Sexual Identity Module

Attachment 3f Sexual Identity Module (4 minutes)

Section name: Adult SEXUALITY Module

Module 52

Section Name Adult SEXUALITY Module

Question ID ASI.005_00.000

Variable Name ASIINTRO

Universe-text Sample adults 18+

Question Text *You are about to enter the Sexual Identity and Lifestyle questions section. This

section includes questions on computer use, the respondent’s neighborhood, sexual

identity, financial worries, mental health, and HIV testing.

Skip Instructions <1> goto ACICPUSE

Question ID ASI.130_00.000

Variable Name ACICPUSE

Universe-text Sample adults 18+

Question Text These questions are about you and your neighborhood.

How often do you use a computer?

*Read answer categories.

Answer Codes 1. Never or almost never

2. Some days

3. Most days

4. Every day

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACISATHC]

Question ID ASI.140_00.000

Variable Name ACISATHC

Universe-text Sample adults 18+

Question Text In general, how satisfied are you with the health care you received in the past 12

months?

*Read answer categories.

Answer Codes 1. Very satisfied

2. Somewhat satisfied

3. Somewhat dissatisfied

4. Very dissatisfied

5. You haven’t had health care in the past 12 months

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACITENUR]

Question ID ASI.150_00.000

Variable Name ACITENUR

Universe-text Sample adults 18+

Question Text About how long have you lived in your present neighborhood?

Answer Codes 1. Less than 1 year

2. 1-3 years

3. 4-10 years

4. 11-20 years

5. More than 20 years

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACINHELP]

Question ID ASI.160_00.000

Variable Name ACINHELP

Universe-text Sample adults 18+

Question Text How much do you agree or disagree with the following statements about your

neighborhood?

People in this neighborhood help each other out.

Would you say…

*Read answer categories.

Answer Codes 1. Definitely agree

2. Somewhat agree

3. Somewhat disagree

4. Definitely disagree

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACINCNTO]

Question ID ASI.170_00.000

Variable Name ACINCNTO

Universe-text Sample adults 18+

Question Text *Read if necessary.

How much do you agree or disagree with the following statements about your

neighborhood?

There are people I can count on in this neighborhood.

Would you say…

*Read answer categories if necessary.

Answer Codes 1. Definitely agree

2. Somewhat agree

3. Somewhat disagree

4. Definitely disagree

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACINTRU]

Question ID ASI.180_00.000

Variable Name ACINTRU

Universe-text Sample adults 18+

Question Text *Read if necessary.

How much do you agree or disagree with the following statements about your

neighborhood?

People in this neighborhood can be trusted.

Would you say…

*Read answer categories if necessary.

Answer Codes 1. Definitely agree

2. Somewhat agree

3. Somewhat disagree

4. Definitely disagree

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACINKNT]

Question ID ASI.190_00.000

Variable Name ACINKNT

Universe-text Sample adults 18+

Question Text *Read if necessary.

How much do you agree or disagree with the following statements about your

neighborhood?

This is a close-knit neighborhood.

Would you say…

*Read answer categories if necessary.

Answer Codes 1. Definitely agree

2. Somewhat agree

3. Somewhat disagree

4. Definitely disagree

Refused

Don't know

Skip Instructions <1-4,R,D> [if SEX=1, goto ACISIM; elseif SEX=2, goto ACISIF]

Question ID ASI.220_00.000

Variable Name ACISIM

Universe-text Male sample adults 18+

Question Text (book) ASI1

Which of the following best represents how you think of yourself?

Answer Codes 1. Gay

2. Straight, that is, not gay

3. Bisexual

4. Something else

5. I don't know the answer

Refused

Skip Instructions <1-3,R> [goto ACIRETR]

<4> [goto ACISMELS]

<5> [goto ACISIMDK]

Question ID ASI.230_00.000

Variable Name ACISMELS

Universe-text Male sample adults 18+ who think of themselves as something else

Question Text (book) ASI3

What do you mean by something else?

Answer Codes 1. You are not straight, but identify with another label such as queer, trisexual,

omnisexual or pansexual

2. You are transgender, transsexual or gender variant

3. You have not figured out or are in the process of figuring out your sexuality

4. You do not think of yourself as having sexuality

5. You do not use labels to identify yourself

6. You mean something else

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIRETR]

<6> [goto ACIMSESP]

Question ID ASI.234_00.000

Variable Name ACISIMDK

Universe-text Male sample adults 18+ who answered don't know at ACISIM

Question Text (book) ASI4

What do you mean by don't know?

Answer Codes 1. You don't understand the words

2. You understand the words, but you have not figured out or are in the process of

figuring out your sexuality

3. You mean something else

Refused

Don't know

Skip Instructions <1,2,R,D> [goto ACIRETR]

<3> [goto ACIMSESP]

Question ID ASI.238_00.000

Variable Name ACIMSESP

Universe-text Male sample adults 18+ who answered something else at ACISMELS or ACISIMDK

Question Text What do you mean by something else?

Answer Codes Allow 75

Refused

Don't know

Skip Instructions <Allow 75,R,D> [goto ACIRETR]

Question ID ASI.240_00.000

Variable Name ACISIF

Universe-text Female sample adults 18+

Question Text (book) ASI2

Which of the following best represents how you think of yourself?

Answer Codes 1. Lesbian or gay

2. Straight, that is, not lesbian or gay

3. Bisexual

4. Something else

5. I don't know the answer

Refused

Skip Instructions <1-3,R> [goto ACIRETR]

<4> [goto ACISFELS]

<5> [goto ACISIFDK]

Question ID ASI.250_00.000

Variable Name ACISFELS

Universe-text Female sample adults 18+ who think of themselves as as something else

Question Text (book) ASI3

What do you mean by something else?

Answer Codes 1. You are not straight, but identify with another label such as queer, trisexual,

omnisexual or pansexual

2. You are transgender, transsexual or gender variant

3. You have not figured out or are in the process of figuring out your sexuality

4. You do not think of yourself as having sexuality

5. You do not use labels to identify yourself

6. You mean something else

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIRETR]

<6> [goto ACIFSESP]

Question ID ASI.254_00.000

Variable Name ACISIFDK

Universe-text Female sample adults 18+ who answered don't know at ACISIM

Question Text (book) ASI4

What do you mean by don't know?

Answer Codes 1. You don't understand the words

2. You understand the words, but you have not figured out or are in the process of

figuring out your sexuality

3. You mean something else

Refused

Don't know

Skip Instructions <1,2,R,D> [goto ACIRETR]

<3> [goto ACIFSESP]

Question ID ASI.258_00.000

Variable Name ACIFSESP

Universe-text Female sample adults 18+ who answered something else at ACISMELS or ACISIMDK

Question Text What do you mean by something else?

Answer Codes Allow 75

Refused

Don't know

Skip Instructions <Allow 75,R,D> [goto ACIRETR]

Question ID ASI.260_00.000

Variable Name ACIRETR

Universe-text Sample adults 18+

Question Text The next questions ask how worried you are right now about financial matters.

How worried are you right now about not having enough money for retirement? Are

you…

*Read answer categories.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACIMEDC]

Question ID ASI.270_00.000

Variable Name ACIMEDC

Universe-text Sample adults 18+

Question Text How worried are you right now about not being able to pay medical costs of a serious

illness or accident? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACISTLV]

Question ID ASI.280_00.000

Variable Name ACISTLV

Universe-text Sample adults 18+

Question Text How worried are you right now about not being able to maintain the standard of living

you enjoy? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACICNHC]

Question ID ASI.290_00.000

Variable Name ACICNHC

Universe-text Sample adults 18+

Question Text How worried are you right now about not being able to pay medical costs for normal

healthcare? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACICCOLL]

Question ID ASI.300_00.000

Variable Name ACICCOLL

Universe-text Sample adults 18+

Question Text How worried are you right now about not having enough money to pay for your

children's college? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

5. This does not apply to me

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACINBILL]

Question ID ASI.310_00.000

Variable Name ACINBILL

Universe-text Sample adults 18+

Question Text How worried are you right now about not having enough to pay your normal monthly

bills? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACIHCST]

Question ID ASI.320_00.000

Variable Name ACIHCST

Universe-text Sample adults 18+

Question Text How worried are you right now about not being able to pay your rent, mortgage, or

other housing costs? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

Refused

Don't know

Skip Instructions <1-4,R,D> [goto ACICCMP]

Question ID ASI.330_00.000

Variable Name ACICCMP

Universe-text Sample adults 18+

Question Text How worried are you right now about not being able to make the minimum payments on

your credit cards? Are you…

*Read answer categories if necessary.

Answer Codes 1. Very worried

2. Moderately worried

3. Not too worried

4. Not worried at all

5. I don't have credit cards

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACISLEEP]

Question ID ASI.340_00.000

Variable Name ACISLEEP

Universe-text Sample adults 18+

Question Text On average, how many hours of sleep do you get in a 24-hour period?

*Enter hours of sleep in whole numbers, rounding 30 minutes (1/2 hour) or more UP to

the next whole hour and dropping 29 or fewer minutes.

Answer Codes Allow 1-24, R, D

Skip Instructions <1-5>[goto ERR_SLEEP];

<1-24, R,D>[goto ACISLPFL]

Question ID ASI.350_00.000

Variable Name ACISLPFL

Universe-text Sample adults 18+

Question Text In the past week, how many times did you have trouble falling asleep?

*Enter '0' if respondent did not have trouble falling asleep in the past week.

*Enter '7' for 7 or more times.

Answer Codes Allow 0-7, R, D

Skip Instructions <0-7,R,D> [goto ACISLPST]

Question ID ASI.360_00.000

Variable Name ACISLPST

Universe-text Sample adults 18+

Question Text In the past week, how many times did you have trouble staying asleep?

*Enter '0' if respondent did not have trouble staying asleep in the past week.

*Enter '7' for 7 or more times.

Answer Codes Allow 0-7, R, D

Skip Instructions <0-7,R,D> [goto ACISLPMD]

Question ID ASI.370_00.000

Variable Name ACISLPMD

Universe-text Sample adults 18+

Question Text In the past week, how many times did you take medication to help you fall asleep or stay

asleep?

*Enter '0' if respondent did not take medication to help sleep in the past week.

*Enter '7' for 7 or more times.

Answer Codes Allow 0-7, R, D

Skip Instructions <0-7,R,D> [goto ACIREST]

Question ID ASI.380_00.000

Variable Name ACIREST

Universe-text Sample adults 18+

Question Text In the past week, on how many days did you wake up feeling well rested?

*Enter '0' if respondent never felt well rested in the past week.

Answer Codes Allow 0-7, R, D

Skip Instructions <0-7,R,D> [goto MHSAD_CK]

Question ID ASI.390_00.000

Variable Name MHSAD_CK

Universe-text Sample adults 18+

Question Text Now I am going to ask you some questions about feelings you may have experienced

over the PAST 30 DAYS.

Answer Codes 1. Enter 1 to Continue

Skip Instructions <1> [goto ACISAD]

Question ID ASI.390_01.000

Variable Name ACISAD

Universe-text Sample adults 18+

Question Text (book) ASI5

DURING THE PAST 30 DAYS, how often did you feel

...So sad that nothing could cheer you up?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACINERV]

Question ID ASI.390_02.000

Variable Name ACINERV

Universe-text Sample adults 18+

Question Text (book) ASI5

* Read if necessary:

During the PAST 30 DAYS, how often did you feel

...Nervous?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIRSTLS]

Question ID ASI.390_03.000

Variable Name ACIRSTLS

Universe-text Sample adults 18+

Question Text (book) ASI5

* Read if necessary:

During the PAST 30 DAYS, how often did you feel

...Restless or fidgety?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIHOPLS]

Question ID ASI.390_04.000

Variable Name ACIHOPLS

Universe-text Sample adults 18+

Question Text (book) ASI5

* Read if necessary:

During the PAST 30 DAYS, how often did you feel

...Hopeless?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIEFFRT]

Question ID ASI.390_05.000

Variable Name ACIEFFRT

Universe-text Sample adults 18+

Question Text (book) ASI5

* Read if necessary:

During the PAST 30 DAYS, how often did you feel

...That everything was an effort?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> [goto ACIWTHLS]

Question ID ASI.390_06.000

Variable Name ACIWTHLS

Universe-text Sample adults 18+

Question Text (book) ASI5

* Read if necessary:

During the PAST 30 DAYS, how often did you feel

...Worthless?

Answer Codes 1. ALL of the time

2. MOST of the time

3. SOME of the time

4. A LITTLE of the time

5. NONE of the time

Refused

Don't know

Skip Instructions <1-5,R,D> if ACISAD or ACINERV or ACIRSTLS or ACIHOPLS or ACIEFFRT or

ACIWTHLS=1-3 [goto ACIMUCH];

else [goto ACIHIVT]

Question ID ASI.400_00.000

Variable Name ACIMUCH

Universe-text Sample adults 18+ who at least some of the time have felt sad, nervous, restless or

fidgety, hopeless, that everything was an effort, or worthless, in the past 30 days

Question Text We just talked about a number of feelings you had during the PAST 30 DAYS.

Altogether, how MUCH did these feelings interfere with your life or activities: a lot, some,

a little, or not at all?

Answer Codes 1. A lot

2. Some

3. A little

4. Not at all

Refused

Don't Know

Skip Instructions <1-4,R,D> [goto ACIHIVT]

Question ID ASI.410_00.000

Variable Name ACIHIVT

Universe-text Sample adults 18+

Question Text The next question is about the test for HIV, the virus that causes AIDS. Except for tests

you may have had as part of blood donations, have you ever been tested for HIV?

Answer Codes 1. Yes

2. No

Refused

Don't know

Skip Instructions <1,R,D> [goto next section]

<2> [goto ACIHIVWN]

Question ID ASI.420_00.000

Variable Name ACIHIVWN

Universe-text Sample adults 18+ who have never been tested for HIV

Question Text (book) ASI6

I am going to show you a list of reasons why some people have not been tested for HIV

(the virus that causes AIDS).

Which one of these would you say is the MAIN reason why you have not been tested?

Answer Codes 1. It's unlikely you've been exposed to HIV

2. You were afraid to find out if you were HIV positive (that you had HIV)

3. You didn't want to think about HIV or about being HIV positive

4. You were worried your name would be reported to the government if you tested

positive

5. You didn't know where to get tested

6. You don't like needles

7. You were afraid of losing job, insurance, housing, friends, family, if people knew you

were positive for AIDS infection

8. Some other reason

9. No particular reason

Refused

Don't know

Skip Instructions <1-9,R,D> [goto next section]

31