested……………………………..……... 6

Couldn’t get to testing locations (transport/access/hours)………….. 7

Didn’t have money or insurance to pay for the test……………….... 8

Was not offered by provider(s)…………………………………….... 9

Other……………………………………………………………..…. 10

Refuse to answer……..……………………………………….…..… 77

Don’t know ......................……..………………………….………... 99

 skip to T14

T10

Was this your first positive test?

No ………………...…………………..………………………..…....... 0

Yes………...…………...……...……………………………….……... 1

 skip to T12

Refuse to answer………………...…………………………….....…… 7

 skip to T12

Don’t know……………..…………………………………………...... 9

 skip to T12

T11

What date did you first test positive for HIV?

__ __/ __ __ __ __ (M M / Y Y Y Y )

[77/7777 = refuse to answer, 99/9999= Don’t know]

T12

Why did you decide to get your last HIV test? [Do Not read choices. Choose one]

Unprotected vaginal or anal sex ...…….....…………………….…....... 1

Wanted to see If I was definitely HIV positive ....………………….... 2

Shared needles, syringes, or works…………....................................… 3

Drug or sex partner is/was HIV-positive……...................................… 4

Because of new partner (asked me / I wanted to).…………………..... 5

Part of routine exam or check-up (including a pregnancy visit) ……... 6

Wanted to make sure I was HIV-negative…......................................... 7

Because I felt sick…………………......…………………………........ 8

Just wanted to know my status/ curious.........……………………….... 9

Partner and I tested together...............................................................  10

Other reason …………………………………………………………. 12

 T12oth

Refuse to answer………………...……………....…………………… 77

Don’t know……………..…………………………............................. 99

T12oth

Other reason (specify):______________________________________________

T13a

If T7 = 1  When you got tested on [response to T11], where did you get tested? If T7 ≠ 1  When you got tested last, where did you get tested? [Do not read choices. Choose one]

Outreach /mobile unit/.................................................... 1

Community health center/ counseling and testing site….. 2

Needle exchange or drug treatment program……….…………......….. 3

Public health clinic/ health dept/ STD/HIV/AIDS clinic…………....... 4

Family planning or prenatal/obstetrics clinic............................………. 5

Hospital or emergency room…………………………………….……. 6

Private doctor’s office (including HMO) ……………………...…...... 7

Correctional facility (jail or prison) ……………………………...…... 8

Blood bank/plasma center………………………………...……..……. 9

Military facility...……………………………………………......…… 10

At home………………………………………………………….…... 11

Faith based institution …………………………………………...... 12

Other location...……………………………………………..……...... 13

 T13oth

Refuse to answer………………...……………………………....…… 77

Don’t know……………..………………………………………......... 99

T13b

Other location (specify):____________________________________________

T14

In the past 12 months has a doctor, nurse or other health care provider told you that you have any of the following sexually transmitted disease or STDs . . . [Read all choices. Choose all that apply]

Syphilis…………...…………………..………………………...…...... 1

Herpes (HSV)..………...……...………………..………………...…... 2

Gonorrhea (clap or drip)...…….....……………..………………...…... 3

Chlamydia …...………...……...………………..………………...…... 4

Hepatitis B …...………...……...…………………..…..……………... 5

Genital warts or HPV...............………………………..………….….. 6

Trichomoniasis ………...……...…………………..…..………...…… 7

If B-5 = 1  don’t read

None of the these……..…………………………………………….....0

T15

Any other STDs?

No ………………...…………………..………………………...…...... 0

 skip to T17

Yes………...…………...……...………………..………………...…... 1

Refuse to answer………………...…………….............................….... 7

 skip to T17

Don’t know……………..…………………………………………...... 9

 skip to T17

T16

Specify other STD: _______________________________________________

If B-5 = 1 skip to T18

T17

In the past 12 months has a doctor, nurse or other health care provider told you that you have Bacterial Vaginosis?

No ………………...…………………..…………………...………...... 0

Yes………...…………...……...…………………………….....……... 1

Refuse to answer………………...…………….............................…… 7

Don’t know……………..…………………………………………...... 9

If T14 = 1 skip to options box after T18

T18

Even though a doctor, nurse, or other health care provider did not tell you that you have syphilis, did you have a test to check for syphilis in the past 12 months?

No ………………...…………………..……………............................. 0

Yes………...…………...……...………………..…………………..… 1

Refuse to answer………………...……………....……………………. 7

Don’t know……………..………………………….............................. 9

SECTION 5.0: SOCIAL DETERMINANTS

SAY: The following questions are about experiences that you may have had and places you may go for social support. Honest responses to these questions are greatly appreciated. Please remember that your responses will be kept private.

SECTION 5.1: Mental Health (All Groups)

Now we want to know if you have had any of the following experiences. [Read each statement. If respondent has had none of these experiences, check not applicable].

Over the past two weeks, how often have you been bothered by any of the following problems?

AR1

Little interest or pleasure in doing things. Would you say that over the past two weeks you have been bothered . . .

Not at all................................................................................................. 1

Several days ........................................….............................................. 2

More than half the days …………........................................…............. 3

Nearly every day …...…..............................................……………….. 4

Refuse to answer…………......…...………….................…....……….. 7

Not applicable .............................................................................. ….... 8

Don’t know……………..………………..................…………............ 9

AR2

What about feeling down, depressed, or hopeless. Again would you say that over the past two weeks you have been bothered . . .

Not at all................................................................................................. 1

Several days ........................................…...............................................2

More than half the days ………….........................................…............ 3

Nearly every day …...…..............................................……………….. 4

Refuse to answer……....………...………….................…....………… 7

Not applicable .............................................................................. ….... 8

Don’t know……………..………………..................…………............ 9

AR3

Restless sleep. Would you say that over the past two weeks you have been bothered by this . . .

Not at all................................................................................................. 1

Several days .......................................…............................................... 2

More than half the days ………….........................................…............ 3

Nearly every day …...…..............................................……………….. 4

Refuse to answer……..…………...………….................…....……….. 7

Not applicable .............................................................................. ….... 8

Don’t know……………..………………..................…………............ 9

SECTION 5.2: Social Support (All Groups)

AR4

How often do you feel there is no one you can turn to? Would you say? [Read all choices. Choose one]

Always….…………...…………….…….……………………………. 1

Usually...…….............…….……...……………..……………………. 2

Sometimes............……….……….……..………....………………….. 3

Rarely .……………………….…...................………………………... 4

Never………………………….…..…………………………………... 5

Refuse to answer………….....…....................…....…………………... 7

Don’t know…………….....…..................…………............................. 9

AR5

Tell me, how often do you feel discriminated against because of your race? [Read all choices. Choose one]

All the time……….....…………………..……………………………. 1

Most of the time...………………...……………..……………………. 2

Some of the time......………………………………………………….. 3

Rarely or occasionally..…………………………………………….…. 4

Never………………………………………………………………….. 5

Refuse to answer…………………...………….…..…………...……... 7

Don’t know…………...…..……………………………………….….. 9

SECTION 5.3 Religiousness/Spirituality (All Groups)

SAY: For the following question please tell me if you agree, disagree, or neither agree nor disagree with the following statements.

AR6

I consider myself to be a spiritual or religious person. [Read all choices. Choose one]

Agree…….……...………………...……………..……………………. 1

Disagree………….......……………………….………………………. 2

 skip to section 5.4

Neither agree nor disagree……………..……………………….…….. 3

Refuse to answer…………………...…………………………...…..… 7

Don’t know…………...…..…………………………….…………….. 9

SAY: I will now ask you some questions about your spirituality and your religious community.

AR7

In the past 12 months, how often did you attend religious services? [Do not read choices. Choose option that best matches response]

Never..………...……………..………………………………….…….. 1

 skip to section 5.4

Less than once a month ..………...……………..…………………….. 2

1-2 times per month.............…………………………………………...3

Weekly ....………….....………………………………………………. 4

More than once a week.………………………………………………. 5

Refuse to answer…………………...…………………………...…..… 7

 skip to section 5.4

Not applicable ………………...………….…..…………………......... 8

Don’t know…………...…..………………………………….……….. 9

 skip to section 5.4

If B-3 = 3  skip to AR10

AR8

My church or religious community welcomes male members who are gay or men who have sex with men. [Read all choices. Choose one]

Agree…….……...………………...……………..……………………. 1

Disagree………….......……………………….………………………. 2

Neither agree nor disagree……………..……………………………... 3

Refuse to answer…………………...………….…..………………….. 7

Don’t know…………...…..…………………………………………... 9

AR9

The religious leaders at my place of worship publically discuss the importance of addressing HIV/AIDS in the African American community. [Read all choices. Choose one]

Agree…….……...………………...……………..……………………. 1

Disagree………….......……………………….………………………. 2

Neither agree nor disagree……………..……………………………... 3

Refuse to answer…………………...………….…..………………….. 7

Don’t know…………...…..…………………………………………... 9

AR10

I have received messages (in print or spoken) from my faith based institution urging me to know my HIV status or be tested for HIV. [Read all choices. Choose one]

Agree…….……...………………...……………..…………………… 1

Disagree………….......……………………….………………………. 2

Neither agree nor disagree……………..……………………………... 3

Refuse to answer….………………………………………………….. 7

Don’t know…...…………………………………………………….… 9

Options: If B-3 = 1 or 2  skip to section 5.5 If B-3 = 3 or 4 section 5.4

SECTION 5.4: HIV Beliefs (Groups 3 and 4)
AH1	Do you personally know at least one person who is or was infected with HIV or AIDS?
			No ………………...…………………..……………............................. 0
			Yes………...…………...……...………………..…………………..… 1
			Refuse to answer….…………………………………………………... 7
			Don’t know…...………………………………………………………. 9
SAY: Now I’d like to ask you about some things that people may believe about HIV. Please tell me if you agree, disagree, or neither agree nor disagree with the following statements.
AH2	HIV is a man-made virus designed to infect black people. [Read all choices. Choose one]
			Agree…….……...………………...……………..……………………. 1
			Disagree ……………………..……………………………………….. 2
			Neither agree nor disagree …………....……………………………… 3
			Refuse to answer….…………………………………………………... 7
			Don’t know…...………………………………………………………. 9
AH3	There is a cure for AIDS. [Read all choices. Choose one]
			Agree…….……...………………...……………..……………………. 1
			Disagree ……………………..……………………………………….. 2
			Neither agree nor disagree …………....……………………………… 3
			Refuse to answer….…………………………………………………... 7
			Don’t know…...………………………………………………………. 9
AH4	When a doctor or hospital does blood tests on someone, they are automatically tested for HIV. [Read all choices. Choose one]
			Agree…….……...………………...……………..……………………. 1
			Disagree ……………………..……………………………………….. 2
			Neither agree nor disagree …………....……………………………… 3
			Refuse to answer….…………………………………………………... 7
			Don’t know…...………………………………………………………. 9
AH5	A man who tests regularly for HIV is probably someone who has sex with other men. [Read all choices. Choose one]
			Agree…….……...………………...……………..……………………. 1
			Disagree ……………………..……………………………………….. 2
			Neither agree nor disagree …………....……………………………… 3
			Refuse to answer….…………………………………………………... 7
			Don’t know…...………………………………………………………. 9
SECTION 5.5: Criminal Justice History (All Groups)
SAY: Now I’d like to ask about you and your partner’s experience with the criminal justice system. Please remember your responses are kept confidential.
AP1	During your relationship with them, have any of your current or previous sex partners been arrested two or more times in a three year period, been on active probation, parole, or in prison?
			No ………………...…………………..…………………...………...... 0
			Yes………...…………...……...…………………………….....……... 1
			Refuse to answer………………...…………….............................…… 7
			Don’t know……………..…………………………………………...... 9
If B-3 = 1 or 2  skip to AP3
AP2	In the past three years, have you been arrested two or more times?
			No ………………...…………………..…………………...………...... 0
			Yes………...…………...……...…………………………….....……... 1
			Refuse to answer………………...…………….............................…… 7
			Don’t know……………..…………………………………………...... 9
AP3	Please tell me if you have served time in prison, jail or a correctional facility and if so, for how long at one time?
			Never served…….............…...…………………...…………………... 1
			Less than one year....………………………………...………………... 2
			At least 1 year but less than 3 years…....................... ........................... 3
			3 years or more.... ……………………………....…..………………… 4
			Refuse to answer…………………………………..………………….. 7
			Don’t know……………..………………………….............................. 9
Options: If B-3 = 1 or 2 section 6.0 If B-3 = 3 skip to section 8.0 If B-3 = 4 skip to section 9.0

SECTION 6.0: Pre-Exposure Prophylaxis (Groups 1 and 2)
Say: I’m now going to ask you some questions about HIV or AIDS medicines.
PR1	Have you ever heard of people who are HIV negative taking AIDS medicines also called antiretrovirals or AIDS cocktails, to keep from getting HIV?
		No ………………...…………………..……………............................. 0		 skip to SAY box before section 7.0
		Yes………...…………...……...………………..……………………... 1
		Refuse to answer………………...……………....…………………….. 7		 skip to SAY box before section 7.0
		Don’t know……………..…………………………............................... 9		 skip to SAY box before section 7.0
PR2	Have you ever taken HIV/AIDS medicines just before having sex because you thought it would reduce your chances of getting HIV?
		No ………………...…………………..……………............................. 0
		Yes………...…………...……...………………..……………………... 1
		Refuse to answer………………...……………....…………………….. 7
		Don’t know……………..…………………………............................... 9
PR3	Have you ever taken HIV/AIDS medicines right after engaging in a risky activity, that is unprotected sex or injection drug use, because you thought it would reduce your chances of getting HIV?
			No ………………...…………………..……………............................. 0
			Yes………...…………...……...………………..…………………….. 1
			Refuse to answer………………...……………....……………………. 7
			Don’t know……………..………………………….............................. 9
If T7 = 1  skip to SAY box before section 7.0
PR4	If taking a daily HIV pill was proven to reduce your chances of getting infected with HIV and had few or no side effects, would you take such a pill?
			No ………………...…………………..……………............................. 0
			Yes………...…………...……...………………..…………………….. 1
			Refuse to answer………………...……………....……………………. 7
			Don’t know……………..………………………….............................. 9

Options:

If B-3 = 1 or 2 section 7.0

If B-3 = 3 skip to section 8.0

If B-3 = 4 skip to section 9.0

SECTION 7.0: Outness (Groups 1 and 2)
Say: To how many of the following people are you “out”? Meaning, how many of the following people have you told that you are attracted to or have sex with other [men/women].
If B-5 = 1 question should include male references If B-5 = 2 question should include female references If 4 = 1 or 2  skip to O2
You can respond by selecting none, a few, some, most, all, or not applicable. Would you say you are out to . . . [Read all choices. Choose one]
O1		People at work
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some………………………………………………..………………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………….…… 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………….…… 9
If 4 = 3  skip to O3
O2		People at school
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
O3		Your male friends who also have sex with other men
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
O4		Your heterosexual friends
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
O5		Your family
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
O6		Your health care providers
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
If S10 = 0 skip to O8
O7		Your female sex partners
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9
O8		People from your religious community
			None…………………………….…………………..………………… 1
			A few………………………………………………..………………… 2
			Some……………………………………………………..…………… 3
			Most…………………………….…………………..………………… 4
			All…………………………………………………..………………… 5
			Refuse to answer…………………………………...…………………. 7
			Not applicable………………….…………………..…………….…… 8
			Don’t know………………………..……………….…………………. 9

Options:

If B-3 = 1 or 2 skip to section 9.0

If B-3 = 3 section 8.0

If B-3 = 4 skip to section 9.0

SECTION 8.0: Attitudes and Norms (Group 3)
SAY: Now I’m going ask you some questions about your expectations before coming to this event.
AT1		Tell me, did you come to this event expecting to have sex with someone?
			No ………………...…………………..……………............................ 0
			Yes………...…………...……...………………..…………………….. 1
			Refuse to answer………………...……………....……………………. 7
			Don’t know……………..………………………….............................. 9
SAY: Now I’m going to read you a list of some things people think. For each one, please tell me if you agree, disagree, or neither agree nor disagree with the following statements. [Read all choices. Choose one]
AT2	It is against your values to have sex with someone you just met.
			Agree…….……...………………...……………..…………………… 1
			Disagree………….......……………………………………………….. 2
			Neither agree nor disagree……………..……………………………. 3
			Refuse to answer…………………...…………........…………………. 7
			Don’t know…………...…..…………………………………………... 9
AT4		When attending events like this one, you should feel free to have sex with someone you meet there if you want to.
			Agree…….……...………………...……………..…………………… 1
			Disagree………….......……………………………………………….. 2
			Neither agree nor disagree……………..……………………………. 3
			Refuse to answer…………………...…………........…………………. 7
			Don’t know…………...…..…………………………………………... 9
AT5		You would be more inclined to have sex with someone you just met on spring break if most of your friends told you they were having sex with people they just met.
			Agree…….……...………………...……………..…………………… 1
			Disagree………….......……………………………………………….. 2
			Neither agree nor disagree……………..……………………………. 3
			Refuse to answer…………………...…………........…………………. 7
			Don’t know…………...…..…………………………………………... 9
AT7		Opportunities to drink alcohol were an important reason for you to come to this event.
			Agree…….……...………………...……………..…………………… 1
			Disagree………….......……………………………………………….. 2
			Neither agree nor disagree……………..……………………………. 3
			Refuse to answer…………………...…………........………………… 7
			Don’t know…………...…..………………………………………….. 9
AT8		Opportunities to do drugs were an important reason for you to come to this event.
			Agree…….……...………………...……………..…………………… 1
			Disagree………….......……………………………………………….. 2
			Neither agree nor disagree……………..……………………………. 3
			Refuse to answer…………………...…………........………………… 7
			Don’t know…………...…..…………………………………………... 9

SECTION 9.0: Prevention Activities (All Groups)
Say: Next, I’d like to ask you about HIV prevention activities where you live.
P1	In the past 12 months, have you received free condoms? Please do not count any free condoms you received here at this event
		No………………….…………………..……………............................ 0		 skip to P3
		Yes………………………………………..…………........................... 1
		Refuse to answer…………………………………..………………….. 7		 skip to P3
		Don’t know……………..………………………….............................. 9		 skip to P3
P2	Where have you received free condoms from? [Do not read choices. Choose all that apply]
		Community-based organization……………………............................. 1
		Health department……………….…..………………………………... 2
		Bar/club…………………………………………….............................. 3
		Adult bookstore/theater….…...……..………………………………… 4
		Bath house/sex club/sex resort...…..…..……………………………… 5
		Circuit party or rave…………….……...……………………………... 6
		Gym…………………………………...……..………………………... 7
		School health clinic……………………………..…………………….. 8
		Student organization…………...…..…………………………………. 9
		At a doctor’s office…………………………………………………... 10
		Other place...……………..…………………………........................... 11
		Refuse to answer…………………………………………...………… 77
		Don’t know………………………….....…………………………….. 99
P3	In the past 12 months have you received information from a counselor or outreach worker on ways to protect yourself or your partners from getting HIV or other sexually transmitted diseases?
		No………………….…………………..……………………………… 0
		Yes………………………………………..…………........................... 1
		Refuse to answer…………………………………..………………….. 7
		Don’t know……………..………………………….............................. 9

SECTION 10.0: Local Questions
Say: Now I would like to ask you a few questions about local health services you might know of
Note: If it is desired by the local partner, the following county specific questions regarding a local program, service or office in the designated county will be loaded into the QDS program and instrument before the event.
LOC1	Have you heard of ( local intervention/ program) before today?
		No………………….…………………..……………………………… 0
		Yes………………………………………..…………........................... 1
		Refuse to answer…………………………………..………………….. 7
		Don’t know……………..………………………….............................. 9
LOC2	Have you heard of or seen the (local intervention/ program) logo before today?
		No………………….…………………..……………………………… 0
		Yes………………………………………..…………........................... 1
		Refuse to answer…………………………………..………………….. 7
		Don’t know……………..………………………….............................. 9
LOC3	Have you visited the (designated county) County (building / location) in the past 12 months?
		No………………….…………………..……………………………… 0
		Yes………………………………………..…………........................... 1
		Refuse to answer…………………………………..………………….. 7
		Don’t know……………..………………………….............................. 9
If B-3 = 1 skip to SAY box before H5
If T7 = 1 skip to SAY box before H5
SECTION 11.0: Offer HIV Testing
If Int2 (screener) = 1, 2, or 3 skip to SAY box before H1
If Int2 (screener) = 4 H0
H0	Can you tell me how you heard about this free HIV testing today? [Do not read choices. Choose one]
		Radio or TV announcement……………………................................... 1
		Flyer or poster advertisement….…..………………………………...... 2
		Read about it in a magazine or newspaper………................................. 3
		Heard about it from recruiters or other interviewers…………………. 4
		Announcement during BART event (e.g. stage or DJ) ………………. 5
		Saw the sign outside…………………………………………………... 6
		Potential partner………………………………………………………. 7
		Friend or unknown person……………………………………………. 8
		Other (no specification) ……………………………………………… 9
		Refuse to answer……………………………………………………... 77
		Don’t know…………………………………………………………... 99
SAY: We are offering free rapid HIV testing today. If you choose to test, you will receive your results today.
H1	Are you interested in receiving a rapid test today?
		No………………….…………………..……………………………… 0
		Yes………………………………………..…………........................... 1	 skip to H4
H2	Could you tell me the main reason why you don’t want to have an HIV test today? [Do not read choices. Choose one]
		Don’t have time……………………...................................................... 1
		Don’t want to be tested during this event…………………………...... 2
		Don’t want to be tested in van or other available site............................ 3
		Had recent HIV test…………………………………………………... 4
		No risk behavior……………………..................................................... 5
		Afraid of learning he/she has HIV.………………………………........ 6
		Worried someone may find out test results…….................................... 7
		Afraid of losing family or friends if test is positive…………………... 8
		Afraid of losing job, health insurance, or housing if test is positive..... 9
		Worried name will be reported to government if test is positive…..... 10
		Other reason……….............................................................................. 11
		Refuse to answer……………………………………………………... 77
		Don’t know…………………………………………………………... 99
If H2 ≠ 11  skip to H4
H3	Other reason (specify): ______________________________________________
H4	[Interviewer: Please enter the testing ID. This is a three-digit number you will find on the respondent’s testing card.]
If H1 = 0 SAY-1 box If H1 = 1 skip to SAY-2 box
SAY-1: I am giving you a testing care in case you change your mind and decide to get tested later. You will be asked for this card at the testing location. Please keep it carefully. [Hand over testing card]
Skip to SAY-3 box
SAY-2: I will now take you to the testing location. When we get there, you will be asked for this card. Please keep it carefully. [Hand over testing card]
Proceed to SAY-3 box
SAY-3: That's the end of the health survey. Thank you again for agreeing to participate. Do you have any questions about what we talked about?
H5	[Interviewer: Record any comments below]
[END THE INTERVIEW]
Time ended: __ __:__ __ AM  1 PM  2

LOC	[Interviewer: Are there local questions added to this survey?]
		No………………….…………………..……………………………… 0	 skip to section 11.0
		Yes………………………………………..…………........................... 1	 section 10.0

APPENDIX E: ASSURANCE OF CONFIDENTIALITY

ASSURANCE OF CONFIDENTIALITY FOR SURVEILLANCE OF ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) AND INFECTION WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND SURVEILLANCE-RELATED DATA (INCLUDING SURVEILLANCE INFORMATION, CASE INVESTIGATIONS AND SUPPLEMENTAL SURVEILLANCE PROJECTS, RESEARCH ACTIVITIES, AND EVALUATIONS)

The national surveillance program for HIV/AIDS is being coordinated by the HIV Incidence and Case Surveillance Branch (HICSB) and the Behavioral and Clinical Surveillance Branch (BCSB) of the Division of HIV/AIDS Prevention - Surveillance and Epidemiology (DHAP - SE), the National Center for HIV/STD/TB Prevention, a component of the Centers for Disease Control and Prevention (CDC), an agency of the United States Department of Health and Human Services. The surveillance information requested by CDC consists of reports of persons with suspected or confirmed AIDS or HIV infection, including children born to mothers infected with HIV, and reports of persons enrolled in studies designed to evaluate the surveillance program. The information collected by CDC is abstracted from laboratory, clinical, and other medical or public health records of suspected or confirmed HIV/AIDS cases; and from interviews that interview persons in recognized HIV risk groups or known to have a diagnosis of HIV/AIDS.

Surveillance data collection is conducted by State and Territorial health departments which forward information to CDC after deleting patient and physician names and other identifying or locating information. Records maintained by CDC are identified by computer-generated codes, patient date of birth, and a state/city assigned patient identification number. The data are used for statistical summaries and research by CDC scientists and cooperating state and local health officials to understand and control the spread of HIV/AIDS. In rare instances, expert CDC staff, at the invitation of state or local health departments, may participate in research or case investigations of unusual transmission circumstances or cases of potential threat to the public health. In these instances, CDC staff may collect and maintain information that could directly identify individuals.

Information collected by CDC under Section 306 of the Public Health Service Act (42 U.S.C. 242k) as part of the HIV/AIDS surveillance system that would permit direct or indirect identification of any individual or institution on whom a record is maintained, and any identifiable information collected during the course of an investigation on either persons supplying the information or persons described in it, is collected with a guarantee that it will be held in confidence, will be used only for the purposes stated in this Assurance, and will not otherwise be disclosed or released without the consent of the individual or institution in accordance with Section 308 (d) of the Public Health Service Act (42 U.S.C. 242m(d)). This protection lasts forever, even after death.

Information that could be used to identify any individual or institution on whom a record is maintained by CDC will be kept confidential. Full names, addresses, social security numbers, and telephone numbers will not be reported to this national HIV/AIDS surveillance system. Medical, personal, and lifestyle information about the individual, and a computer-generated patient code will be collected.

Surveillance information reported to CDC will be used without identifiers primarily for statistical and analytic summaries and for evaluations of the surveillance program in which no individual or institution on whom a record is maintained can be identified, and secondarily, for special research investigations of the characteristics of populations suspected or confirmed to be at increased risk for infection with HIV and of the natural history and epidemiology of HIV/AIDS. When necessary for confirming surveillance information or in the interest of public health and disease prevention, CDC may confirm information contained in case reports or may notify other medical personnel or health officials of such information; in each instance, only the minimum information necessary will be disclosed.

No CDC HIV/AIDS surveillance or research information that could be used to identify any individual or institution on whom a record is maintained, either directly or indirectly, will be made available to anyone for non-public health purposes. In particular, such information will not be disclosed to the public; to family members; to parties involved in civil, criminal, or administrative litigation, or for commercial purposes; to agencies of the federal, state, or local government. Data will only be released to the public, to other components of CDC, or to agencies of the federal, state, or local government for public health purposes in accordance with the policies for data release established by the Council of State and Territorial Epidemiologists.

Information in this surveillance system will be kept confidential. Only authorized employees of DHAP - SE in HICSB, BCSB, and in the Statistics and Data Management Branch (SDMB), their contractors, guest researchers, fellows, visiting scientists, research interns and graduate students who participate in activities jointly approved by CDC and the sponsoring academic institution, and the like, will have access to the information. Authorized individuals are required to handle the information in accordance with procedures outlined in the Confidentiality Security Statement for Surveillance of Acquired Immunodeficiency Syndrome (AIDS) and Infection with Human Immunodeficiency Virus (HIV) and Surveillance-Related Data (Including Surveillance Information, Case Investigations and Supplemental Surveillance Projects, Research Activities, and Evaluations.

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Behavioral Assessment and Rapid Testing (BART) Protocol October 28, 2010