Consumer Web Survey

Form Approved

OMB No. 0920-0572

Expiration Date 03/31/2018

Submission under

0920-0572 Health Message Testing System

Attachment 9: Consumer Message Testing for High Impact Prevention Project Web Survey

Public reporting burden of this collection of information is estimated to average 2 hours 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 (0920-0572

Consumer Message Testing for High Impact Prevention Project Web Survey

Perception of HIV as a Problem

1.1. On a scale from 1 to 10, where 1 is the least important and 10 is the most important, how would you rate the importance of HIV as a health problem facing the nation today?

SECTION 1: ONLINE ACTIVITY AND [INSERT MATERIAL TYPE] RECEPTIVITY

SCRIPT: We’d like to ask you some questions about your online activity.

[TIME SPENT ONLINE]

1.2. In an average month, how often do you…

	Daily	2 -5 Times a Week	Once a Week	2-3 Times a Month	Once a Month	Less than Once a Month	Never	Prefer not to Answer
a. use Facebook? (www.facebook.com)	1	2	3	4	5	6	7	9
b. use Twitter? (www.twitter.com)	1	2	3	4	5	6	7	9
c. use YouTube? (www.youtube.com)	1	2	3	4	5	6	7	9
d. use Instagram (www.instagram.com)	1	2	3	4	5	6	7	9
e. use dating/hook-up sites or mobile apps? (e.g., manhunt.com, adam4adam, Grindr, etc.)	1	2	3	4	5	6	7	9
f. visit online news websites? (e.g., cnn.com, slate.com, etc.)	1	2	3	4	5	6	7	9
g. watch television?	1	2	3	4	5	6	7	9
h. listen to radio?	1	2	3	4	5	6	7	9
i. use buses, subways, or trains?	1	2	3	4	5	6	7	9
j. read magazines?	1	2	3	4	5	6	7	9
k. read newspapers?	1	2	3	4	5	6	7	9
l. Other [Specify________]	1	2	3	4	5	6	7	9

1.3. In an average month, how often do you use the following dating or hook-up sites or mobile apps?

	Daily	2 -5 Times a Week	Once a Week	2-3 Times a Month	Once a Month	Less than Once a Month	Never	Prefer not to Answer
a. Manhunt	1	2	3	4	5	6	7	9
b. Adam4adam	1	2	3	4	5	6	7	9
c. Grindr	1	2	3	4	5	6	7	9
d. Tinder	1	2	3	4	5	6	7	9
e. Match.com	1	2	3	4	5	6	7	9
f. eHarmony.com	1	2	3	4	5	6	7	9
g. Christianmingle. com	1	2	3	4	5	6	7	9
h. Jdate.com	1	2	3	4	5	6	7	9
i. Ourtime.com	1	2	3	4	5	6	7	9
j. OKcupid	1	2	3	4	5	6	7	9
k. Plentyoffish.com	1	2	3	4	5	6	7	9
l. Blackgaychat (BCGlive)	1	2	3	4	5	6	7	9
m. Craigslist	1	2	3	4	5	6	7	9
n. BarebackRT	1	2	3	4	5	6	7	9
o. Scruff	1	2	3	4	5	6	7	9
p. Jack’d	1	2	3	4	5	6	7	9
q. Other [Specify________]	1	2	3	4	5	6	7	9

1.4. Please indicate how much you disagree or agree with the following statements.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Prefer not to answer
a. I know all I need to know about HIV.	1	2	3	4	5	9
b. I know about how to prevent getting or transmitting HIV.	1	2	3	4	5	9
c. I know how often I should be tested for HIV.	1	2	3	4	5	9
d. I feel knowledgeable about HIVI could learn more about HIV	1	2	3	4	5	9

[[INSERT MATERIAL TYPE] Receptivity]

1.5. Now I’m going to ask each of you to rate the [INSERT MATERIAL TYPE] on a scale from 1-10 for how likely is it that the [INSERT MATERIAL TYPE] will [INSERT DESCRIPTOR HERE], with 1 not likely at all to [INSERT DESCRIPTOR] and 10 being very likely to [INSERT DESCRIPTOR], how would you rate this [INSERT MATERIAL TYPE]? Please mark your rating on your paper.

1.6. Which [INSERT MATERIAL TYPE] [INSERT DESCRIPTOR]?

1.6a. What made you choose that[material/descriptor]?

1.7. You are now about to see [INSERTNUMBER HERE] [INSERT MATERIAL TYPE] about [INSERT TOPIC HERE]. After you view each [INSERT MATERIAL TYPE], please tell us how much you agree or disagree with each of the following statements. [Repeat for each [INSERT MATERIAL TYPE]]

Perceived Effectiveness Scale	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree	Prefer not to answer
a. This [INSERT MATERIAL TYPE] grabbed my attention.	1	2	3	4	5	9
b. This [INSERT MATERIAL TYPE] was confusing.	1	2	3	4	5	9
c. This [INSERT MATERIAL TYPE] convinced me to [INSERT BEHAVIOR/ACTIVITY/STRATEGY HERE]	1	2	3	4	5	9
d. This [INSERT MATERIAL TYPE] something important to me.	1	2	3	4	5	9
e. I learned something new from this [INSERT MATERIAL TYPE].	1	2	3	4	5	9
f. I liked this [INSERT MATERIAL TYPE] overall.	1	2	3	4	5	9
g. I do not like this [INSERT MATERIAL TYPE] overall.	1	2	3	4	5	9
h. This [INSERT MATERIAL TYPE] gave me good reasons to [insert behavior/activity/strategy here]	1	2	3	4	5	9
i. This [INSERT MATERIAL TYPE] spoke to me.	1	2	3	4	5	9

[INSERT MATERIAL TYPE] Receptivity	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree	Prefer not to answer
a. This [INSERT MATERIAL TYPE] was easy to read	1	2	3	4	5	9
b. I am interested in this [INSERT MATERIAL TYPE]’s topic	1	2	3	4	5	9
c. I was interested in reading this [INSERT MATERIAL TYPE]	1	2	3	4	5	9
d. This [INSERT MATERIAL TYPE] was written for a person like me.	1	2	3	4	5	9
e. This [INSERT MATERIAL TYPE] was easy to understand.	1	2	3	4	5	9
f. I would read this [INSERT MATERIAL TYPE] if I saw it.	1	2	3	4	5	9
g. This [INSERT MATERIAL TYPE] grabbed my attention.	1	2	3	4	5	9
h. I trust the information in this [INSERT MATERIAL TYPE]	1	2	3	4	5	9
i. This [INSERT MATERIAL TYPE] said something important to me.	1	2	3	4	5	9
j. This [INSERT MATERIAL TYPE] was convincing.	1	2	3	4	5	9
k. This [INSERT MATERIAL TYPE] was believable.	1	2	3	4	5	9
l This [INSERT MATERIAL TYPE] told me something I didn’t already know.	1	2	3	4	5	9
m. This [INSERT MATERIAL TYPE] would be helpful in convincing my friends to do the behavior/activity/strategy it suggests.	1	2	3	4	5	9
n. This [INSERT MATERIAL TYPE] made me feel confident that I could do the behavior/activity/strategy it suggests.	1	2	3	4	5	9
o. This [INSERT MATERIAL TYPE] would make me feel bad if I [insert behavior/activity/strategy here]	1	2	3	4	5	9
p. This [INSERT MATERIAL TYPE] [insert descriptor]	1	2	3	4	5	9

	Strongly Disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to Answer
a. There was too much information.	1	2	3	4	5	6
b. I liked the way the information was organized.	1	2	3	4	5	6
c. It was hard to find the information that I was interested in.	1	2	3	4	5	6
d. The information upset me.	1	2	3	4	5	6
e. The [INSERT MATERIAL TYPE] has important information for people like me.	1	2	3	4	5	6
f. The [INSERT MATERIAL TYPE] stereotypes certain people.	1	2	3	4	5	6
f1. What groups of people do you feel this [INSERT MATERIAL TYPE] stereotypes:_____________
g. The [INSERT MATERIAL TYPE] was offensive.	1	2	3	4	5	6
g1. What did you find to be offensive in this [INSERT MATERIAL TYPE]:_____________
h. The information in the [INSERT MATERIAL TYPE] was confusing.	1	2	3	4	5	6
h1. What about this [INSERT MATERIAL TYPE] was confusing:___________
i. The information in the [INSERT MATERIAL TYPE] speaks to me.	1	2	3	4	5	6
j. The [INSERT MATERIAL TYPE] gave me good reasons to take responsibility for my health.	1	2	3	4	5	6
k. The [INSERT MATERIAL TYPE] gave me good reasons to take responsibility for my sex partner’s health.	1	2	3	4	5	6
l. The [INSERT MATERIAL TYPE] gave me good reasons to talk to my sex partners about ways we can prevent HIV.	1	2	3	4	5	6
m. By doing the behavior/activity/strategy suggested in the [INSERT MATERIAL TYPE], I can protect myself from getting or transmitting HIV.	1	2	3	4	5	6
n. There are many things I can do to prevent getting or transmitting HIV.	1	2	3	4	5	6
o. The information in the [INSERT MATERIAL TYPE] was persuasive.	1	2	3	4	5	6
p. The information in the [INSERT MATERIAL TYPE] was motivating.	1	2	3	4	5	6
q. The [INSERT MATERIAL TYPE] was boring.	1	2	3	4	5	6
r. I would recommend the [INSERT MATERIAL TYPE] to others.	1	2	3	4	5	6
s. The [INSERT MATERIAL TYPE] used a fresh, new approach to communicate information about HIV.	1	2	3	4	5	6
t. I would share the [INSERT MATERIAL TYPE] with others.	1	2	3	4	5	6
u. I would look at the [INSERT MATERIAL TYPE] again if I wanted more information.	1	2	3	4	5	6
v. I liked the way the [INSERT MATERIAL TYPE] looks.	1	2	3	4	5	6
w. I liked the colors, images and graphics.	1	2	3	4	5	6
x. I can do what the [INSERT MATERIAL TYPE] suggests.	1	2	3	4	5	6
y. I will do what the [INSERT MATERIAL TYPE] suggests.	1	2	3	4	5	6
z. There was information in the [INSERT MATERIAL TYPE] about HIV risk that I had never seen before.	1	2	3	4	5	6
aa. There was information in the [INSERT MATERIAL TYPE] about HIV prevention strategies that I had never seen before.	1	2	3	4	5	6

1.8. How could the [INSERT MATERIAL TYPE] be changed to make it better?________ [no forced response]

1.9. Please indicate how much you agree or disagree with the following statements.

The [INSERT MATERIAL TYPE] …	Strongly Disagree	Disagree	Neither Disagree nor Agree	Agree	Strongly Agree	Refuse to Answer
a. helped me recognize that the sexual behaviors I choose to do may increase or decrease my risk of getting or transmitting HIV	1	2	3	4	5	6
b. Prepared me to make a better decision about which behaviors I will do in the future	1	2	3	4	5	6
c. Helped me think about the pros/cons of different HIV prevention options	1	2	3	4	5	6
d. Helped me think about the pros/cons of different HIV prevention options that are most important to me	1	2	3	4	5	6
e. Helped me know that the decisions I make depend on what matters most to me	1	2	3	4	5	6
f. Helped me identify the questions I want to ask [my doctor or my partner or other]	1	2	3	4	5	6
g. Prepared me to talk [my doctor or partner or other] about what matters most to me	1	2	3	4	5	6
h. Prepared me for a follow-up [visit or conversation or other] with [my doctor or partner or other]	1	2	3	4	5	6

SECTION 2: HIV TESTING

[NORMS]

2.1. Please tell us how much you agree or disagree with each of the following statements.

	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree	Prefer not to answer
a. Most people who are important to me think I should [insert behavior/activity/strategy here]. (By “people who are important to me,” we mean sexual partners, friends, family, and anyone else who is an important part of your life.)	1	2	3	4	5	9
b. Most of my sexual partners [insert behavior here].	1	2	3	4	5	9
c. Most people I know [insert behavior/activity/strategy here].	1	2	3	4	5	9

[HIV-testing: KNOWLEDGE]

2.2. Please tell us how much you agree or disagree with each of the following statements.

Someone who is HIV-negative and not taking medicines to prevent HIV (e.g., PrEP/Truvada,) should get tested for HIV every 6 months if they…

	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree	Prefer not to answer
a. …always have sex with a condom.	1	2	3	4	5	9
b. …have had anal insertive sex (topping) without a condom.	1	2	3	4	5	9
c. …have had anal receptive sex (bottoming) without a condom.	1	2	3	4	5	9
d. …have a sex partner who is HIV positive.	1	2	3	4	5	9
e. …have had anal sex without a condom (receptive or insertive) with a partner whose HIV status they don’t know.	1	2	3	4	5	9
f. …have had more than one sex partner since their last HIV test.	1	2	3	4	5	9

[HIV-testing: Self-Efficacy]

2.3. Please tell us how much you agree or disagree with the following statement: I am confident that I can get an HIV test.

₁ Strongly agree

₂ Agree

₃ Neither agree nor disagree

₄ Disagree

₅ Strongly disagree

₉ Prefer not to answer

2.4. How easy or hard would it be for you to get an HIV test every 6 months if you:

	Very Easy	Easy	Neither Easy nor Hard	Hard	Very Hard	Prefer not to Answer
a. Could find a free testing site.	1	2	3	4	5	9
b. Had to travel far to find a free testing site.	1	2	3	4	5	9
c. Could get the results of your HIV test within 20 minutes.	1	2	3	4	5	9
d. Knew that your test results would be kept confidential.	1	2	3	4	5	9
e. Could not find an HIV test provider that spoke your language, (e.g., English or Spanish).	1	2	3	4	5	9
f. Could find a provider that you feel comfortable with and trust.	1	2	3	4	5	9
g. Could use a home-based testing kit.	1	2	3	4	5	9

[BEHAVIORAL BELIEFS]

2.5. Please tell us how much you agree or disagree with each of the following statements:

Please tell us how much you agree or disagree with each of the following statements:

	Strongly agree	Agree	Neither agree or disagree	Disagree	Strongly disagree	Prefer not to answer
a. Your HIV test result expires every time you have risky sex.	1	2	3	4	5	9
b. Getting an HIV test is free, fast, and confidential.	1	2	3	4	5	9
c. My family/friends are my reason(s) for [insert behavior here].	1	2	3	4	5	9
d. My reason for [insert behavior here]is me	1	2	3	4	5	9
e. Getting [insert behavior here]will help me stay strong and informed.	1	2	3	4	5	9
f. [insert behavior here]will help me take better care of my sexual partner	1	2	3	4	5	9
g. [insert behavior here]keeps me healthy	1	2	3	4	5	9
h. [insert behavior here]will help my future.	1	2	3	4	5	9

[ATTITUDES]

2.6. Please answer the following questions by choosing the answer that best describes your opinion.

	Very Important	Somewhat Important	Neither Important nor Unimportant	Somewhat Unimportant	Very Unimportant	Prefer not to Answer
a. Having access to free [INSERT HERE] is…	1	2	3	4	5	9
b. Having access to confidential HIV test results is…	1	2	3	4	5	9
c. Taking better care of my sexual partner is…	1	2	3	4	5	9
d. Keeping myself healthy is…	1	2	3	4	5	9
e. Doing things to help my future is…	1	2	3	4	5	9

[HIV TESTING: INTENTIONS]

2.7. Please tell us how likely or unlikely it is that you intend to...

	Very Likely	Somewhat Likely	Neither Likely Nor Unlikely	Somewhat Unlikely	Very Unlikely	Prefer Not to Answer
a. …get an HIV test within the next 6 months	1	2	3	4	5	9
b. …get an HIV test within the next 12 months	1	2	3	4	5	9
c. …get an HIV test before sex with a new sexual partner	1	2	3	4	5	9
d. …get tested together (e.g. tested with a sexual partner)	1	2	3	4	5	9

SECTION 3: MAIN/CASUAL PARTNER/SEROSTATUS DISCLOSURE

SCRIPT: Next, we’d like to ask you some questions about the people you have sex with and things you might talk to them about.

3.1. Do you currently have a main male sexual partner—that is, a partner you would call your boyfriend, spouse, significant other, or life partner?

₁ Yes (Go to Q3.1a)

₂ No

₉ Prefer not to answer

3.1a. [If YES – currently have a main male sexual partner] How long have you been in a sexual relationship with your main male sexual partner?

Please enter length of relationship: _______years and ________months

₉ Prefer not to answer

3.2. Do you know the HIV status of your main male sexual partner?

₁ Yes

₂ No

₉ Prefer not to answer

3.2a. [If YES] What is your main male sexual partner’s HIV status?

₁ My main partner is HIV negative.

₂ My main partner is HIV positive.

₉ Prefer not to answer

3.3. Have you had sex with another man during the time you have been with your current main male sexual partner?

₁ Yes

₂ No

₉ Prefer not to answer

SCRIPT: We’d now like to ask you some questions about casual sexual partners. A non-main or casual sexual partner is someone who you do not consider to be a spouse, significant other, or life partner.

3.4. In the past 12 months, how many casual (non-main), male sexual partners did you have anal or oral sex with?

NUMBER __________________

₉₉ Prefer not to answer

3.5. Do you know the HIV status of your most recent casual (non-main) male sexual partner?

₁ Yes

₂ No

₉ Prefer not to answer

3.5a. [If YES] What is the HIV status of your most recent casual (non-main) male sexual partner?

₁ My most recent casual (non-main) male sexual partner is HIV negative.

₂ My most recent casual (non-main) male sexual partner is HIV positive.

₉ Prefer not to answer

SECTION 4: MAIN PARTNER COMMUNICATION BEHAVIOR

[COMMUNICATION: BEHAVIOR]

4.1. In the past 12 months, how often have you had one-on-one conversations with your current main male sexual partner about ways to prevent HIV?

₁ Very often

₂ Often

₃ Sometimes

₄ Rarely

₅ Never

₉ Prefer not to answer

4.2. In the past 12 months, how often have you discussed the following topics with your current main male sexual partner?

	Very Often	Often	Some-times	Rarely	Never	Prefer Not to Answer
a. Your last HIV test and test results	1	2	3	4	5	9
b. Your partner’s last HIV test and test results	1	2	3	4	5	9
c. Getting tested for HIV	1	2	3	4	5	9
d. Getting tested for HIV together	1	2	3	4	5	9
e. Using condoms	1	2	3	4	5	9
f. Taking medicines to treat HIV infection (e.g., antiretroviral therapy or ART)	1	2	3	4	5	9
g. Your or your partner’s viral load	1	2	3	4	5	9
h. Taking medicines daily to reduce the chance of being HIV infected (e.g., Truvada, pre-exposure prophylaxis, or PrEP)	1	2	3	4	5	9
i. Taking medicines after sex to reduce the chance of being HIV infected (e.g., post-exposure prophylaxis, nPEP)	1	2	3	4	5	9
j. Which sexual activities (i.e., oral and anal intercourse) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	9
k. Which sexual roles or positions (i.e., insertive/top or receptive/bottom) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	9
l. Making agreements with your main male sexual partner about having sex with other partners (i.e., whether to, when, with whom, and what kind of sex that takes place inside and outside the relationship)	1	2	3	4	5	9

SECTION 5: CASUAL PARTNER COMMUNICATION BEHAVIOR

[COMMUNICATION: BEHAVIOR]

5.1. In the past 12 months, how often have you had one-on-one conversations with a casual male sexual partner about ways to prevent HIV?

₁ Very often

₂ Often

₃ Sometimes

₄ Rarely

₅ Never

₉ Prefer not to answer

5.2. In the past 12 months, have you discussed the following topics with a casual male sexual partner?

	Very Often	Often	Some-Times	Rarely	Never	Prefer Not to Answer
a. Your last HIV test and test results	1	2	3	4	5	9
b. Your partner’s last HIV test and test results	1	2	3	4	5	9
c. Getting tested for HIV	1	2	3	4	5	9
d. Getting tested for HIV together	1	2	3	4	5	9
e. Using condoms	1	2	3	4	5	9
f. Taking medicines to treat HIV infection (e.g., antiretroviral therapy or ART)	1	2	3	4	5	9
g. Your or your partner’s viral load	1	2	3	4	5	9
h. Taking medicines daily to reduce the chance of being HIV infected (e.g., Truvada, pre-exposure prophylaxis, or PrEP)	1	2	3	4	5	9
i. Taking medicines after sex to reduce the chance of being HIV infected (e.g., post-exposure prophylaxis, nPEP)	1	2	3	4	5	9
j. Which sexual activities (i.e., oral and anal intercourse) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	9
k. Which sexual roles or positions (i.e., insertive/top or receptive/bottom) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	9
l. Looking for partners with the same HIV status	1	2	3	4	5	9

SECTION 6: COMMUNICATION (Self-Efficacy, Intentions, Attitudes, Norms)

[COMMUNICATION: SELF-EFFICACY]

6.1. How sure are you that you could have one-on-one conversations with a main male sexual partner about ways to prevent HIV?

₁ Very sure

₂ Somewhat sure

₃ Neither sure nor unsure

₄ Somewhat unsure

₅ Very unsure

₉ Prefer not to answer

6.2. How sure are you that you could have one-on-one conversations with a casual male sexual partner about ways to prevent HIV?

₁ Very sure

₂ Somewhat sure

₃ Neither sure nor unsure

₄ Somewhat unsure

₅ Very unsure

₉ Prefer not to answer

[COMMUNICATION: INTENTIONS]

6.3. In the next 12 months, how likely or unlikely is it that you will discuss the following topics with a main male sexual partner?

	Very Likely	Some-What Likely	Neither Likely Nor Unlikely	Some-What Unlikely	Very Unlikely	N/A	Prefer Not to Answer
a. Your last HIV test and test results	1	2	3	4	5	8	9
b. Your partner’s last HIV test and test results	1	2	3	4	5	8	9
c. Getting tested for HIV	1	2	3	4	5	8	9
d. Getting tested for HIV together	1	2	3	4	5	8	9
e. Using condoms	1	2	3	4	5	8	9
f. Taking medicines to treat HIV infection (e.g., antiretroviral therapy or ART)	1	2	3	4	5	8	9
g. Your or your partner’s viral load	1	2	3	4	5	8	9
h. Taking medicines daily to reduce the chance of being HIV infected (e.g., Truvada, pre-exposure prophylaxis, or PrEP)	1	2	3	4	5	8	9
i. Taking medicines after sex to reduce the chance of being HIV infected (e.g., post-exposure prophylaxis, nPEP)	1	2	3	4	5	8	9
j. Which sexual activities (i.e., oral and anal intercourse) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	8	9
k. Which sexual roles or positions (i.e., insertive/top or receptive/bottom) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	8	9
l. Making agreements with your main male sexual partner about having sex with other partners (i.e., whether to, when, with whom, and what kind of sex that takes place inside and outside the relationship)	1	2	3	4	5	8	9

6.4. In the next 12 months, how likely or unlikely is it that you will discuss the following topics with a casual male sexual partner?

	Very Likely	Some-What Likely	Neither Likely Nor Unlikely	Some-What Unlikely	Very Unlikely	N/A	Prefer Not to Answer
a. Your last HIV test and test results	1	2	3	4	5	8	9
b. Your partner’s last HIV test and test results	1	2	3	4	5	8	9
c. Getting tested for HIV	1	2	3	4	5	8	9
d. Getting tested for HIV together	1	2	3	4	5	8	9
e. Using condoms	1	2	3	4	5	8	9
f. Taking medicines to treat HIV infection (e.g., antiretroviral therapy or ART)	1	2	3	4	5	8	9
g. Your or your partner’s viral load	1	2	3	4	5	8	9
h. Taking medicines daily to reduce the chance of being HIV infected (e.g., Truvada, pre-exposure prophylaxis, or PrEP)	1	2	3	4	5	8	9
i. Taking medicines after sex to reduce the chance of being HIV infected (e.g., post-exposure prophylaxis, nPEP)	1	2	3	4	5	8	9
j. Which sexual activities (i.e., oral and anal intercourse) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	8	9
k. Which sexual roles or positions (i.e., insertive/top or receptive/bottom) you would engage in based on your HIV status or your partner’s HIV status	1	2	3	4	5	8	9
l. Looking for partners with the same HIV status	1	2	3	4	5	8	9

[COMMUNICATION: ATTITUDES]

6.5. Talking to a main sexual partner about ways to prevent HIV would be…

₁ Very good

₂ Somewhat good

₃ Neither good nor bad

₄ Somewhat bad

₅ Very bad

₉ Prefer not to answer

6.6. Talking to a casual sexual partner about ways to prevent HIV would be…

₁ Very good

₂ Somewhat good

₃ Neither good nor bad

₄ Somewhat bad

₅ Very bad

₉ Prefer not to answer

[COMMUNICATION: NORMS]

6.7. Most of my friends, family, and other people close to me think I should talk to my sexual partner(s) about ways to prevent HIV.

₁ Strongly agree

₂ Agree

₃ Neither agree nor disagree

₄ Disagree

₅ Strongly disagree

₉ Prefer not to answer

6.8. Most of my sexual partners think I should talk to them about ways to prevent HIV.

₁ Strongly agree

₂ Agree

₃ Neither agree nor disagree

₄ Disagree

₅ Strongly disagree

₉ Prefer not to answer

6.9. How often do you think that your friends and other people close to you discuss ways to prevent HIV with their sexual partner(s)?

₁ Very often

₂ Often

₃ Sometimes

₄ Rarely

₅ Never

₉ Prefer not to answer

SECTION 7: INFORMATION SEEKING

7.1. [HIV/AIDS INFORMATION SEEKING BEHAVIOR]

In the past 12 months, how often have you looked for information about…

	Very often	Often	Some-times	Rarely	Never	Prefer not to answer
a. HIV?	1	2	3	4	5	9
b. HIV testing?	1	2	3	4	5	9
c. condoms?	1	2	3	4	5	9
d. taking medicines to treat HIV infection (e.g., antiretroviral therapy or ART)?	1	2	3	4	5	9
e. taking medicines daily to reduce the chance of being HIV infected (e.g., Truvada, pre-exposure prophylaxis, or PrEP)?	1	2	3	4	5	9
f. taking medicines after sex to reduce the chance of being HIV infected (e.g., post-exposure prophylaxis, nPEP or PEP)?	1	2	3	4	5	9
g. how to talk to my sexual partner(s) about HIV?	1	2	3	4	5	9

7.2. In the past 12 months, how often have you…

	Very Often	Often	Some-times	Rarely	Never	Prefer Not to answer
a. searched online for a location to get an HIV test?	1	2	3	4	5	9
b. called an HIV testing hotline?	1	2	3	4	5	9
c. texted your zip code for a location to get an HIV test?	1	2	3	4	5	9
d. visited a Centers for Disease Control website for HIV information?	1	2	3	4	5	9

[HIV/AIDS INFORMATION SEEKING SELF-EFFICACY]

[trust in cdc]

7.3. Please tell us if you agree or disagree with the following statement: I trust the Centers for Disease Control, or CDC, as a source for HIV information.

₁ Strongly agree

₂ Agree

₃ Neither agree nor disagree

₄ Disagree

₅ Strongly disagree

₉ Prefer not to answer

SECTION 8: HIV RISK BEHAVIOR/PREVENTION STRATEGIES

These next few questions are about your personal behaviors, including sexual activity. Please remember that your answers are kept private.

Sexual Activity

8.1. Did you have anal sex with any of your male partner(s) in the past [INSERT TIME FRAME]?

a. Yes [1]

b. No [0]

c. Refuse to answer [9]

[If yes…]

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

a. Never used a condom [1]

b. Occasionally used a condom [2]

c. Usually used a condom [3]

d. Always used a condom [4]

e. Refuse to answer [9]

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

a. Yes [1]

b. No [0]

c. Refuse to answer [9]

8.4. In the past [INSERT TIME FRAME], how many non-main partners – that is, somebody who you did not consider to be a spouse, significant other, or life partner – did you have oral, vaginal, or anal sex with?

a. 0 [1]

b. 1-5 [2]

c. 6-10 [3]

d. 11-15 [4]

e. 16-20 [5]

f. Over 20 [6]

g. Refuse to answer [9]

8.5. Did you have unprotected anal sex with any male partners in the past [INSERT TIME FRAME] whose HIV status you didn’t know? By unprotected sex, I mean anal sex when you or your partner didn’t use a condom.

a. Yes [1]

b. No [0]

c. Refuse to answer [9]

8.6. Did you have unprotected anal sex with any male partners in the past [INSERT TIME FRAME] who you knew or thought to be HIV positive? By unprotected sex, I mean anal sex when you or your partner didn’t use a condom.

a. Yes [1]

b. No [0]

c. Refuse to answer [9]

HIV Awareness and Knowledge

8.7. There are medications available to treat HIV.

a. Strongly agree [4]

b. Agree [3]

c. Disagree [2]

d. Strongly disagree [1]

e. Don’t know [8]

f. Refuse to answer [9]

8.8. Because of new treatments for HIV, I think people are taking more sexual risks.

a. Strongly agree [4]

b. Agree [3]

c. Disagree [2]

d. Strongly disagree [1]

e. Don’t know [8]

f. Refuse to answer [9]

8.9. Because of new treatments for HIV, I’m more willing to have unprotected sex with someone who is HIV negative.

a. Strongly agree [4]

b. Agree [3]

c. Disagree [2]

d. Strongly disagree [1]

e. Don’t know [8]

f. Refuse to answer [9]

8.10. Because of new treatments for HIV, I’m more willing to have unprotected sex with someone who is HIV positive.

a. Strongly agree [4]

b. Agree [3]

c. Disagree [2]

d. Strongly disagree [1]

e. Don’t know [8]

f. Refuse to answer [9]

8.11. On a scale from 1 to 5, where 1 is extremely harmful and 5 is extremely beneficial, how would you rate…

	Extremely Harmful 1	Harmful 2	Neither Harmful Nor Beneficial 3	Beneficial 4	Extremely Beneficial 5	Refuse to Answer
a. taking medicines to treat HIV infection (e.g. antiretroviral therapy or ART) to prevent HIV transmission?	1	2	3	4	5	9
b. taking medicines to prevent HIV [e.g., post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP)] to prevent HIV?.	1	2	3	4	5	9

8.12. Please tell us how much you disagree or agree with each of the following statements: “Taking medicines to prevent HIV….”

	Strongly disagree 1	Disagree 2	Neither disagree or agree 3	Agree 4	Strongly agree 5
a. is expensive.
b. is inconvenient.
c. allows me to have unprotected sex with my partner(s)
d. is for someone like me.

8.13. Please tell us how much you disagree or agree with each of the following statements: “Taking medicines to treat HIV….”

	Strongly disagree 1	Disagree 2	Neither disagree or agree 3	Agree 4	Strongly agree 5
a. is expensive.
b. is inconvenient.
c. allows me to have unprotected sex with my partner(s)
d. is for someone like me.

[Perceived risk of HIV infection]

Risk

8.14. Thinking about the sex you’ve had over the past 6 months, do you consider yourself to be high, medium or low risk for getting/transmitting HIV?

a. Low risk [1]

b. Medium risk [2]

c. High risk [3]

d. Refuse to answer [9]

8.15. Thinking about the sex you’ve had over the past 12 months, do you consider yourself to be low, medium or high risk for getting HIV?

₁ Low risk

₂ Medium risk

₃ High risk

₉ Prefer not to answer

8.16. In the past 12 months, how often did you use condoms for anal sex with your current main sexual partner?

₁ Always

₂ Usually

₃ Occasionally

₄ Never

₉ Prefer not to answer

8.17. Some couples develop agreements about whether, when, and with whom sex outside the relationship is okay. Which one of the following scenarios best describes any agreements that you and your main partner have?

₁ Both of us cannot have any sex with an outside partner

₂ We can have sex with outside partners but with some restrictions

₃ We can have sex with outside partners without any restrictions

₄ We do not have an agreement

₉ Prefer not to answer

8.18. In the past 12 months, how often did you use condoms for anal sex with casual (non-main) sexual partners?

₁ Always

₂ Usually

₃ Occasionally

₄ Never

₉ Prefer not to answer

8.19. Tell me how risky you think each behavior/activity/strategy is for [getting OR transmitting] HIV. Use a scale where 0 is lowest risk and 100 is highest risk. Please assign any number in that range to each of the behaviors listed.

a. Deep kissing _____

b. Receptive anal sex (“bottom”) with a condom _____

c. Receptive anal sex (“bottom”) without a condom _____

d. Receptive oral sex (“giving a blow job”) with a condom _____

e. Receptive oral sex (“giving a blow job”) without a condom _____

f. Insertive anal sex (“top”) with a condom _____

g. Insertive anal sex (“top”) without a condom _____

h. Insertive oral sex (“getting a blow job”) with a condom _____

i. Insertive oral sex (“getting a blow job”) without a condom _____

j. [INSERT BEHAVIOR]

k. Refuse to answer

8.19a. [INSERT BEHAVIOR/ACTIVITY/STRATEGY] is [more OR less] risky for [getting OR transmitting] HIV than [INSERT BEHAVIOR/ACTIVITY/STRATEGY].

₁ Strongly agree

₂ Agree

₃ Neither agree nor disagree

₄ Disagree

₅ Strongly disagree

₉ Prefer not to answer

Script: The next few questions are for people living with HIV. Earlier in the survey you reported that you had tested positive for HIV.

8.20. Are you currently taking antiretroviral medicines to treat your HIV infection?

₁ Yes

₂ No

₉ Prefer not to answer

8.21. What is the main reason you are not currently taking any antiretroviral medicines?

₁ Not currently going to a health care provider for my HIV infection

₂ CD4 count and viral load are good

₃ Don’t have money or insurance for antiretroviral medicines

₄ Don’t want to take antiretroviral medicines

₅ Other [Specify:_____________________]

₉ Prefer not to answer

8.22. Have you ever had an HIV viral load test? `

₁ Yes

₂ No [SKIP TO 8.11]

₃ Don’t know [SKIP TO 8.11]

₉ Prefer not to answer [SKIP TO 8.11]

8.22a. What was the result of your most recent viral load test?

₁ Undetectable

₂ Detectable copies/ml

₈ Don’t know

₉ Prefer not to answer

8.23. Before today, have you ever heard of people who do not have HIV taking HIV medicines (PrEP or Truvada) before sex, to keep from getting HIV?

₁ Yes

₂ No

₉ Prefer not to answer

8.24. Before today, have you ever heard of people who do not have HIV taking HIV medicines (post-exposure prophylaxis, nPEP, or PEP) after sex, to keep from getting HIV?

₁ Yes

₂ No

₉ Prefer not to answer

8.25. True or False: If someone has HIV and their viral load is “undetectable”, they cannot transmit HIV to other people.

₁ True

₂ False

₉ Prefer not to answer

8.26. In the past 12 months, have you taken HIV medicines (post-exposure prophylaxis, nPEP or PEP) after sex because you thought it would keep you from getting HIV?

₁ Yes

₂ No

₉ Prefer not to answer

8.27. In the past 12 months, have you taken HIV medicines (pre-exposure prophylaxis, PrEP or Truvada) before sex because you thought it would keep you from getting HIV?

₁ Yes

₂ No

₉ Prefer not to answer

HIV RISK BEHAVIOR/PREVENTION STRATEGIES

[Perceived risk of HIV infection]

[CURRENT RISK BEHAVIOR/ personal prevention strategies]

8.28. In the past 12 months, how often did you look for male sexual partners with same HIV status as you?

₁ Always

₂ Usually

₃ Occasionally

₄ Never

₉ Prefer not to answer

8.29. In the past 12 months, how often did you use your HIV status and your male partner’s HIV status to determine which sexual activities (i.e., oral and anal intercourse) you would engage in?

₁ Always

₂ Usually

₃ Occasionally

₄ Never

₉ Prefer not to answer

8.30. In the past 12 months, how often did you use your HIV status and your male partner’s HIV status to determine which sexual roles/positions (i.e., insertive/top or receptive/bottom) you would engage in?

₁ Always

₂ Usually

₃ Occasionally

₄ Never

₉ Prefer not to answer

Script: Earlier in the survey you reported that you were last tested for HIV in [INSERT DATE from S11].

8.31. When you got tested in ____/____ [insert date from S11], where did you get tested?

₁ Private doctor’s office

₂ HIV counseling and testing site

₃ Public health clinic/community health clinic

₄ Street outreach program/mobile unit

₅ Sexually transmitted disease clinic

₆ Hospital (inpatient)

₇ Correctional facility (jail or prison)

₈ Emergency room

₉ At home

₁₀ Other

₈₈ Don’t know [INELIGIBLE]

₉₉ Prefer not to answer [INELIGIBLE]

Script: Earlier in the survey you reported that you had never been tested for HIV.

8.32. Below is a list of reasons why some people have not been tested for HIV. Which of these best describes the most important reason you have not been tested for HIV in the past 6 months? [Check one]

₁ I think I am at low risk for HIV infection.

₂ I am afraid of finding out that I have HIV.

₃ I didn’t have time.

₄ Some other reason [Specify: ]

₅ No particular reason

₉ Prefer not to answer