MyLife 6 Mo Follow-Up v2
Form Approved:
OMB No. 0920-0913
Expiration Date: XX/XX/XXXX
Evaluating Locally-Developed HIV Prevention Interventions for African-American MSM in Los Angeles
Attachment 3h
6-month Questionnaire
Public reporting burden of this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-0913)
MyLife 6 Mo Follow-Up v2 (English)
START
SQ1. Enter type of survey administering: (Choose one) 1 Baseline
2 3 Month Follow-Up
3 6 Month Follow-Up
If SQ1 is equal to 1 or SQ1 is equal to 2 then READ: "This is the assessment tool for the 6 month follow-up. Please, stop and restart with the baseline or 3 month follow up assessment." and skip to SQ1.
SQ2. Enter site: (Choose one) 1 ITMT
2 In community
3 DHSP
SQ3. Interviewer ID: __ __ __ __
SQ4. Study ID: __ __ __ __
SQ5. Re-enter participant's Study I.D. number: __ __ __ __
If SQ4 is not equal to SQ5 then READ: "The participant Study ID numbers that you have entered do not match. Please try again." and skip to SQ4.
READ: Okay I'm going to ask you the same questions I asked you when you completed your baseline and 3 month survey. These questions create a unique id for you. Is that okay?
SQ6. What are the first 2 letters of YOUR LAST name? (ex. Smith = SM) __ __
SQ7. What is the first letter of YOUR FIRST name? (ex. John = J) __
SQ8. What is the first letter of YOUR MOTHER'S FIRST name? (ex. Susan = S) __
SQ9. What MONTH were you born? Enter 2 digits for month (ex. August = 08, November = 11)
__ __
SQ10. What YEAR were you born? Enter 2 digits for year (ex. 1968 = 68) __ __
SQ11. Do you consider yourself male, female or transgender? (male = M, female = F, transgender = T) (Choose one)
1 M
2 F
3 T
SQ12A. Do you consider yourself to be Hispanic or Latino?
01 Yes
02 No
98 Refuse to Answer
SQ12B. What racial or ethnic group or groups do you consider yourself to be in? (B = Black/African American, W = White, A = Asian, AI= American Indian or Alaska Native, NH= Native Hawaiian or Pacific Islander) (Select all that apply)
UID = CONCAT(UID1, UID2, UID3, UID4, UID5, UID6, UID7)
AGO3M_6 = ShortDate(FU6_DT - 90)
AGO2YR_6 = ShortDate(FU6_DT - 730)
AGO6MO_6 = FU6_DT - 183
HIVDATE = Date(1985, 3, 1)
READ: Thank you for taking the time to answer questions for our study. Remember, all your answers will be kept private and your name will not be attached to any of the answers you provide today. It is important to be as honest as possible when answering these questions. Please remember that you can decide not to answer a specific question if you do not want to.
READ:
Demographic
Section:
If you would like help understanding a question, please talk to the
project staff member who can help you.
Please
remember your answers will be kept private.
A. DEMOGRAPHICS
A1. In the past 3 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.
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
If A1 is equal to 0, then skip to A3.
A2. Are you currently homeless? 1 Yes
0 No
7 Don't Know
8 Refuse to Answer
A3. What best describes your employment status? Are you: (Choose one) (Choose one)
01 Employed full-time
02 Employed part-time
04 A full-time student
06 Disabled for work
07 Unemployed
08 Other
97 Don't Know
98 Refuse to Answer
If A3 is not equal to 8, then skip to A4.
A3a. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
A4. During the past 3 months, how often did you run out of money for your basic necessities like rent or food? (Choose one) (Choose one)
0 Never
1 Once
2 Twice
3 Three times or more
8 Refuse to Answer
A5. What kind of health insurance or coverage do you currently have? (Check all that apply) (Check all that apply)
__ Medicaid (MediCal)
__ Medicare
__ Veteran's Administration
__ Ryan White
__ Private Insurance or HMO (e.g. Blue Cross or Kaiser)
__ No Insurance
__ Self-pay
__ Other health insurance
__ Don't Know
__ Refuse to Answer
READ: The next question refers to recent experiences you may have had with the jail or prison system. Please answer as honestly as you can. Your answers will be kept private.
A6. Have you been arrested and taken to jail or prison in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
B. Integrated Race and Sexuality
READ:
Integrated
Race and Sexuality Section:
The next several questions are about race and sexuality. Please
indicate how strongly you agree or disagree with the following
statements.
Please
remember your answers will be kept private.
B1. Black homosexual and bisexual men contribute to black communities. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B2. Both my race and my sexuality are important to who I am as a man. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B3. I can't imagine a loving sexual relationship between two Black men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B4. I believe Black men can be in loving committed relationships with each other. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B5. Black men who have sex with men do nothing to improve the quality of Black communities. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B6. Black homosexual and bisexual men can play an important role in Black families. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B7. A Black man who has sex with men can still be a strong man. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B8. It is more important that people see me as a man than as a Black person. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B9. It is more important that people see me as a man than as a homosexual/bisexual man. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B10. I am comfortable being open as a Black homosexual/bisexual man. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
B11. Black homosexual and bisexual men only make it more difficult for Black people in general. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
C. Sexual Behavior
READ: Next, are some questions about having sex. Please remember your answers will be kept private.
READ:
For these questions, "having sex" means oral,
vaginal or anal sex.
·Oral
sex means mouth on the vagina, penis or anus (butt);
·Vaginal
sex means penis in the vagina; and
·Anal
sex means penis in the anus (butt).
Note
that some questions may not apply to your situation.
C1. In the past 3 months, that is since [AGO3M_6], with how many different men have you had oral or anal sex?
__ __ __
998 Refuse to Answer
999 Not Applicable
C2. In the past 3 months, that is since [AGO3M_6], with how many different women have you had oral, vaginal or anal sex?
__ __ __
998 Refuse to Answer
999 Not Applicable
C3. In the past 3 months, that is since [AGO3M_6], with how many different transgender persons have you had oral, vaginal or anal sex?
__ __ __
998 Refuse to Answer
999 Not Applicable
If C2 is equal to 0 and C1 is equal to 0 and C3 is equal to 0, then skip to instruction before E1.
READ: The next questions are specifically about people you have had either anal or vaginal intercourse with in the past 3 months - between [AGO3M_6] and [FU6_DT]. These sex partners should not include anyone you ONLY had oral sex with.
C4. With how many people have you had anal or vaginal intercourse in the past three months (since [AGO3M_6])?
__ __ __
NUMSP3_6 = C1 + C2 + C3
If C4 is greater than NUMSP3_6 then READ: "This number is higher than you stated earlier. Please go back and correct." and skip to C1.
NUMOP3_6 = NUMSP3_6 - C4
If C4 is equal to NUMSP3_6, then skip to instruction before C6.
C5. So you only had oral sex with the other [NUMOP3_6] partner(s)? 1 Yes
0 No
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C5 is equal to 0 then READ: "Please go back and correct your answers." and skip to C1.
If C4 is equal to 0, then skip to instruction before E1.
READ: Now we are going to ask you questions specifically about these partners or if you have had more than 5 partners in the past 3 months, please answer questions about the 5 you had sex with most often. First, please type in the initials, a nickname, or another easy way to refer to each partner in the past 3 months to help you in answering the questions.
C6. Partner #1's initials or nickname: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C4 is less than 2, then skip to C11.
C7. Partner #2's initials or nickname: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C4 is less than 3, then skip to C11.
C8. Partner #3's initials or nickname: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C4 is less than 4, then skip to C11.
C9. Partner #4's initials or nickname: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C4 is less than 5, then skip to C11.
C10. Partner #5's initials or nickname: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C11. What is Partner 1's ([Response to C6]'s) gender? (Choose one) (Choose one)
1 Male
2 Female
3 Male to female transgender (transwoman)
4 Female to male transgender (transman)
7 Don't Know
8 Refuse to Answer
C12. How old is partner 1 ([Response to C6])? __ __
97 Don't Know
98 Refuse to Answer
If C12 is not equal to 97 and C12 is not equal to 98, then skip to C13.
C12a. Was this partner... (Choose one) (Choose one)
1 About the same age as you (within 5 years)
2 5 or more years older than you
3 5 or more years younger than you
C13. What type of partner is partner 1 ([Response to C6])? (Choose one) (Choose one)
1 Exchange partner (Sex for money or goods)
2 Anonymous partner (One time partner)
3 Casual partner (Sex without commitment)
4 Main Partner (Primary sexual partner)
If C13 is equal to 1, then skip to C13a.
If C13 is equal to 2 or C13 is equal to 3 or C13 is equal to 4, then skip to C13b.
C13a. Did you give partner 1 ([Response to C6]) money or goods for sex OR did partner 1 ([Response to C6]) give you money or goods for sex? (Choose one) (Choose one)
1 I gave this partner money or goods for sex
2 This partner gave me money or goods for sex
C13b. When was the first time you had anal (or vaginal) sex with partner 1 ([Response to C6])? (Choose one) (Choose one)
1 Within the past 3 months
2 Between 3 and 12 months ago
3 Over 12 months ago
C14. How would you describe partner 1's ([Response to C6]) race/ethnicity? (Choose one) (Choose one)
1 American Indian/Alaskan Native
2 Asian or Pacific Islander
3 Black, not of Hispanic origin
4 Hispanic
5 White, not of Hispanic origin
6 Other race/ethnicity (specify):_________
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C14 is not equal to 6, then skip to C15.
C14a. Other race/ethnicity (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C15. Did you and partner 1 ([Response to C6]) discuss each other's H.I.V. status before you had intercourse the first time? (Choose one)
1 Yes
0 No
8 Refuse to Answer
C16. To the best of your knowledge, what is partner 1's ([Response to C6]'s) H.I.V. status? (Choose one) (Choose one)
0 Negative
1 Positive
2 Unknown/Don't know
If C16 is equal to 2, then skip to C18.
C17. How do you know that partner 1's ([Response to C6]'s) H.I.V. status is [Response to C16]? (Check all that apply) (Check all that apply)
__ I could tell by the way he/she looked
__ One of his/her friends told me what his/her status was
__ I could tell his/her status by some of the things that he/she told me
__ I checked out his/her medicine cabinet to look for H.I.V. medications
__ He/She told me directly without me asking
__ I asked him/her directly and he/she told me
__ Other (specify):____________
If C17G is not equal to 1, then skip to C18.
C17a. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C18. Did you and partner 1 ([Response to C6]) discuss each other's sexually transmitted infection status (other than H.I.V. status) before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C19. Where did you first meet partner 1 ([Response to C6])? (Choose one) (Choose one)
01 Gay bar, cafe, nightclub or restaurant
02 Sex club, bathhouse, adult novelty store or bookstore
03 Public places including street, park, shopping mall, grocery store, library, public transportation
04 Church, political function
05 Work or school
06 Gym/health club/athletic activity
07 Internet (hook up, dating or social networking site)
08 Newspaper ads
09 Private party or social club
10 Through friends
11 Non-gay bar, nightclub
12 At In the Meantime program or event
13 Social organizations/volunteer service activities
14 Vacation/business trip
15 Some other way (specify):_______________
97 Don't Know
98 Refuse to Answer
99 Not Applicable
If C19 is not equal to 15, then skip to instruction before C20.
C19a. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C1 is equal to 0, then skip to instruction before C33.
(Male Partner)
If C11 is equal to 2, then skip to instruction before C33.
If C11 is equal to 3 or C11 is equal to 4, then skip to instruction before C40.
C20. How many times did you have insertive anal intercourse (you put your penis in his butt) with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C23
997 Don't Know Skip to C23
998 Refuse to Answer Skip to C23
999 Not Applicable Skip to C23
C21. Of the [Response to C20] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C23
997 Don't Know Skip to C23
998 Refuse to Answer Skip to C23
999 Not Applicable Skip to C23
If C21 is greater than C20 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C21.
C22. Of the [Response to C21] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C23
997 Don't Know Skip to C23
998 Refuse to Answer Skip to C23
999 Not Applicable Skip to C23
If C22 is greater than C21 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C22.
C23. How many times did you have receptive anal intercourse (he put his penis in your butt) with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C26
997 Don't Know Skip to C26
998 Refuse to Answer Skip to C26
999 Not Applicable Skip to C26
C24. Of the [Response to C23] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C26
997 Don't Know Skip to C26
998 Refuse to Answer Skip to C26
999 Not Applicable Skip to C26
If C24 is greater than C23 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C24.
C25. Of the [Response to C24] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C26
997 Don't Know Skip to C26
998 Refuse to Answer Skip to C26
999 Not Applicable Skip to C26
If C25 is greater than C24 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C25.
C26. In the past 3 months, how many times did you NOT have anal sex because you or partner 1 ([Response to C6]) did not have a condom?
__ __ __ time(s)
C27. In the past 3 months, as far as you know, has partner 1 ([Response to C6]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(Male Main Partner)
If C13 is equal to 1 or C13 is equal to 2 or C13 is equal to 3, then skip to instruction before C33.
C28. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 1 ([Response to C6]) to get tested for sexually transmitted infections (not including H.I.V.)?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C29. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 1 ([Response to C6]) if he was being faithful to you?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C29a. Did he tell you that he had been unfaithful to you in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
C30. Who usually has more say about whether you use condoms? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C31. Who usually has more say about what types of sexual acts you do? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C32. In general, who do you think has more power in your relationship? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
(Female Partner)
If C11 is equal to 1, then skip to instruction before C51.
C33. How many times did you have vaginal intercourse with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C36
997 Don't Know Skip to C36
998 Refuse to Answer Skip to C36
999 Not Applicable Skip to C36
C34. Of the [Response to C33] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C36
997 Don't Know Skip to C36
998 Refuse to Answer Skip to C36
999 Not Applicable Skip to C36
If C34 is greater than C33 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C34.
C35. Of the [Response to C34] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C36
997 Don't Know Skip to C36
998 Refuse to Answer Skip to C36
999 Not Applicable Skip to C36
If C35 is greater than C34 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C35.
C36. How many times did you have anal intercourse (your penis in her butt) with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C39
997 Don't Know Skip to C39
998 Refuse to Answer Skip to C39
999 Not Applicable Skip to C39
C37. Of the [Response to C36] time(s) you had anal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C39
997 Don't Know Skip to C39
998 Refuse to Answer Skip to C39
999 Not Applicable Skip to C39
If C37 is greater than C36 then READ: "The number you have given is greater than the total number of times you had anal sex." and skip to C37.
C38. Of the [Response to C37] time(s) you had anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C39
997 Don't Know Skip to C39
998 Refuse to Answer Skip to C39
999 Not Applicable Skip to C39
If C38 is greater than C37 then READ: "The number you have given is greater than the total number of times you had anal sex without a condom." and skip to C38.
C39. In the past 3 months, how many times did you NOT have vaginal or anal sex because you or partner 1 ([Response to C6]) did not have a condom?
__ __ __ time(s)
(Transgender Partner)
If C11 is equal to 1 or C11 is equal to 2, then skip to instruction before C51.
C40. How many times did you have insertive anal intercourse (you put your penis in your transgender partner's butt) with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C43
997 Don't Know Skip to C43
998 Refuse to Answer Skip to C43
999 Not Applicable Skip to C43
C41. Of the [Response to C40] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C43
997 Don't Know Skip to C43
998 Refuse to Answer Skip to C43
999 Not Applicable Skip to C43
If C41 is greater than C40 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C41.
C42. Of the [Response to C41] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C43
997 Don't Know Skip to C43
998 Refuse to Answer Skip to C43
999 Not Applicable Skip to C43
If C42 is greater than C41 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C42.
C43. How many times did you have receptive anal intercourse (your transgender partner put their penis in your butt) with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C46
997 Don't Know Skip to C46
998 Refuse to Answer Skip to C46
999 Not Applicable Skip to C46
C44. Of the [Response to C43] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C46
997 Don't Know Skip to C46
998 Refuse to Answer Skip to C46
999 Not Applicable Skip to C46
If C44 is greater than C43 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C44.
C45. Of the [Response to C44] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C46
997 Don't Know Skip to C46
998 Refuse to Answer Skip to C46
999 Not Applicable Skip to C46
If C45 is greater than C44 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C45.
C46. How many times did you have vaginal intercourse with partner 1 ([Response to C6]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C49
997 Don't Know Skip to C49
998 Refuse to Answer Skip to C49
999 Not Applicable Skip to C49
C47. Of the [Response to C46] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C49
997 Don't Know Skip to C49
998 Refuse to Answer Skip to C49
999 Not Applicable Skip to C49
If C47 is greater than C46 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C47.
C48. Of the [Response to C47] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C49
997 Don't Know Skip to C49
998 Refuse to Answer Skip to C49
999 Not Applicable Skip to C49
If C48 is greater than C47 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C48.
C49. In the past 3 months, how many times did you NOT have anal sex because you or partner 1 ([Response to C6]) did not have a condom?
__ __ __ time(s)
C50. In the past 3 months, as far as you know, has partner 1 ([Response to C6]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
If C4 is less than 2, then skip to instruction before C215.
C51. What is Partner 2's ([Response to C7]'s) gender? (Choose one) (Choose one)
1 Male
2 Female
3 Male to female transgender (transwoman)
4 Female to male transgender (transman)
7 Don't Know
8 Refuse to Answer
C52. How old is partner 2 ([Response to C7])? __ __
97 Don't Know
98 Refuse to Answer
If C52 is not equal to 97 and C52 is not equal to 98, then skip to C53.
C52a. Was this partner... (Choose one) (Choose one)
1 About the same age as you (within 5 years)
2 5 or more years older than you
3 5 or more years younger than you
C53. What type of partner is partner 2 ([Response to C7])? (Choose one) (Choose one)
1 Exchange partner (Sex for money or goods)
2 Anonymous partner (One time partner)
3 Casual partner (Sex without commitment)
4 Main Partner (Primary sexual partner)
If C53 is equal to 1, then skip to C53a.
If C53 is equal to 2 or C53 is equal to 3 or C53 is equal to 4, then skip to C53b.
C53a. Did you give partner 2 ([Response to C7]) money or goods for sex OR did partner 2 ([Response to C7]) give you money or goods for sex? (Choose one) (Choose one)
1 I gave this partner money or goods for sex
2 This partner gave me money or goods for sex
C53b. When was the first time you had anal (or vaginal) sex with partner 2 ([Response to C7])? (Choose one) (Choose one)
1 Within the past 3 months
2 Between 3 and 12 months ago
3 Over 12 months ago
C54. How would you describe partner 2's ([Response to C7]) race/ethnicity? (Choose one) (Choose one)
1 American Indian/Alaskan Native
2 Asian or Pacific Islander
3 Black, not of Hispanic origin
4 Hispanic
5 White, not of Hispanic origin
6 Other race/ethnicity (specify):_________
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C54 is not equal to 6, then skip to C55.
C54a. Other race/ethnicity (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C55. Did you and partner 2 ([Response to C7]) discuss each other's H.I.V. status before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C56. To the best of your knowledge, what is partner 2's ([Response to C7]'s) H.I.V. status? (Choose one) (Choose one)
0 Negative
1 Positive
2 Unknown/Don't know
If C56 is equal to 2, then skip to C58.
C57. How do you know that partner 2's ([Response to C7]'s) H.I.V. status is [Response to C56]? (Check all that apply) (Check all that apply)
__ I could tell by the way he/she looked
__ One of his/her friends told me what his/her status was
__ I could tell his/her status by some of the things that he/she told me
__ I checked out his/her medicine cabinet to look for H.I.V. medications
__ He/She told me directly without me asking
__ I asked him/her directly and he/she told me
__ Other (specify):____________
If C57G is not equal to 1, then skip to C58.
C57a. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C58. Did you and partner 2 ([Response to C7]) discuss each other's sexually transmitted infection status (other than H.I.V. status) before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C59. Where did you first meet partner 2 ([Response to C7])? (Choose one) (Choose one)
01 Gay bar, cafe, nightclub or restaurant
02 Sex club, bathhouse, adult novelty store or bookstore
03 Public places including street, park, shopping mall, grocery store, library, public transportation
04 Church, political function
05 Work or school
06 Gym/health club/athletic activity
07 Internet (hook up, dating or social networking site)
08 Newspaper ads
09 Private party or social club
10 Through friends
11 Non-gay bar, nightclub
12 At In the Meantime program or event
13 Social organizations/volunteer service activities
14 Vacation/business trip
15 Some other way (specify):_______________
97 Don't Know
98 Refuse to Answer
99 Not Applicable
If C59 is not equal to 15, then skip to instruction before C61.
C60. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C1 is equal to 0, then skip to instruction before C74.
(Male Partner)
If C51 is equal to 2, then skip to instruction before C74.
If C51 is equal to 3 or C51 is equal to 4, then skip to instruction before C81.
C61. How many times did you have insertive anal intercourse (you put your penis in his butt) with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C64
997 Don't Know Skip to C64
998 Refuse to Answer Skip to C64
999 Not Applicable Skip to C64
C62. Of the [Response to C61] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C64
997 Don't Know Skip to C64
998 Refuse to Answer Skip to C64
999 Not Applicable Skip to C64
If C62 is greater than C61 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C62.
C63. Of the [Response to C62] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C64
997 Don't Know Skip to C64
998 Refuse to Answer Skip to C64
999 Not Applicable Skip to C64
If C63 is greater than C62 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C63.
C64. How many times did you have receptive anal intercourse (he put his penis in your butt) with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C67
997 Don't Know Skip to C67
998 Refuse to Answer Skip to C67
999 Not Applicable Skip to C67
C65. Of the [Response to C64] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C67
997 Don't Know Skip to C67
998 Refuse to Answer Skip to C67
999 Not Applicable Skip to C67
If C65 is greater than C64 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C65.
C66. Of the [Response to C65] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C67
997 Don't Know Skip to C67
998 Refuse to Answer Skip to C67
999 Not Applicable Skip to C67
If C66 is greater than C65 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C66.
C67. In the past 3 months, how many times did you NOT have anal sex because you or partner 2 ([Response to C7]) did not have a condom?
__ __ __ time(s)
C68. In the past 3 months, as far as you know, has partner 2 ([Response to C7]) had sex with other people? (Choose one) (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(Male Main Partner)
If C53 is equal to 1 or C53 is equal to 2 or C53 is equal to 3, then skip to instruction before C74.
C69. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 2 ([Response to C7]) to get tested for sexually transmitted infections (not including H.I.V.)?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C70. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 2 ([Response to C7]) if he was being faithful to you?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C70a. Did he tell you that he had been unfaithful to you in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
C71. Who usually has more say about whether you use condoms? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C72. Who usually has more say about what types of sexual acts you do? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C73. In general, who do you think has more power in your relationship? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
(Female Partner)
If C51 is equal to 1, then skip to instruction before C92.
C74. How many times did you have vaginal intercourse with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C77
997 Don't Know Skip to C77
998 Refuse to Answer Skip to C77
999 Not Applicable Skip to C77
C75. Of the [Response to C74] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C77
997 Don't Know Skip to C77
998 Refuse to Answer Skip to C77
999 Not Applicable Skip to C77
If C75 is greater than C74 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C75.
C76. Of the [Response to C75] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C77
997 Don't Know Skip to C77
998 Refuse to Answer Skip to C77
999 Not Applicable Skip to C77
If C76 is greater than C75 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C76.
C77. How many times did you have anal intercourse (your penis in her butt) with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C80
997 Don't Know Skip to C80
998 Refuse to Answer Skip to C80
999 Not Applicable Skip to C80
C78. Of the [Response to C77] time(s) you had anal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C80
997 Don't Know Skip to C80
998 Refuse to Answer Skip to C80
999 Not Applicable Skip to C80
If C78 is greater than C77 then READ: "The number you have given is greater than the total number of times you had anal sex." and skip to C78.
C79. Of the [Response to C78] time(s) you had anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C80
997 Don't Know Skip to C80
998 Refuse to Answer Skip to C80
999 Not Applicable Skip to C80
If C79 is greater than C78 then READ: "The number you have given is greater than the total number of times you had anal sex without a condom." and skip to C79.
C80. In the past 3 months, how many times did you NOT have vaginal or anal sex because you or partner 2 ([Response to C7]) did not have a condom?
__ __ __ time(s)
(Transgender Partner)
If C51 is equal to 1 or C51 is equal to 2, then skip to instruction before C92.
C81. How many times did you have insertive anal intercourse (you put your penis in your transgender partner's butt) with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C84
997 Don't Know Skip to C84
998 Refuse to Answer Skip to C84
999 Not Applicable Skip to C84
C82. Of the [Response to C81] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C84
997 Don't Know Skip to C84
998 Refuse to Answer Skip to C84
999 Not Applicable Skip to C84
If C82 is greater than C81 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C82.
C83. Of the [Response to C82] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C84
997 Don't Know Skip to C84
998 Refuse to Answer Skip to C84
999 Not Applicable Skip to C84
If C83 is greater than C82 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C83.
C84. How many times did you have receptive anal intercourse (your transgender partner put their penis in your butt) with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C87
997 Don't Know Skip to C87
998 Refuse to Answer Skip to C87
999 Not Applicable Skip to C87
C85. Of the [Response to C84] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C87
997 Don't Know Skip to C87
998 Refuse to Answer Skip to C87
999 Not Applicable Skip to C87
If C85 is greater than C84 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C85.
C86. Of the [Response to C85] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C87
997 Don't Know Skip to C87
998 Refuse to Answer Skip to C87
999 Not Applicable Skip to C87
If C86 is greater than C85 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C86.
C87. How many times did you have vaginal intercourse with partner 2 ([Response to C7]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C90
997 Don't Know Skip to C90
998 Refuse to Answer Skip to C90
999 Not Applicable Skip to C90
C88. Of the [Response to C87] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C90
997 Don't Know Skip to C90
998 Refuse to Answer Skip to C90
999 Not Applicable Skip to C90
If C88 is greater than C87 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C88.
C89. Of the [Response to C88] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C90
997 Don't Know Skip to C90
998 Refuse to Answer Skip to C90
999 Not Applicable Skip to C90
If C89 is greater than C88 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C89.
C90. In the past 3 months, how many times did you NOT have anal sex because you or partner 2 ([Response to C7]) did not have a condom?
__ __ __ time(s)
C91. In the past 3 months, as far as you know, has partner 2 ([Response to C7]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
If C4 is less than 3, then skip to instruction before C215.
C92. What is Partner 3's ([Response to C8]'s) gender? (Choose one) (Choose one)
1 Male
2 Female
3 Male to female transgender (transwoman)
4 Female to male transgender (transman)
7 Don't Know
8 Refuse to Answer
C93. How old is partner 3 ([Response to C8])? __ __
97 Don't Know
98 Refuse to Answer
If C93 is not equal to 97 and C93 is not equal to 98, then skip to C94.
C93a. Was this partner... (Choose one) (Choose one)
1 About the same age as you (within 5 years)
2 5 or more years older than you
3 5 or more years younger than you
C94. What type of partner is partner 3 ([Response to C8])? (Choose one) (Choose one)
1 Exchange partner (Sex for money or goods)
2 Anonymous partner (One time partner)
3 Casual partner (Sex without commitment)
4 Main Partner (Primary sexual partner)
If C94 is equal to 1, then skip to C94a.
If C94 is equal to 2 or C94 is equal to 3 or C94 is equal to 4, then skip to C94b.
C94a. Did you give partner 3 ([Response to C8]) money or goods for sex OR did partner 3 ([Response to C8]) give you money or goods for sex? (Choose one) (Choose one)
1 I gave this partner money or goods for sex
2 This partner gave me money or goods for sex
C94b. When was the first time you had anal (or vaginal) sex with partner 3 ([Response to C8])? (Choose one) (Choose one)
1 Within the past 3 months
2 Between 3 and 12 months ago
3 Over 12 months ago
C95. How would you describe partner 3's ([Response to C8]) race/ethnicity? (Choose one) (Choose one)
1 American Indian/Alaskan Native
2 Asian or Pacific Islander
3 Black, not of Hispanic origin
4 Hispanic
5 White, not of Hispanic origin
6 Other race/ethnicity (specify):_________
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C95 is not equal to 6, then skip to C96.
C95a. Other race/ethnicity (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C96. Did you and partner 3 ([Response to C8]) discuss each other's H.I.V. status before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C97. To the best of your knowledge, what is partner 3's ([Response to C8]'s) H.I.V. status? (Choose one) (Choose one)
0 Negative
1 Positive
2 Unknown/Don't know
If C97 is equal to 2, then skip to C99.
C98. How do you know that partner 3's ([Response to C8]'s) H.I.V. status is [Response to C97]? (Check all that apply) (Check all that apply)
__ I could tell by the way he/she looked
__ One of his/her friends told me what his/her status was
__ I could tell his/her status by some of the things that he/she told me
__ I checked out his/her medicine cabinet to look for H.I.V. medications
__ He/She told me directly without me asking
__ I asked him/her directly and he/she told me
__ Other (specify):____________
If C98G is not equal to 1, then skip to C99.
C98a. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C99. Did you and partner 3 ([Response to C8]) discuss each other's sexually transmitted infection status (other than H.I.V. status) before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C100. Where did you first meet partner 3 ([Response to C8])? (Choose one) (Choose one)
01 Gay bar, cafe, nightclub or restaurant
02 Sex club, bathhouse, adult novelty store or bookstore
03 Public places including street, park, shopping mall, grocery store, library, public transportation
04 Church, political function
05 Work or school
06 Gym/health club/athletic activity
07 Internet (hook up, dating or social networking site)
08 Newspaper ads
09 Private party or social club
10 Through friends
11 Non-gay bar, nightclub
12 At In the Meantime program or event
13 Social organizations/volunteer service activities
14 Vacation/business trip
15 Some other way (specify):_______________
97 Don't Know
98 Refuse to Answer
99 Not Applicable
If C100 is not equal to 15, then skip to instruction before C102.
C101. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C1 is equal to 0, then skip to instruction before C115.
(Male Partner)
If C92 is equal to 2, then skip to instruction before C115.
If C92 is equal to 3 or C92 is equal to 4, then skip to instruction before C122.
C102. How many times did you have insertive anal intercourse (you put your penis in his butt) with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C105
997 Don't Know Skip to C105
998 Refuse to Answer Skip to C105
999 Not Applicable Skip to C105
C103. Of the [Response to C102] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C105
997 Don't Know Skip to C105
998 Refuse to Answer Skip to C105
999 Not Applicable Skip to C105
If C103 is greater than C102 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C103.
C104. Of the [Response to C103] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C105
997 Don't Know Skip to C105
998 Refuse to Answer Skip to C105
999 Not Applicable Skip to C105
If C104 is greater than C103 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C104.
C105. How many times did you have receptive anal intercourse (he put his penis in your butt) with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C108
997 Don't Know Skip to C108
998 Refuse to Answer Skip to C108
999 Not Applicable Skip to C108
C106. Of the [Response to C105] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C108
997 Don't Know Skip to C108
998 Refuse to Answer Skip to C108
999 Not Applicable Skip to C108
If C106 is greater than C105 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C106.
C107. Of the [Response to C106] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C108
997 Don't Know Skip to C108
998 Refuse to Answer Skip to C108
999 Not Applicable Skip to C108
If C107 is greater than C106 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C107.
C108. In the past 3 months, how many times did you NOT have anal sex because you or partner 3 ([Response to C8]) did not have a condom?
__ __ __ time(s)
C109. In the past 3 months, as far as you know, has partner 3 ([Response to C8]) had sex with other people? (Choose one) (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(Male Main Partner)
If C94 is equal to 1 or C94 is equal to 2 or C94 is equal to 3, then skip to instruction before C115.
C110. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 3 ([Response to C8]) to get tested for sexually transmitted infections (not including H.I.V.)?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C111. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 3 ([Response to C8]) if he was being faithful to you?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C111a. Did he tell you that he had been unfaithful to you in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
C112. Who usually has more say about whether you use condoms? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C113. Who usually has more say about what types of sexual acts you do? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C114. In general, who do you think has more power in your relationship? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
(Female Partner)
If C92 is equal to 1, then skip to instruction before C133.
C115. How many times did you have vaginal intercourse with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C118
997 Don't Know Skip to C118
998 Refuse to Answer Skip to C118
999 Not Applicable Skip to C118
C116. Of the [Response to C115] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C118
997 Don't Know Skip to C118
998 Refuse to Answer Skip to C118
999 Not Applicable Skip to C118
If C116 is greater than C115 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C116.
C117. Of the [Response to C116] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C118
997 Don't Know Skip to C118
998 Refuse to Answer Skip to C118
999 Not Applicable Skip to C118
If C117 is greater than C116 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C117.
C118. How many times did you have anal intercourse (your penis in her butt) with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C121
997 Don't Know Skip to C121
998 Refuse to Answer Skip to C121
999 Not Applicable Skip to C121
C119. Of the [Response to C118] time(s) you had anal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C121
997 Don't Know Skip to C121
998 Refuse to Answer Skip to C121
999 Not Applicable Skip to C121
If C119 is greater than C118 then READ: "The number you have given is greater than the total number of times you had anal sex." and skip to C119.
C120. Of the [Response to C119] time(s) you had anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C121
997 Don't Know Skip to C121
998 Refuse to Answer Skip to C121
999 Not Applicable Skip to C121
If C120 is greater than C119 then READ: "The number you have given is greater than the total number of times you had anal sex without a condom." and skip to C120.
C121. In the past 3 months, how many times did you NOT have vaginal or anal sex because you or partner 3 ([Response to C8]) did not have a condom?
__ __ __ time(s)
(Transgender Partner)
If C92 is equal to 1 or C92 is equal to 2, then skip to instruction before C133.
C122. How many times did you have insertive anal intercourse (you put your penis in your transgender partner's butt) with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C125
997 Don't Know Skip to C125
998 Refuse to Answer Skip to C125
999 Not Applicable Skip to C125
C123. Of the [Response to C122] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C125
997 Don't Know Skip to C125
998 Refuse to Answer Skip to C125
999 Not Applicable Skip to C125
If C123 is greater than C122 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C123.
C124. Of the [Response to C123] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C125
997 Don't Know Skip to C125
998 Refuse to Answer Skip to C125
999 Not Applicable Skip to C125
If C124 is greater than C123 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C124.
C125. How many times did you have receptive anal intercourse (your transgender partner put their penis in your butt) with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C128
997 Don't Know Skip to C128
998 Refuse to Answer Skip to C128
999 Not Applicable Skip to C128
C126. Of the [Response to C125] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C128
997 Don't Know Skip to C128
998 Refuse to Answer Skip to C128
999 Not Applicable Skip to C128
If C126 is greater than C125 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C126.
C127. Of the [Response to C126] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C128
997 Don't Know Skip to C128
998 Refuse to Answer Skip to C128
999 Not Applicable Skip to C128
If C127 is greater than C126 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C127.
C128. How many times did you have vaginal intercourse with partner 3 ([Response to C8]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C131
997 Don't Know Skip to C131
998 Refuse to Answer Skip to C131
999 Not Applicable Skip to C131
C129. Of the [Response to C128] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C131
997 Don't Know Skip to C131
998 Refuse to Answer Skip to C131
999 Not Applicable Skip to C131
If C129 is greater than C128 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C129.
C130. Of the [Response to C129] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C131
997 Don't Know Skip to C131
998 Refuse to Answer Skip to C131
999 Not Applicable Skip to C131
If C130 is greater than C129 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C130.
C131. In the past 3 months, how many times did you NOT have anal sex because you or partner 3 ([Response to C8]) did not have a condom?
__ __ __ time(s)
C132. In the past 3 months, as far as you know, has partner 3 ([Response to C8]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
If C4 is less than 4, then skip to instruction before C215.
C133. What is Partner 4's ([Response to C9]'s) gender? (Choose one) (Choose one)
1 Male
2 Female
3 Male to female transgender (transwoman)
4 Female to male transgender (transman)
7 Don't Know
8 Refuse to Answer
C134. How old is partner 4 ([Response to C9])? __ __
97 Don't Know
98 Refuse to Answer
If C134 is not equal to 97 and C134 is not equal to 98, then skip to C135.
C134a. Was this partner... (Choose one) (Choose one)
1 About the same age as you (within 5 years)
2 5 or more years older than you
3 5 or more years younger than you
C135. What type of partner is partner 4 ([Response to C9])? (Choose one) (Choose one)
1 Exchange partner (Sex for money or goods)
2 Anonymous partner (One time partner)
3 Casual partner (Sex without commitment)
4 Main Partner (Primary sexual partner)
If C135 is equal to 1, then skip to C135a.
If C135 is equal to 2 or C135 is equal to 3 or C135 is equal to 4, then skip to C135b.
C135a. Did you give partner 4 ([Response to C9]) money or goods for sex OR did partner 4 ([Response to C9]) give you money or goods for sex? (Choose one) (Choose one)
1 I gave this partner money or goods for sex
2 This partner gave me money or goods for sex
C135b. When was the first time you had anal (or vaginal) sex with partner 4 ([Response to C9])? (Choose one) (Choose one)
1 Within the past 3 months
2 Between 3 and 12 months ago
3 Over 12 months ago
C136. How would you describe partner 4's ([Response to C9]) race/ethnicity? (Choose one)
1 American Indian/Alaskan Native
2 Asian or Pacific Islander
3 Black, not of Hispanic origin
4 Hispanic
5 White, not of Hispanic origin
6 Other race ethnicity (specify):_________
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C136 is not equal to 6, then skip to C137.
C136a. Other race/ethnicity (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C137. Did you and partner 4 ([Response to C9]) discuss each other's H.I.V. status before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C138. To the best of your knowledge, what is partner 4's ([Response to C9]'s) H.I.V. status? (Choose one) (Choose one)
0 Negative
1 Positive
2 Unknown/Don't know
If C138 is equal to 2, then skip to C140.
C139. How do you know that partner 4's ([Response to C9]'s) H.I.V. status is [Response to C138]? (Check all that apply) (Check all that apply)
__ I could tell by the way he/she looked
__ One of his/her friends told me what his/her status was
__ I could tell his/her status by some of the things that he/she told me
__ I checked out his/her medicine cabinet to look for H.I.V. medications
__ He/She told me directly without me asking
__ I asked him/her directly and he/she told me
__ Other (specify):____________
If C139G is not equal to 1, then skip to C140.
C139a. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C140. Did you and partner 4 ([Response to C9]) discuss each other's sexually transmitted infection status (other than H.I.V. status) before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C141. Where did you first meet partner 4 ([Response to C9])? (Choose one) (Choose one)
01 Gay bar, cafe, nightclub or restaurant
02 Sex club, bathhouse, adult novelty store or bookstore
03 Public places including street, park, shopping mall, grocery store, library, public transportation
04 Church, political function
05 Work or school
06 Gym/health club/athletic activity
07 Internet (hook up, dating or social networking site)
08 Newspaper ads
09 Private party or social club
10 Through friends
11 Non-gay bar, nightclub
12 At In the Meantime program or event
13 Social organizations/volunteer service activities
14 Vacation/business trip
15 Some other way (specify):_______________
97 Don't Know
98 Refuse to Answer
99 Not Applicable
If C141 is not equal to 15, then skip to instruction before C143.
C142. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C1 is equal to 0, then skip to instruction before C156.
(Male Partner)
If C133 is equal to 2, then skip to instruction before C156.
If C133 is equal to 3 or C133 is equal to 4, then skip to instruction before C163.
C143. How many times did you have insertive anal intercourse (you put your penis in his butt) with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C146
997 Don't Know Skip to C146
998 Refuse to Answer Skip to C146
999 Not Applicable Skip to C146
C144. Of the [Response to C143] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C146
997 Don't Know Skip to C146
998 Refuse to Answer Skip to C146
999 Not Applicable Skip to C146
If C144 is greater than C143 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C144.
C145. Of the [Response to C144] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C146
997 Don't Know Skip to C146
998 Refuse to Answer Skip to C146
999 Not Applicable Skip to C146
If C145 is greater than C144 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C145.
C146. How many times did you have receptive anal intercourse (he put his penis in your butt) with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C149
997 Don't Know Skip to C149
998 Refuse to Answer Skip to C149
999 Not Applicable Skip to C149
C147. Of the [Response to C146] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C149
997 Don't Know Skip to C149
998 Refuse to Answer Skip to C149
999 Not Applicable Skip to C149
If C147 is greater than C146 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C147.
C148. Of the [Response to C147] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C149
997 Don't Know Skip to C149
998 Refuse to Answer Skip to C149
999 Not Applicable Skip to C149
If C148 is greater than C147 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C148.
C149. In the past 3 months, how many times did you NOT have anal sex because you or partner 4 ([Response to C9]) did not have a condom?
__ __ __ time(s)
C150. In the past 3 months, as far as you know, has partner 4 ([Response to C9]) had sex with other people? (Choose one) (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(Male Main Partner)
If C135 is equal to 1 or C135 is equal to 2 or C135 is equal to 3, then skip to instruction before C156.
C151. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 4 ([Response to C9]) to get tested for sexually transmitted infections (not including H.I.V.)?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C152. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 4 ([Response to C9]) if he was being faithful to you?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C152a. Did he tell you that he had been unfaithful to you in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
C153. Who usually has more say about whether you use condoms? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C154. Who usually has more say about what types of sexual acts you do? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C155. In general, who do you think has more power in your relationship? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
(Female Partner)
If C133 is equal to 1, then skip to instruction before C174.
C156. How many times did you have vaginal intercourse with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C159
997 Don't Know Skip to C159
998 Refuse to Answer Skip to C159
999 Not Applicable Skip to C159
C157. Of the [Response to C156] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C159
997 Don't Know Skip to C159
998 Refuse to Answer Skip to C159
999 Not Applicable Skip to C159
If C157 is greater than C156 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C157.
C158. Of the [Response to C157] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C159
997 Don't Know Skip to C159
998 Refuse to Answer Skip to C159
999 Not Applicable Skip to C159
If C158 is greater than C157 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C158.
C159. How many times did you have anal intercourse (your penis in her butt) with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C162
997 Don't Know Skip to C162
998 Refuse to Answer Skip to C162
999 Not Applicable Skip to C162
C160. Of the [Response to C159] time(s) you had anal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C162
997 Don't Know Skip to C162
998 Refuse to Answer Skip to C162
999 Not Applicable Skip to C162
If C160 is greater than C159 then READ: "The number you have given is greater than the total number of times you had anal sex." and skip to C160.
C161. Of the [Response to C160] time(s) you had anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C162
997 Don't Know Skip to C162
998 Refuse to Answer Skip to C162
999 Not Applicable Skip to C162
If C161 is greater than C160 then READ: "The number you have given is greater than the total number of times you had anal sex without a condom." and skip to C161.
C162. In the past 3 months, how many times did you NOT have vaginal or anal sex because you or partner 4 ([Response to C9]) did not have a condom?
__ __ __ time(s)
(Transgender Partner)
If C133 is equal to 1 or C133 is equal to 2, then skip to instruction before C174.
C163. How many times did you have insertive anal intercourse (you put your penis in your transgender partner's butt) with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C166
997 Don't Know Skip to C166
998 Refuse to Answer Skip to C166
999 Not Applicable Skip to C166
C164. Of the [Response to C163] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C166
997 Don't Know Skip to C166
998 Refuse to Answer Skip to C166
999 Not Applicable Skip to C166
If C164 is greater than C163 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C164.
C165. Of the [Response to C164] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C166
997 Don't Know Skip to C166
998 Refuse to Answer Skip to C166
999 Not Applicable Skip to C166
If C165 is greater than C164 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C165.
C166. How many times did you have receptive anal intercourse (your transgender partner put their penis in your butt) with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C169
997 Don't Know Skip to C169
998 Refuse to Answer Skip to C169
999 Not Applicable Skip to C169
C167. Of the [Response to C166] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C169
997 Don't Know Skip to C169
998 Refuse to Answer Skip to C169
999 Not Applicable Skip to C169
If C167 is greater than C166 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C167.
C168. Of the [Response to C167] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C169
997 Don't Know Skip to C169
998 Refuse to Answer Skip to C169
999 Not Applicable Skip to C169
If C168 is greater than C167 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C168.
C169. How many times did you have vaginal intercourse with partner 4 ([Response to C9]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C172
997 Don't Know Skip to C172
998 Refuse to Answer Skip to C172
999 Not Applicable Skip to C172
C170. Of the [Response to C169] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C172
997 Don't Know Skip to C172
998 Refuse to Answer Skip to C172
999 Not Applicable Skip to C172
If C170 is greater than C169 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C170.
C171. Of the [Response to C170] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C172
997 Don't Know Skip to C172
998 Refuse to Answer Skip to C172
999 Not Applicable Skip to C172
If C171 is greater than C170 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C171.
C172. In the past 3 months, how many times did you NOT have anal sex because you or partner 4 ([Response to C9]) did not have a condom?
__ __ __ time(s)
C173. In the past 3 months, as far as you know, has partner 4 ([Response to C9]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
If C4 is less than 5, then skip to instruction before C215.
C174. What is Partner 5's ([Response to C10]'s) gender? (Choose one) (Choose one)
1 Male
2 Female
3 Male to female transgender (transwoman)
4 Female to male transgender (transman)
7 Don't Know
8 Refuse to Answer
C175. How old is partner 5 ([Response to C10])? __ __
97 Don't Know
98 Refuse to Answer
If C175 is not equal to 97 and C175 is not equal to 98, then skip to C176.
C175a. Was this partner... (Choose one) (Choose one)
1 About the same age as you (within 5 years)
2 5 or more years older than you
3 5 or more years younger than you
C176. What type of partner is partner 5 ([Response to C10])? (Choose one) (Choose one)
1 Exchange partner (Sex for money or goods)
2 Anonymous partner (One time partner)
3 Casual partner (Sex without commitment)
4 Main Partner (Primary sexual partner)
If C176 is equal to 1, then skip to C176a.
If C176 is equal to 2 or C176 is equal to 3 or C176 is equal to 4, then skip to C176b.
C176a. Did you give partner 5 ([Response to C10]) money or goods for sex OR did partner 5 ([Response to C10]) give you money or goods for sex? (Choose one) (Choose one)
1 I gave this partner money or goods for sex
2 This partner gave me money or goods for sex
C176b. When was the first time you had anal (or vaginal) sex with partner 5 ([Response to C10])? (Choose one) (Choose one)
1 Within the past 3 months
2 Between 3 and 12 months ago
3 Over 12 months ago
C177. How would you describe partner 5's ([Response to C10]) race/ethnicity? (Choose one)
1 American Indian/Alaskan Native
2 Asian or Pacific Islander
3 Black, not of Hispanic origin
4 Hispanic
5 White, not of Hispanic origin
6 Other race/ethnicity (specify):_________
7 Don't Know
8 Refuse to Answer
9 Not Applicable
If C177 is not equal to 6, then skip to C178.
C177a. Other race/ethnicity (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C178. Did you and partner 5 ([Response to C10]) discuss each other's H.I.V. status before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C179. To the best of your knowledge, what is partner 5's ([Response to C10]'s) H.I.V. status? (Choose one) (Choose one)
0 Negative
1 Positive
2 Unknown/Don't know
If C179 is equal to 2, then skip to C181.
C180. How do you know that partner 5's ([Response to C10]'s) H.I.V. status is [Response to C179]? (Check all that apply) (Check all that apply)
__ I could tell by the way he/she looked
__ One of his/her friends told me what his/her status was
__ I could tell his/her status by some of the things that he/she told me
__ I checked out his/her medicine cabinet to look for H.I.V. medications
__ He/She told me directly without me asking
__ I asked him/her directly and he/she told me
__ Other (specify):____________
If C180G is not equal to 1, then skip to C181.
C180a. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
C181. Did you and partner 5 ([Response to C10]) discuss each other's sexually transmitted infection status (other than H.I.V. status) before you had intercourse the first time?
1 Yes
0 No
8 Refuse to Answer
C182. Where did you first meet partner 5 ([Response to C10])? (Choose one) (Choose one)
01 Gay bar, cafe, nightclub or restaurant
02 Sex club, bathhouse, adult novelty store or bookstore
03 Public places including street, park, shopping mall, grocery store, library, public transportation
04 Church, political function
05 Work or school
06 Gym/health club/athletic activity
07 Internet (hook up, dating or social networking site)
08 Newspaper ads
09 Private party or social club
10 Through friends
11 Non-gay bar, nightclub
12 At In the Meantime program or event
13 Social organizations/volunteer service activities
14 Vacation/business trip
15 Some other way (specify):_______________
97 Don't Know
98 Refuse to Answer
99 Not Applicable
If C182 is not equal to 15, then skip to instruction before C184.
C183. Other (specify): __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If C1 is equal to 0, then skip to instruction before C197.
(Male Partner)
If C174 is equal to 2, then skip to instruction before C197.
If C174 is equal to 3 or C174 is equal to 4, then skip to instruction before C204.
C184. How many times did you have insertive anal intercourse (you put your penis in his butt) with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C187
997 Don't Know Skip to C187
998 Refuse to Answer Skip to C187
999 Not Applicable Skip to C187
C185. Of the [Response to C184] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C187
997 Don't Know Skip to C187
998 Refuse to Answer Skip to C187
999 Not Applicable Skip to C187
If C185 is greater than C184 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C185.
C186. Of the [Response to C185] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C187
997 Don't Know Skip to C187
998 Refuse to Answer Skip to C187
999 Not Applicable Skip to C187
If C186 is greater than C185 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C186.
C187. How many times did you have receptive anal intercourse (he put his penis in your butt) with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C190
997 Don't Know Skip to C190
998 Refuse to Answer Skip to C190
999 Not Applicable Skip to C190
C188. Of the [Response to C187] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C190
997 Don't Know Skip to C190
998 Refuse to Answer Skip to C190
999 Not Applicable Skip to C190
If C188 is greater than C187 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C188.
C189. Of the [Response to C188] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C190
997 Don't Know Skip to C190
998 Refuse to Answer Skip to C190
999 Not Applicable Skip to C190
If C189 is greater than C188 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C189.
C190. In the past 3 months, how many times did you NOT have anal sex because you or partner 5 ([Response to C10]) did not have a condom?
__ __ __ time(s)
C191. In the past 3 months, as far as you know, has partner 5 ([Response to C10]) had sex with other people? (Choose one) (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(Male Main Partner)
If C176 is equal to 1 or C176 is equal to 2 or C176 is equal to 3, then skip to instruction before C197.
C192. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 5 ([Response to C10]) to get tested for S.T.I's (not including H.I.V.)?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C193. In the past 3 months, that is since [AGO3M_6], how many times did you ask partner 5 ([Response to C10]) if he was being faithful to you?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
99 Not Applicable
C193a. Did he tell you that he had been unfaithful to you in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
C194. Who usually has more say about whether you use condoms? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C195. Who usually has more say about what types of sexual acts you do? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
C196. In general, who do you think has more power in your relationship? (Choose one) (Choose one)
1 Your partner
2 Both of you equally
3 You
(Female Partner)
If C174 is equal to 1, then skip to instruction before C215.
C197. How many times did you have vaginal intercourse with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C200
997 Don't Know Skip to C200
998 Refuse to Answer Skip to C200
999 Not Applicable Skip to C200
C198. Of the [Response to C197] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C200
997 Don't Know Skip to C200
998 Refuse to Answer Skip to C200
999 Not Applicable Skip to C200
If C198 is greater than C197 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C198.
C199. Of the [Response to C198] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C200
997 Don't Know Skip to C200
998 Refuse to Answer Skip to C200
999 Not Applicable Skip to C200
If C199 is greater than C198 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C199.
C200. How many times did you have anal intercourse (your penis in her butt) with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C203
997 Don't Know Skip to C203
998 Refuse to Answer Skip to C203
999 Not Applicable Skip to C203
C201. Of the [Response to C200] time(s) you had anal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C203
997 Don't Know Skip to C203
998 Refuse to Answer Skip to C203
999 Not Applicable Skip to C203
If C201 is greater than C200 then READ: "The number you have given is greater than the total number of times you had anal sex." and skip to C201.
C202. Of the [Response to C201] time(s) you had anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C203
997 Don't Know Skip to C203
998 Refuse to Answer Skip to C203
999 Not Applicable Skip to C203
If C202 is greater than C201 then READ: "The number you have given is greater than the total number of times you had anal sex without a condom." and skip to C202.
C203. In the past 3 months, how many times did you NOT have vaginal or anal sex because you or partner 5 ([Response to C10]) did not have a condom?
__ __ __ time(s)
(Transgender Partner)
If C174 is equal to 1 or C174 is equal to 2, then skip to instruction before C215.
C204. How many times did you have insertive anal intercourse (you put your penis in your transgender partner's butt) with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C207
997 Don't Know Skip to C207
998 Refuse to Answer Skip to C207
999 Not Applicable Skip to C207
C205. Of the [Response to C204] time(s) you had insertive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C207
997 Don't Know Skip to C207
998 Refuse to Answer Skip to C207
999 Not Applicable Skip to C207
If C205 is greater than C204 then READ: "The number you have given is greater than the total number of times you had insertive anal sex." and skip to C205.
C206. Of the [Response to C205] time(s) you had insertive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C207
997 Don't Know Skip to C207
998 Refuse to Answer Skip to C207
999 Not Applicable Skip to C207
If C206 is greater than C205 then READ: "The number you have given is greater than the total number of times you had insertive anal sex without a condom." and skip to C206.
C207. How many times did you have receptive anal intercourse (your transgender partner put their penis in your butt) with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C210
997 Don't Know Skip to C210
998 Refuse to Answer Skip to C210
999 Not Applicable Skip to C210
C208. Of the [Response to C207] time(s) you had receptive anal sex, how many times was a condom NOT used?
__ __ __ time(s)
000 zero Skip to C210
997 Don't Know Skip to C210
998 Refuse to Answer Skip to C210
999 Not Applicable Skip to C210
If C208 is greater than C207 then READ: "The number you have given is greater than the total number of times you had receptive anal sex." and skip to C208.
C209. Of the [Response to C208] time(s) you had receptive anal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C210
997 Don't Know Skip to C210
998 Refuse to Answer Skip to C210
999 Not Applicable Skip to C210
If C209 is greater than C208 then READ: "The number you have given is greater than the total number of times you had receptive anal sex without a condom." and skip to C209.
C210. How many times did you have vaginal intercourse with partner 5 ([Response to C10]) in the past 3 months (between [AGO3M_6] and [FU6_DT])?
__ __ __ time(s)
000 zero Skip to C213
997 Don't Know Skip to C213
998 Refuse to Answer Skip to C213
999 Not Applicable Skip to C213
C211. Of the [Response to C210] time(s) you had vaginal sex, how many times did you NOT use a condom?
__ __ __ time(s)
000 zero Skip to C213
997 Don't Know Skip to C213
998 Refuse to Answer Skip to C213
999 Not Applicable Skip to C213
If C211 is greater than C210 then READ: "The number you have given is greater than the total number of times you had vaginal sex." and skip to C211.
C212. Of the [Response to C211] time(s) you had vaginal sex without a condom, how many times were you high or drunk?
__ __ __ time(s)
000 zero Skip to C213
997 Don't Know Skip to C213
998 Refuse to Answer Skip to C213
999 Not Applicable Skip to C213
If C212 is greater than C211 then READ: "The number you have given is greater than the total number of times you had vaginal sex without a condom." and skip to C212.
C213. In the past 3 months, how many times did you NOT have anal sex because you or partner 5 ([Response to C10]) did not have a condom?
__ __ __ time(s)
C214. In the past 3 months, as far as you know, has partner 5 ([Response to C10]) had sex with other people? (Choose one)
0 No
1 Yes, with other men
2 Yes, with other women
3 Yes, with both men and women
4 Yes, but I don't know who they had sex with
5 Don't know
(All Respondents)
C215. In the past 3 months, did you have anal sex with any male sex partners because they gave you drugs, money, a place to stay, or other things you needed? (Choose one) (Choose one)
0 No
1 Yes, only with one man
2 Yes, with more than one man
8 Refuse to Answer
C216. Before having sex with a man for the first time, how often do you discuss both of your H.I.V. statuses? (Choose one) (Choose one)
1 All the time
2 More than half the time
3 About half the time
4 Less than half the time
5 None of the time
8 Refuse to Answer
C217. Before having sex with a man for the first time, how often do you discuss being tested for sexually transmitted infections (like gonorrhea, Chlamydia but not including H.I.V.)? (Choose one) (Choose one)
1 All the time
2 More than half the time
3 About half the time
4 Less than half the time
5 None of the time
8 Refuse to Answer
C218. Before having sex with a man for the first time, how often do you discuss having safer sex (like mutual masturbation/oral sex instead of anal sex)? (Choose one) (Choose one)
1 All the time
2 More than half the time
3 About half the time
4 Less than half the time
5 None of the time
8 Refuse to Answer
C219. In the past 3 months, how many times have you been in a situation where your partner wanted to have anal or vaginal sex without a condom?
__ __ __ time(s)
000 zero Skip to instruction before C220
997 Don't Know Skip to instruction before C220
998 Refuse to Answer Skip to instruction before C220
999 Not Applicable Skip to instruction before C220
C219a. Of those [Response to C219] time(s), how many times did you have anal or vaginal sex without a condom?
__ __ __ time(s)
997 Don't Know
998 Refuse to Answer
999 Not Applicable
If C219a is greater than C219 then READ: "The number you have given is greater than the total number of times have you been in a situation where your partner wanted to have anal or vaginal sex without a condom." and skip to C219a.
C220. During the past 3 months, how emotionally satisfying was your sex life? (Choose one) (Choose one)
1 Not at all satisfying
2 Slightly satisfying
3 Moderately satisfying
4 Very satisfying
5 Extremely satisfying
C221. During the past 3 months, how physically pleasurable was your sex life? (Choose one) (Choose one)
1 Not at all pleasurable
2 Slightly pleasurable
3 Moderately pleasurable
4 Very pleasurable
5 Extremely pleasurable
E. Internalized Homophobia
READ:
Attraction
to Men:
The next several questions are about attractions to men. Please read
each item and use the following scale to rate how well you agree or
disagree with the statement.
Please
remember your answers will be kept private.
E1. In the past 3 months, I have tried to stop being attracted to men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E2. If someone offered me the chance to be completely heterosexual (straight), I would accept it. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E3. I wish I were not sexually involved with men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E4. I would change my sexual preferences if I could. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E5. In the past 3 months, I have tried to become more sexually attracted to women. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E6. I try to avoid personal or social involvement with gay or homosexual men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E7. I try to avoid personal or social involvement with men who are bisexually or sexually active with both men and women. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E8. I don't like being gay/homosexual. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E9. I wish that I could develop more sexual desire towards women. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E10. I am uncomfortable being attracted to men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E11. I value my sexuality as it is. (Choose one) (Choose one) 1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
E12. I try to avoid contact with overly effeminate men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
F. Gender Role Conflict
READ:
Gender
Role Conflict:
Please answer the next set of questions about how you might show
affection for others.
Please
remember your answers will be kept private.
F1. Verbally expressing my love or caring for another man is difficult for me. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F2. Affection with other men makes me tense. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F3. Expressing my emotions to other men is risky. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F4. Men who touch other men make me uncomfortable. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F5. Hugging other men is difficult for me. (Choose one) (Choose one) 1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F6. I am sometimes hesitant to show my affection to men because of how others might perceive me. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F7. Being very personal with other men makes me feel uncomfortable. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F8. Men who are overly friendly make me wonder about their sexual preference. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F9. I never want to look or seem weak. (Choose one) (Choose one) 1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F10. Men should never show their feminine side. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F11. I do not want to seem effeminate, girlish, or womanly. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F12. It is important for men to look tough. (Choose one) (Choose one) 1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
F13. Men must seem strong to be respected. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree
3 Mildly disagree
4 Mildly agree
5 Agree
6 Strongly agree
8 Refuse to Answer
G. Social Support for Safer Sex/Risk Reduction
READ:
Social
Support for Safer Sex/Risk Reduction:
The next set of questions are about people you know including friends
and family members.
Please
remember your answers will be kept private.
G1. Who have you told that you have sex with men? (Check all that apply) (Check all that apply)
__ My mother or the woman who raised me
__ My father or the man who raised me
__ My brother(s)
__ My sister(s)
__ My minister or priest
__ Straight friends
__ Gay friends
__ Therapist
__ Health care provider
__ My teacher/counselor
__ Other
__ Refuse to Answer
If G1K is not equal to 1, then skip to G2.
G1a. Other (specify):___________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
G2. How important is it for you that people who are close to you know that you have sex with men? (Choose one) (Choose one)
1 Very important
2 Somewhat important
3 A little important
4 Not at all important
8 Refuse to Answer
G3. How close do you feel to your family? On a scale of 1 to 5 with 1="Not at all close" and 5="Extremely close"
1 Not at all close
2
3
4
5 Extremely close
READ: How much do you agree or disagree with the following statements about your family?
4a. I have family members who remind me to stay safe sexually. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4b. I have family members who will try to advise me if they think I'm in an unhealthy relationship. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4c. I have family members who encourage me to know the truth about my H.I.V./sexually transmitted infection status. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4d. I have family members who remind me to protect myself from H.I.V./sexually transmitted infections. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4e. I have family members who encourage me to always use condoms. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4f. I have family members who would express concern if I tell them my boyfriend is having sex with other people. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4g. I have family members who are supportive of me being monogamous in my relationships with men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4h. I have family members who I can talk to if I find out I have a sexually transmitted infection (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4i. I have family members who I can talk to if I have unprotected sex. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
4j. I have family members who are willing to talk to me about the intimate details of my sex life. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
5. What kind of influence does your family have on your ability to practice safer sex? (Choose one) (Choose one)
1 Very negative
2 Negative
3 Neither negative nor positive
4 Positive
5 Very positive
READ: How much do you agree or disagree with the following statements about your friends?
6a. I have friends who remind me to stay safe sexually. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6b. I have friends who will try to advise me if they think I'm in an unhealthy relationship. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6c. I have friends who encourage me to know/find out my H.I.V. status. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6d. I have friends who remind me to protect myself from H.I.V./sexually transmitted infections. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6e. I have friends who encourage me to always use condoms. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6f. I have friends who would express concern if I tell them my boyfriend is having sex with other people. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6g. I have friends who are supportive of me being monogamous in my relationships with men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6h. I have friends who I can talk to if I find out I have a sexually transmitted infection. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6i. I have friends who I can talk to if I have unprotected sex. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
6j. I have friends who are willing to talk to me about the intimate details of my sex life. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
7. What kind of influence do your friends have on your ability to practice safer sex? (Choose one) (Choose one)
1 Very negative
2 Negative
3 Neither negative nor positive
4 Positive
5 Very positive
H. Homophobia and Sexual Identity/Sexual Relationships
READ:
Homophobia
and Sexual Identity/Sexual Relationships:
The next set of questions are about sexual identity and sexual or
love relationships.
Please
remember your answers will be kept private.
H1. Homophobia makes it harder for me to find a sexual or love relationship. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H2. I have strong Black gay male role models who help me feel more comfortable being open about my sexual orientation. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H3. I would feel comfortable bringing a male partner home for a family gathering and introducing him as my boyfriend. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H4. I avoid family gatherings because of the pressure of not having a girlfriend. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H5. I avoid family gatherings because family members suspect I'm gay. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H6. I sometimes change the way I look after leaving my home to go out to a gay club or venue (so that no one will suspect I'm going to a gay venue). (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H7. I change the way I act and talk when I am around straight black men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H8. I put up with anti-gay jokes when I am in a setting like a barbershop. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
H9. When I talk about dating with my family (or others who don't know I date men), I refer to my male partners as she or them and not "him." (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
I. Knowledge of HIV Risk for Self and Community
READ:
Knowledge
of H.I.V. Risk for Self and Community:
These next few questions are about the risk of H.I.V. among young
Black men. "MSM" in these questions refers to men who have
sex with men.
Please
remember your answers will be kept private.
I1. Most new H.I.V. infections among Black MSM occur among Black MSM younger than 30. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I2. Compared with other MSM, Black MSM have the lowest rates of H.I.V./AIDS. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I3. About 1 in 3 Black MSM in Los Angeles may be H.I.V. infected. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I4. At least half of H.I.V.-infected Black MSM do not know they have the virus. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I5. Black MSM are more likely to know they have H.I.V. compared with White MSM. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I6. Men who have a sexually transmitted infection (e.g. syphillis, gonorrhea) are more likely to get H.I.V. or transmit H.I.V. during sex. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I7. The rate of H.I.V. infection is higher for young Black MSM than for any other group. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
I8. Half of all H.I.V.-positive people in the U.S. are African American or Black. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J. HIV/AIDS Knowledge and Risk Reduction
READ:
HIV/AIDS
Knowledge and Risk Reduction:
Please answer the following questions about H.I.V. and AIDS.
Please
remember your answers will be kept private.
J1. If a man pulls out before cumming, rubbers or condoms don't need to be used to protect against H.I.V./AIDS. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J2. Most people who have H.I.V./AIDS look sick. (Choose one) (Choose one) 1 True
2 False
7 Don't Know
J3. Vaseline and other oils should not be used to lubricate rubbers or condoms. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J4. Rubbers or condoms made of latex products protect against the H.I.V./AIDS virus. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J5. Cleaning injection needles with water is enough to kill the H.I.V./AIDS virus. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J6. If someone has H.I.V., they will have a sunken face and a large belly. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J7. Rubbers or condoms made of lambskin protect against the H.I.V./AIDS virus. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J8. Many people who have H.I.V./AIDS feel and look healthy. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J9. Hand lotion is a good lubricant to use with a condom or rubber. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J10. It is almost impossible for a man to get H.I.V. during sex with another man if he is the top (insertive partner). (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J11. You have to have sex with someone more than once to get H.I.V./AIDS. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J12. If the man you are having sex with agrees not to have sex with other people, you have no reason to use a condom or rubber. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J13. You cannot get H.I.V. by touching an infected person's sweat. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J14. Some sexually transmitted infections cause men to become sterile. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J15. Having a sexually transmitted infection does not affect a person's risk of getting H.I.V. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J16. If an H.I.V.-positive person has an undetectable viral load, they cannot transmit H.I.V. through sex. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J17. Because of the "window period", it is possible to get an H.I.V.-negative test result and still have H.I.V. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
J18. An H.I.V.-positive person is most infectious (can spread H.I.V. easily) in the first few weeks after getting infected. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
READ: STOP. Take a break. You are about half way done. Check in briefly with project staff and use the restroom or stretch, if needed.
K. HIV and STI Testing
READ:
HIV
and STI Testing:
Please remember your answers will be kept private.
K1. In the past 3 months, since [AGO3M_6], have you been tested for H.I.V.?
1 Yes Skip to K2
0 No
7 Don't Know
8 Refuse to Answer
If K1 is equal to 7, then skip to instruction before 3a.
K1a. Do you already know that you have HIV?
1 Yes Skip to instruction before 4a
0 No Skip to instruction before 4a
7 Don't Know Skip to instruction before 4a
8 Refuse to Answer Skip to instruction before 4a
K2. What was the result of this recent H.I.V. test? (Choose one) (Choose one)
0 H.I.V. negative
1 H.I.V. positive
2 Did not get results
3 Indeterminate/inconclusive
READ: When you got tested in the past 3 months, did you get tested for any of the following reasons:
3a. Because you thought you might have been exposed to H.I.V. in the 3 to 6 months before the test?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3b. Because you got tested on a regular basis and it was time for you to get tested again?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3c. Because you had symptoms that made you think you should get tested?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3d. Because you were just checking to make sure you were H.I.V. negative?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3e. Because your doctor or health care provider recommended you get tested?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3f. Because your were required to get tested by either insurance, the military, a court order, or by some other agency?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
3g. Because there was some other reason you wanted to get tested? 1 Yes
0 No
7 Don't Know
8 Refuse to Answer
If 3g is not equal to 1, then skip to instruction before 4a.
3h. Other (specify):_____________ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
READ:
In the past
3 months,
has a doctor, nurse or other health care provider told you that you
had any of the following sexually transmitted infections? [Read
choices. Check yes or no for each one]
4a. Syphilis? 1 Yes
0 No
7 Don't Know
If 4a is not equal to 1, then skip to 4b.
4a1. Did you get treated? 1 Yes
0 No
7 Don't Know
4b. Gonorrhea (clap or drip) 1 Yes
0 No
7 Don't Know
If 4b is not equal to 1, then skip to 4c.
4b1. Did you get treated? 1 Yes
0 No
7 Don't Know
4c. Chlamydia? 1 Yes
0 No
7 Don't Know
If 4c is not equal to 1, then skip to 4d.
4c1. Did you get treated? 1 Yes
0 No
7 Don't Know
4d. Genital herpes (HSV)? 1 Yes
0 No
7 Don't Know
If 4d is not equal to 1, then skip to 4e.
4d1. Did you get treated? 1 Yes
0 No
7 Don't Know
4e. Genital warts (HPV)? 1 Yes
0 No
7 Don't Know
If 4e is not equal to 1, then skip to 4f.
4e1. Did you get treated? 1 Yes
0 No
7 Don't Know
4f. Any other sexually transmitted infection? 1 Yes
0 No
7 Don't Know
If 4f is not equal to 1, then skip to 5.
4f1. Did you get treated? 1 Yes
0 No
7 Don't Know
If 4f is not equal to 1, then skip to 5.
4g. Other sexually transmitted infection (specify): _______________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
5. Have you been vaccinated for hepatitis A or B in the past 3 months?
1 Yes
0 No Skip to 6
7 Don't Know Skip to 6
8 Refuse to Answer Skip to 6
5a. Was it for: (Choose one) (Choose one) 1 Hepatitis A
2 Hepatitis B
3 Hepatitis A and B
7 Don't Know
6. Have you been vaccinated for HPV (human papilloma virus, or genital warts) in the past 3 months?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
7. How comfortable do you feel telling your doctor/health provider that you have anal sex? (Choose one) (Choose one)
1 Not comfortable at all
2 A little comfortable
3 Comfortable
4 Extremely comfortable
8. How comfortable do you feel telling your doctor/health provider that you are gay/bisexual? (Choose one) (Choose one)
1 Not comfortable at all
2 A little comfortable
3 Comfortable
4 Extremely comfortable
9. Has a doctor/health provider treated you differently after you shared your sexual identity?
1 Yes
0 No
8 Refuse to Answer
9 Not Applicable
L. Self-efficacy for Condoms and Partner Communication
READ:
Self-efficacy
for Condoms and Partner Communication:
How confident or sure are you that you could...
Please
remember your answers will be kept private.
L1. Put a male rubber or condom on a hard penis. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L2. Correctly unroll a rubber or condom down to the base of the penis on the first try. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L3. Squeeze the tip of the condom while rolling it down. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L4. Use water-based lubricant with a male condom. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
READ: Now, please think about how well you would be able to do the following when using condoms.
L5. I can talk to every new partner about the importance of using condoms. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L6. I can find another way to get off (such as mutual masturbation) when a condom isn't available. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L7. I can be the one to put the condom on my male partner even if I'm nervous. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L8. I can put a condom on myself or my partner so that it will not slip or break. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L9. I can get every potential partner to use a condom with me. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L10. I can use a condom with a new partner without breaking the mood. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L11. Even if we haven't used them in the past, I can make sex fun while using condoms with a partner. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L12. I can put a condom on myself or my partner and enjoy the experience. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L13. I can get a new partner to use a condom, even if I'm drunk or high. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
L14. I can get a partner who I haven't used condoms with before to use one, even if I'm drunk or high. (Choose one) (Choose one)
1 Not at all sure I can do
2 Somewhat unsure
3 Undecided
4 Somewhat sure
5 Completely sure I can do
READ: The next few questions are about discussing H.I.V. status with your male sex partners.
L15. I only tell a partner about my H.I.V. status if we are going to have anal sex without a condom. (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
L16. I always talk to partners about my H.I.V. status before having sex with them. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
L17. I talk to all my partners about my H.I.V. status even if we are just having oral sex. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
L18. When a partner tells me he is H.I.V. negative, I always ask when he was last tested. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
If K2 is equal to 0, then skip to L20.
L19. I sometimes lie about my H.I.V. status to people I'm going to have sex with. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
L20. Even if my partners tell me they are H.I.V. negative, I tend not to believe them. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
L21. I lose my desire to have sex if my partner tries to discuss H.I.V. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree or disagree
4 Agree somewhat
5 Strongly agree
M. Anal and Penile Health
READ:
Anal
and Penile Health:
These next few questions are about sexually transmitted infections or
S.T.I. s (examples are gonorrhea, Chlamydia, syphilis, herpes,
etc.)
Please
remember your answers will be kept private.
M1. Sexually transmitted infection's may increase a man's H.I.V. risk if he has openings/ulcers on his genitals. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M2. An H.I.V.-positive person who has a sexually transmitted infection can more easily spread H.I.V. to his or her sex partners. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M3. Treating sexually transmitted infections helps to reduce the risk of getting H.I.V. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M4. If condoms are used 100% of the time, a person cannot get a sexually transmitted infection. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M5. You can get hepatitis A from rimming ("eating ass"). (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M6. There is a vaccine for hepatitis A, B, and C. (Choose one) (Choose one) 1 True
2 False
7 Don't Know
M7. Condoms do not protect against Chlamydia. (Choose one) (Choose one) 1 True
2 False
7 Don't Know
M8. Gonorrhea infections can be found in the anus, penis and throat. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M9. It is easy to detect a sexually transmitted infection in the anal area. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M10. Untreated syphilis can lead to brain damage and even death. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
M11. Using water-based lubricant for anal sex can help protect against anal tearing. (Choose one) (Choose one)
1 True
2 False
7 Don't Know
O. HIV Care and Treatment
(For HIV+ men)
If K2 is not equal to 1 and K1a is not equal to 1, then skip to instruction before P1.
READ:
HIV
Care and Treatment:
The next set of questions has to do with care and treatment you may
have received for your H.I.V.
Please
remember your answers will be kept private.
O1. Have you ever received any health care or treatment for H.I.V./AIDS?
1 Yes
0 No Skip to instruction before O8
7 Don't Know Skip to instruction before O8
8 Refuse to Answer Skip to instruction before O8
9 Not Applicable Skip to instruction before O8
O2. When did you last go to your health care provider for H.I.V. care?
__ __ / __ __ __ __ mm / yyyy
2097 Don't Know (Year)
2098 Refuse to Answer (Year)
If O2 is less than HIVDATE then READ: "The date you have entered is before 1985 when no HIV test was available. Please correct your answer." and skip to O2.
If O2 is greater than FU6_DT then READ: "The date you have entered is past today's date. Please correct your answer." and skip to O2.
O3. Have you ever taken any H.I.V. medications (antiretroviral medicines)?
1 Yes
0 No Skip to instruction before O9
7 Don't Know Skip to instruction before O9
8 Refuse to Answer Skip to instruction before O9
O4. Did your doctor take time to educate you about your H.I.V. medications?
1 Yes
0 No
7 Don't Know
8 Refuse to Answer
O5. When did you last take any H.I.V. medications (antiretroviral medicine)? (Choose one) (Choose one)
1 Within the past 3 months
2 3-5 months ago
3 6-12 months ago
4 More than a year ago
8 Refuse to Answer
If O5 is not equal to 1, then skip to instruction before O9.
O6. Are you currently taking any H.I.V. medications (antiretroviral medicine)?
1 Yes
0 No
8 Refuse to Answer
O7. Have you skipped taking any of your H.I.V. medications (antiretroviral medicines) in the past 3 months?
1 Yes
0 No
8 Refuse to Answer
If O1 is equal to 1, then skip to instruction before O9.
O8. What is the main reason you have never received any health care for your H.I.V. infection? (Choose one) (Choose one)
01 Feel good. Don't need to go
02 Don't want to think about being H.I.V. positive/denial
03 Didn't have money or insurance
04 Couldn't find health care provider/Didn't know where to go
05 Inconvenient (location/hours/time, etc.)
06 Forgot to go/Missed appointment
07 Too busy to go
08 Drinking or using drugs
09 Homeless
10 Appointment pending
11 I thought I would be treated poorly by the staff or medical provider because of my sexual orientation
12 Other
97 Don't Know
98 Refuse to Answer
Skip to instruction before P1.
If O2 is less than AGO6MO_6 then skip to O9
If not, then skip to instruction before P1.
O9. What is the main reason you have not received H.I.V. health care in the past 6 months? (Choose one) (Choose one)
01 Feel good. Don't need to go
02 Don't want to think about being H.I.V. positive/denial
03 Didn't have money or insurance
04 Couldn't find health care provider/Didn't know where to go
05 Inconvenient (location/hours/time, etc.)
06 Forgot to go/Missed appointment
07 Too busy to go
08 Drinking or using drugs
09 Homeless
10 Appointment pending
11 I thought I would be treated poorly by the staff or medical provider because of my sexual orientation
12 Other
97 Don't Know
98 Refuse to Answer
P. Alcohol/Drug Use
READ: Alcohol/Drug Use: The next questions are about alcohol and drug use. Please remember your answers will be kept private. For these questions, "a drink of alcohol" means a 12 oz beer, a 5 oz glass of wine, or a 1.5 oz shot of liquor.
P1. In the past 3 months, did you drink any alcohol such as beer, wine, malt liquor or hard liquor?
1 Yes
0 No Skip to P4
7 Don't Know Skip to P4
8 Refuse to Answer Skip to P4
P2. In the past 30 days, on how many days did you drink any alcohol?
__ __
00 zero Skip to P4
97 Don't Know Skip to P4
98 Refuse to Answer Skip to P4
P3. In the past 30 days, how many times did you have 5 or more alcoholic drinks in one sitting?
__ __ time(s)
97 Don't Know
98 Refuse to Answer
P4. Other than alcohol, have you ever used drugs to get high?
1 Yes
0 No Skip to instruction before Q1
8 Refuse to Answer Skip to instruction before Q1
P5. Have you used drugs in the past 3 months?
1 Yes
0 No Skip to instruction before Q1
8 Refuse to Answer Skip to instruction before Q1
P6. In the past 3 months, have you used crystal methamphetamine, other amphetamines, crank, speed, ice or Tina?
1 Yes
0 No
8 Refuse to Answer
P7. In the past 3 months, have you used crack, powder cocaine or coke?
1 Yes
0 No
8 Refuse to Answer
P8. In the past 3 months, have you used heroin? 1 Yes
0 No
8 Refuse to Answer
P9. In the past 3 months, have you used club drugs such as ecstasy or X, GHB, ketamine, or Special K?
1 Yes
0 No
8 Refuse to Answer
P10. In the past 3 months, have you used amyl nitrates/poppers? 1 Yes
0 No
8 Refuse to Answer
P11. In the past 3 months, have you used marijuana? 1 Yes
0 No
8 Refuse to Answer
P12. In the past 3 months, have you used prescription drugs not prescribed to you?
1 Yes
0 No
8 Refuse to Answer
P13. In the past 3 months, did you tend to have more unprotected anal sex with men when you were under the influence of alcohol or drugs? (Choose one) (Choose one)
0 No
1 Yes, when using alcohol
2 Yes, when using drugs
3 Yes, with alcohol or drugs
8 Refuse to Answer
Q. Internet and Cell Phone Use
READ:
Internet
and Cell Phone Use:
The next questions are about the internet.
Please
remember your answers will be kept private.
Q1. During the past 3 months, how often did you go online to connect with or find men for social and personal connections other than sex? (Choose one) (Choose one)
0 Never
1 Very rarely
2 Monthly
3 Weekly
4 Daily
Q2. During the past 3 months, how often did you go online to connect with or find male sex partners? (Choose one) (Choose one)
0 Never
1 Very rarely
2 Monthly
3 Weekly
4 Daily
Q3. During the past 3 months, how often did you use apps on a cell phone or mobile device to find people for sex? Examples of apps are Grindr and Facebook. (Choose one) (Choose one)
0 Never Skip to Q4
1 Very rarely
2 Monthly
3 Weekly
4 Daily
Q3a. What apps did you use, please specify:___________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Q4. How much do you agree with the following statement? The Internet is one of the only places I can connect with other young Black men who have sex with men. (Choose one) (Choose one)
1 Strongly disagree
2 Disagree somewhat
3 Neither agree nor disagree
4 Agree somewhat
5 Strongly agree
8 Refuse to Answer
R. Psychological Distress (CES-D)
READ:
Psychological
Distress:
In this section, you are going to read a list of the ways you might
have felt or behaved in the past week. Please check how often you
have felt this way during
the past week.
The answers for each question in this section are the same.
When you answer 'Less than one day' that would mean you felt
that way rarely or none of the time this past week,
'1 to 2 days' means you have
felt that way some or a little of the time this past week,
'3 to 4 days' means
you have felt that way occasionally or a moderate amount of time this
past week,
'5 to 7 days' means you have felt that way most or all of the time
this past week.
Please
remember your answers will be kept private.
R1. During the past week, I was bothered by things that usually don't bother me. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R2. During the past week, I had trouble keeping my mind on what I was doing. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R3. During the past week, I felt depressed. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R4. During the past week, I felt that everything I did was an effort. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R5. During the past week, I felt hopeful about the future. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R6. During the past week, I felt fearful. (Choose one) (Choose one) 1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R7. During the past week, my sleep was restless. (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R8. During the past week, I was happy. (Choose one) (Choose one) 1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R9. During the past week, I felt lonely. (Choose one) (Choose one) 1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
R10. During the past week, I could not "get going". (Choose one) (Choose one)
1 Less than one day
2 1 to 2 days
3 3 to 4 days
4 5 to 7 days
8 Refuse to Answer
READ: Thank you for answering those questions. We are now interested in knowing what things in your life cause you the most stress.
R11. Please look at this list of things that can cause stress in a person's life. What causes you stress on a regular basis? (Check all that apply) (Check all that apply)
__ Finances, money
__ Health
__ Love relationships
__ Family
__ Job
__ Unemployment
__ Living situation
__ Threats of violence
__ Being found out as gay
__ Achieving life goals
__ Other
If R11K is not equal to 1, then skip to instruction before S1a.
R11a1. Other (specify):_______________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
S. Prevention Intervention Questions
READ: Prevention Intervention Questions: In the time since you completed this computer-based questionnaire about 3 months ago, what programs or events have you taken part in at In The Meantime Men's Group?
S1a. NIA group session? 1 Yes
0 No
7 Don't Know
If S1a is not equal to 1, then skip to S1b.
S1a1. Number of times attended in the past 3 months... __ __ time(s)
97 Don't Know
S1b. Brothers Reaching Brothers (Tues night group)? 1 Yes
0 No
7 Don't Know
If S1b is not equal to 1, then skip to S1c.
S1b1. Number of times attended in the past 3 months... __ __ time(s)
97 Don't Know
S1c. Kick Back group discussion (Thurs night group)? 1 Yes
0 No
7 Don't Know
If S1c is not equal to 1, then skip to S1d.
S1c1. Number of times attended in the past 3 months... __ __ time(s)
97 Don't Know
S1d. Hang out at the Kick Back space 1 Yes
0 No
7 Don't Know
If S1d is not equal to 1, then skip to S1e.
S1d1. Number of times attended in the past 3 months... __ __ time(s)
97 Don't Know
S1e. Men's Health Conference? 1 Yes
0 No
7 Don't Know
S1f. Umoja Retreat? 1 Yes
0 No
7 Don't Know
S1g. HIV testing on the In the Meantime testing van? 1 Yes
0 No
7 Don't Know
If S1g is not equal to 1, then skip to S1h.
S1g1. Number of times tested with In the Meantime in the past 3 months...
__ __ time(s)
97 Don't Know
S1h. Any other special event? 1 Yes
0 No
7 Don't Know
If S1h is not equal to 1, then skip to S1i.
S1h1. Other (specify):________________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
S1i. I haven't taken part in any programs or events sponsored by In The Meantime.
1 Yes
0 No
7 Don't Know
S2. In the time since you completed this computer-based questionnaire about 3 months ago, what types of H.I.V. prevention programs or interventions have you attended at another agency? (Check all that apply) (Check all that apply)
__ Individual/One-on-one intervention
__ Discussion or intervention with a group
__ H.I.V. conference
__ H.I.V. retreat
__ Research study
__ Other program/intervention
If S2E is not equal to 1, then skip to instruction before S2f1.
S2e1. Other research study (specify):___________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
If S2F is not equal to 1, then skip to S3.
S2f1. Other program/intervention (specify):___________
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
S3. Thinking about all your male sex partners over the past three months, how many of them have participated in any MyLife MyStyle sessions?
__ __ sex partners
97 Don't Know
S4. How many of your friends have ever participated in any MyLife MyStyle sessions?
__ __ friends
97 Don't Know
S5. Over the past 3 months, have you talked about what you have learned at In The Meantime Men's Group or the MyLife MyStyle sessions with (check all that apply) (Check all that apply)
__ Friend(s)
__ Sex partner(s)
__ Another research participant
__ Family member(s)
__ Other
__ I haven't discussed what I've learned with others
S6. Do you keep in contact with anyone you met through MyLife MyStyle sessions? (Choose one)
1 No
2 Yes
3 I did not meet anyone while participating
S7. On a scale from 1 to 4, how honest were you in answering the questions in the survey today? (Choose one) (Choose one)
1 Not honest at all
2 A little bit honest
3 Somewhat honest
4 Very honest
READ: That was the last question. We want to thank you for taking time to answer these questions. We know some were difficult to answer and we want to remind you that all your answers will be kept private. If these questions brought up painful memories and you would like a referral to a counselor or some other service, please let your interviewer know at this time. Thank you.
S1. Project Staff Person: Please enter CODE to close and SAVE the interview. __ __ __ __
S2. Was this interview interrupted or suspended for any reason? 1 Yes
0 No
S3. Flag this interview? 1 Yes
0 No
If S3 is equal to 0, then skip to end of questionnaire.
S4. Please briefly describe the reason for flagging this interview.
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Version
DE31470EN Page
| File Type | text/rtf |
| Author | CDC User |
| Last Modified By | CDC User |
| File Modified | 2014-11-19 |
| File Created | 2014-11-19 |