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MMP 2014 Interview Questionnaire-English
Medical Monitoring Project
0920-0740
Form Approved
OMB Number: 0920–0740
Expiration Date: 05/31/2015
2014 Standard Questionnaire for
Medical Monitoring Project (MMP)
VERSION 10.3.0
Public reporting burden of this collection of information is estimated to average 45 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden to: CDC, Project Clearance Officer, 1600 Clifton Road, MS D–74, Atlanta, GA
30329, ATTN: PRA (0920–0740). Do not send the completed form to this address.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Centers for Disease Control and Prevention
Atlanta, GA 30329
2014 MMP QUESTIONNAIRE
GENERAL NOTES FOR QDS PROGRAMMER ...................................................................................................3
PRELIMINARY INFORMATION (I) ......................................................................................................................4
DEMOGRAPHICS (D) ...............................................................................................................................................6
ACCESS TO CARE (A) ............................................................................................................................. ............... 16
HIV TESTING AND CARE EXPERIENCES .................................................................................................................. .16
SOURCES OF CARE ............................................................................................................................. ......................24
MET AND UNMET NEEDS ............................................................................................................................. ............28
STIGMA AND DISCRIMINATION (R)................................................................................................................. 34
HIV TREATMENT AND ADHERENCE (T)......................................................................................................... 36
SEXUAL BEHAVIOR (S) ........................................................................................................................................ 56
TOTAL SEX PARTNERS (ST) ............................................................................................................................. ........56
EXCHANGE SEX (SE) ............................................................................................................................. ..................60
NAMES OF PARTNERS (SN) ............................................................................................................................. .........61
PARTNER DEMOGRAPHICS (SP)............................................................................................................................. ...66
VAGINAL SEX (SV) ............................................................................................................................. .....................74
ANAL SEX (SL) ............................................................................................................................. ...........................83
TRANSGENDER AND UNKNOWN GENDER SEX (SG) ................................................................................................111
STATUS (SS) ............................................................................................................................. .............................122
PRE-EXPOSURE PROPHYLAXIS (SR) ...................................................................................................................... .128
AGGREGATE INFORMATION (SA).......................................................................................................................... .130
SEROSORTING ............................................................................................................................. ...........................133
DRUG AND ALCOHOL USE (U) ......................................................................................................................... 135
CIGARETTE AND ALCOHOL USE ............................................................................................................................135
NON-INJECTION DRUG USE ............................................................................................................................. ......137
INJECTION DRUG USE ............................................................................................................................. ...............141
TRANSMISSION RISK BEHAVIORS (B) .......................................................................................................... 145
PREVENTION ACTIVITIES (P) .......................................................................................................................... 150
DEPRESSION (M) .................................................................................................................................................. 153
GYNECOLOGICAL AND REPRODUCTIVE HISTORY (G) .......................................................................... 154
HEALTH CONDITIONS AND PREVENTIVE THERAPY (C) ........................................................................ 166
INTERVIEW COMPLETION (E) ........................................................................................................................ 174
END OF INTERVIEW............................................................................................................................. ...................174
PAYMENT VERIFICATION ............................................................................................................................. ..........174
DATA VALIDITY ............................................................................................................................. .......................175
RESPONSE CARDS ............................................................................................................................................... 176
2013 CALENDAR ................................................................................................................................................... 182
2014 CALENDAR ................................................................................................................................................... 183
General notes for QDS programmer
Additional programming notes are located throughout the questionnaire:
1) Use version 2.6.1 of QDS.
2) Every question requires a response to move forward in the application unless otherwise
noted.
3) Use the following values: .D = 8, .R = 7, NA = 6.
4) For all “other–specify” variables in “check all that apply” questions, use the “other” variable
name (which should end in “O”) and add an “S” on the end. If the variable name becomes
too long, then drop the letter immediately preceding the consecutive letter at the end of the
main part of the variable name. For example, if the “other” variable is named
“KINDG_9O”(where KIND is the stem variable name and G denotes the lettered response
option) the “specify” variable should be named “KING_9OS”
5) QDS programming notes are not included in the application; they are merely there to help
with coding.
6) Interviewer instructions and inconsistency checks are notes for the interviewers, but may
also include coding instructions.
7) The QDS codebook should have a brief description of the variable. This includes all
calculated variables.
8) Calculate questionnaire version number using variable name VERSION. This must be
updated every time a change is made in the application.
9) Calculate QDS version number using variable name QDSVERN3. This variable describes the
QDS version used to create the QAD file. For 2014 cycle the value is 2.6.1.
10) Calculate data collection cycle using variable name CYCYR. CYCYR = 2014.
11) For all date variables also create an automatic variable that is a copy of the date variable.
For example, if the variable for date was called DATE, then the automatic variable would
look like: a. variable name: TXFORM, b. type of date: String Expression, c. numeric
calculation/string expression: DATE
12) Label module sections in the codebook. Use the Table of Contents for guidance.
13) PDP start date is January 1, 2014.
14) PDP end date is April 30, 2014.
15) Calculate the time to conduct an interview from D1 to C20 (i.e., exclude Preliminary
Information and Interview Completion sections.
16) Calculate time to conduct each module.
17) Do not include the Response cards and calendars in the QDS program.
18) Distinguish between English and Spanish versions of the questionnaires.
19) The maximum size of text values is 100 except for E5 which is 200.
MMP Standard Questionnaire Preliminary Information
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
3
Preliminary Information (I)
Interviewer instructions: Enter Preliminary Information prior to interview.
Participant ID [PARID]:
I1a. Site ID [SITEID]
I1b. Facility ID [FACILID]
I1c.
Respondent ID [INDID]
QDS programming note:
Site ID, Facility ID, and Respondent ID all must be 4 digits with leading 0s. [PARID] is a 12 digit
calculated variable based on [SITEID] + [FACILID] + [INDID]
Range 1–9999
I1d.
The Participant ID is
/
/
. Is that correct? [IDCONFN3]
No ...........................................................................................☐ 0
Return to I1a
Yes ..........................................................................................☐ 1
QDS programming note: Enter PARID for question. If I1d is “No,” loop back to I1a.
Display for interviewer should include dashes after every 4th number for legibility (e.g., “The
participant ID is 1111-2222-3333. Is that correct?” DO NOT create a new variable reflecting
PARID. Display when I1d is NO should read: “Interviewer: Please re-enter participant ID.”
I2.
Interviewer ID:
[INTID]
QDS programming note for I2: Range 1–999
I3.
Computer device ID:
[DEVICEID]
QDS programming note for I3: Range 1–999
I4.
Interview date:
[IDATE]
__/
(M
M/
D D /
/
Y
Y
Y
Y)
QDS programming note for I4: Automatically calculate in QDS.
I5.
Are you conducting a telephone interview or face-to-face interview? [TI_F2F]
Telephone interview ..............................................................☐ 1
Face-to-face interview ...........................................................☐ 2
I6.
Was the interview originally administered on paper? [MODEADM]
MMP Standard Questionnaire Preliminary Information
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
4
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
MMP Standard Questionnaire Preliminary Information
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
5
Demographics (D)
SAY: “I’d like to thank you for taking part in this interview. Remember that all the information
you give me will be confidential and your name wo n ’t be recorded in the survey responses.
The answers to some questions may seem obvious to you, but I need to ask you all of the
questions.”
Interviewer instructions: If I5 [TI_F2F] is “telephone interview,” then go to Say box below;
otherwise skip to D1.
SAY: “You have chosen to complete the interview over the telephone. Before we begin, I would
like to remind you that there is a set of response cards that I will ask you to refer to throughout
the course of the interview. These response cards will be needed for some of the questions you
will be asked during the interview. The set of cards contains a calendar, some pictures, and text
to help guide you through the response options for some of the questions. Each card is labeled.
Please keep this set of response cards nearby so you can use them when needed. I will let you
know which questions require response cards and the label that corresponds to the card that is
needed.”
D1.
D1a.
Have you ever participated in the MMP interview? [PARTCPT]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Skip to D2
Skip to Say box before D2
Skip to D2
What month and year did you participate in the MMP interview? [PARTIC]
(M M
/
Y
Y
Y
Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If the respondent does not know the month, code this date as Don’t
know.
Inconsistency check: D1a (date respondent participated in MMP) cannot be earlier than
January 2005 or later than I4 (interview date).
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
6
QDS programming note for D1a: This requires a full response for month and year.
D1b.
In what city were you interviewed?
(City) [CITY_9]
[7 = Refused, 8 = Don’t know]
D1c.
In what state were you interviewed?
(State) [STATE_9]
[7 = Refused, 8 = Don’t know]
Interviewer instructions: If D1a [PARTIC] is during the 2014 data collection cycle, or “Refused to
answer,” go to Say box before D2; otherwise, skip to D2.
QDS programming note for Interviewer instructions after D1c: parameters for the 2014 data
collection cycle are May 1, 2014 to I4 (interview date).
SAY: “We are only interviewing people who haven’t already been interviewed during 2014
(2015). Thank you very much for your time.” [DISCONTINUE INTERVIEW AND SKIP TO INTERVIEW
COMPLETION.]
QDS programming note for Say box after D1c: use 2014 if the year in I4 (date of interview) is
2014. Use 2015 if the year in I4 (date of interview) is 2015.
D2.
Please tell me the month and year of your date of birth? [DOB_13]
/
(M M /
Y
Y
Y
Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If D2 [DOB_13] is less than 18 years prior to January 1, 2014 skip to
say box before D3. If D2 is “Refused to answer” or “Don’t know,” or if D2 is 18 years and 0-11
months prior to January 1, 2014 go to D2a; otherwise, skip to D3.
Inconsistency check: D2 [DOB_13] cannot be earlier than January 1, 1900 or later than the I4
(interview date).
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
7
QDS programming note for D2: This requires a full response for month and year. Use the 1st of
the month to calculate age.
D2a.
Were you at least 18 years old on January 1, 2014? [AGE_VER1]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Skip to Say box before D3
Skip to D3
Skip to Say box before
D3
SAY: “We are only interviewing people who were 18 years or older on January 1, 2014. Thank
you very much for your time.” [DISCONTINUE INTERVIEW AND SKIP TO INTERVIEW COMPLETION.]
D3.
What is the highest level of education you completed? [DON’T READ CHOICES. CHECK
ONLY ONE.] [EDUC]
Never attended school ............................................................... ☐ 1
Grades 1 through 8 ..................................................................... ☐ 2
Grades 9 through 11 ................................................................... ☐ 3
Grade 12 or GED .......................................................................... ☐ 4
Some college, associate’s degree, or technical degree ......... ☐ 5
Bachelor’s degree ........................................................................ ☐ 6
Any post–graduate studies ........................................................ ☐ 7
Refused to answer....................................................................... ☐ 77
Don’t know ................................................................................... ☐ 88
D4.
Do you consider yourself to be of Hispanic, Latino/a, or Spanish origin? [HISPA_13]
No .................................................................................................. ☐ 0
Skip to D5
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Skip to D5
Don’t know ................................................................................... ☐ 8
D4a.
Which of the following describes your Hispanic, Latino/a, or Spanish origin? You can
choose more than one. [READ CHOICES. CHECK ALL THAT APPLY.] [HISN3]
Mexican, Mexican American, or Chicano/a ............................. ☐ 1 [HISN3A]
Puerto Rican ................................................................................. ☐ 2 [HISN3B]
Cuban ............................................................................................ ☐ 3[HISN3C]
Another Hispanic, Latino/a, or Spanish origin ......................... ☐ 4[HISN3D]
(Specify:
)[HISN3_OS]
Refused to answer....................................................................... ☐ 7
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
8
Don’t know ................................................................................... ☐ 8
D5.
Which racial group or groups do you consider yourself to be in? You may choose more
than one option. [READ CHOICES. CHECK ALL THAT APPLY.] [RACE_9]
American Indian or Alaska Native ..........................................☐ 1 [RACE_9A]
Asian.......................................................................................☐ 2 [RACE_9B]
Black or African American......................................................☐ 3 [RACE_9C]
Native Hawaiian or Other Pacific Islander .............................☐ 4 [RACE_9D]
White......................................................................................☐ 5 [RACE_9E]
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
D6.
In what country or territory were you born? [DON’T READ CHOICES. CHECK ONLY ONE.]
[CO_BORN]
United States..........................................................................☐ 1
Skip to D7
Puerto Rico.............................................................................☐ 2
Mexico....................................................................................☐ 3
Cuba .......................................................................................☐ 4
Other (Specify:
_) .............☐ 5 [OTCTRY]
Refused to answer....................................................................... ☐ 7
Skip to D7
Don’t know.............................................................................☐ 8
D6a.
How many years have you been living in the United States? [US_YRS]
years
[Years: 777 = Refused to answer, 888 = Don’t know]
Interviewer instructions: If years living in the U.S. are less than 1 year, enter “0.”
Inconsistency check: D6a [US_YRS] must be ≤ the respondent’s age at the date of the interview.
Range 0–110.
QDS programming note for inconsistency check after D6a: If D6a >= (&[AGE_INTD]), display
note to interviewer: “The number of years living in the US (&[US_YRS]) must be less than or
equal to the age as of the interview date (&[AGE_INTD]).”
D7.
How well do you speak English? [READ CHOICES. CHECK ONLY ONE.] [LANWL1N3]
Very well ....................................................................................... ☐ 1
Well ............................................................................................... ☐ 2
Not well......................................................................................... ☐ 3
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
9
Not at all.................................................................................☐ 4
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
D8.
Do you speak a language other than English at home? [LANWL2N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Skip to D9
Skip to D9
D8a.
What is this language? [DON’T READ CHOICES. CHECK ONLY ONE.] [LANWL3N3]
Spanish .......................................................................................... ☐ 1
French ........................................................................................... ☐ 2
Chinese...................................................................................☐ 3
German ......................................................................................... ☐ 4
Tagalog ...................................................................................☐ 5
Vietnamese .................................................................................. ☐ 6
Italian ............................................................................................ ☐ 7
Korean ........................................................................................... ☐ 8
Russian .......................................................................................... ☐ 9
Polish ............................................................................................. ☐ 10
Other (Specify:
_) .................... ☐ 11 [LANN3_OS]
Refused to answer....................................................................... ☐ 77
Don’t know ................................................................................... ☐ 88
D9.
What was your sex at birth? [READ CHOICES EXCEPT “Intersex/ambiguous.” CHECK ONLY
ONE.] [BIRTGEN]
Male .............................................................................................. ☐ 1
Female........................................................................................... ☐ 2
Intersex/ambiguous .................................................................... ☐ 3
Refused to answer .................................................................☐ 7
Don’t know ................................................................................... ☐ 8
D10.
Do you consider yourself to be male, female, or transgender? [CHECK ONLY ONE.]
[GENDER]
Male .............................................................................................. ☐ 1
Female........................................................................................... ☐ 2
Transgender ................................................................................. ☐ 3
Refused to answer .................................................................☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
10
D11.
Do you think of yourself as: [READ CHOICES. CHECK ONLY ONE.] [SEXORI8]
Homosexual, gay, or lesbian ..................................................☐ 1
Heterosexual or straight ........................................................☐ 2
Bisexual ..................................................................................☐ 3
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “Now I’m going to ask you some questions about the past 12 months. We will use the
calendar to refer to the past 12 months. That is from last year (DATE WITH PREVIOUS YEAR) to
now (INTERVIEW DATE).”
QDS programming note for Say box before D12: The QDS program should enter the appropriate
dates. EXAMPLE: If IDATE is 11/11/2014 then the program should read “That is from last year,
11/11/2013 to now 11/11/2014.”
D12.
During the past 12 months, have you
No (0)
Yes (1)
Refused
D12a. …lived on the street? [HOMEL_9A]
☐0
☐1
☐7
Don’t
know (8)
☐8
D12b.
D12c.
☐0
☐0
☐1
☐1
☐7
☐7
☐8
☐8
☐0
☐1
☐7
☐8
(7)
…lived in a shelter? [HOMEL_9B]
…lived in a Single Room
Occupancy (SRO) hotel? [HOMEL_9C]
D12d. …lived in a car? [HOMEL_9D]
D13.
During the past 12 months, have you been arrested and put in jail, detention, or prison
for longer than 24 hours? [JAIL]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
D14.
During the past 12 months, have you had any kind of health insurance or health
coverage? This includes Medicaid and Medicare. [HTHINS_9]
No .................................................................................................. ☐ 0
Skip to Say box
before D17
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Skip to Say box
Don’t know ................................................................................... ☐ 8
before D17
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
11
D15.
During the past 12 months, what were all the kinds of health insurance or health
coverage you had? Please tell me about each of these kinds of insurance.
(8)
Don’t know
Refused to
answer (7)
Private health insurance
Yes (1)
No (0)
D15a.
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
[KINDA_3]
D15b.
D15c.
D15d.
D15e.
D15f.
D15g.
D15h.
Medicaid [KINDB_3]
Medicare [KINDC_3]
Ryan White [KINDD_3]
ADAP [KINDE_3]
Tricare or CHAMPUS [KINDF_3]
Veterans Administration
coverage [KINDG_3]
City, county, state or other
publicly funded insurance
[KINDH_N3]
D15i.
Other insurance [KINDI_3]
(Specify:
_)
[KII_3OS]
Inconsistency check: If D14 is “yes” at least one of D15a-D15i must be “yes.”
QDS programming note for D15 series: If D14 is “yes” and none of D15a-D15i is “yes,” display
note to interviewer: “Interviewer: Respondent reported health insurance or coverage in past
12 months but did not answer “yes” to any type.” Confirm response to D14 and repeat D15aD15i if D14 remains “yes.”
D16.
During the past 12 months, was there a time that you didn’t have any health
insurance or health coverage? [INS12_9]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
SAY: “For the next question, please choose the answer that best describes your current status
AFTER I have read all the choices.”
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
12
D17.
Are you currently…? [READ CHOICES. CHECK ONLY ONE.] [WORK_N3]
Employed for wages ................................................................... ☐ 1
Self-employed ............................................................................. ☐ 2
Out of work for more than 1 year ............................................ ☐ 3
Out of work for less than 1 year ............................................... ☐ 4
A Homemaker ............................................................................. ☐ 5
A Student ..................................................................................... ☐ 6
Retired .......................................................................................... ☐ 7
Or unable to work ....................................................................... ☐ 8
Refused to answer....................................................................... ☐ 77
D18.
During the past 12 months, where did most of your money or financial support come
from? [DON’T READ CHOICES. CHECK ONLY ONE.] [SRC_IN_9]
Salary or wages ......................................................................☐ 1
Savings or investments ..........................................................☐ 2
Pension or retirement fund ...................................................☐ 3
Supplemental Security Income (SSI) or Social Security
Disability Insurance (SSDI) ............................................☐ 4
Other public assistance (e.g., “welfare”) ...............................☐ 5
Family, partner, or friend(s) ...................................................☐ 6
Illegal or possibly illegal activities ..........................................☐ 7
Skip to Say box before A1
No income or financial support .............................................☐ 8
Other (Specify:
_) ☐ 9 [SOIN_9OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Programming note for Say box before D19 and D19a and D19b: use the calendar year prior to
interview year. EXAMPLE: If interview date is 12–01–14, ask about 2013.
SAY: “Now I would like to ask you some questions about 2013 (2014). That is January 1st, 2013
(2014) to December 31st, 2013 (2014). For this next question, we will use Response Card A and
the calendar.”
D19.
In 2013 (2014), what was your combined monthly or yearly household income from all
sources before taxes? When I say “combined household income,” I mean the total
amount of money from all people living in the household. [DON’T READ CHOICES. CHECK
ONLY ONE.]
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
13
SAY: “Please take a look at Response Card A and tell me the letter that corresponds to either
your monthly or yearly household income before taxes.”
D19a. Interviewer question: Does the respondent report the income as monthly? [MONTHLY]
Yes ................................................................................................. ☐ 1
No .................................................................................................. ☐ 2
Monthly Income [MTH_IN_3]
a.
$0 to $416
b.
$417 to $833
c.
$834 to $1041
d.
$1042 to $1249
e.
$1250 to $1666
f.
$1667 to $2083
g.
$2084 to $2499
h.
$2500 to $2916
i.
$2917 to $3333
j.
$3334 to $4166
k.
$4167 to $4999
l.
$5000 to $6249
m.
$6250 or more
77
Refused to answer
88
Don’t know
Yearly Income [YR_IN_3]
n. $0 to $4,999
o. $5,000 to $9,999
p. $10,000 to $12,499
q. $12,500 to $14,999
r.
$15,000 to $19,999
s.
$20,000 to $24,999
t.
$25,000 to $29,999
u. $30,000 to $34,999
v.
$35,000 to $39,999
w.
$40,000 to $49,999
x.
$50,000 to $59,999
y.
$60,000 to $74,999
z.
$75,000 or more
77 Refused to answer
88 Don’t know
D19a. Including you, how many people depended on this income in 2013 (2014)? [DEPND_IN]
[77 = Refused to answer, 88 = Don’t know]
Inconsistency check: D19a must be ≥ 1 and < 50.
Interviewer instructions: If D19a is >1, go to D19b; otherwise, skip to say box before A1.
D19b. Of the people who depended on this income in 2013 (2014), how many were less than
18 years old? [DEPND_N3]
[77 = Refused to answer, 88 = Don’t know]
Inconsistency check: D19b must be < D19a (unless D19b is skipped).
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
14
QDS programming note for inconsistency check after D19b: If D19b >= D19a, display note to
interviewer: “The number of people under 18 who depended on your income in 2013 (2014)
must be less than the total number of people who depended on your income in 2013 (2014).”
Do not allow the program to advance.
MMP Standard Questionnaire Demographics
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not r ead
responses
15
Access to Care (A)
HIV Testing and Care Experiences
SAY: “Now I’m going to ask you some questions about getting tested for HIV.”
A1.
What month and year did you first test positive for HIV? Tell me when you got your
result, not when you got your test. [POS1S_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency check: A1 (date first tested positive for HIV) cannot be earlier than D2 [DOB_13].
If A1 is earlier than March 1985 or later than April 30, 2014, the PDP end date, confirm
response.
QDS programming note for inconsistency check after A1: If A1 is earlier than D2 [DOB_13],
display message: “The date first tested positive for HIV cannot be earlier than respondent's
date of birth. Please re-enter date.” Then, loop back to A1. If A1 is earlier than 03/1985, display
note to the interviewer: “The date entered is earlier than 03/1985 (date of first FDA-approved
HIV test). Confirm date of HIV test. Go back to previous question to confirm date.” Program
should move forward regardless of date. Allow a blank response for month. If A1 is later than
April 30, 2014, display note to interviewers: “The date entered is after 04/30/2014 (PDP end
date). Go back to previous question to confirm date of HIV test.” The program will then go to
the Say box before A2.
Interviewer instructions: If A1 (date first tested positive for HIV) is after April 30, 2014, go to
the Say box before A2. If A1 is “Refused to answer” or “Don’t know,” skip to A7. If A1 (date
first tested positive for HIV) is within 12 months of I4 (interview date), go to A2; otherwise
skip to instructions before A3.
SAY: “We are only interviewing people who tested positive for HIV before April 30, 2014.
Thank you very much for your time.” [DISCONTINUE INTERVIEW AND SKIP TO INTERVIEW
COMPLETION.]
A2.
Before your positive test in
/
[INSERT DATE FROM A1], did you ever have
a negative HIV test? [HIVBEF_9]
Skip to interviewer
No ...........................................................................................☐ 0
instructions before A3
MMP Standard Questionnaire HIV Testing and Care Experiences
16
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to interviewer
instructions before A3
QDS programming note for A2: Insert date from A1 in question.
A2a.
What month and year did you get your most recent negative HIV test? Tell me when you
got your result, not when you got your test. [LASTN_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency check: A2a (date of the most recent negative HIV test) cannot be earlier than D2
(respondent’s date of birth) or later than A1 (date first tested positive for HIV). If A2a is
earlier than March 1985, confirm response.
QDS programming note for inconsistency check after A2a: If A2a is earlier than DOB_13, display
note to interviewer: “The date of the most recent negative HIV test cannot be before the date
of birth. Confirm response.” Allow program to move forward. If A2a is after A1, display note to
interviewer: “The date of the most recent negative HIV test cannot be after the date first tested
positive for HIV. Confirm response. If A2a is earlier than 03/1985, display note to interviewer:
“The date entered is earlier than 03/1985 (date of first FDA-approved HIV test). Confirm date
of HIV test.” Program should move forward regardless of date. Allow a blank response for
month.
Interviewer instructions: If A1 (date first tested positive for HIV) is less than 5 years earlier
than April 30, 2014, go to A3; otherwise skip to A7.
A3.
When you tested positive in
/
[INSERT DATE FROM A1], at what type of
facility were you tested? [DON’T READ CHOICES. CHECK ONLY ONE.] [TESLOC_9]
Private doctor’s office ............................................................☐ 1
Primary care clinic or community health center ...................☐ 2
Health department ................................................................☐ 3
Labor/delivery setting ............................................................☐ 4
OB-GYN or family planning clinic ...........................................☐ 5
Emergency room ....................................................................☐ 6
Inpatient hospital (not labor/delivery or emergency room) .☐ 7
HIV counseling and testing site..............................................☐ 8
MMP Standard Questionnaire HIV Testing and Care Experiences
17
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
STD clinic ................................................................................☐ 9
HIV/AIDS infectious disease clinic..........................................☐ 10
Mobile test site ......................................................................☐ 11
Correctional facility ................................................................☐ 12
Blood donation facility ...........................................................☐ 13
Substance abuse treatment center .......................................☐ 14
Insurance or employee clinic .................................................☐15
Military or VA facility .............................................................☐ 16
Other (Specify:
)…☐ 17 [TESL9_OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Inconsistency check: Confirm response if A3 (testing location) is “labor/delivery setting” or
“OB-GYN or family planning clinic” and [BIRTGEN] is “male”.
QDS programming note for A3: Insert date in question. If A3 is “labor/delivery setting” or “OBGYN or family planning clinic” and [BIRTGEN] is “male,” display the following message:
“Respondent said he was first tested in a labor/delivery setting or OB-GYN or family planning
clinic. Confirm response.” Allow the program to advance.
A4.
When you tested positive in
/
[INSERT DATE FROM A1], what was the
main reason you were tested? [DON’T READ CHOICES. CHECK ONLY ONE.] [MRTEST_9]
Concerned about exposure through sexual contact .............☐ 1
Concerned about exposure through IDU...............................☐ 2
Part of STD screening or due to STD diagnosis ......................☐ 3
Due to other illness (not STD) ................................................☐ 4
Due to pregnancy...................................................................☐ 5
Personal initiative to routinely test .......................................☐ 6
Provider recommendation as part of routine care................☐ 7
Health department partner notification (PCRS) ....................☐ 8
Before blood donation ...........................................................☐ 9
Needle stick follow-up or occupational exposure .................☐ 10
Requirement (military, court order, or insurance). ...............☐ 11
Other (Specify:
_) ☐ 12 [MRTE_9OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
QDS programming note for A4: Insert date from A1 in question.
MMP Standard Questionnaire HIV Testing and Care Experiences
18
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Inconsistency check: A4 (main reason tested) cannot be “due to pregnancy” if [BIRTGEN] is
“male”.
QDS programming note for inconsistency check after A4: If [BIRTGEN] is “male” and response to
A4 is “due to pregnancy,” display note to interviewer: “Main reason tested cannot be due to
pregnancy if respondent was born male.” Do not allow the program to advance.
A5.
After you tested positive in
/
[INSERT DATE FROM A1], did someone
from the health department or a health care provider offer to tell or help you tell your
sex or drug use partners that they may have been exposed to HIV? [PARTNO_9]
No ...........................................................................................☐ 0
Skip to Say box
Yes ..........................................................................................☐ 1
before A6
Not applicable ........................................................................☐ 6
Refused to answer .................................................................☐ 7
Skip to Say box
Don’t know.............................................................................☐ 8
before A6
SAY: “For this next question, please use Response Card B.”
A5a.
What was your response when someone from the health department or a health care
provider offered to tell or help you tell your sex or drug use partners? [READ CHOICES.
CHECK ONLY ONE.] [RESNOT_9]
I asked them not to tell any of my partners ..........................☐ 1
I asked them to tell only some of my partners ......................☐ 2
I asked them to tell all of my partners ...................................☐ 3
I told them that I didn’t have any partners ...........................☐ 4
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
A5b.
Skip to A5c
Skip to Say box
before A6
What was the main reason you asked someone from the health department or a health
care provider not to tell any of your partners? [READ CHOICES. CHECK ONLY ONE.]
[NOPAR_10]
Didn’t know partners’ contact information ...........................☐1
Was afraid of what partners would do ..................................☐ 2
Didn’t trust health department/provider to tell partners .....☐ 3
Was afraid partners would find out who may have infected
them ..............................................................................☐ 4
Wanted to tell partners personally........................................☐ 5
Partners are HIV positive .......................................................☐ 6
MMP Standard Questionnaire HIV Testing and Care Experiences
19
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Other (Specify:
)☐ 8 [NOP_10OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: Skip to Say box before A6.
A5c.
What was the main reason you asked someone from the health department or a health
care provider to tell only some of your partners? [READ CHOICES. CHECK ONLY ONE.]
[NOSOM_10]
Didn’t know some partners’ contact information .................☐1
Was afraid of what some of his or her partners would do....☐ 2
Didn’t trust health department/provider to tell some
partners .............................................................................☐ 3
Was afraid some partners would find out who may have
infected them ....................................................................☐ 4
Wanted to tell some partners personally ..............................☐ 5
Some partners are HIV positive .............................................☐ 6
Other (Specify:
) ☐ 8 [NOS_10OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
SAY: “Now I’m going to ask you about HIV medical care. When I say ‘HIV medical care,’ I mean
physical exams, prescriptions for HIV medicines, or lab tests such as HIV viral load and CD4
testing.”
A6.
Since testing positive for HIV, what month and year did you first visit a doctor, nurse, or
other health care worker for HIV medical care? [CARE_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency check: Confirm response if A6 (date first went to provider for HIV care) is earlier
than the A1 (date first tested positive for HIV) or earlier than [DOB_13] (date of birth) or later
than April 30, 2014, the PDP end date.
QDS programming note for inconsistency check after A6: If A6 is earlier than A1, display note to
interviewer: “The date entered is earlier than the date first tested positive for HIV. Go back to
previous question to confirm date.” Allow the program to advance. If A6 is later than
MMP Standard Questionnaire HIV Testing and Care Experiences
20
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
04/30/2014, display a note to the interviewer: “The date entered is later than April 30, 2014
(PDP end date). Go back to previous question to confirm date.” Allow the program to advance.
Allow a blank response for month. If A6 date earlier than respondent’s [DOB_13] (date of birth)
display a note to the interviewer: "The date entered is earlier than respondent's date of birth.
Go back to previous question to confirm date."
Interviewer instructions: If A6 (date first went to provider for HIV care) is > 3 months after A1
(date first tested positive for HIV), go to A6a; otherwise, skip to A7. If A6 is “Refused to
answer” or “Don’t know,” skip to A7.
A6a.
What was the main reason you didn’t go to a doctor, nurse, or other health care worker
for HIV medical care within 3 months of testing positive for HIV? [DON’T READ CHOICES.
CHECK ONLY ONE.] [MRNOCA_9]
Felt good ................................................................................☐ 1
Initial CD4 count and viral load were good............................☐ 2
Didn’t believe test result........................................................☐ 3
Didn’t want to think about being HIV positive ......................☐ 4
Didn’t have enough money or health insurance ...................☐ 5
Had other responsibilities such as child care or work ...........☐ 6
Experienced homelessness ....................................................☐ 7
Was drinking or using drugs ..................................................☐ 8
Felt sick...................................................................................☐ 9
Forgot to go............................................................................☐ 10
Missed appointment(s) ..........................................................☐ 11
Moved or out of town............................................................☐ 12
Unable to get transportation .................................................☐ 13
Facility is inconvenient (location, facility hours, wait-time) ..☐ 14
Didn’t know where to go .......................................................☐ 15
Couldn’t find the right HIV health care provider ...................☐ 16
Unable to get earlier appointment ........................................☐ 17
Unaware of recommendation to enter care within 3 months☐ 18
Other (Specify:
) ......☐ 19 [MRNO_9OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
A7.
When was your most recent visit to a doctor, nurse, or other health care worker for HIV
medical care? Please tell me the month and year. [LASCA_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
MMP Standard Questionnaire HIV Testing and Care Experiences
21
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Year: 7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for A7: Allow a blank response for month.
Inconsistency check: A7 (date of most recent visit to a provider for HIV care) cannot be earlier
than A6 (date first visit to a provider for HIV care), earlier than D2 (date of birth) or later than
I4 (interview date).
QDS programming note for inconsistency check after A7: If A7 is earlier than A6, display note to
interviewer: “The date of the most recent visit to a provider for HIV care cannot be earlier than
the date first visited a provider for HIV care.” If A7 is earlier than D2, display note to
interviewer: “The date of the most recent visit to a provider for HIV care cannot be earlier than
respondent’s date of birth. Please re-enter date.” If A7 is later than I4, display note to
interviewer: “The date of the most recent visit to a provider for HIV care cannot be later than
the interview date.” Go back to A7.
Interviewer instructions: If A7 (date of most recent visit to a provider for HIV care) is > 6
months prior to I4 (interview date), go to A7a; otherwise, skip to Say box before A8. If A7 is
“Refused to answer” or “Don’t know,” skip to Say box before A8.
SAY: “For this next question we will use the calendar to refer to the past 6 months.”
A7a.
What was the main reason you didn’t visit a doctor, nurse, or other health care worker
for HIV medical care during the past 6 months? [DON’T READ CHOICES. CHECK ONLY ONE.]
[MRNOC_10]
Felt good ................................................................................☐ 1
CD4 count and viral load were good......................................☐ 2
Didn’t believe test result........................................................☐ 3
Didn’t want to think about being HIV positive ......................☐ 4
Didn’t have enough money or health insurance ...................☐ 5
Had other responsibilities such as child care or work ...........☐ 6
Experienced homelessness ....................................................☐ 7
Was drinking or using drugs ..................................................☐ 8
Felt sick...................................................................................☐ 9
Forgot to go............................................................................☐ 10
Missed appointment(s) ..........................................................☐ 11
Moved or out of town............................................................☐ 12
Unable to get transportation .................................................☐ 13
Facility is inconvenient (location, facility hours, wait-time) ..☐ 14
MMP Standard Questionnaire HIV Testing and Care Experiences
22
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Didn’t know where to go .......................................................☐ 15
Couldn’t find the right HIV health care provider ...................☐ 16
Unable to get earlier appointment ........................................☐ 17
Other (Specify:
_) ......☐ 18 [MRN_10OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
MMP Standard Questionnaire HIV Testing and Care Experiences
23
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Sources of Care
SAY: “Now I’m going to ask you about the places where you get HIV outpatient medical care. By
HIV outpatient medical care I mean care not in an emergency room, urgent care center, or
while staying overnight in the hospital. If you don’t remember everything, that’s okay. Tell me
what you remember.”
A8.
During the past 12 months, was there one usual place, like a doctor’s office or clinic,
where you went for most of your HIV medical care? [PLCARE_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Skip to A9
Refused to answer .................................................................☐ 7
Skip to Say box before
Don’t know.............................................................................☐ 8
A10a
A8a.
What was the main reason you didn’t have a usual place to get HIV medical care during
the past 12 months? [READ CHOICES. CHECK ONLY ONE.] [UC_RS_10]
Couldn’t afford a usual source of HIV care ............................☐ 1
Didn’t know where to find a usual source of HIV care ..........☐ 2
Couldn’t get regular appointments anywhere ......................☐ 3
It wasn’t available in the area ................................................☐ 4
Didn’t think it was necessary .................................................☐ 5
Thought it was necessary, but never tried to get a usual
source of care ...............................................................☐ 6
Other (Specify:
_) ☐ 7 [UC_R10OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: Skip to Say box before A10a.
A9.
Do you have a person you think of as your HIV doctor, nurse, or other healthcare
provider? [YRHIVN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “For the next two questions, tell me how strongly you agree or disagree with the following
statements about your HIV medical care.”
MMP Standard Questionnaire Sources of Care
24
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
A10a. The HIV medical care you have been receiving is just about perfect. [READ CHOICES.
CHECK ONLY ONE.] [GESAT1N3]
Strongly agree ........................................................................☐ 1
Agree ......................................................................................☐ 2
Uncertain ...............................................................................☐ 3
Disagree .................................................................................☐ 4
Strongly disagree ...................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
A10b. You are dissatisfied with some things about the HIV medical care you receive. [READ
CHOICES. CHECK ONLY ONE.] [GESAT2N3]
Strongly agree ........................................................................☐ 1
Agree ......................................................................................☐ 2
Uncertain ...............................................................................☐ 3
Disagree .................................................................................☐ 4
Strongly disagree ...................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Interviewer instructions: If [PLCARE_9] (usual source of care) is “No,” then skip to A14.
A11. What is the name of your usual place of HIV medical care?
Interviewer instructions: The name of the usual place of care is not recorded in QDS but will
be used in later questions.
Interviewer instructions: The name of the usual place of care is not recorded in QDS but will
be used in later questions. Please answer the following question based on the respondent’s
usual place of care.
A11a. Is the respondent’s usual place of care the same as the sampled facility? [USCSFN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
A12.
In the past 12 months, between [ONE YEAR PRIOR TO INTERVIEW DATE (IDATE)] and
today, how many times did you go to your HIV doctor or other care provider at [INSERT
USUAL SOURCE OF CARE FACILITY NAME] for any sort of care? [TIMCR_13]
[777 = Refused to answer, 888 = Don’t know]
MMP Standard Questionnaire Sources of Care
25
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Inconsistency check: The number of visits in A12 must be between 0 and 365.
A13.
About how many minutes does it usually take you to get to [INSERT USUAL SOURCE OF
CARE FACILITY NAME]? [MIN_TRVL]
[777 = Refused to answer, 888 = Don’t know]
Inconsistency check: The number of minutes in A13 must be between 0 and 776.
A14.
Between [INSERT PDP START DATE] and [INSERT PDP END DATE], at how many facilities
besides [INSERT NAME OF SAMPLED FACILITY] have you received HIV medical care?
[MLTFACN3]
[777 = Refused to answer, 888 = Don’t know]
Interviewer instructions: A different clinic in the same hospital would be considered a different
facility if different on the sampling frame.
Inconsistency check: The number of facilities in A14 must be between 0 and 99.
SAY: “Now I’m going to ask you about general medical care. When I say, ‘general medical care,’
I mean care for any sort of general medical problem besides your HIV.”
A15.
During the past 12 months, was there one usual place, like a doctor’s office or clinic,
where you went for most of your general medical care? [OCAREL_9]
No ...........................................................................................☐ 0
Skip to A16
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to A16
A15a. Was your usual place of general medical care the same as your usual place of HIV
medical care? [OCAEQN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
A16.
During the past 12 months, how many times did you go to an emergency room or
urgent care center for HIV medical care? [ERU_VI_9]
MMP Standard Questionnaire Sources of Care
26
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
[77 = Refused to answer, 88 = Don’t know]
Inconsistency check: A16 must be ≤ 76.
A17. During the past 12 months, how many times were you admitted to a hospital
because of an HIV-related illness? Please don’t include visits that were made only to the
emergency room. [HOSP]
[77 = Refused to answer, 88 = Don’t know]
Interviewer instructions: If A17 (times admitted to a hospital) is “0”, “Refused to answer,” or
“Don’t know,” skip to A18.
Inconsistency check: A17 (times admitted to a hospital) must be ≤ 76.
A17a. During the past 12 months, how many days total did you spend in a hospital because of
an HIV-related illness? [HOSPDAY]
[77=Refused to answer, 88=Don’t know]
Inconsistency check: A17a cannot be “0” and must be ≤ 365.
A18.
During the past 12 months, were you enrolled in an inpatient mental health facility?
[ADMENH_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
A19.
During the past 12 months, were you enrolled in an inpatient drug or alcohol treatment
facility? [ADDRAL_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Sources of Care
27
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Met and Unmet Needs
SAY: “For the next set of questions, I’m going to ask about services you used or needed during
the past 12 months, (That is, from last year, (DATE WITH PREVIOUS YEAR) to now (INTERVIEW
DATE).” First I'll ask whether you received the service; then I'll ask whether you needed this
service. If you weren't able to get this service, I’ll ask you the main reason you weren't able to
get it. These questions might sound similar, but I need to ask you all of the questions.”
QDS programming note for Say box before met and unmet need questions: The QDS program
should enter the appropriate dates. EXAMPLE: If IDATE is 11/11/2014 then the program should
read “That is from last year, 11/11/2013 to now 11/11/2014.”
Interviewer instructions: If response to A20a is “No,” “Refused to answer,” or “Don’t know,”
go to A20b; otherwise, skip to A21a. If response to A20b is “Yes,” go to A20c; otherwise, skip
to A21a. Follow the same pattern for A20–A38.
During the past
12 months, did
you get:
IF “No,” “Refused
to answer,” or
“Don’t know,” IN
A20a–A38a ASK:
During the past
12 months, have
you needed:
A20.
HIV case
management
services?
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
a. [_
b. [_
_]
[HIVC12_9]
]
[HIVCMS_9]
IF “Yes” IN A20b–A38b ASK:
What was the main reason
you haven’t been able to
get this service during the
past 12 months?
CODE:
SEE CODE LIST BELOW FOR
RESPONSES.
[DON’T READ CHOICES.
CHECK ONLY ONE.]
c. [_
]
[HIVCRS_9]
Other (Specify:
_)
[HIVC_9OS]
A21.
Counseling about
how to prevent the
spread of HIV?
a. [_
[HIVE12_9]
_]
b. [_
[HIVEDU_9]
]
c. [_
]
[HIVERS_9]
Other (Specify:
_)
[HIVE_9OS]
Interviewer instructions: If applicable, use the state program name for ADAP when asking A22
(medicine through ADAP).
MMP Standard Questionnaire Met and Unmet Needs
28
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
During the past
12 months, did
you get:
IF “No,” “Refused
to answer,” or
“Don’t know,” IN
A20a–A38a ASK:
During the past
12 months, have
you needed:
A22.
A23.
A24.
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
Medicine through
the AIDS Drug
Assistance Program
(ADAP)?
a. [_
b. [_
Professional help
remembering to take
your HIV medicines
on time or correctly?
HIV peer group
support?
a. [_
_]
[GET_ADAP]
]
[NED_ADAP]
IF “Yes” IN A20b–A38b ASK:
What was the main reason
you haven’t been able to
get this service during the
past 12 months?
CODE:
SEE CODE LIST BELOW FOR
RESPONSES.
[DON’T READ CHOICES.
CHECK ONLY ONE.]
c. [_
]
[RS_ADAP]
Other (Specify:
_)
[RS_A_9OS]
_]
[ASS12_9]
b. [_
]
[ASS_9]
c. [_
]
[ASSRS_9]
Other (Specify:
_)
[ASSR_9OS]
a. [_
_]
[GET_GRP]
b. [_
]
[NED_GRP]
c. [_
]
[RS_GRP]
Other (Specify:
_)
[RS_G_9OS]
A25.
Dental care?
a. [_
_]
[DENS12_9]
b. [_
]
[DENSER_9]
c. [_
]
[DENSRS_9]
Other (Specify:
_)
[DENS_9OS]
A26.
Mental health
services?
a. [_
_]
[MENC12_9]
b. [_
]
[MENCON_9]
c. [_
]
[MENCRS_9]
Other (Specify:
_)
[MENC_9OS]
A27.
Drug or alcohol
counseling or
treatment?
a. [_
[GET_SUBU]
_]
b. [_
[NED_SUBU]
]
c. [_
]
[RS_SUBU]
Other (Specify:
_)
[RS_U_9OS]
MMP Standard Questionnaire Met and Unmet Needs
29
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
During the past
12 months, did
you get:
IF “No,” “Refused
to answer,” or
“Don’t know,” IN
A20a–A38a ASK:
During the past
12 months, have
you needed:
A28.
A29.
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
Public benefits
including
Supplemental
Security Income (SSI)
or Social Security
Disability Insurance
(SSDI)?
a. [_
b. [_
Domestic violence
services?
a. [_
_]
[GET_SSDI]
]
[NED_SSDI]
IF “Yes” IN A20b–A38b ASK:
What was the main reason
you haven’t been able to
get this service during the
past 12 months?
CODE:
SEE CODE LIST BELOW FOR
RESPONSES.
[DON’T READ CHOICES.
CHECK ONLY ONE.]
c. [_
]
[RS_SSDI]
Other (Specify:
_)
[RS_S_9OS]
_]
[GET_DOMS]
b. [_
]
[NED_DOMS]
c. [_
]
[RS_DOMS]
Other (Specify:
_)
[RS_D_9OS]
A30.
Shelter or housing
services?
a. [_
_]
[SHLT12_9]
b. [_
]
[SHLTER_9]
c. [_
]
[SHLTRS_9]
Other (Specify:
_)
[SHLT_9OS]
A31.
Meal or food
services?
a. [_
_]
[MLSF12_9]
b. [_
]
[MLSFOD_9]
c. [_
]
[MLSFRS_9]
Other (Specify:
_)
[MLSF_9OS]
A32.
Home health
services?
a. [_
_]
[HHSA12_9]
b. [_
]
[HHSASS_9]
c. [_
]
[HHSARS_9]
Other (Specify:
_)
[HHSA_9OS]
A33.
Transportation
assistance?
a. [_
_]
[TRAS12_9]
b. [_
]
[TRASAS_9]
c. [_
]
[TRASRS_9]
Other (Specify:
_)
[TRAS_9OS]
A34.
Childcare services?
a. [_
[CHLD12_9]
_]
b. [_
[CHLDCR_9]
]
c. [_
]
[CHLDRS_9]
Other (Specify:
_)
[CHLD_9OS]
MMP Standard Questionnaire Met and Unmet Needs
30
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
During the past
12 months, did
you get:
IF “No,” “Refused
to answer,” or
“Don’t know,” IN
A20a–A38a ASK:
During the past
12 months, have
you needed:
A35.
Interpreter services?
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
CODE:
No = 0,
Yes = 1, Refused to
answer = 7,
Don’t know = 8
a. [_
b. [_
_]
[GET_INTS]
]
[NED_INTS]
IF “Yes” IN A20b–A38b ASK:
What was the main reason
you haven’t been able to
get this service during the
past 12 months?
CODE:
SEE CODE LIST BELOW FOR
RESPONSES.
[DON’T READ CHOICES.
CHECK ONLY ONE.]
c. [_
]
[RS_INTS]
Other (Specify:
_)
[RS_I_9OS]
A36.
Nutritional services?
a. [_
_]
[GET_NUTR]
b. [_
]
[NED_NUTR]
c. [_
]
[RS_NUTR]
Other (Specify:
_)
[RS_N10OS]
A37.
Eye or vision
services?
a. [_
_]
[GET_ICN3]
b. [_
]
[NED_ICN3]
d. [_
]
[RS_ICN3]
Other (Specify:
_)
[RS_IN3OS]
A38.
A lawyer or legal
services?
a. [_
_]
[GET_LAN3]
b. [_
[NED_LAN3]
]
e. [_
]
[RS_LAN3]
Other (Specify:
_)
[RS_LN3OS]
Code list for A20c–A38c
1
Didn’t know where to go or whom to call
2
In process of getting the service
3
Waiting list is too long
4
Service isn’t available
5
Not eligible or denied services
6
Transportation problems
7
Service hours are inconvenient
8
Service costs too much/lack of insurance
9
Language barrier
10 Too sick to get service
11
Psychological barrier
12
Other (Specify:_
_)
77
Refused to answer
MMP Standard Questionnaire Met and Unmet Needs
31
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
88
Don’t know
SAY: “Now I’m going to ask you some questions about health information. For the first question
we will use Response Card C.”
A39.
How often do you have problems learning about your medical condition because of
difficulty understanding written information? [READ CHOICES. CHOOSE ONLY ONE]
[HLUW_12]
Always ........................................................................................... ☐ 1
Often ............................................................................................. ☐ 2
Sometimes.................................................................................... ☐ 3
Occasionally ................................................................................. ☐ 4
Never ............................................................................................. ☐ 5
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
SAY: “Now we will use Response Card D.”
A40.
How confident are you filling out medical forms by yourself? [READ CHOICES. CHOOSE
ONLY ONE.] [HLMF_12]
Extremely...................................................................................... ☐ 1
Quite a bit ..................................................................................... ☐ 2
Somewhat..................................................................................... ☐ 3
A little bit ...................................................................................... ☐ 4
Not at all ....................................................................................... ☐ 5
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
SAY: “For this next question we will use Response Card E.”
A41.
How often do you have someone help you read hospital materials? [READ CHOICES.
CHOOSE ONLY ONE] [HLHM_12]
Never ............................................................................................. ☐ 1
Occasionally ................................................................................ ☐ 2
Sometimes.................................................................................... ☐ 3
Often ............................................................................................. ☐ 4
Always ........................................................................................... ☐ 5
Not applicable .............................................................................. ☐ 6
Refused to answer....................................................................... ☐ 7
MMP Standard Questionnaire Met and Unmet Needs
32
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Met and Unmet Needs
33
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Stigma and Discrimination (R)
SAY: “Next I would like to read you a few statements that some people living with HIV have said they
sometimes feel. We are asking you these questions to better understand how often people living with
HIV experience these negative feelings. These statements are not things that I or anyone in this
project thinks about people with HIV. These statements may be uncomfortable for you to
answer. Please remember that you do not have to answer any question you don’t want to. For each
statement that I read, please tell me whether you disagree or agree.”
(8)
Don’t know
Refused to
answer (7)
(1)
Agree
Disagree (0)
R1a.
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
I hide my HIV status from
others [STIGMA1F]
☐
☐
☐
☐
People with HIV sometimes
sense discrimination from
health care providers in
different ways. Has anyone in
the health care system done
any of the following to you
since testing positive for HIV?
Exhibited hostility or a lack of
respect toward you? [STIGMA2A]
Given you less attention than
other patients? [STIGMA2B]
Refused you service? [STIGMA2C]
No (0)
Yes (1)
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
It is difficult to tell people
about my HIV infection
[STIGMA1A]
R1b.
R1c.
R1d.
R1e.
Being HIV positive makes me
feel dirty [STIGMA1B]
I feel guilty that I am HIV
positive [STIGMA1C]
I am ashamed that I am HIV
positive [STIGMA1D]
I sometimes feel worthless
because I am HIV positive
[STIGMA1E]
R1f.
R2a.
R2b.
R2c.
Refused to
answer (7)
Don’t
know (8)
MMP Standard Questionnaire Stigma and Discrimination
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read responses
34
Interviewer instructions: If any of the responses in R2a–R2c is “yes,” go to R3. Otherwise, skip to
Say box before T1.
R3.
R3a.
R3b.
R3c.
R3d.
Did the discrimination occur
because of
…your HIV infection? [STIGMA3A]
…your gender? [STIGMA3B]
…your sexual orientation and
practices? [STIGMA3C]
…your race or ethnicity?
No (0)
Yes (1)
Refused to
answer (7)
☐
☐
☐
Don’t
know (8)
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
[STIGMA3D]
R3e.
your drug injecting habit?
[STIGMA3E]
MMP Standard Questionnaire Stigma and Discrimination
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read responses
35
HIV Treatment and Adherence (T)
SAY: “Now I’m going to ask some questions about medicines that you are taking for your
HIV. These medicines are called antiretroviral medicines, also known as ART, HAART, or
the AIDS cocktail.”
T1.
Have you ever taken any antiretroviral medicines for your HIV? [ANTIRE_9]
No………………….…………………..……............................................☐ 0
Yes………………………………………..…… .........................................☐ 1
Skip to T3
Refused to answer…………………………… ...................................☐ 7
Skip to T18
Don’t know….......... ................................................................☐ 8
T2.
What is the main reason you have never taken any antiretroviral medicines? [DON’T
READ CHOICES. CHECK ONLY ONE.] [NANTRE_9]
Doctor advised to delay treatment........................................☐ 1
Participant believed he/she didn’t need medications because
felt healthy or believed HIV laboratory results were good .☐ 2
Due to side effects of medication ..........................................☐ 3
Felt depressed or overwhelmed ............................................☐ 4
Didn’t want to think about being HIV positive ......................☐ 5
Worried about ability to adhere ............................................☐ 6
Drinking or using drugs ..........................................................☐ 7
Money or insurance issues ....................................................☐ 8
Homeless................................................................................☐ 9
Taking alternative or complementary medicines ..................☐ 10
Other (Specify:
) ..........☐ 11 [NANT_9OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: Skip to T18.
T3.
When was the first time you ever took any antiretroviral medicines for your HIV? Please
tell me the month and year. [FSTMY_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency checks: Confirm response if T3 (date first time took ART) is earlier than A6 (date
MMP Standard Questionnaire HIV Treatment and Adherence
36
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
first went to a provider for HIV care). Confirm response if T3 is earlier than A1 (date tested
positive for HIV). T3 cannot be later than I4 (interview date).
QDS programming note for T3: If T3 is earlier than A6, display note to interviewer: “Date
entered is earlier than the date first went to a provider for HIV care. Confirm response.” Allow
program to advance. Allow a blank response for month. If T3 is earlier than A1, display a
message to the interviewer saying, “Date entered is earlier than date first tested positive for
HIV. Confirm response." Allow the program to advance.
T4.
Are you currently taking any antiretroviral medicines for your HIV? [CURME_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Skip to Say box
Refused to answer .................................................................☐ 7
before T5
Don’t know.............................................................................☐ 8
Skip to T14
T4a.
What is the main reason you aren’t currently taking any antiretroviral medicines?
[DON’T READ CHOICES. CHECK ONLY ONE.] [NMANT8_9]
Doctor advised to delay or stop treatment ...........................☐ 1
Participant believed he/she didn’t need medications because
felt healthy or believed HIV laboratory results were good ☐ 2
Due to side effects of medications ........................................☐ 3
Felt depressed or overwhelmed ............................................☐ 4
Didn’t want to think about being HIV positive ......................☐ 5
Worried about ability to adhere ............................................☐ 6
Drinking or using drugs ..........................................................☐ 7
Money or insurance issues ....................................................☐ 8
Homeless................................................................................☐ 9
Taking alternative or complementary medicines ..................☐ 10
Other (Specify:
) ..........☐ 11 [NMA8_9OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: Skip to T14.
SAY: “Now we will use the HIV Medications Card. Please tell me which of these medicines you
are currently taking—ones you are taking now to treat your HIV. If you are taking any
combination medicines, please tell me the name of the combination, not the separate name of
each medicine in the combination. I will also ask you how many times you missed taking your
medicine. Don’t worry about telling me that you don’t take all your medicine. And please
MMP Standard Questionnaire HIV Treatment and Adherence
37
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
remember, none of this information will be shared with your doctor, nurse, or other health care
worker.”
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Combination
Treatments
Combivir
(AZT+3TC)
Trizivir
(AZT+3TC+
ABC)
Epzicom
(3TC+ABC)
T5a_a.
T5a_b.
T5a_c.
T5a_d.
T5a_e.
T5a_f.
[COMBCUR]
[COMBET_9]
[COMBDY_9]
[CBMIS1_9]
[CBMIS2_9]
[CBMIS3_9]
T5b_a.
T5b_b.
T5b_c.
T5b_d.
T5b_e.
T5b_f.
[TRIZCUR]
[TRIZET_9]
[TZMIS1_9]
[TZMIS2_9]
[TZMIS3_9]
T5c_a.
T5c_b.
T5c_c.
T5c_d.
T5c_e.
T5c_f.
[EPZICUR]
[EPZIET_9]
[EPZIDY_9]
[EPMIS1_9]
[EPMIS2_9]
[EPMIS3_9]
[TRIZDY_9]
MMP Standard Questionnaire HIV Treatment and Adherence
38
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Truvada
(FTC+TDF)
Atripla
(EFV/FTC/TDF)
Complera
(FTC/RPV/TDF)
Stribild (“Quad,”
EVG/
COBI/FTC/TDF)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5d_a.
T5d_b.
T5d_c.
T5d_d.
[TRUVCUR]
[TRUVET_9]
[TRUVDY_9]
[TRMIS1_9]
T5e_a.
T5e_b.
T5e_c.
T5e_d.
T5e_e.
T5e_f.
[ATRIPLA]
[ATRTIM_9]
[ATRDAY_9]
[ATMIS1_9]
[ATMIS2_9]
[ATMIS3_9]
T5e1_a.
T5e1_b.
T5e1_c.
T5e1_d.
T5e1_e.
T5e1_f.
[COMPLERA]
[COMPL_ET]
[COMPL_DY]
[COMPL_S1]
[COMPL_S2]
[COMPL_S3]
T5e2_a.
T5e2_b.
T5e2_c.
T5e2_d.
T5e2_e.
T5e2_f.
[STRIBAN3]
[STRIETN3]
[STRIDYN3]
[STRIS1N3]
[STRIS2N3]
[STRIS3N3]
MMP Standard Questionnaire HIV Treatment and Adherence
T5d_e.
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[TRMIS2_9]
T5d_f.
[TRMIS3_9]
39
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Nucleoside/
Nucleotide
Analogue
Reverse
Transcriptase
Inhibitors (NRTI),
also known as
‘Nukes’
Epivir
(lamivudine, 3TC)
T5f_a.
T5f_b.
T5f_c.
T5f_d.
T5f_e.
T5f_f.
[LAMICUR]
[LAMIET_9]
[LAMIDY_9]
[LAMIS1_9]
[LAMIS2_9]
[LAMIS3_9]
MMP Standard Questionnaire HIV Treatment and Adherence
40
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Videx EC
(didanosine, ddI
EC)
Videx
(didanosine, ddI)
Emtriva
(emtricitabine,
FTC)
Viread (tenofovir,
TDF)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5g_a.
T5g_b.
T5g_c.
T5g_d.
T5g_e.
[DAECCUR]
[DAECET_9]
[DAECDY_9]
[DAMIS1_9]
[DAMIS2_9]
T5h_a.
T5h_b.
T5h_c.
T5h_d.
T5h_e.
T5h_f.
[DIDACUR]
[DIDAET_9]
[DIDADY_9]
[DIMIS1_9]
[DIMIS2_9]
[DIMIS3_9]
T5i_a.
T5i_b.
T5i_c.
T5i_d.
T5i_e.
T5i_f.
[EMTRCUR]
[EMTRET_9]
[EMTRDY_9]
[EMMIS1_9]
[EMMIS2_9]
T5j_a.
T5j_b.
T5j_c.
T5j_d.
T5j_e.
T5j_f.
[TENOCUR]
[TENOET_9]
[TENODY_9]
[TEMIS1_9]
[TEMIS2_9]
[TEMIS3_9]
MMP Standard Questionnaire HIV Treatment and Adherence
T5g_f.
[DAMIS3_9]
[EMMIS3_9]
41
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Zerit (stavudine,
d4T)
Retrovir
(zidovudine, AZT,
ZDV)
Ziagen (abacavir,
ABC)
Protease
Inhibitors (PI)
Invirase
(saquinavir hard
gel, SQV)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5l_a.
T5l_b.
T5l_c.
T5l_d.
T5l_e.
T5l_f.
[STAVCUR]
[STAVET_9]
[STAVDY_9]
[STMIS1_9]
[STMIS2_9]
[STMIS3_9]
T5m_a.
T5m_b.
T5m_c.
T5m_d.
T5m_e.
T5m_f.
[ZIDOCUR]
[ZIDOET_9]
[ZIDODY_9]
[ZIMIS1_9]
[ZIMIS2_9]
[ZIMIS3_9]
T5n_a.
T5n_b.
T5n_c.
T5n_d.
T5n_e.
T5n_f.
[ABACACUR]
[ABACET_9]
[ABACDY_9]
[ABMIS1_9]
[ABMIS2_9]
[ABMIS3_9]
T5p_a.
T5p_b.
T5p_c.
T5p_d.
T5p_e.
T5p_f.
[SACQCUR]
[SACQT_9]
[SACQDY_9]
[SAMIS1_9]
[SAMIS2_9]
[SAMIS3_9]
MMP Standard Questionnaire HIV Treatment and Adherence
42
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Kaletra
(lopinavir/
ritonavir, LPVr)
Crixivan
(indinavir, IDV)
Lexiva
(fosamprenavir,
FPV)
Reyataz
(atazanavir, ATV)
Norvir (ritonavir,
RTV)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5q_a.
T5q_b.
T5q_c.
T5q_d.
[LOPICUR]
[LOPIT_9]
[LOPIDY_9]
[LOMIS1_9]
T5r_a.
T5r_b.
T5r_c.
T5r_d.
T5r_e.
T5r_f.
[INDICUR]
[INDIET_9]
[INDIDY_9]
[INMIS1_9]
[INMIS2_9]
[INMIS3_9]
T5s_a.
T5s_b.
T5s_c.
T5s_d.
T5s_e.
T5s_f.
[FUSACUR]
[FUSAET_9]
[FUSADY_9]
[FOMIS1_9]
[FOMIS2_9]
[FOMIS3_9]
T5t_a.
T5t_b.
T5t_c.
T5t_d.
T5t_e.
T5t_f.
[ATAZCUR]
[ATAZET_9]
[ATAZDY_9]
[ATZIS1_9]
[ATZIS2_9]
[ATZIS3_9]
T5v_a.
T5v_b.
T5v_c.
T5v_d.
T5v_e.
T5v_f.
[RITOCUR]
[RITOET_9]
[RITODY_9]
[RIMIS1_9]
[RIMIS2_9]
[RIMIS3_9]
MMP Standard Questionnaire HIV Treatment and Adherence
T5q_e.
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[LOMIS2_9]
T5q_f.
[LOMIS3_9]
43
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Viracept
(nelfinavir, NFV)
Aptivus
(tipranavir, TPV)
Prezista
(darunavir, DRV)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5w_a.
T5w_b.
T5w_c.
T5w_d.
T5w_e.
T5w_f.
[NELFCUR]
[NELFET_9]
[NELFDY_9]
[NEMIS1_9]
[NEMIS2_9]
[NEMIS3_9]
T5x_a.
T5x_b.
T5x_c.
T5x_d.
T5x_e.
T5x_f.
[TIPRCUR]
[TIPRET_9]
[TIPRDY_9]
[TIMIS1_9]
[TIMIS2_9]
[TIMIS3_9]
T5y_a.
T5y_b.
T5y_c.
T5y_d.
T5y_e.
T5y_f.
[PREZCUR]
[PREZET_9]
[PREZDY_9]
[PRMIS1_9]
[PRMIS2_9]
[PRMIS3_9]
Non-Nucleoside
Reverse
Transcriptase
Inhibitors
(NNRTI), also
known as ‘Nonnukes’
MMP Standard Questionnaire HIV Treatment and Adherence
44
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Rescriptor
(delavirdine, DLV)
Viramune
(nevirapine, NVP)
Sustiva
(efavirenz, EFV)
Intelence
(etravirine ETV)
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5z_b.
T5z_c.
[DELACUR]
[DELAET_9]
[DELADY_9]
T5za_a.
T5za_b.
T5za_c.
T5za_d.
T5za_e.
T5za_f.
[NEVICUR]
[NEVIET_9]
[NEVIDY_9]
[NEVIS1_9]
[NEVIS2_9]
[NEVIS3_9]
T5zb_a.
T5zb_b.
T5zb_c.
T5zb_d.
T5zb_e.
T5zb_f.
[EFAVCUR]
[EFAVET_9]
[EFAVDY_9]
[EFMIS1_9]
[EFMIS2_9]
[EFMIS3_9]
T5zc_a.
T5zc_b.
T5zc_c.
T5zc_d.
T5zc_e.
T5zc_f.
[TMC]
[TMCTIM_9]
[TMCDAY_9]
[TMMIS1_9]
[TMMIS2_9]
[TMMIS3_9]
[DEMIS1_9]
T5z_e.
[INSERT DRUG
NAME]?
T5z_a.
MMP Standard Questionnaire HIV Treatment and Adherence
T5z_d.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[DEMIS2_9]
T5z_f.
[DEMIS3_9]
45
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Edurant
(rilpivirine, RPV)
Entry/Fusion
Inhibitors
Fuzeon
(enfuvirtide, T–
20)
Selzentry
(maraviroc, MVC)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zd_a.
T5zd_b.
T5zd_c.
T5zd_d.
T5zd_e.
T5zd_f.
[EDURANT]
[EDURA_ET]
[EDURA_DY]
[EDURA_S1]
[EDURA_S2]
[EDURA_S3]
T5ze_a.
T5ze_b.
T5ze_c.
T5ze_d.
T5ze_e.
T5ze_f.
[ENFUCUR]
[ENFUET_9]
[ENFUND_9]
[ENMIS1_9]
[ENMIS2_9]
[ENMIS3_9]
T5zf_a.
T5zf_b.
T5zf_c.
T5zf_d.
T5zf_e.
T5zf_f.
[MARAVIRO]
[MARTIM_9]
[MARDAY_9]
[MAMIS1_9]
[MAMIS2_9]
[MAMIS3_9]
Integrase
Inhibitors
MMP Standard Questionnaire HIV Treatment and Adherence
46
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T5.
a. Are you
currently
taking
b. How many
pills,
spoonfuls, or
[INSERT DRUG injections are
NAME]?
you
supposed to
CODES: No =
take of
0, Yes = 1,
Refused to
answer = 7,
Don’t know =
8
[INSERT DRUG
NAME] each
If “Yes,” go to
T5b;
otherwise,
skip to next
drug.
CODES:
Refused to
answer = 77,
Don’t know =
88
time you
take it?
c. How many
times per
day are you
supposed to
take [INSERT
DRUG
NAME]?
CODES:
Refused to
answer = 77,
Don’t know =
88
d. Yesterday,
how many
times did you
miss taking a
dose or a set
of pills,
spoonfuls, or
injections of
e. The day
before
yesterday,
how many
times did you
miss taking a
dose or a set
of these pills,
[INSERT DRUG spoonfuls, or
NAME]? If
injections of
you only
[INSERT DRUG
took part of
NAME]?
your dose,
Again, if you
please report only took
this as the
part of your
whole dose
dose, please
missed.
report this as
the whole
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
Isentress,
(raltegravir, RAL)
Tivicay,
(dolutegravir,
DTG)
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
f. Three days
ago, how
many times
did you miss
taking a dose
or a set of
these pills,
spoonfuls, or
injections of
[INSERT DRUG
NAME]?
Again, if you
only took
part of your
dose, please
report this as
the whole
dose missed.
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zg_a.
T5zg_b.
T5zg_c.
T5zg_d.
T5zg_e.
T5zg_f.
[RALTEGRA]
[RALTIM_9]
[RALDAY_9]
[RAMIS1_9]
[RAMIS2_9]
[RAMIS3_9]
T5zg1_a.
T5zg2_a.
T5zg3_a.
T5zg4_a.
T5zg5_a.
T5zg6_a.
[DOLUCUR4]
[DOLUETN4]
[DOLUDYN4]
[DOLUM1N4]
[DOLUS2N4]
[DOLUM3N4]
Other ART Medicines
T5zh_a.
Are you currently taking any other antiretroviral medicine? [OTSPAYN1]
No........................................................................................... ☐ 0
Yes.......................................................................................... ☐ 1
Refused to answer ................................................................. ☐ 7
Don’t know ............................................................................ ☐ 8
MMP Standard Questionnaire HIV Treatment and Adherence
47
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions: If OTSPAYN1 (taking other meds 1) is “Yes,” go to OTANM1OS (other specify meds 1);
else go to Inconsistency check before T6 (MEDINSTR).
T5zh_ao. (Specify other ARV:
_) [7 = Refused, 8 = Don’t know] [OTANM1OS]
Interviewer instructions: If OTANM10S (taking other meds 1) is “Refused” or “Don’t know,” go to Inconsistency
check before T6) (MEDINSTR); else go to ODRET1_9 (How many pills, etc. are you supposed to take…?).
b. How many c. How many d. Yesterday, e. The day
f. Three days
times per
pills,
how many
before
ago, how
spoonfuls, or day are you
times did you yesterday,
many times
injections are supposed to miss taking a how many
did you miss
take [INSERT dose or a set times did you taking a dose
you
supposed to DRUG
of pills,
miss taking a or a set of
NAME]?
take of
spoonfuls, or dose or a set these pills,
[INSERT DRUG
injections of of these pills, spoonfuls, or
CODES:
NAME] each
[INSERT DRUG spoonfuls, or injections of
Refused to
time you
NAME]? If
injections of [INSERT DRUG
answer = 77,
take it?
you only
[INSERT DRUG NAME]?
Don’t know =
took part of
NAME]?
Again, if you
88
CODES:
your dose,
Again, if you only took
Refused to
part of your
please report only took
answer = 77,
this as the
part of your
dose, please
Don’t know =
whole dose
dose, please report this as
88
missed.
report this as the whole
the whole
dose missed.
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zh_b.
T5zh_c.
T5zh_d.
T5zh_e.
T5zh_f.
[ODRET1_9]
[ODTDY1_9]
[ODMIS1_9]
[ODMIS2_9]
[ODMIS3_9]
T5zi_a. Are you currently taking any other antiretroviral medicine? [OTSPAYN2]
No........................................................................................... ☐ 0
Yes.......................................................................................... ☐ 1
Refused to answer ................................................................. ☐ 7
Don’t know ............................................................................ ☐ 8
MMP Standard Questionnaire HIV Treatment and Adherence
48
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions: If OTSPAYN2 (taking other meds 2) is “Yes,” go to OTANM2OS (other specify meds 2);
else go to Inconsistency check before T6 (MEDINSTR).
T5zi_ao. (Specify other ARV:
_) [7 = Refused, 8 = Don’t know] [OTANM2OS]
Interviewer instructions: If OTANM2OS (specify other meds 2) is “Refused” or “Don’t know,” go to
Inconsistency check before T6 (MEDINSTR); else go to ODRET2_9 (how many pills, etc are you supposed to
take…)
b. How many c. How many d. Yesterday, e. The day
f. Three days
times per
pills,
how many
before
ago, how
spoonfuls, or day are you
times did you yesterday,
many times
injections are supposed to miss taking a how many
did you miss
take [INSERT dose or a set times did you taking a dose
you
of pills,
miss taking a or a set of
supposed to DRUG
NAME]?
spoonfuls, or dose or a set these pills,
take of
[INSERT DRUG
injections of of these pills, spoonfuls, or
CODES:
NAME] each
[INSERT DRUG spoonfuls, or injections of
Refused to
NAME]? If
time you
injections of [INSERT DRUG
answer = 77,
you only
take it?
[INSERT DRUG NAME]?
Don’t know =
took
part
of
NAME]?
Again, if you
88
CODES:
your dose,
Again, if you only took
Refused to
part of your
please report only took
answer = 77,
this as the
part of your
dose, please
Don’t know =
whole dose
dose, please report this as
88
missed.
report this as the whole
the whole
dose missed.
CODES: Not
dose missed.
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zi_b.
T5zi_c.
[ODRET2_9]
[ODTDY2_9]
MMP Standard Questionnaire HIV Treatment and Adherence
T5zi_d.
[ODMI21_9]
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zi_e.
[ODMI22_9]
CODES: Not
applicable =
66, Refused to
answer = 77,
Don’t know =
88
T5zi_f.
[ODMI23_9]
49
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Inconsistency check: The number of doses or set of pills, spoonfuls, or injections missed must be ≤ the number
of times the respondent is supposed to take these pills, spoonfuls, or injections. The number of pills, spoonfuls,
or injections that the respondent is supposed to take each time he or she takes them must be ≤ 35. The
number of times each day the respondent is supposed to take these pills, spoonfuls, or injections must be ≤ 9.
The number of times the respondent missed taking a dose or set of these pills, spoonfuls, or injections
yesterday must be ≤ 9. The number of times the respondent missed taking a dose or set of these pills,
spoonfuls, or injections the day before yesterday must be ≤ 9. If T4 is "Yes" and all T5 responses are "No,"
return to previous question (T4).
QDS programming note after T5: If the number of times they missed the medication is greater
than the number of times they are supposed to take the medication, display message to
interviewer: “The number of times the respondent missed a dose cannot be greater than
number of times they were supposed to take a dose.” If T4 is “Yes” and all T5 responses are
“No,” display message to interviewer: “You said you were taking antiretroviral medications.
Please tell me the name of the medication you are taking.” Return to T4.
T6.
Do any of your antiretroviral medicines have special instructions, such as “take with
food” or “on an empty stomach” or “with plenty of fluids”? [MEDINSTR]
No………………….…………………..……............................................☐ 0
Skip to Say box before
Yes………………………………………..…… .........................................☐ 1
T8
Refused to answer…………………………… ...................................☐ 7
Skip to Say box
Don’t know….......... ................................................................☐ 8
before T8
SAY: “We will use Response Card F for the next question. You will also need the calendar to
refer to the past 3 days.”
T7. During the past 3 days, how often did you follow all of those special instructions? [READ
CHOICES. CHECK ONLY ONE.] [FLMDIN_9]
Never......................................................................................☐ 1
Rarely .....................................................................................☐ 2
About half of the time............................................................☐ 3
Most of the time ....................................................................☐ 4
Always ....................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know .............................................................................☐ 8
SAY: “We will use Response Card F. You’ll also need the calendar to refer to the past 3 days.”
MMP Standard Questionnaire HIV Treatment and Adherence
50
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T8.
Most antiretroviral medicines need to be taken on a schedule, such as “2 times a day” or
“3 times a day” or “every 8 hours.” How closely did you follow your specific schedule
during the past 3 days? [READ CHOICES. CHECK ONLY ONE.] [MDSCHD_9]
Never......................................................................................☐ 1
Rarely .....................................................................................☐ 2
About half of the time............................................................☐ 3
Most of the time ....................................................................☐ 4
Always ....................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know .............................................................................☐ 8
QDS programming note for T9: If respondent says that they missed a dose for any antiretroviral
medication in T5d, T5e, T5f, then the program will skip T9 (last time missed ART) and go to T10.
SAY: “We will now use Response Card G.”
T9.
When was the last time you missed any of your antiretroviral medicines? [READ
CHOICES. CHECK ONLY ONE.] [LTMMED10]
Within the past week ............................................................☐ 1
1–2 weeks ago .......................................................................☐ 2
3–4 weeks ago .......................................................................☐ 3
1–3 months ago .....................................................................☐ 4
More than 3 months ago .......................................................☐ 5
Never skip medicines .............................................................☐ 6
Skip to Say box
Refused to answer .................................................................☐ 7
before T11
Don’t know.............................................................................☐ 8
T10.
The last time you missed taking your antiretroviral medicines, what were the reasons?
[DON’T READ CHOICES. CHECK ALL THAT APPLY.] [MSMD_12]
Problem with prescription or refill ........................................☐ 1 [MSMD_12A]
Felt sick or tired .....................................................................☐ 2 [MSMD_12B]
Change in daily routine including travel ................................☐ 3 [MSMD_12C]
Due to side effects of medications ........................................☐ 4 [MSMD_12D]
Felt depressed or overwhelmed ............................................☐ 5 [MSMD_12E]
Drinking or using drugs ..........................................................☐ 6 [MSMD_12F]
Money or insurance issues ....................................................☐ 7 [MSMD_12G]
Homeless................................................................................☐ 8 [MSMD_12H]
Had too many pills to take .....................................................☐ 9 [MSMD_12I]
Forgot to take them ...............................................................☐ 10 [MSMD_12J]
MMP Standard Questionnaire HIV Treatment and Adherence
51
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Other .....................................................................................☐ 11 [MSMD_12K]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: If “Other” is selected for T10, go to T10_o1. Otherwise, skip to Say
Box before T11.
T10_o1. Specify other reason missed taking medication:
[MSK_12OS]
[7 = Refused, 8 = Don’t know]
T10_o2. Are there any more reasons that you missed taking your medicine? [MSMD_12L]
Yes .........................................................................................☐ 1
No ..........................................................................................☐ 0
Interviewer instructions: If T10_o2. is “Yes,” go to T10_o3. Otherwise, skip to Say Box before
T11.
T10_o3. Specify other reason missed taking medication:
[MSL_12OS]
[7 = Refused, 8 = Don’t know]
SAY: “Now I’m going to ask you a question about the past 30 days. We will use Response Card
H. We will also use the calendar to refer to the past 30 days.”
T11.
During the past 30 days, how troubled were you by side effects from your antiretroviral
medications? [READ CHOICES. CHECK ONLY ONE.] [TRBL_EFT]
Never......................................................................................☐ 1
Rarely .....................................................................................☐ 2
About half of the time............................................................☐ 3
Most of the time ....................................................................☐ 4
Always ....................................................................................☐ 5
Been on medications less than 30 days .................................☐ 6
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “For these next three questions we will use Response Card I.”
MMP Standard Questionnaire HIV Treatment and Adherence
52
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T12a. How sure are you that you will be able to take all or most of your medication as
directed? [READ CHOICES. CHECK ONLY ONE.] [TK_MD_DR]
Not at all sure.........................................................................☐ 0
Somewhat sure ......................................................................☐ 1
Very sure ................................................................................☐ 2
Extremely sure .......................................................................☐ 3
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
T12b. How sure are you that your medication will have a positive effect on your health? [READ
CHOICES. CHECK ONLY ONE.] [MD_POSEF]
Not at all sure.........................................................................☐ 0
Somewhat sure ......................................................................☐ 1
Very sure ................................................................................☐ 2
Extremely sure .......................................................................☐ 3
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
T12c. How sure are you that if you do not take your medication exactly as instructed, the HIV
in your body will become resistant to HIV medications? [READ CHOICES. CHECK ONLY
ONE.] [SR_HIVRS]
Not at all sure.........................................................................☐ 0
Somewhat sure ......................................................................☐ 1
Very sure ................................................................................☐ 2
Extremely sure .......................................................................☐ 3
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “Now we will use Response Card J.”
T13a. In general, how satisfied are you with the overall support you get from your friends and
family members? [READ CHOICES. CHECK ONLY ONE.] [SUPRT_FF]
Very dissatisfied .....................................................................☐ 0
Somewhat dissatisfied ...........................................................☐ 1
Somewhat satisfied................................................................☐ 2
Very satisfied..........................................................................☐ 3
Refused to answer .................................................................☐ 7
MMP Standard Questionnaire HIV Treatment and Adherence
53
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know.............................................................................☐ 8
SAY: “Now we will use Response Card K.”
T13b. To what extent do your friends or family members help you remember to take your
medication? [READ CHOICES. CHECK ONLY ONE.] [MED_SUPT]
Not at all.................................................................................☐ 0
A little .....................................................................................☐ 1
Somewhat ..............................................................................☐ 2
A lot ........................................................................................☐ 3
Not applicable .........................................................................☐ 6
Refused to answer ..................................................................☐ 7
Don’t know.............................................................................☐ 8
Interviewer instructions: Skip to T15.
T14.
During the past 12 months, have you taken antiretroviral medicines? [ATMD12_9]
No………………….…………………..……............................................☐ 0
Skip to T18
Yes………………………………………..…… .........................................☐ 1
Refused to answer…………………………… ...................................☐ 7
Skip to T18
Don’t know….......... ................................................................☐ 8
T15.
During the past 12 months, what were the ways your antiretroviral medicines were paid
for? [DON’T READ CHOICES. CHECK ALL THAT APPLY.] [PREM_12]
Private health insurance ........................................................☐ 1 [PREM_12A]
Medicaid ................................................................................☐ 2 [PREM_12B]
Medicare ................................................................................☐ 3 [PREM_12C]
AIDS Drug Assistance Program (ADAP) ..................................☐ 4 [PREM_12D]
An AIDS service organization provided medicines ................☐ 5 [PREM_12E]
Got medicines at a public clinic .............................................☐ 6 [PREM_12F]
7
Clinical trial or drug study provided medicines .....................☐ 7 [PREM_12G]
Paid for medicines out of pocket ...........................................☐ 8 [PREM_12H]
Other 1 (Specify:
_) ........☐ 9 [PREM_12I] [PRI_12OS]
Other 2 (Specify:
_) ........☐ 10 [PREM_12J] [PRJ_12OS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
MMP Standard Questionnaire HIV Treatment and Adherence
54
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
T16.
During the past 12 months, did your doctor or other clinic staff ask you whether you
missed taking any doses of your antiretroviral medicines or if you had difficulty taking
your antiretroviral medicines? [MDASKN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
T17.
During the past 12 months, have you ever purposefully taken a “drug holiday” from
your antiretroviral medicines that wasn’t recommended by your doctor? That is, did
you plan to not take any doses of one or more of your antiretroviral medicines for at
least two whole days in a row? [DRGHOL_9]
Label: Past 12 months, ever taken a drug holiday
No ...........................................................................................☐ 0
Skip to T18
Yes………………………………………..…… .........................................☐ 1
Refused to answer…………………………… ...................................☐ 7
Skip to T18
Don’t know….......... ................................................................☐ 8
T17a. What was the main reason that you took a drug holiday from your antiretroviral
medicines? [READ CHOICES. CHECK ONLY ONE.] [RDRHO_10]
Medicine has side effects or makes me feel bad...................☐ 1
Got tired of taking medicines or needed a break ..................☐ 2
Was using drugs or alcohol ....................................................☐ 3
Was on vacation.....................................................................☐ 4
Felt good ................................................................................☐ 5
Other (Specify:
_) ....☐ 6 [RDR_10OS]
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
T18.
During the past 12 months, have you participated in an HIV clinical trial? [CLTREC_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire HIV Treatment and Adherence
55
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Sexual Behavior (S)
Total sex partners (ST)
SAY: “Next, I'm going to ask you some questions about sex. Please remember that your answers
will be kept confidential and that you don’t have to answer any questions that you don’t want
to. I’ll ask you about the number of people you had sex with during the past 12 months. When I
say “sex,” I mean vaginal or anal sex. Vaginal sex means penis in the vagina and anal sex means
penis in the anus. When thinking about your answers, please include anyone whom you had
vaginal or anal sex with during the past 12 months. The number of people could range
anywhere from 0 to over a hundred.”
Calculated variable for sex gender:
SX_GEN=
If GENDER=Male and BIRTGEN=Male then SX_GEN=1 (Male).
If GENDER=Female and BIRTGEN=Female then SX_GEN=2 (Female).
If (GENDER=Male and BIRTGEN=Female) or (GENDER=Female and BIRTGEN=Male) or
(GENDER=Transgender and [BIRTGEN=Male, Female, don’t know, or refused to answer]) then
SX_GEN=3 (Transgender).
If BIRTGEN is intersex, then SX_GEN=4 (Indeterminate).
If ([GENDER= refused to answer or don’t know] and [BIRTGEN = Male, Female, refused to
answer, or don’t know], then SX_GEN=4 (Indeterminate).
If BIRTGEN is refused to answer or don’t know, and GENDER is male, female, refused to answer,
or don’t know, then SX_GEN=4 (Indeterminate).
In other words:
Male
Gender
Male
SX_GEN = 1
male
Female
SX_GEN = 3
transgender
Transgender SX_GEN = 3
transgender
Refused
SX_GEN = 4
Indeterminate
Don’t know SX_GEN = 4
BIRTGEN
Female
Intersex
SX_GEN = 3
transgender
SX_GEN = 2
female
SX_GEN = 3
transgender
SX_GEN = 4
Indeterminate
SX_GEN = 4
SX_GEN = 4
Indeterminate
SX_GEN = 4
Indeterminate
SX_GEN = 4
Indeterminate
SX_GEN = 4
Indeterminate
SX_GEN = 4
Refused to
answer
SX_GEN = 4
Indeterminate
SX_GEN = 4
Indeterminate
SX_GEN = 3
transgender
SX_GEN = 4
Indeterminate
SX_GEN = 4
Don’t know
SX_GEN = 4
Indeterminate
SX_GEN = 4
Indeterminate
SX_GEN = 3
transgender
SX_GEN = 4
Indeterminate
SX_GEN = 4
56
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Indeterminate
Indeterminate Indeterminate
Indeterminate Indeterminate
Variable label for SX_GEN=sex gender
Interviewer instructions for SX_TFPN4 (number of female partners):
If SX_GEN=2 (Female), skip to SX_TMPN4 (number of male partners).
Else, go to SX_TFPN4 (number of female partners).
ST.1.0. During the past 12 months, how many females have you had sex with? [SX_TFPN4]
[7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for SX_TFPN4 (number of female partners):
Range is 0–999.
Variable label for SX_TFPN4 is number of female partners.
ST.2.0. During the past 12 months, how many males have you had sex with? [SX_TMPN4]
[7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for SX_TMPN4 (number of male partners):
Range is 0–999.
Variable label for SX_TMPN4 is number of male partners.
ST.3.0. During the past 12 months, how many transgender persons have you had sex with?
[SX_TTPN4]
[7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for SX_TTPN4 (number of transgender partners):
Range is 0–999.
Variable label for SX_TTPN4 is number of transgender partners.
Calculated variables for SX_TFPN4 (number of female partners), SX_TMPN4 (number of male
partners), and SX_TTPN4 (number of transgender partners):
Total number of vaginal and anal sex partners: create a calculated variable SX_TOTN4 where
the sum of SX_TFPN4 + SX_TMPN4 + SX_TTPN4 = SX_TOTN4. Variable label for SX_TOTN4 is
57
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
total number of vaginal and anal sex partners. If the response to SX_TFPN4 (number of female
partners), SX_TMPN4 (number of male partners), or SX_TTPN4 (number of transgender
partners) is “don’t know,” or “refused to answer,” then calculate the response as “0.”
EXAMPLE: if SX_TFPN4 = “don’t know” AND SX_TMPN4 = “don’t know,” AND SX_TTPN4 =
“refused to answer,” THEN SX_TOTN4 = 0. If any of the values are skipped (.S), then do not
include the value in the calculation. EXAMPLE: if SX_TFPN4 = “2” AND SX_TMPN4 = “don’t
know,” AND SX_TTPN4 = skipped, then SX_TOTN4 = 2.
Female only partners: create a calculated variable SXFMONN4 (female only partners) if
SX_TMPN4 (number of male partners) = 0, don’t know, or refused to answer AND SX_TTPN4
(number of transgender partners) = 0, don’t know, or refused to answer AND SX_TFPN4
(number of female partners) ≥ 1, then SXFMONN4 (female only partners) = 1; otherwise
SXFMONN4 = 0. Variable label for SXFMONN4 is female only partners.
Male only partners: create a calculated variable SXMLONN4 (male only partners) if SX_TFPN4
(number of female partners) = 0, don’t know, or refused to answer or skipped AND SX_TTPN4
(number of transgender partners) = 0, don’t know, or refused to answer AND SX_TMPN4
(number of male partners) ≥ 1, then SXMLONN4 (male only partners) = 1; otherwise SXMLONN4
= 0. Variable label for SXMLONN4 is male only partners.
Transgender only partners: create a calculated variable SXTGONN4 (transgender only partners)
if SX_TFPN4 (number of female partners) = 0, don’t know, or refused to answer AND SX_TMPN4
(number of male partners) = 0, don’t know, or refused AND SX_TTPN4 (number of transgender
partners) ≥ 1, then SXTGONN4 (transgender only partners) = 1; otherwise SXTGONN4 = 0.
Variable label for SXTGONN4 is transgender only partners.
Interviewer instructions for SX_TWPN4 (number of female-female partners):
If SX_GEN=2 (Female), go to Say Box before SX_TWPN4 (number of female-female partners).
If SX_GEN is not 2 (Female) and SX_TOTN4 (total number of sex partners) = 0, skip to Say box
before SEROSRT1 (serosorting).
Else, if SX_GEN is not 2 (Female) and SX_TOTN4 (total number of sex partners) ≥ 1 skip to
interviewer instructions before SX_EXCN4 (exchange sex).
SAY: “Now, I’m going to ask you about sex with women.”
ST.4.0. During the past 12 months, how many women did you have sex with? [SX_TWPN4]
[7777 = Refused to answer, 8888 = Don’t know]
58
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note for SX_TWPN4 (number of female-female partners):
Range is 0–999.
Variable label for SX_TWPN4 is number of female-female partners.
Female-female only partners: create a calculated variable SXFFONN4 (female-female only
partners) if SX_TMPN4 (number of male partners) = 0, don’t know, or refused AND SX_TTPN4
(number of transgender partners) =0, don’t know, refused AND SX_TWPN4 (number of femalefemale partners) ≥ 1, then SXFFONN4 (female-female only partners) = 1; otherwise SXFFONN4 =
0. Variable label of SXFFONN4 is female-female only partners.
59
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions before SX_EXCN4 (exchange sex):
Women who only had sex with women: If SX_GEN=2 AND SX_TMPN4 (number of male
partners) = “0,” “don’t know,” or “refused to answer,” AND SX_TTPN4 (number of transgender
partners) = “0,” “don’t know,” or “refused to answer,” skip to the serosorting section (Say box
before SEROSRT1).
No vaginal or anal sex partners: If SX_TFPN4 (number of female partners), SX_TMPN4 (number
of male partners), and SX_TTPN4 (number of transgender partners) are all some combination of
“0,” “don’t know,” or “refused to answer,” then skip to the serosorting section (Say box before
SEROSRT1).
Otherwise, go to SX_EXCN4 (exchange sex).
Exchange sex (SE)
SE.1.0. During the past 12 months, did you have sex in exchange for things like food, shelter,
transportation, money, or drugs? [SX_EXCN4]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
QDS programming note for SX_EXCN4:
Variable label for SX_EXCN4 is exchange sex.
60
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Names of partners (SN)
Interviewer instructions before SX_NM1N4 (name of partner 1): If SX_TOTN4 (total number of
sex partners) = 1, go to Say box #1 before SX_NM1N4 (name of partner 1). If SX_TOTN4 ≥ 2, skip
to Say box #2 before SX_NM1N4 (name of partner 1).
Say box #1 before SX_NM1N4 (name of partner 1):
SAY: “Now I’m going to ask you some questions about the person that you recently had sex
with during the past 12 months, such as his or her age and race. Please answer to the best of
your knowledge, but it is okay to tell me that you don’t know or that you’re unsure. Since I’ll be
asking questions about this person, I need some way to refer to him or her. You may refer to
him or her in any way you want—initials, nickname, or where you met. However, please don’t
provide a last name or any other identifying information.”
Interviewer instructions after Say box #1 before SX_NM1N4 (name of partner 1):
Skip to SX_NM1N4 (name of partner 1).
Say box #2 before SX_NM1N4 (name of partner 1):
SAY: “Now I’m going to ask you some questions about the [IF SX_TOTN4 (total number of sex
partners) is 2, 3, or 4, THEN INSERT RESPONSE FROM SX_TOTN4 (total number of sex
partners). IF SX_TOTN4 (total number of sex partners) ≥5, THEN INSERT “5.”] people you
recently had sex with during the past 12 months, such as their age and race. Please answer to
the best of your knowledge, but it is okay to tell me that you don’t know or that you’re unsure.
Since I’ll be asking questions about each person, I need some way to refer to them, so that
when I ask you follow-up questions, we both know we’re talking about the same person. You
may refer to them in any way you want—initials, nicknames, or where you met. However,
please don’t provide last names or any other identifying information.”
SN.1.0. What shall we call the person with whom you most recently had sex during the past 12
months? [SX_NM1N4]
[7 = Refused to answer]
Interviewer instructions for SX_NM1N4 (name of partner 1):
If SX_NM1N4 (name of partner 1), is “refused to answer,” display the message “Interviewer:
remind the respondent that he or she can provide initials, nicknames, or another name to
identify the partner.” Allow program to move forward.
If SX_TOTN4 (total number of sex partners) =1 AND SX_NM1N4 (name of partner 1), is still
“refused to answer,” skip to the serosorting section (Say box before SEROSRT1). If SX_TOTN4
61
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
(total number of sex partners) ≥ 2, go to SX_NM2N4 (name of partner 2). Else, go to SXTOVRN4
(verification of total sex partners)
QDS programming note for SX_NM1N4:
Open-ended response.
Character limit = 50.
Do not allow a “don’t know” response option.
Variable label is name of partner 1.
SN.1.1. What shall we call the 2nd person with whom you had sex during the past 12 months?
[SX_NM2N4]
[7 = Refused to answer]
Interviewer instructions for SX_NM2N4 (name of partner 2):
If SX_NM2N4 (name of partner 2) is “refused to answer,” display the message “Interviewer:
remind the respondent that he or she can provide initials, nicknames, or another name to
identify the partner.” Allow program to move forward.
If SX_TOTN4 (total number of sex partners) = 2 AND SX_NM1N4 (name of partner 1) AND
SX_NM2N4 (name of partner 2) are “refused to answer,” skip to the serosorting section (say box
before SEROSRT1). If SX_TOTN4 ≥ 3, go to SX_NM3N4 (name of partner 3). Else, go to
SXTOVRN4 (verification of total sex partners)
EXAMPLE: SX_NM1N4 (name of partner 1) is “refused to answer” AND SX_NM2N4 (name of
partner 2) is “John,” then go to SX_NM3N4 (name of partner 3).
QDS programming note for SX_NM2N4:
Use open-ended response.
Character limit = 50.
Do not allow for a “don’t know” response option.
Variable label is name of partner 2.
If SX_NM1N4 (name of partner 1) and SX_NM2N4 (name of partner 2) are identical, then
display the following message, “You gave me the same name for another partner. Can you
please give me another name?” The program should return to SX_NM2N4 (name of partner 2).
SN.1.2. What shall we call the 3rd person with whom you had sex during the past 12 months?
[SX_NM3N4]
62
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
[7 = Refused to answer]
Interviewer instructions for SX_NM3N4 (name of partner 3):
If SX_NM3N4 (name of partner 3) is “refused to answer,” display the message “Interviewer:
remind the respondent that he or she can provide initials, nicknames, or another name to
identify the partner.” Allow program to move forward.
If SX_TOTN4 (total number of sex partners) = 3 AND SX_NM1N4 (name of partner 1) AND
SX_NM2N4 (name of partner 2) AND SX_NM3N4 (name of partner 3) are “refused to answer,”
skip to the serosorting question (say box before SEROSRT1). If SX_TOTN4 (total number of sex
partners) ≥4, go to SX_NM4N4 (name of partner 4). Else skip to SXTOVRN4 (verification of total
sex partners)
EXAMPLE: SX_NM1N4 (name of partner 1) is “refused to answer” AND SX_NM2N4 (name of
partner 2) is “John” and SX_NM3N4 (name of partner 3) is “Jane,” then go to SX_NM4N4 (name
of partner 4).
QDS programming note for SX_NM3N4:
Use open-ended response.
Character limit = 50.
Do not allow for a “don’t know” response option.
Variable label is name of partner 3.
If either SX_NM1N4 (name of partner 1), SX_NM2N4 (name of partner 2), or SX_NM3N4 (name
of partner 3) are identical, then display the following message, “You gave me the same name
for another partner. Can you please give me another name?” The program should return to
SX_NM3N4 (name of partner 3).
SN.1.3. What shall we call the 4th person with whom you had sex during the past 12 months?
[SX_NM4N4]
[7 = Refused to answer]
Interviewer instructions for SX_NM4N4 (name of partner 4):
If SX_NM4N4 (name of partner 4), is “refused to answer,” display the message “Interviewer:
remind the respondent that he or she can provide initials, nicknames, or another name to
identify the partner.” Allow program to move forward.
If SX_TOTN4 (total number of sex partners) = 4 AND SX_NM1N4 (name of partner 1) AND
SX_NM2N4 (name of partner 2) AND SX_NM3N4 (name of partner 3) AND SX_NM4N4 (name of
63
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
partner 4) are “refused to answer,” skip to the serosorting section (Say box before SEROSRT1. If
SX_TOTN4 (total number of sex partners) ≥5, go to SX_NM5N4 (name of partner 5). Else, skip to
SXTOVRN4 (verification of total sex partners)
EXAMPLE: SX_NM1N4 (name of partner 1) is “refused to answer” AND SX_NM2N4 (name of
partner 2) is “John” and SX_NM3N4 (name of partner 3) is “Jane” and SX_NM4N4 (name of
partner 4) is “JB,” then go to SX_NM5N4 (name of partner 5).
QDS programming note for SX_NMN4:
Use open-ended response.
Character limit = 50.
Do not allow for a “don’t know” response option.
Variable label is name of partner 4.
If either SX_NM1N4 (name of partner 1), SX_NM2N4 (name of partner 2), SX_NM3N4 (name of
partner 3), or SX_NM4N4 (name of partner 4) are identical, then display the following message,
“You gave me the same name for another partner. Can you please give me another name?” The
program should return to SX_NM4N4 (name of partner 4).
SN.1.4. What shall we call the 5th person with whom you had sex during the past 12 months?
[SX_NM5N4]
[7 = Refused to answer]
Interviewer instructions for SX_NM5N4 (name of partner 5):
If SX_NM5N4 (name of partner 5), is “refused to answer,” display the message “Interviewer:
remind the respondent that he or she can provide initials, nicknames, or another name to
identify the partner.” Allow program to move forward.
If SX_TOTN4 (total number of sex partners) = 5 AND SX_NM1N4 (name of partner 1),
SX_NM2N4 (name of partner 2), SX_NM3N4 (name of partner 3), SX_NM4N4 (name of partner
4), SX_NM5N4 (name of partner 5) are all “refused to answer,” skip to the serosorting section
(Say box before SEROSRT1).
Otherwise go to SXTOVRN4 (verification of total sex partners).
QDS programming note for SX_NM5N4:
Use open-ended response.
Character limit = 50.
Do not allow for a “don’t know” response option.
64
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Variable label is name of partner 5.
If either SX_NM1N4 (name of partner 1), SX_NM2N4 (name of partner 2), SX_NM3N4 (name of
partner 3), SX_NM4N4 (name of partner 4), or SX_NM5N4 (name of partner 5) are identical,
then display the following message, “You gave me the same name for another partner. Can you
please give me another name?” The program should return to SX_NM5N4 (name of partner 5).
If SX_TOTN4 (total number of sex partners) > 5 and SX_NM1N4 (name of partner 1), SX_NM2N4
(name of partner 2), SX_NM3N4 (name of partner 3), SX_NM4N4 (name of partner 4), and
SX_NM5N4 (name of partner 5) are all “don’t know” or “refused to answer,” then skip to the
aggregate information section (Say box before SXAGC1N4).
SN.1.5. So, the total number of people you had vaginal or anal sex with during the past 12
months was [INSERT SX_TOTN4]? [SXTOVRN4]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
QDS programming note for SXTOVRN4:
Variable label for SXTOVRN4 is verification of total sex partners.
Interviewer instructions for SXTOVRN4 (verification of total sex partners): If SXTOVRN4 = 0
(no) or 8 (don’t know), return to interviewer instructions before SX_TFPN4 (number of female
partners). If SXTOVRN4 = 1 (yes), go to interviewer instructions at beginning of partner
demographics section. If SXTOVRN4 = 7 (refused to answer), skip to the serosorting section (Say
box before SEROSRT1).
65
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Partner demographics (SP)
NOTE: In QDS, the numbering convention will not match the paper format. The convention in
QDS would apply to all partners as follows:
SPA1.0_Partner1.
SPB1.0_Partner2.
SPC1.0_Partner3.
SPD1.0_Partner4.
SPE1.0_Partner5.
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner name partner
partner
partner
partner
SX_NM1N4]
name
name
name
name
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Instructions for partner demographics partner-by-partner series table: The questions and response options
are in the far left column of the table. Each question is asked for partners 1–5. Partners 1-5 are labeled in
columns Partner 1, Partner 2, Partner 3, Partner 4, and Partner 5. All Partner 1 questions are asked before
moving to Partner 2 questions. Detailed instructions are provided in each table cell.
When question instructions say “insert partner name,” and the variable is in the Partner 1 column, then insert
response from SX_NM1N4 (name of partner 1).
When question instructions say “insert partner name,” and variable is in the Partner 2 column, insert
response to SX_NM2N4 (name of partner 2).
When question instructions say “insert partner name,” and variable is in the same column as Partner 3, insert
response to SX_NM3N4 (name of partner 3).
When question instructions say “insert partner name,” and variable is in the same column as Partner 4, insert
response to SX_NM4N4 (name of partner 4).
When question instructions say “insert partner name,” and variable is in the same column as Partner 5, insert
response to SX_NM5N4 (name of partner 5).
Interviewer instructions before SXPGN1N4 (partner gender-partner 1), SXPGN2N4 (partner gender-partner
2), SXPGN3N4 (partner gender-partner 3), SXPGN4N4 (partner gender-partner 4), SXPGN5N4 (partner
gender-partner 5):
Skip question series if respondent refuses to provide a partner name:
If SX_TOTN4 = 2 AND respondent provided name for partner 2 (SX_NM2N4 not equal to 7), skip to interviewer
instructions before SXPGN2N4 (partner gender-partner 2). If respondent refused to provide name for partner 2
(SX_NM2N4 = 7), skip to serosorting section (Say box before SEROSRT1).
If SX_TOTN4 = 3 AND respondent provided name for partner 3 (SX_NM3N4 not equal to 7), skip to interviewer
66
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner name partner
partner
partner
partner
SX_NM1N4]
name
name
name
name
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
instructions before SXPGN3N4 (partner gender-partner 3). If respondent refused to provide name for partner 3
(SX_NM3N4 = 7), skip to serosorting section (Say box before SEROSRT1).
If SX_TOTN4 = 4 AND respondent provided name for partner 4 (SX_NM4N4 not equal to 7), skip to interviewer
instructions before SXPGN4N4 (partner gender-partner 4). If respondent refused to provide name for partner4
(SX_NM4N4 = 7), skip to serosorting section (Say box before SEROSRT1).
If SX_TOTN4 = 5 AND respondent provided name for partner 5 (SX_NM5N4 not equal to 7), skip to interviewer
instructions before SXPGN5N4 (partner gender-partner 5). If respondent refused to provide name for partner 5
(SX_NM5N4 = 7), skip to serosorting section (Say box before SEROSRT1).
Skip partner gender questions if the respondent had sex with only one gender: If SXTGONN4 (transgender
only partners) = 1, OR SXFMONN4 (female only partners) = 1 OR SXMLONN4 (male only partners) = 1 then skip
SXPGN1N4 (partner gender-partner 1), SXPGN2N4 (partner gender-partner 2), SXPGN3N4 (partner genderpartner 3), SXPGN4N4 (partner gender-partner 4), and SXPGN5N4 (partner gender-partner 5) and go to the SAY
box for SXPAG1N4 (partner age-partner 1), SXPAG2N4 (partner age-partner 2), SXPAG3N4 (partner agepartner 3), SXPAG4N4 (partner age-partner 4), and SXPAG5N4 (partner age-partner 5).
Otherwise, go to SXPGN1N4 (partner gender-partner 1) when answering partner 1 series questions,
SXPGN2N4 (partner gender-partner 2) when answering partner 2 series questions, SXPGN3N4 (partner
gender-partner 3) when answering partner 3 series questions, SXPGN4N4 (partner gender-partner 4) when
answering partner 4 series questions, or SXPGN5N4 (partner gender-partner 5) when answering partner 5
series questions.
SP.1.0. Is [INSERT PARTNER
[SXPGN1N4]
[SXPGN2N4] [SXPGN3N4] [SXPGN4N4] [SXPGN5N4]
NAME] male, female, or
transgender? [READ CHOICES.
CHECK ONLY ONE.]
1
1
1
1
1
Male 1
Female 2
2
2
2
2
2
Transgender
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
67
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner name partner
SX_NM1N4]
name
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
If response is If response is If response is If response is If response is
1, 2, 3, 7, or 8, 1, 2, 3, 7, or
1, 2, 3, 4, or
1, 2, 3, 4, or
1, 2, 3, 4, or
go to
8, go to
7, go to
7, go to
7, go to
SXPAG1N4
SXPAG2N4
SXPAG3N4
SXPAG4N4
SXPAG5N4
(partner age- (partner age- (partner age- (partner age- (partner agepartner 1).
partner 2).
partner 3.
partner 4).
partner 5).
QDS programming note for SXPGN1N4 (partner gender-partner 1), SXPGN2N4 (partner gender-partner 2),
SXPGN3N4 (partner gender-partner 3), SXPGN4N4 (partner gender-partner 4), and SXPGN5N4 (partner
gender-partner 5):
Variable label for SXPGN1N4 is partner gender-partner 1.
Variable label for SXPGN2N4 is partner gender-partner 2.
Variable label for SXPGN3N4 is partner gender-partner 3.
Variable label for SXPGN4N4 is partner gender-partner 4.
Variable label for SXPGN5N4 is partner gender-partner 5.
Inconsistency check for SXPGN1N4 [partner gender]
If SX_GEN = 2 (female) and [SXPGN1N4] or [SXPGN2N4] or [SXPGN3N4] or [SXPGN4N4] or [SXPGN5N4] is
female, display the following message: “Only include partners with whom you had vaginal or anal sex.
Remember, for these questions, vaginal sex means penis in the vagina and anal sex means penis in the anus.
Interviewer instructions: Return to previous question if necessary.” Allow survey to move forward. Else, go
to Say Box before SXPAG1N4 [partner1 age] for partner 1, SXPAG2N4 [partner 2 age] for partner 2, SXPAG3N4
[partner 3 age] for partner 3, SXPAG4N4 [partner 4 age] for partner 4, SXPAG5N4 [partner 5 age] for partner
5.
SAY box for SXPAG1N4 (partner age-partner 1), SXPAG2N4 (partner age-partner 2), SXPAG3N4 (partner
age-partner 3), SXPAG4N4 (partner age-partner 4), and SXPAG5N4 (partner age-partner 5)
SAY: “For the next question we will use Response Card K-1.”
SP.2.0. Which of the following
[SXPAG1N4] [SXPAG2N4] [SXPAG3N4] [SXPAG4N4] [SXPAG5N4]
age groups best describes
[INSERT PARTNER NAME]?
[READ CHOICES. CHECK ONLY
ONE.]
≤24 years old 1
1
1
1
1
1
25-29 years old
2
2
2
2
2
2
68
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner name partner
SX_NM1N4]
name
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
30-34 years old
3
3
3
3
3
3
35-39 years old
4
4
4
4
4
4
40-44 years old
5
5
5
5
5
5
45-49 years old
6
6
6
6
6
6
>=50 years old
7
7
7
7
7
7
Refused to answer
77
77
77
77
77
77
Don’t know
88
88
88
88
88
88
For all
For all
For all
For all
For all
responses, go responses,
responses,
responses,
responses,
to Say box
go to
go to
go to
go to
before
SXPEN2N4
SXPEN3N4
SXPEN4N4
SXPEN5N4
SXPEN1N4
(partner
(partner
(partner
(partner
(partner
ethnicityethnicityethnicityethnicityethnicitypartner 2).
partner 3).
partner 4).
partner 5).
partner 1).
QDS programming note for SXPAG1N4 (partner age-partner 1), SXPAG2N4 (partner age-partner 2),
SXPAG3N4 (partner age-partner 3), SXPAG4N4 (partner age-partner 4), and SXPAG5N4 (partner agepartner 5):
Variable label for SXPAG1N4 is partner age-partner 1.
Variable label for SXPAG2N4 is partner age-partner 2.
Variable label for SXPAG3N4 is partner age-partner 3.
Variable label for SXPAG4N4 is partner age-partner 4.
Variable label for SXPAG5N4 is partner age-partner 5.
SAY: “The next two questions ask about partners’ race and ethnicity. We’re asking them to better understand
the health of all groups.”
SP.3.0. Is [INSERT PARTNER
[SXPEN1N4]
[SXPEN2N4]
[SXPEN3N4]
[SXPEN4N4]
[SXPEN5N4]
69
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner name partner
SX_NM1N4]
name
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
NAME] Hispanic, Latino/a, or
of Spanish origin? If you’re not
sure, give me your best guess.
No 0
0
0
0
0
0
Yes 1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
For all
For all
For all
responses,
responses,
responses,
responses,
go to
go to
go to
go to
SXPR2N4
SXPR3N4
SXPR4N4
SXPR5N4
(partner
(partner
(partner
(partner
race-partner race-partner race-partner race-partner
2).
3).
4).
5).
QDS programming note for SXPEN1N4 (partner ethnicity-partner 1), SXPEN2N4 (partner ethnicity-partner
2), SXPEN3N4 (partner ethnicity-partner 3), SXPEN4N4 (partner ethnicity-partner 4), and SXPEN5N4
(partner ethnicity-partner 5):
Variable label for SXPEN1N4 is partner ethnicity-partner 1.
Variable label for SXPEN2N4 is partner ethnicity-partner 2.
Variable label for SXPEN3N4 is partner ethnicity-partner 3.
Variable label for SXPEN4N4 is partner ethnicity-partner 4.
Variable label for SXPEN5N4 is partner ethnicity-partner 5.
SP.4.0. Which of the following
[SXPR1N4]
[SXPR2N4]
[SXPR3N4]
[SXPR4N4]
[SXPR5N4]
racial group or groups best
describes [INSERT PARTNER
NAME]? Please choose all
that apply. If you’re not sure,
give me your best guess.
[READ CHOICES. CHECK ALL
For all
responses, go
to SXPR1N4
(partner racepartner 1).
70
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner name partner
SX_NM1N4]
name
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
THAT APPLY.]
American Indian or Alaskan
Native 1
1[
SXPR1N4A]
1[
SXPR2N4A]
1[
SXPR3N4A]
1[
SXPR4N4A]
1[
SXPR5N4A]
Asian 2
2[
SXPR1N4B]
2[
SXPR2N4B]
2[
SXPR3N4B]
2[
SXPR4N4B]
2[
SXPR5N4B]
Black or African American 3
3[
SXPR1N4C]
3
[
3[
SXPR3N4C]
3[
SXPR4N4C]
3[
SXPR5N4C]
4[
SXPR3N4D]
4[
SXPR4N4D]
4[
SXPR5N4D]
5[
SXPR3N4E]
5[
SXPR4N4E]
7
7
7
Native Hawaiian or Other
Pacific Islander 4
White 5
Refused to answer
Don’t know
SXPR2N4C]
4[
SXPR1N4D]
5[
SXPR1N4E]
4[
SXPR2N4D]
5[
SXPR5N4E]
7
7
5[
SXPR2N4E]
8
8
7
8
8
8
For all
responses, go
to SXPCM1N4
(commitmentpartner 1).
8
For all
responses,
go to
SXPCM3N4
commitmentpartner 3).
For all
responses,
go to
SXPCM4N4
commitmentpartner 4).
For all
responses,
go to
SXPCM5N4
commitmentpartner 5).
For all
responses, go
to SXPCM2N4
commitmentpartner 2).
71
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner name partner
partner
partner
partner
SX_NM1N4]
name
name
name
name
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
QDS programming note for SXPRC1N4 (race-partner 1), SXPRC2N4 (race-partner 2), SXPRC3N4 (race-partner
3), SXPRC4N4 (race-partner 4), and SXPRC5N4 (race -partner 5):
Variable label for SXPRC1N4 is race-partner 1.
Variable label for SXPRC2N4 is race-partner 2.
Variable label for SXPRC3N4 is race-partner 3.
Variable label for SXPRC4N4 is race-partner 4.
Variable label for SXPRC5N4 is race-partner 5.
SP.5.0. How would you
[SXPCM1N4] [SXPCM2N4] [SXPCM3N4] [SXPCM4N4] [SXPCM5N4]
describe your level of
commitment to [INSERT
PARTNER NAME]? Are you…
[READ CHOICES. CHECK ONLY
ONE.]
Not at all committed
1
1
1
1
1
1
Somewhat committed
2
2
2
2
2
2
Very committed
3
3
3
3
3
3
Committed to above and
beyond anyone else 4
4
4
4
4
4
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
responses, go
to interviewer
instructions
before
SX_VS1N4
(vaginal sex-
For all
responses,
go to
interviewer
instructions
before
SX_VS2N4
For all
responses,
go to
interviewer
instructions
before
SX_VS3N4
For all
responses,
go to
interviewer
instructions
before
SX_VS4N4
For all
responses,
go to
interviewer
instructions
before
SX_VS5N4
72
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner name partner
partner
partner
partner
SX_NM1N4]
name
name
name
name
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
partner 1).
(vaginal sex- (vaginal sex- (vaginal sex- (vaginal sexpartner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for SXPCM1N4 (commitment-partner 1), SXPCM2N4 (commitment-partner 2),
SXPCM3N4 (commitment-partner 3), SXPCM4N4 (commitment-partner 4), and SXPCM5N4 (commitmentpartner 5):
Variable label for SXPCM1N4 is commitment-partner 1.
Variable label for SXPCM2N4 is commitment-partner 2.
Variable label for SXPCM3N4 is commitment-partner 3.
Variable label for SXPCM4N4 is commitment-partner 4.
Variable label for SXPCM5N4 is commitment-partner 5.
73
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Vaginal sex (SV)
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Instructions for vaginal sex partner-by-partner series table: The questions and response options are in the
far left column of the table. Each question is asked for partners 1–5. Partners 1-5 are labeled in columns
Partner 1, Partner 2, Partner 3, Partner 4, and Partner 5. All Partner 1 questions are asked before moving to
Partner 2 questions. Detailed instructions are provided in each table cell.
When question instructions say “insert partner name,” and the variable is in the Partner 1 column, then insert
response from SX_NM1N4 (name of partner 1).
When question instructions say “insert partner name,” and variable is in the Partner 2 column, insert
response to SX_NM2N4 (name of partner 2).
When question instructions say “insert partner name,” and variable is in the same column as Partner 3, insert
response to SX_NM3N4 (name of partner 3).
When question instructions say “insert partner name,” and variable is in the same column as Partner 4, insert
response to SX_NM4N4 (name of partner 4).
When question instructions say “insert partner name,” and variable is in the same column as Partner 5, insert
response to SX_NM5N4 (name of partner 5).
Interviewer instructions before SX_VS1N4 (vaginal-partner 1), SX_VS2N4 (vaginal-partner 2), SX_VS3N4
(vaginal-partner 3), SX_VS4N4 (vaginal-partner 4), and SX_VS5N4 (vaginal-partner 5):
Transgender/unknown gender respondent: If the respondent is transgender (SX_GEN=3) or unknown gender
(SX_GEN=4), then skip to transgender and unknown gender partner-by-partner series table (SX_TG1N4
[transgender partner 1], SX_TG2N4 [transgender partner 2], SX_TG3N4 [transgender partner 3], SX_TG4N4
[transgender partner 4], or SX_TG5N4 [transgender partner 5]). Transgender/unknown gender partner: If the
respondents’ partner(s) is(are) transgender[If SXTGONN4 = 1 (transgender only partner) OR (SXPGN1N4
(partner gender-partner 1), SXPGN2N4 (partner gender-partner2), SXPGN3N4 (partner gender-partner 3),
SXPGN4N4 (partner gender-partner 4), SXPGN5N4 (partner gender-partner 5) = 3, don’t know, or refused to
answer], then skip to transgender and unknown gender partner-by-partner series table (SX_TG1N4
[transgender partner 1], SX_TG2N4 [transgender partner 2], SX_TG3N4 [transgender partner 3], SX_TG4N4
[transgender partner 4], or SX_TG5N4 [transgender partner 5]).
Male-male partners: If the respondent is male (SX_GEN=1), and he reports only male partners (SXMLONN4 =
1), then skip to anal sex partner-by-partner series table (SXANL1N4 [anal sex-partner1], SXANL2N4 [anal sexpartner 2], SXANL3N4 [anal sex-partner 3], SXANL4N4 [anal sex-partner 4], or SXANL5N4 [anal sex-partner 5]).
74
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Female respondent female partner: If the respondent is female (SX_GEN=2) and SX_TOTN4 = 1, skip to
serosorting section (Say box before SEROSRT1). If 2 ≤ SX_TOTN4 ≤ 5, skip to interviewer instructions before
SXPGN2N4 (partner gender-partner 2), SXPGN3N4 (partner gender-partner 3, SXPGN4N4 (partner genderpartner 4), or SXPGN5N4 (partner gender-partner 5). If SX_TOTN4 ≥ 6, skip to serosorting section (Say box
before SEROSRT1).
Otherwise: go to vaginal sex partner-by-partner series table (SX_VS1N4 [vaginal-partner 1], SX_VS2N4
[vaginal-partner 2], SX_VS3N4 [vaginal-partner 3], SX_VS4N4 [vaginal-partner 4], or SX_VS5N4 [vaginalpartner 5]).
SV.1.0. During the past 12
[SX_VS1N4] [SX_VS2N4] [SX_VS3N4] [SX_VS4N4] [SX_VS5N4]
months, did you have vaginal sex
with [INSERT PARTNER NAME]?
No 0
0
0
0
0
0
Skip to
Skip to
Skip to
Skip to
Skip to
SXANL1N4
SXANL2N4
SXANL3N4
SXANL4N4
SXANL5N4
(anal sex(anal sex(anal sex(anal sex(anal sexpartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
Yes 1
1
Go to
SV10_1N4
(vaginal10partner 1)
1
Go to
SV10_2N4
(vaginal10partner 2)
1
Go to
SV10_3N4
(vaginal10partner 3)
1
Go to
SV10_4N4
(vaginal10partner 4)
1
Go to
SV10_5N4
(vaginal10partner 5)
Refused to answer
7
7
Skip to
SXANL1N4
(anal sexpartner 1)
7
Skip to
SXANL2N4
(anal sexpartner 2)
7
Skip to
SXANL3N4
(anal sexpartner 3)
7
Skip to
SXANL4N4
(anal sexpartner 4)
7
Skip to
SXANL5N4
(anal sexpartner 5)
Don’t know
8
8
Skip to
SXANL1N4
(anal sex-
8
Skip to
SXANL2N4
(anal sex-
8
Skip to
SXANL3N4
(anal sex-
8
Skip to
SXANL4N4
(anal sex-
8
Skip to
SXANL5N4
(anal sex75
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
partner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SX_VS1N4 (vaginal sex-partner 1), SX_VS2N4 (vaginal sex-partner 2), SX_VS3N4
(vaginal sex-partner 3), SX_VS4N4 (vaginal sex-partner 4), SX_VS5N4 (vaginal sex-partner 5):
Variable label for SX_VS1N4 is vaginal sex-partner 1.
Variable label for SX_VS2N4 is vaginal sex-partner 2.
Variable label for SX_VS3N4 is vaginal sex-partner 3.
Variable label for SX_VS4N4 is vaginal sex-partner 4.
Variable label for SX_VS5N4 is vaginal sex-partner 5.
SV.1.1. During the past 12
[SV10_1N4] [SV10_2N4] [SV10_3N4] [SV10_4N4] [SV10_5N4]
months, did you have vaginal sex
with [INSERT PARTNER NAME]
more than 10 times? [READ
CHOICES. CHECK ONLY ONE.]
No
0
0
0
0
0
0
Go to
Go to
Go to
Go to
Go to
SXVEN1N4
SXVEN2N4
SXVEN3N4
SXVEN4N4
SXVEN5N4
(times
(times
(times
(times
(times
vaginal sex- vaginal sex- vaginal sex- vaginal sex- vaginal sexpartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
Yes
1
1
Skip to
SXANV1N4
(average
number
vaginalpartner 1).
1
Skip to
SXANV2N4
(average
number
vaginalpartner 2).
1
Skip to
SXANV3N4
(average
number
vaginalpartner 3).
1
Skip to
SXANV4N4
(average
number
vaginalpartner 4).
1
Skip to
SXANV5N4
(average
number
vaginalpartner 5).
Refused to answer
7
7
Skip to
SXANL1N4
(anal sexpartner 1)
7
Skip to
SXANL2N4
(anal sexpartner 2)
7
Skip to
SXANL3N4
(anal sexpartner 3)
7
Skip to
SXANL4N4
(anal sexpartner 4)
7
Skip to
SXANL5N4
(anal sexpartner5)
76
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Don’t know
8
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
SXANL1N4
SXANL2N4
SXANL3N4
SXANL4N4
SXANL5N4
(anal sex(anal sex(anal sex(anal sex(anal sexpartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SV10_1N4 (vaginal 10-partner 1), SV10_2N4 (vaginal 10-partner 2), SV10_3N4
(vaginal 10-partner 3), SV10_4N4 (vaginal 10-partner 4), SV10_5N4 (vaginal 10-partner 5):
Variable label for SV10_1N4 is vaginal 10-partner 1.
Variable label for SV10_2N4 is vaginal 10-partner 2.
Variable label for SV10_3N4 is vaginal 10-partner 3.
Variable label for SV10_4N4 is vaginal 10-partner 4.
Variable label for SV10_5N4 is vaginal 10-partner 5.
SV.1.2. During the past 12
[SXVEN1N4] [SXVEN2N4] [SXVEN3N4] [SXVEN4N4] [SXVEN5N4]
months, please tell me the exact
number of times that you had
vaginal sex with [INSERT
PARTNER NAME]?
Skip to Say
box before
SXVC1AN4
(condom
vaginalpartner 1a).
Skip to
instructions
before
SXVC2AN4
(condom
vaginalpartner 2a).
Skip to
instructions
before
SXVC3AN4
(condom
vaginalpartner 3a).
Skip to
instructions
before
SXVC4AN4
(condom
vaginalpartner 4a).
Skip to
instructions
before
SXVC5AN4
(condom
vaginalpartner 5a).
Refused to answer
77
77
Skip to
SXANL1N4
(anal sexpartner 1)
77
Skip to
SXANL2N4
(anal sexpartner 2)
77
Skip to
SXANL3N4
(anal sexpartner 3)
77
Skip to
SXANL4N4
(anal sexpartner 4)
77
Skip to
SXANL5N4
(anal sexpartner 5)
Don’t know
88
88
Skip to
88
Skip to
88
Skip to
88
Skip to
88
Skip to
77
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
SXANL1N4
SXANL2N4
(anal sex(anal sexpartner 1)
partner 2)
Partner 3
[Insert
partner
name
SX_NM3N4]
SXANL3N4
(anal sexpartner 3)
Partner 4
[Insert
partner
name
SX_NM4N4]
SXANL4N4
(anal sexpartner 4)
Partner 5
[Insert
partner
name
SX_NM5N4]
SXANL5N4
(anal sexpartner 5)
QDS programming note for SXVEN1N4 (times vaginal sex-partner 1), SXVEN2N4 (times vaginal sex-partner
2), SXVEN3N4 (times vaginal sex-partner 3), SXVEN4N4 (times vaginal sex-partner 4), and SXVEN5N4 (times
vaginal sex-partner 5):
Range 1–10.
If response to SXVEN1N4 (times vaginal sex-partner 1), SXVEN2N4 (times vaginal sex-partner 2), SXVEN3N4
(times vaginal sex-partner 3), SXVEN4N4 (times vaginal sex-partner 4), and SXVEN5N4 (times vaginal sexpartner 5) is out of range, display the following message: “Number too big (if >10) or too small (if = 0)”
Confirm response and if necessary return to previous question.”
Variable label for SXVEN1N4 is times vaginal sex-partner 1.
Variable label for SXVEN2N4 is times vaginal sex-partner 2.
Variable label for SXVEN3N4 is times vaginal sex-partner 3.
Variable label for SXVEN4N4 is times vaginal sex-partner 4.
Variable label for SXVEN5N4 is times vaginal sex-partner 5.
SV.1.3. On average, how many
[SXANV1N4] [SXANV2N4] [SXANV3N4] [SXANV4N4] [SXANV5N4]
times did you have vaginal sex
with [INSERT PARTNER NAME]
per month?
Refused to answer
777
Go to
SXMVG1N4
(months
vaginal sexpartner 1).
Go to
SXMVG2N4
(months
vaginal sexpartner 2).
Go to
SXMVG3N4
(months
vaginal sexpartner 3).
Go to
SXMVG4N4
(months
vaginal sexpartner 4).
Go to
SXMVG5N4
(months
vaginal sexpartner 5).
777
Go to
SXMVG1N4
(months
vaginal sex-
777
Go to
SXMVG2N4
(months
vaginal sex-
777
Go to
SXMVG3N4
(months
vaginal sex-
777
Go to
SXMVG4N4
(months
vaginal sex-
777
Go to
SXMVG5N4
(months
vaginal sex78
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
partner 1).
partner 2).
Don’t know
Partner 3
[Insert
partner
name
SX_NM3N4]
partner 3).
Partner 4
[Insert
partner
name
SX_NM4N4]
partner 4).
Partner 5
[Insert
partner
name
SX_NM5N4]
partner 5).
888
888
888
888
888
888
Go to
Go to
Go to
Go to
Go to
SXMVG1N4
SXMVG2N4
SXMVG3N4
SXMVG4N4
SXMVG5N4
(months
(months
(months
(months
(months
vaginal sex- vaginal sex- vaginal sex- vaginal sex- vaginal sexpartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for SXANV1N4 (average number vaginal-partner 1), SXANV2N4 (average number
vaginal-partner 2), SXANV3N4 (average number vaginal-partner 3), SXANV4N4 (average number vaginalpartner 4), and SXANV5N4 (average number vaginal-partner 5):
Range 1–90.
Variable label for SXANV1N4 is average number vaginal-partner 1.
Variable label for SXANV2N4 is average number vaginal-partner 2.
Variable label for SXANV3N4 is average number vaginal-partner 3.
Variable label for SXANV4N4 is average number vaginal-partner 4.
Variable label for SXANV5N4 is average number vaginal-partner 5.
SV.1.4. During the past 12
[SXMVG1N4] [SXMVG2N4] [SXMVG3N4] [SXMVG4N4] [SXMVG5N4]
months, how many months did
you have vaginal sex with
[INSERT PARTNER NAME]?
months
Refused to answer
77
77
77
77
77
77
Don’t know
88
88
88
88
88
88
For all
responses,
skip to
instructions
before
For all
responses,
skip to
instructions
before
For all
responses,
go to Say
box before
SXVC1AN4
For all
responses,
skip to
instructions
before
For all
responses,
skip to
instructions
before
79
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
(condom
SXVC2AN4
SXVC3AN4
SXVC4AN4
SXVC5AN4
vaginal(condom
(condom
(condom
(condom
partner 1a). vaginalvaginalvaginalvaginalpartner 2a). partner 3a). partner 4a). partner 5a).
QDS programming note for SXMVG1N4 (months vaginal sex-partner 1), SXMVG2N4 (months vaginal sexpartner 2), SXMVG3N4 (months vaginal sex-partner 3), SXMVG4N4 (months vaginal sex-partner 4), and
SXMVG5N4 (months vaginal sex-partner 5):
Range 1–12.
Variable label for SXMVG1N4 is months vaginal sex-partner 1.
Variable label for SXMVG2N4 is months vaginal sex-partner 2.
Variable label for SXMVG3N4 is months vaginal sex-partner 3.
Variable label for SXMVG4N4 is months vaginal sex-partner 4.
Variable label for SXMVG5N4 is months vaginal sex-partner 5.
SAY box before SXVC1AN4 (condom vaginal-partner 1a): SAY: “The next question is about condom use.
Please include when a condom was used the entire time, not only part of the time during sex.”
Interviewer instructions before SXVC1AN4 (condom vaginal-partner 1a), SXVC2AN4 (condom vaginalpartner 2a), SXVC3AN4 (condom vaginal-partner 3a), SXVC4AN4 (condom vaginal-partner 4a), SXVC5AN4
(condom vaginal-partner 5a):
If SXVEN1N4 (times vaginal sex-partner 1) = 1, then go to SXVC1AN4 (condom vaginal-partner 1a); otherwise
skip to SXVC1BN4 (condom vaginal-partner 1b).
If SXVEN2N4 (times vaginal sex-partner 2) = 1, then go to SXVC2AN4 (condom vaginal-partner 2a); otherwise
skip to SXVC2BN4 (condom vaginal-partner 2b).
If SXVEN3N4 (times vaginal sex-partner 3) =1, then go to SXVC3AN4 (condom vaginal-partner 3a); otherwise
skip to SXVC3BN4 (condom vaginal-partner 3b).
If SXVEN4N4 (times vaginal sex-partner 4) = 1, then go to SXVC4AN4 (condom vaginal-partner 4a); otherwise
skip to SXVC4BN4 (condom vaginal-partner 4b).
If SXVEN5N4 (times vaginal sex-partner 5) = 1, then go to SXVC5AN4 (condom vaginal-partner 5a); otherwise
skip to SXVC5BN4 (condom vaginal-partner 5b).
SV.1.5.a. During the past 12
[SXVC1AN4] [SXVC2AN4] [SXVC3AN4] [SXVC4AN4] [SXVC5AN4]
80
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
months, when you had vaginal
sex with [INSERT PARTNER
NAME] was a condom used?
No
0
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
0
0
0
0
0
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
Yes
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
skip to
skip to
skip to
skip to
skip to
SXANL1N4
SXANL2N4
SXANL3N4
SXANL4N4
SXANL5N4
(anal sex(anal sex(anal sex(anal sex(anal sexpartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for SXVC1AN4 (condom vaginal-partner 1a), SXVC2AN4 (condom vaginal-partner
2a), SXVC3AN4 (condom vaginal-partner 3a), SXVC4AN4 (condom vaginal-partner 4a), SXVC5AN4 (condom
vaginal-partner 5a):
Variable label for SXVC1AN4 is condom vaginal-partner 1a.
Variable label for SXVC2AN4 is condom vaginal-partner 2a.
Variable label for SXVC3AN4 is condom vaginal-partner 3a.
Variable label for SXVC4AN4 is condom vaginal-partner 4a.
Variable label for SXVC5AN4 is condom vaginal-partner 5a.
SV.1.5.b. During the past 12
[SXVC1BN4] [SXVC2BN4]
months, when you had vaginal
sex with [INSERT PARTNER
NAME] was a condom used...
[READ CHOICES. CHECK ONLY
ONE.]
Never- not even once
1
1
1
[SXVC3BN4]
[SXVC4BN4]
[SXVC5BN4]
1
1
1
81
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
One or more times
Absolutely every time
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
2
2
2
Partner 3
[Insert
partner
name
SX_NM3N4]
2
Partner 4
[Insert
partner
name
SX_NM4N4]
2
Partner 5
[Insert
partner
name
SX_NM5N4]
2
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
go to
go to
go to
go to
go to
SXANL1N4
SXANL2N4
SXANL3N4
SXANL4N4
SXANL5N4
(anal sex(anal sex(anal sex(anal sex(anal sexpartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for SXVC1BN4 (condom vaginal-partner 1b), SXVC2BN4 (condom vaginal-partner
2b), SXVC3BN4 (condom vaginal-partner 3b), SXVC4BN4 (condom vaginal-partner 4b), SXVC5BN4 (condom
vaginal-partner 5b):
Variable label for SXVC1BN4 is condom vaginal-partner 1b.
Variable label for SXVC2BN4 is condom vaginal-partner 2b.
Variable label for SXVC3BN4 is condom vaginal-partner 3b.
Variable label for SXVC4BN4 is condom vaginal-partner 4b.
Variable label for SXVC5BN4 is condom vaginal-partner 5b.
82
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Anal sex (SL)
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Instructions for anal partner-by-partner series table: The questions and response options are in the far left
column of the table. Each question is asked for partners 1–5. Partners 1-5 are labeled in columns Partner 1,
Partner 2, Partner 3, Partner 4, and Partner 5. All Partner 1 questions are asked before moving to Partner 2
questions. Detailed instructions are provided in each table cell.
When question instructions say “insert partner name,” and the variable is in the Partner 1 column, then
insert response from SX_NM1N4 (name of partner 1).
When question instructions say “insert partner name,” and variable is in the Partner 2 column, insert
response to SX_NM2N4 (name of partner 2).
When question instructions say “insert partner name,” and variable is in the same column as Partner 3,
insert response to SX_NM3N4 (name of partner 3).
When question instructions say “insert partner name,” and variable is in the same column as Partner 4,
insert response to SX_NM4N4 (name of partner 4).
When question instructions say “insert partner name,” and variable is in the same column as Partner 5,
insert response to SX_NM5N4 (name of partner 5).
SL.1.0. During the past 12
[SXANL1N4] [SXANL2N4] [SXANL3N4] [SXANL4N4] [SXANL5N4]
months, did you have anal sex
with [INSERT PARTNER
NAME]?
No 0
0
0
0
0
0
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
Yes 1
1
Go to
SA10_1N4
(anal 10partner 1).
1
Go to
SA10_2N4
(anal 10partner 2).
1
Go to
SA10_3N4
(anal 10partner 3).
1
Go to
SA10_4N4
(anal 10partner 4).
1
Go to
SA10_5N4
(anal 10partner 5).
83
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Refused to answer
7
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
7
Skip to
STATS1N4
(aware
statuspartner 1)
7
Skip to
STATS3N4
(aware
statuspartner 3)
7
Skip to
STATS4N4
(aware
statuspartner 4)
7
Skip to
STATS5N4
(aware
statuspartner 5)
7
Skip to
STATS2N4
(aware
statuspartner 2)
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SXANL1N4 (anal sex-partner 1), SXANL2N4 (anal sex-partner 2), SXANL3N4
(anal sex-partner 3), SXANL4N4 (anal sex-partner 4), SXANL5N4 (anal sex-partner 5):
Don’t know
8
Variable label for SXANL1N4 is anal sex-partner 1.
Variable label for SXANL2N4 is anal sex-partner 2.
Variable label for SXANL3N4 is anal sex-partner 3.
Variable label for SXANL4N4 is anal sex-partner 4.
Variable label for SXANL5N4 is anal sex-partner 5.
84
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note for SXANL1N4 (anal sex-partner 1), SXANL2N4 (anal sex-partner 2), SXANL3N4
(anal sex-partner 3), SXANL4N4 (anal sex-partner 4), SXANL5N4 (anal sex-partner 5) continued:
No vaginal or anal sex partners reported among respondents who previously said they had vaginal or
anal sex:
If SX_VS1N4 (vaginal sex-partner 1) is 0 (no) AND SXANL1N4 (anal sex-partner 1) is 0 (no), then display the
following message: “Earlier you told me that you had vaginal or anal sex with [INSERT partner name
SX_NM1N4]. Is this correct? Interviewer instructions: return to previous questions to correct error.” Allow
program to move forward.
If SX_VS2N4 (vaginal sex-partner 2) is 0 (no) AND SXANL2N4 (anal sex-partner 2) is 0 (no), then display the
following message: “Earlier you told me that you had vaginal or anal sex with [INSERT partner name
SX_NM2N4]. Is this correct? Interviewer instructions: return to previous questions to correct error.” Allow
program to move forward.
If SX_VS3N4 (vaginal sex-partner 3) is 0 (no) AND SXANL3N4 (anal sex-partner 3) is 0 (no), then display the
following message: “Earlier you told me that you had vaginal or anal sex with [INSERT partner name
SX_NM3N4]. Is this correct? Interviewer instructions: return to previous questions to correct error.” Allow
program to move forward.
If SX_VS4N4 (vaginal sex-partner 4) is 0 (no) AND SXANL4N4 (anal sex-partner 4) is 0 (no), then display the
following message: “Earlier you told me that you had vaginal or anal sex with [INSERT partner name
SX_NM4N4]. Is this correct? Interviewer instructions: return to previous questions to correct error.” Allow
program to move forward.
If SX_VS5N4 (vaginal sex-partner 5) is 0 (no) AND SXANL5N4 (anal sex-partner 1) is 0 (no), then display the
following message: “Earlier you told me that you had vaginal or anal sex with [INSERT partner name
SX_NM5N4]. Is this correct? Interviewer instructions: return to previous questions to correct error.” Allow
program to move forward.
QDS programming note for SXANL1N4 (anal sex-partner 1), SXANL2N4 (anal sex-partner 2), SXANL3N4
(anal sex-partner 3), SXANL4N4 (anal sex-partner 4), SXANL5N4 (anal sex-partner 5) continued:
No anal sex partners reported among male respondents who previously said they had only male
partners:
If SX_GEN (sex gender) = 1 (male) and (If SXPGN1N4 = 1 OR SXMLONN4 (male only partners) = 1) and
SXANL1N4 (anal sex-partner 1) is 0 (no), then display the following message: “Earlier you told me that you
had vaginal or anal sex with [INSERT partner name SX_NM1N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
85
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
If SX_GEN (sex gender) = 1 (male) and (If SXPGN2N4 = 1 OR SXMLONN4 (male only partners) = 1) and
SXANL2N4 (anal sex-partner 2) is 0 (no), then display the following message: “Earlier you told me that you
had vaginal or anal sex with [INSERT partner name SX_NM2N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_GEN (sex gender) = 1 (male) and (If SXPGN3N4 = 1 OR SXMLONN4 (male only partners) = 1) and
SXANL3N4 (anal sex-partner 3) is 0 (no), then display the following message: “Earlier you told me that you
had vaginal or anal sex with [INSERT partner name SX_NM3N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_GEN (sex gender) = 1 (male) and (If SXPGN4N4 = 1 OR SXMLONN4 (male only partners) = 1) and
SXANL4N4 (anal sex-partner 4) is 0 (no), then display the following message: “Earlier you told me that you
had vaginal or anal sex with [INSERT partner name SX_NM4N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_GEN (sex gender) = 1 (male) and (If SXPGN5N4 = 1 OR SXMLONN4 (male only partners) = 1) and
SXANL5N4 (anal sex-partner 1) is 0 (no), then display the following message: “Earlier you told me that you
had vaginal or anal sex with [INSERT partner name SX_NM5N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
SL.1.1. During the past 12
months, did you have anal sex
with [INSERT PARTNER NAME]
more than 10 times? [READ
CHOICES. CHECK ONLY ONE.]
No
0
[SA10_1N4]
[SA10_2N4]
[SA10_3N4]
[SA10_4N4]
[SA10_5N4]
0
0
0
0
0
Go to
SXAEN1N4
(times anal
sex-partner
1).
Go to
SXAEN2N4
(times anal
sex-partner
2).
Go to
SXAEN3N4
(times anal
sex-partner
3).
Go to
SXAEN4N4
(times anal
sex-partner
4).
Go to
SXAEN5N4
(times anal
sex-partner
5).
86
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Yes
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
1
1
1
Skip to
Skip to
SXANA1N4
SXANA2N4
(average
(average
number
number
anal-partner anal-partner
1).
2).
Refused to answer
7
Don’t know
8
7
Skip to
STATS1N4
(aware
statuspartner 1)
7
Skip to
STATS2N4
(aware
statuspartner 2)
Partner 3
[Insert
partner
name
SX_NM3N4]
1
Skip to
SXANA3N4
(average
number
anal-partner
3).
Partner 4
[Insert
partner
name
SX_NM4N4]
1
Skip to
SXANA4N4
(average
number
anal-partner
4).
Partner 5
[Insert
partner
name
SX_NM5N4]
1
Skip to
SXANA5N4
(average
number
anal-partner
5).
7
Skip to
STATS3N4
(aware
statuspartner 3)
7
Skip to
STATS4N4
(aware
statuspartner 4)
7
Skip to
STATS5N4
(aware
statuspartner 5)
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SA10_1N4 (anal 10-partner 1), SA10_2N4 (anal 10-partner 2), SA10_3N4 (anal
10-partner 3), SA10_4N4 (anal 10-partner 4), SA10_5N4 (anal 10-partner 5):
Variable label for SA10_1N4 is anal 10-partner 1.
Variable label for SA10_2N4 is anal 10-partner 2.
Variable label for SA10_3N4 is anal 10-partner 3.
Variable label for SA10_4N4 is anal 10-partner 4.
Variable label for SA10_5N4 is anal 10-partner 5.
SL.1.2. During the past 12
[SXAEN1N4] [SXAEN2N4] [SXAEN3N4] [SXAEN4N4] [SXAEN5N4]
months, please tell me the
exact number of times that you
had anal sex with [INSER
87
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
Skip to
interviewer
instructions
before
SXAC1AN4
(condom
anal-partner
1a).
Skip to
interviewer
instructions
before
SXAC2AN4
(condom
anal-partner
2a).
Skip to
interviewer
instructions
before
SXAC3AN4
(condom
anal-partner
3a).
Skip to
interviewer
instructions
before
SXAC4AN4
(condom
anal-partner
4a).
Skip to
interviewer
instructions
before
SXAC5AN4
(condom
anal-partner
5a).
77
Skip to
STATS1N4
(aware
statuspartner 1)
77
Skip to
STATS2N4
(aware
statuspartner 2)
77
Skip to
STATS3N4
(aware
statuspartner 3)
77
Skip to
STATS4N4
(aware
statuspartner 4)
77
Skip to
STATS5N4
(aware
statuspartner 5)
PARTNER NAME]?
Refused to answer 77
88
88
88
88
88
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SXAEN1N4 (times anal sex-partner 1), SXAEN2N4 (times anal sex-partner 2),
SXAEN3N4 (times anal sex-partner 3), SXAEN4N4 (times anal sex-partner 4), SXAEN5N4):
Range 1–10.
Don’t know
88
Variable label for SXAEN1N4 is times anal sex-partner 1.
Variable label for SXAEN2N4 is times anal sex-partner 2.
Variable label for SXAEN3N4 is times anal sex-partner 3.
Variable label for SXAEN4N4 is times anal sex-partner 4.
88
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Variable label for SXAEN5N4 is times anal sex-partner 5.
SL.1.3. On average, how many
[SXANA1N4] [SXANA2N4]
times did you have anal sex
with [INSERT PARTNER NAME]
per month?
Refused to answer
Don’t know
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
[SXANA3N4]
[SXANA4N4]
[SXANA5N4]
777
777
777
777
777
777
888
888
888
888
888
888
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
go to
go to
go to
go to
go to
SXMAN1N4
SXMAN2N4
SXMAN3N4
SXMAN4N4
SXMAN5N4
(months
(months
(months
(months
(months
anal sexanal sexanal sexanal sexanal sexpartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming SXANA1N4 (average number anal-partner1), SXANA2N4 (average number anal-partner
2), SXANA3N4 (average number anal-partner 3), SXANA4N4 (average number anal-partner 4), SXANA1N4
(average number anal-partner 5):
Range 1–90.
Variable label for SXANA1N4 is average number anal-partner 1.
Variable label for SXANA2N4 is average number anal-partner 2.
Variable label for SXANA3N4 is average number anal-partner 3.
Variable label for SXANA4N4 is average number anal-partner 4.
Variable label for SXANA5N4 is average number anal-partner 5.
SL.1.4. During the past 12
[SXMAN1N4] [SXMAN2N4] [SXMAN3N4] [SXMAN4N4] [SXMAN5N4]
months, how many months did
you have anal sex with [INSERT
PARTNER NAME]?
89
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
months
Refused to answer
77
77
77
77
77
77
Don’t know
88
88
88
88
88
88
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
go to
go to
go to
go to
go to
interviewer
interviewer
interviewer
interviewer
interviewer
instructions
instructions
instructions
instructions
instructions
before
before
before
before
before
SXAC1AN4
SXAC2AN4
SXAC3AN4
SXAC4AN4
SXAC5AN4
(condom
(condom
(condom
(condom
(condom
anal-partner anal-partner anal-partner anal-partner anal-partner
1a).
2a).
3a).
4a).
5a).
QDS programming note for SXMAN1N4 (months anal sex-partner 1), SXMAN2N4 (months anal sexpartner 2), SXMAN3N4 (months anal sex-partner 3), SXMAN4N4 (months anal sex-partner 4), and
SXMAN5N4 (months anal sex-partner 5):
Range 1–12.
Variable label for SXMAN1N4 is months anal sex-partner 1.
Variable label for SXMAN2N4 is months anal sex-partner 2.
Variable label for SXMAN3N4 is months anal sex-partner 3.
Variable label for SXMAN4N4 is months anal sex-partner 4.
Variable label for SXMAN5N4 is months anal sex-partner 5.
Interviewer instructions before SXAC1AN4 (condom anal-partner 1a), SXAC2AN4 (condom anal-partner
2a), SXAC2AN4 (condom anal-partner 3a), SXAC2AN4 (condom anal-partner 4a), SXAC2AN4 (condom
anal-partner 5a):
Female-male partner #1-anal sex once: If the respondent is female (SX_GEN=2) AND partner 1 is male
(SXPGN1N4 [partner gender-partner 1] = 1 [male] or SMLONN4 [male only partners] = 1) AND the
90
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
respondent had anal sex with partner 1 only one time (SXAEN1N4 [times anal sex-partner 1] = 1), then go to
Say box before SXAC1AN4 (condom anal-partner 1a).
Female-male partner #1-anal sex more than once: If the respondent is female (SX_GEN=2) AND partner 1 is
male (SXPGN1N4 [partner gender-partner 1] = 1 [male] or SMLONN4 [male only partners]=1) AND the
respondent had anal sex with partner 1 more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2) OR
SA10_1N4 (anal 10-partner 1) = “yes,” then go to Say box before SXAC1BN4 (condom anal-partner 1b).
Female-male partners #2, 3, 4, 5-anal sex once: If the respondent is female (SX_GEN=2) AND partners 2, 3,
4, or 5 are male (SXPGN2N4 [partner gender-partner 2] = 1 [male], SXPGN3N4 [partner gender-partner 3] =
1 [male], SXPGN4N4 [partner gender-partner 4] = 1 [male], SXPGN5N4 [partner gender-partner 5] = 1 [male]
OR SXMLONN4 [male only partners] = 1) AND the respondent had anal sex with partners 2, 3, 4, or 5 only
one time (SXAEN2N4 [times anal sex-partner 2] = 1, SXAEN3N4 [times anal sex-partner 3] = 1, SXAEN4N4
[times anal sex-partner 4] = 1, SXAEN5N4 [times anal sex-partner 5] = 1), then go to SXAC2AN4 (condom
anal-partner 2a), SXAC3AN4 (condom anal-partner 3a), SXAC4AN4 (condom anal-partner 4a), or SXAC5AN4
(condom anal-partner 5a).
Female-male partners #2, 3, 4, 5-anal sex more than once: If the respondent is female (SX_GEN=2) AND
partners 2, 3, 4, or 5 are male ( SXPGN2N4 [partner gender-partner 2] = 1 [male], SXPGN3N4 [partner
gender-partner 3] = 1 [male], SXPGN4N4 [partner gender-partner 4] = 1 [male], SXPGN5N4 [partner genderpartner 5] = 1 [male]) OR SXMLONN4 [male only partners] = 1) AND the respondent had anal sex with
partners 2, 3, 4, or 5 more than once (SXAEN2N4 [times anal sex-partner 2] ≥ 2, SXAEN3N4 [times anal sexpartner 3] ≥ 2, SXAEN4N4 [times anal sex-partner 4] ≥ 2, SXAEN5N4 [times anal sex-partner 5] ≥ 2 OR
SA10_2N4 (anal 10-partner 2) = “yes,”, SA10_3N4 (anal 10-partner 3) = “yes,”, SA10_4N4 (anal 10-partner
4) = “yes,”, SA10_5N4 (anal 10-partner 5) = “yes,”, then go to SXAC2BN4 (condom anal-partner 2b),
SXAC3BN4 (condom anal-partner 3b), SXAC4BN4 (condom anal-partner 4b), SXAC5BN4 (condom analpartner 5b).
Male-female partner #1-anal sex once: If the respondent is male (SX_GEN=1) and partner 1 is female
(SXPGN1N4 [partner gender-partner 1] = 2 [female] OR SXFMONN4 [female only partners] =1), AND the
respondent had anal sex with partner 1 only one time (SXAEN1N4 [times anal sex-partner 1] = 1), then go to
Say box before SXAC1AN4 (condom anal-partner 1a).
91
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Male-female partner #1-anal sex more than once: If the respondent is male (SX_GEN=1) AND partner 1 is
female (SXPGN1N4 [partner gender-partner 1] = 2 [female] OR SXFMONN4 [female only partners] =1 ), AND
the respondent had anal sex with partner 1 more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2) OR
SA10_1N4 (anal 10-partner 1) = “yes,” then go to Say box before SXAC1BN4 (condom anal-partner 1b).
Male-female partners # 2, 3, 4, 5-anal sex once: If the respondent is male (SX_GEN=1) AND partners 2, 3, 4,
or 5 are female (SXPGN2N4 [partner gender-partner 2] = 2 [female], SXPGN3N4 [partner gender-partner 3] =
2 [female], SXPGN4N4 [partner gender-partner 4] = 2 [female], SXPGN5N4 [partner gender-partner 5] = 2
[female] OR SXFMONN4 [female only partners] = 1) AND the respondent had anal sex with partners 2, 3, 4,
or 5 only one time (SXAEN2N4 [times anal sex-partner 2] = 1, SXAEN3N4 [times anal sex-partner 3] = 1,
SXAEN4N4 [times anal sex-partner 4] = 1, SXAEN5N4 [times anal sex-partner 5] = 1, then go to SXAC2AN4
(condom anal-partner 2a), SXAC3AN4 (condom anal-partner 3a), SXAC4AN4 (condom anal-partner 4a),
SXAC5AN4 (condom anal-partner 5a).
Male-female partners # 2, 3, 4, 5-anal sex more than once: If the respondent is male (SX_GEN=1) AND
partners 2, 3, 4, or 5 are female ( SXPGN2N4 [partner gender-partner 2] = 2 [female], SXPGN3N4 [partner
gender-partner 3] = 2 [female], SXPGN4N4 [partner gender-partner 4] = 2 [female], SXPGN5N4 [partner
gender-partner 5] = 2 [female]) OR SXFMONN4 [female only partners] = 1) AND the respondent had anal sex
with partners 2, 3, 4, or 5 more than once (SXAEN2N4 [times anal sex-partner 2] ≥ 2, SXAEN3N4 [times anal
sex-partner 3] ≥ 2, SXAEN4N4 [times anal sex-partner 4] ≥ 2, SXAEN5N4 [times anal sex-partner 5] ≥ 2 OR
SA10_2N4 (anal 10-partner 2) = “yes,”, SA10_3N4 (anal 10-partner 3) = “yes,”, SA10_4N4 (anal 10-partner
4) = “yes,”, SA10_5N4 (anal 10-partner 5) = “yes,”, then go to SXAC2BN4 (condom anal-partner 2b),
SXAC3BN4 (condom anal-partner 3b), SXAC4BN4 (condom anal-partner 4b), SXAC5BN4 (condom analpartner 5b).
Male-male partner(s): If the respondent is male (SX_GEN=1) and partner is male
(SXPGN1N4 [partner gender-partner 1] = 1, SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner
gender-partner 3] = 1, SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1
OR SXMLONN4 [male only partners] = 1), then skip to interviewer instructions before ABTM1AN4 (receptive
anal-partner 1a), interviewer instructions before ABTM2AN4 (receptive anal-partner 2a), interviewer
instructions before ABTM3AN4 (receptive anal-partner 3a), interviewer instructions before ABTM4AN4
(receptive anal-partner 4a), interviewer instructions before ABTM5AN4 (receptive anal-partner 5a).
92
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
If SA10_1N4 (anal 10-partner 1) = Refused to answer or don’t know, SA10_2N4 (anal 10-partner 2) =
Refused to answer or don’t know, SA10_3N4 (anal 10-partner 3) = Refused to answer or don’t know,
SA10_4N4 (anal 10-partner 4) = Refused to answer or don’t know, SA10_5N4 (anal 10-partner 5) = Refused
to answer or don’t know OR if SXAEN1N4 (times anal sex-partner 1) = 0, SXAEN2N4 (times anal sex-partner
2) =0, SXAEN3N4 (times anal sex-partner 3) =0, SXAEN4N4 (times anal sex-partner 4) =0, SXAEN5N4 (times
anal sex-partner 5) =0, skip to instructions for partner-by-partner status series table: STATS1N4 (aware
status-partner 1) when answering partner 1 series, STATS2N4 (aware status-partner 2) when answering
partner 2 series, STATS3N4 (aware status-partner 3) when answering partner 3 series, STATS4N4 (aware
status-partner 4) when answering partner 4 series, STATS5N4 (aware status-partner 5) when answering
partner 5 series.
SAY box before SXAC1AN4 (condom anal-partner 1a): SAY: “The next question is about condom use.
Please include when a condom was used the entire time, not only part of the time.”
SL.1.5.a. During the past 12
[SXAC1AN4] [SXAC2AN4] [SXAC3AN4] [SXAC4AN4] [SXAC5AN4]
months, when you had anal
sex with INSERT PARTNER
NAME] was a condom used?
No
0
0
0
0
0
0
Yes
1
1
1
1
1
1
refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
skip to
skip to
skip to
skip to
skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SXAC1AN4 (condom anal-partner 1a), SXAC2AN4 (condom anal-partner 2a),
93
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
SXAC3AN4 (condom anal-partner 3a), SXAC4AN4 (condom anal-partner 4a), SXAC5AN4 (condom analpartner 5a):
Variable label for SXAC1AN4 is condom anal-partner 1a.
Variable label for SXAC2AN4 is condom anal-partner 2a.
Variable label for SXAC3AN4 is condom anal-partner 3a.
Variable label for SXAC4AN4 is condom anal-partner 4a.
Variable label for SXAC5AN4 is condom anal-partner 5a.
SAY box before SXAC1BN4 (condom anal-partner 1b), SXAC2BN4 (condom anal-partner 2b), SXAC3BN4
(condom anal-partner 3b), SXAC4BN4 (condom anal-partner 4b), SXAC5BN4 (condom anal-partner 5b):
SAY: “The next question is about condom use. Please include times when a condom was used the entire
time, not only part of the time.”
SL.1.5.b.During the past 12
[SXAC1BN4] [SXAC2BN4] [SXAC3BN4] [SXAC4BN4] [SXAC5BN4]
months, when you had anal
sex with [PARTNER NAME]
was a condom used…
[READ CHOICES. CHECK ONLY
ONE.]
Never – not even once
1
1
1
1
1
1
One or more times
2
2
2
2
2
2
Absolutely every time
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
responses,
skip to
STATS1N4
For all
responses,
skip to
STATS2N4
For all
responses,
skip to
STATS3N4
For all
responses,
skip to
STATS4N4
For all
responses,
skip to
STATS5N4
94
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for SXAC1BN4 (condom anal-partner 1b), SXAC2BN4 (condom anal-partner 2b),
SXAC3BN4 (condom anal-partner 3b), SXAC4BN4 (condom anal-partner 4b), SXAC5BN4 (condom analpartner 5b):
Variable label for SXAC1BN4 is condom anal-partner 1b.
Variable label for SXAC2BN4 is condom anal-partner 2b.
Variable label for SXAC3BN4 is condom anal-partner 3b.
Variable label for SXAC4BN4 is condom anal-partner 4b.
Variable label for SXAC5BN4 is condom anal-partner 5b.
Interviewer instructions for ABTM1AN4 (receptive anal-partner 1a), ABTM2AN4 (receptive anal-partner
2a), ABTM3AN4 (receptive anal-partner 3a), ABTM4AN4, (receptive anal-partner 4a), ABTM5AN4
(receptive anal-partner 5a):
Male-male partner-anal sex once: If the respondent is male (SX_GEN=1) and partner is male (SXPGN1N4
[partner gender-partner 1] = 1, SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner genderpartner 3] = 1, SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1 OR
SXMLONN4 [male only partners] = 1), AND the respondent had anal sex with partners 1, 2, 3, 4, or 5 only
one time (SXAEN1N4 [times anal sex-partner 1] = 1, SXAEN2N4 [times anal sex-partner 2] = 1, SXAEN3N4
[times anal sex-partner 3] = 1, SXAEN4N4 [times anal sex-partner 4] = 1, SXAEN5N4 [times anal sex-partner
5] = 1, THEN go to ABTM1AN4 (receptive anal-partner 1a), ABTM2AN4 (receptive anal-partner 2a),
ABTM3AN4 (receptive anal-partner 3a), ABTM4AN4, (receptive anal-partner 4a), ABTM5AN4 (receptive
anal-partner 5a).
Male-male partner-anal sex more than once: If the respondent is male (SX_GEN=1) and partner is male
(SXPGN1N4 [partner gender-partner 1] = 1, SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner
gender-partner 3] = 1, SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1
OR SXMLONN4 [male only partners] = 1), AND the respondent had anal sex with partners 1, 2, 3, 4, or 5
more than one time (SXAEN1N4 [times anal sex-partner 1] ≥ 2, SXAEN2N4 [times anal sex-partner 2] ≥ 2,
SXAEN3N4 [times anal sex-partner 3] ≥ 2, SXAEN4N4 [times anal sex-partner 4] ≥ 2, SXAEN5N4 [times anal
sex-partner 5] ≥ 2 OR SA10_1N4 (anal 10-partner 1) =1, , SA10_2N4 (anal 10-partner 2) =1, SA10_3N4 (anal
95
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
10-partner 3) =1, SA10_4N4 (anal 10-partner 4) =1, SA10_5N4 (anal 10-partner 5) =1 THEN skip to
ABTM1BN4 (receptive anal-partner 1b), ABTM2BN4 (receptive anal-partner 2b), ABTM3BN4 (receptive analpartner 3b), ABTM4BN4, (receptive anal-partner 4b), ABTM5BN4 (receptive anal-partner 5b).
SL.1.6.a. During the past 12
[ABTM1AN4] [ABTM2AN4] [ABTM3AN4] [ABTM4AN4] [ABTM5AN4]
months, when you had anal
sex with INSERT PARTNER
NAME], did you have anal sex
where you were a bottom?
No
0
0
Skip to
ATP1AN4
(insertive
anal-partner
1a).
0
Skip to
ATP2AN4
(insertive
anal-partner
2a).
0
Skip to
ATP3AN4
(insertive
anal-partner
3a).
0
Skip to
ATP4AN4
(insertive
anal-partner
4a).
0
Skip to
ATP5AN4
(insertive
anal-partner
5a).
Yes
1
1
1
1
1
1
Go to
interviewer
instructions
before
ABTC1AN4
(condom
receptive
anal-partner
1a).
Go to
interviewer
instructions
before
ABTC2AN4
(condom
receptive
anal-partner
2a).
Go to
interviewer
instructions
before
ABTC3AN4
(condom
receptive
anal-partner
3a).
Go to
interviewer
instructions
before
ABTC4AN4
(condom
receptive
anal-partner
4a).
Go to
interviewer
instructions
before
ABTC5AN4
(condom
receptive
anal-partner
5a).
7
Skip to
ATP1AN4
(insertive
anal-partner
1a).
7
Skip to
ATP2AN4
(insertive
anal-partner
2a).
7
Skip to
ATP3AN4
(insertive
anal-partner
3a).
7
Skip to
ATP4AN4
(insertive
anal-partner
4a).
7
Skip to
ATP5AN4
(insertive
anal-partner
5a).
Refused to answer
7
96
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Don’t know
8
Never
1
Sometimes
2
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
ATP1AN4
ATP2AN4
ATP3AN4
ATP4AN4
ATP5AN4
(insertive
(insertive
(insertive
(insertive
(insertive
anal-partner anal-partner anal-partner anal-partner anal-partner
1a).
2a).
3a).
4a).
5a).
QDS programming note for ABTM1AN4 (receptive anal-partner 1a), ABTM2AN4 (receptive anal-partner
2a), ABTM3AN4 (receptive anal-partner 3a), ABTM4AN4, (receptive anal-partner 4a), ABTM5AN4
(receptive anal-partner 5a):
Variable label for ABTM1AN4 receptive anal-partner 1a.
Variable label for ABTM2AN4 receptive anal-partner 2a.
Variable label for ABTM3AN4 receptive anal-partner 3a.
Variable label for ABTM4AN4 receptive anal-partner 4a.
Variable label for ABTM5AN4 receptive anal-partner 5a.
SL.1.6.b. During the past 12
[ABTM1BN4] [ABTM2BN4] [ABTM3BN4] [ABTM4BN4] [ABTM5BN4]
months, when you had anal
sex with [INSERT PARTNER
NAME], how often did you
have anal sex where you were
a bottom? [READ CHOICES.
CHECK ONLY ONE.]
1
Skip to
ATP1BN4
(insertive
anal-partner
1b).
1
Skip to
ATP2BN4
(insertive
anal-partner
2b).
2
Go to
1
Skip to
ATP3BN4
(insertive
anal-partner
3b).
2
Go to
1
Skip to
ATP4BN4
(insertive
anal-partner
4b).
2
Go to
1
Skip to
ATP5BN4
(insertive
anal-partner
5b).
2
Go to
2
Go to
97
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
interviewer
interviewer
instructions
instructions
before
before
ABTC1AN4
ABTC2AN4
(condom
(condom
receptive
receptive
anal-partner anal-partner
1a.)
2a.)
Always
3
Partner 3
[Insert
partner
name
SX_NM3N4]
interviewer
instructions
before
ABTC3AN4
(condom
receptive
anal-partner
3a.)
Partner 4
[Insert
partner
name
SX_NM4N4]
interviewer
instructions
before
ABTC4AN4
(condom
receptive
anal-partner
4a.)
Partner 5
[Insert
partner
name
SX_NM5N4]
interviewer
instructions
before
ABTC5AN4
(condom
receptive
anal-partner
5a.)
3
3
3
3
3
Go to
interviewer
instructions
before
ABTC1AN4
(condom
receptive
anal-partner
1a.)
Go to
interviewer
instructions
before
ABTC2AN4
(condom
receptive
anal-partner
2a.)
Go to
interviewer
instructions
before
ABTC3AN4
(condom
receptive
anal-partner
3a.)
Go to
interviewer
instructions
before
ABTC4AN4
(condom
receptive
anal-partner
4a.)
Go to
interviewer
instructions
before
ABTC5AN4
(condom
receptive
anal-partner
5a.)
Refused to answer
7
7
Skip to
ATP1BN4
(insertive
anal-partner
1b).
7
Skip to
ATP2BN4
(insertive
anal-partner
2b).
7
Skip to
ATP3BN4
(insertive
anal-partner
3b).
7
Skip to
ATP4BN4
(insertive
anal-partner
4b).
7
Skip to
ATP5BN4
(insertive
anal-partner
5b).
Don’t know
8
8
Skip to
ATP1BN4
(insertive
anal-partner
1b).
8
Skip to
ATP2BN4
(insertive
anal-partner
2b).
8
Skip to
ATP3BN4
(insertive
anal-partner
3b).
8
Skip to
ATP4BN4
(insertive
anal-partner
4b).
8
Skip to
ATP5BN4
(insertive
anal-partner
5b).
98
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
QDS programming note for ABTM1BN4 (receptive anal-partner 1b), ABTM2BN4 (receptive anal-partner
2b), ABTM3BN4 (receptive anal-partner 3b), ABTM4BN4, (receptive anal-partner 4b), ABTM5BN4
(receptive anal-partner 5b):
Variable label for ABTM1BN4 receptive anal-partner 1b.
Variable label for ABTM2BN4 receptive anal-partner 2b.
Variable label for ABTM3BN4 receptive anal-partner 3b.
Variable label for ABTM4BN4 receptive anal-partner 4b.
Variable label for ABTM5BN4 receptive anal-partner 5b.
Interviewer instructions for ABTC1AN4 (condom receptive anal-partner 1a), ABTC2AN4 (condom receptive
anal-partner 2a), ABTC3AN4 (condom receptive anal-partner 3a), ABTC4AN4 (condom receptive analpartner 4a), ABTC5AN4 (condom receptive anal-partner 5a):
Male-partner #1 male-anal sex once: If the respondent is male (SX_GEN=1) AND partner is male
( SXPGN1N4 [partner gender-partner 1] = 1 OR SXMLONN4 [male only partners] = 1) AND the respondent
had anal sex with partner #1 only one time (SXAEN1N4 [times anal sex-partner 1] = 1, THEN go to Say box
before ABTC1AN4 (condom receptive anal-partner 1a).
Male-partners #2, 3, 4, 5 male-anal sex once :If the respondent is male (SX_GEN=1) AND the respondent’s
partners # 2, 3, 4, or 5 are male (SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner genderpartner 3] = 1, SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1) OR
SXMLONN4 [male only partners] = 1), AND the respondent had anal sex with partners #2, 3, 4, or 5 only one
time (SXAEN2N4 [times anal sex-partner 2] = 1, SXAEN3N4 [times anal sex-partner 3] = 1, SXAEN4N4 [times
anal sex-partner 4] = 1, SXAEN5N4 [times anal sex-partner 5] = 1, THEN go to ABTC2AN4 (condom receptive
anal-partner 2a), ABTC3AN4 (condom receptive anal-partner 3a), ABTC4AN4 (condom receptive analpartner 4a), ABTC5AN4 (condom receptive anal-partner 5a).
Male-partner #1 male-anal sex more than once: if the respondent is male (SX_GEN=1) AND partner is male
(SXPGN1N4 [partner gender-partner 1] OR SXMLONN4 [male only partners] = 1) AND the respondent had
anal sex with partner #1more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2 OR SA10_1N4 [anal 10partner 1]) =1, THEN go to Say box before ABTC1BN4 (condom receptive anal-partner 1b).
Male-partner #2, 3, 4, 5, male-anal sex more than once: If the respondent is male (SX_GEN=1)
AND partner is male (SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner gender-partner 3] = 1,
99
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1 OR SXMLONN4 [male
only partners] = 1), AND the respondent had anal sex with partners 2, 3, 4, or 5 more than one time
(SXAEN2N4 [times anal sex-partner 2] ≥ 2, SXAEN3N4 [times anal sex-partner 3] ≥ 2, SXAEN4N4 [times anal
sex-partner 4] ≥ 2, SXAEN5N4 [times anal sex-partner 5] ≥ 2, OR SA10_2N4 (anal 10-partner 2) =1,
SA10_3N4 (anal 10-partner 3) =1, SA10_4N4 (anal 10-partner 4) =1, SA10_5N4 (anal 10-partner 5) =1, THEN
go to ABTC2BN4 (condom receptive anal-partner 2b), ABTC3BN4 (condom receptive anal-partner 3b),
ABTC4BN4 (condom receptive anal-partner 4b), ABTC5BN4 (condom receptive anal-partner 5b).
SAY box for ABTC1AN4 (condom receptive anal-partner 1a):
SAY: “The next question is about condom use. Please include when a condom was used the entire time,
not only part of the time during sex.”
SL.1.7a. During the past 12
[ABTC1AN4] [ABTC2AN4] [ABTC3AN4] [ABTC4AN4] [ABTC5AN4]
months, when you had anal
sex with [INSERT PARTNER
NAME] where you were a
bottom, was a condom used?
No
0
0
0
0
0
0
Yes
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
responses,
skip to
interviewer
instructions
before
ATP1AN4
(insertive
anal-partner
For all
responses,
skip to
interviewer
instructions
before
ATP2AN4
(insertive
anal-partner
For all
responses,
skip to
interviewer
instructions
before
ATP3AN4
(insertive
anal-partner
For all
responses,
skip to
interviewer
instructions
before
ATP4AN4
(insertive
anal-partner
For all
responses,
skip to
interviewer
instructions
before
ATP5AN4
(insertive
anal-partner
100
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
1a).
2a).
3a).
4a).
5a).
QDS programming note for ABTC1AN4 (condom receptive anal-partner 1a), ABTC2AN4 (condom
receptive anal-partner 2a), ABTC3AN4 (condom receptive anal-partner 3a), ABTC4AN4 (condom receptive
anal-partner 4a), ABTC5AN4 (condom receptive anal-partner 5a):
Variable label for ABTC1AN4 condom receptive anal-partner 1a.
Variable label for ABTC2AN4 condom receptive anal-partner 2a.
Variable label for ABTC3AN4 condom receptive anal-partner 3a.
Variable label for ABTC4AN4 condom receptive anal-partner 4a.
Variable label for ABTC5AN4 condom receptive anal-partner 5a.
SAY box for ABTC1BN4 (condom receptive anal-partner 1b):
SAY: “The next question is about condom use. Please include when a condom was used the entire time,
not only part of the time during sex.”
SL.1.7.b. During the past 12
[ABTC1BN4] [ABTC2BN4] [ABTC3BN4] [ABTC4BN4] [ABTC5BN4]
months, when you had anal
sex with [INSERT PARTNER
NAME] where you were a
bottom, was a condom used …
[READ CHOICES. CHECK ONLY
ONE.]
Never – not even once
1
1
1
1
1
1
2
2
2
2
2
2
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
One or more times
Absolutely every time
For all
responses,
go to
For all
responses,
go to
For all
responses,
go to
For all
responses,
go to
For all
responses,
go to
101
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
ATP1BN4
ATP2BN4
ATP3BN4
ATP4BN4
ATP5BN4
(insertive
(insertive
(insertive
(insertive
(insertive
anal-partner
anal-partner anal-partner anal-partner anal-partner
1b).
2b).
3b).
4b).
5b).
QDS programming note for ABTC1BN4 (condom receptive anal-partner 1b), ABTC2BN4 (condom receptive
anal-partner 2b), ABTC3BN4 (condom receptive anal-partner 3b), ABTC4BN4 (condom receptive analpartner 4b), ABTC5BN4 (condom receptive anal-partner 5b):
Variable label for ABTC1BN4 condom receptive anal-partner 1b.
Variable label for ABTC2BN4 condom receptive anal-partner 2b.
Variable label for ABTC3BN4 condom receptive anal-partner 3b.
Variable label for ABTC4BN4 condom receptive anal-partner 4b.
Variable label for ABTC5BN4 condom receptive anal-partner 5b.
SL.1.8.a. During the past 12
[ATP1AN4]
[ATP2AN4] [ATP3AN4]
[ATP4AN4]
[ATP5AN4]
months, when you had anal
sex with [INSERT PARTNER
NAME], did you have anal sex
where you were a top?
No
0
0
0
0
0
0
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
Yes
1
1
Skip to
interviewer
instructions
before
ATPC1AN4
(condom
insertive
1
Skip to
interviewer
instructions
before
ATPC2AN4
(condom
insertive
1
Skip to
interviewer
instructions
before
ATPC3AN4
(condom
insertive
1
Skip to
interviewer
instructions
before
ATPC4AN4
(condom
insertive
1
Skip to
interviewer
instructions
before
ATPC5AN4
(condom
insertive
102
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Refused to answer
7
Don’t know
8
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
anal-partner anal-partner
1a.)
2a.)
Partner 3
[Insert
partner
name
SX_NM3N4]
anal-partner
3a.)
Partner 4
[Insert
partner
name
SX_NM4N4]
anal-partner
4a.)
Partner 5
[Insert
partner
name
SX_NM5N4]
anal-partner
5a.)
7
Skip to
STATS1N4
(aware
statuspartner 1)
7
Skip to
STATS3N4
(aware
statuspartner 3)
7
Skip to
STATS4N4
(aware
statuspartner 4)
7
Skip to
STATS5N4
(aware
statuspartner 5)
7
Skip to
STATS2N4
(aware
statuspartner 2)
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1)
partner 2)
partner 3)
partner 4)
partner 5)
QDS programming note for ATP1AN4 (condom insertive anal-partner 1a), ATP2AN4 (condom insertive
anal-partner 2a), ATP3AN4 (condom insertive anal-partner 3a), ATP4AN4 (condom insertive anal-partner
4a), ATP5AN4 (condom insertive anal-partner 5a):
Variable label for ATP1AN4 insertive anal-partner 1a.
Variable label for ATP2AN4 insertive anal-partner 2a.
Variable label for ATP3AN4 insertive anal-partner 3a.
Variable label for ATP4AN4 insertive anal-partner 4a.
Variable label for ATP5AN4 insertive anal-partner 5a.
SL.1.8.b. During the past 12
[ATP1BN4]
[ATP2BN4]
months when you had anal sex
with [INSERT PARTNER
NAME], how often did you
have anal sex where you were
a top? [READ CHOICES. CHECK
ONLY ONE.]
[ATP3BN4]
[ATP4BN4]
[ATP5BN4]
103
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Never
Sometimes
Always
Refused to answer
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
1
1
1
Skip to
Skip to
STATS1N4
STATS2N4
(aware
(aware
statusstatuspartner 1).
partner 2).
2
3
7
Partner 3
[Insert
partner
name
SX_NM3N4]
1
Skip to
STATS3N4
(aware
statuspartner 3).
Partner 4
[Insert
partner
name
SX_NM4N4]
1
Skip to
STATS4N4
(aware
statuspartner 4).
Partner 5
[Insert
partner
name
SX_NM5N4]
1
Skip to
STATS5N4
(aware
statuspartner 5).
2
2
2
2
2
Go to
interviewer
instructions
before
ATPC1AN4
(condom
insertive
anal-partner
1a).
Go to
interviewer
instructions
before
ATPC2AN4
(condom
insertive
anal-partner
2a).
Go to
interviewer
instructions
before
ATPC3AN4
(condom
insertive
anal-partner
3a).
Go to
interviewer
instructions
before
ATPC4AN4
(condom
insertive
anal-partner
4a).
Go to
interviewer
instructions
before
ATPC5AN4
(condom
insertive
anal-partner
5a).
3
3
3
3
3
Go to
interviewer
instructions
before
ATPC1AN4
(condom
insertive
anal-partner
1a).
Go to
interviewer
instructions
before
ATPC2AN4
(condom
insertive
anal-partner
2a).
Go to
interviewer
instructions
before
ATPC3AN4
(condom
insertive
anal-partner
3a).
Go to
interviewer
instructions
before
ATPC4AN4
(condom
insertive
anal-partner
4a).
Go to
interviewer
instructions
before
ATPC5AN4
(condom
insertive
anal-partner
5a).
7
Skip to
STATS1N4
7
Skip to
STATS2N4
7
Skip to
STATS3N4
7
Skip to
STATS4N4
7
Skip to
STATS5N4
104
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
(aware
(aware
statusstatuspartner 1).
partner 2).
Don’t know
Partner 3
[Insert
partner
name
SX_NM3N4]
(aware
statuspartner 3).
Partner 4
[Insert
partner
name
SX_NM4N4]
(aware
statuspartner 4).
Partner 5
[Insert
partner
name
SX_NM5N4]
(aware
statuspartner 5).
8
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for ATPC1BN4 (insertive anal-partner 1b), ATPC2BN4 (insertive anal-partner 2b),
ATPC3BN4 (insertive anal-partner 3b), ATPC4BN4, (insertive anal-partner 4b), ATPC5BN4 (insertive analpartner 5b):
Variable label for ATP1BN4 insertive anal-partner 1b.
Variable label for ATP2BN4 insertive anal-partner 2b.
Variable label for ATP3BN4 insertive anal-partner 3b.
Variable label for ATP4BN4 insertive anal-partner 4b.
Variable label for ATP5BN4 insertive anal-partner 5b.
Respondent states he did not have receptive or insertive anal sex:
If SXANL1N4 (anal sex partner 1) = 1 (yes) and ABTM1AN4 (receptive anal sex partner 1) = 0 (no) and
ATP1AN4 (insertive anal sex partner 1) = 0 (no), display the following: “Earlier you told me that you had anal
sex with [INSERT partner name SX_NM1N4]. Is this correct? Interviewer instructions: return to previous
questions to correct error.” Allow program to move forward.
If SXANL1N4 (anal sex partner 1) = 1 (yes) and ABTM1BN4 (receptive anal sex partner 1) = 1 (Never) and
ATP1BN4 (insertive anal sex partner 1) = 1 (Never), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM1N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
If SXANL2N4 (anal sex partner 2) = 1 (yes) and ABTM2AN4 (receptive anal sex partner 2) = 0 (no) and
ATP2AN4 (insertive anal sex partner 2) = 0 (no), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM2N4]. Is this correct? Interviewer instructions: return to
105
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
[Insert
[Insert
[Insert
partner
partner
partner
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4]
previous questions to correct error.” Allow program to move forward.
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
If SXANL2N4 (anal sex partner 2) = 1 (yes) and ABTM2BN4 (receptive anal sex partner 2) = 1 (Never) and
ATP2BN4 (insertive anal sex partner 2) = 1 (Never), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM2N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
If SXANL3N4 (anal sex partner 3) = 1 (yes) and ABTM3AN4 (receptive anal sex partner 3) = 0 (no) and
ATP3AN4 (insertive anal sex partner 3) = 0 (no), display the following: “Earlier you told me that you had anal
sex with [INSERT partner name SX_NM3N4]. Is this correct? Interviewer instructions: return to previous
questions to correct error.” Allow program to move forward.
If SXANL3N4 (anal sex partner 3) = 1 (yes) and ABTM3BN4 (receptive anal sex partner 3) = 1 (Never) and
ATP3BN4 (insertive anal sex partner 3) = 1 (Never), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM3N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
If SXANL4N4 (anal sex partner 4) = 1 (yes) and ABTM4AN4 (receptive anal sex partner 4) = 0 (no) and
ATP4AN4 (insertive anal sex partner 4) = 0 (no), display the following: “Earlier you told me that you had anal
sex with [INSERT partner name SX_NM4N4]. Is this correct? Interviewer instructions: return to previous
questions to correct error.” Allow program to move forward.
If SXANL4N4 (anal sex partner 4) = 1 (yes) and ABTM4BN4 (receptive anal sex partner 4) = 1 (Never) and
ATP4BN4 (insertive anal sex partner 4) = 1 (Never), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM4N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
If SXANL5N4 (anal sex partner 5) = 1 (yes) and ABTM5AN4 (receptive anal sex partner 5) = 0 (no) and
ATP5AN4 (insertive anal sex partner 5) = 0 (no), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM5N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
If SXANL5N4 (anal sex partner 5) = 1 (yes) and ABTM5BN4 (receptive anal sex partner 5) = 1 (Never) and
106
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
ATP5BN4 (insertive anal sex partner 5) = 1 (Never), display the following: “Earlier you told me that you had
anal sex with [INSERT partner name SX_NM5N4]. Is this correct? Interviewer instructions: return to
previous questions to correct error.” Allow program to move forward.
Interviewer instructions for ATPC1AN4 (condom insertive anal-partner 1a), ATPC2AN4 (condom insertive
anal-partner 2a), ATPC3AN4 (condom insertive anal-partner 3a), ATPC4AN4 (condom insertive analpartner 4a), ATPC5AN4 (condom insertive anal-partner 5a):
Male-partner #1 male-anal sex once: If the respondent is male (SX_GEN=1) AND partner is male
( SXPGN1N4 [partner gender-partner 1] = 1 OR SXMLONN4 [male only partners] = 1) AND the respondent
had anal sex with partner #1 only one time (SXAEN1N4 [times anal sex-partner 1] = 1, THEN go to Say box
before ATPC1AN4 (condom insertive anal-partner 1a).
Male-partners #2, 3, 4, 5 male-anal sex once :If the respondent is male (SX_GEN=1) AND partner is male
(SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner gender-partner 3] = 1, SXPGN4N4 [partner
gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1 OR SXMLONN4 [male only partners] = 1),
AND the respondent had anal sex with partners #2, 3, 4, or 5 only one time (SXAEN2N4 [times anal sexpartner 2] = 1, SXAEN3N4 [times anal sex-partner 3] = 1, SXAEN4N4 [times anal sex-partner 4] = 1,
SXAEN5N4 [times anal sex-partner 5] = 1, THEN go to ATPC2AN4 (condom insertive anal-partner 2a),
ATPC3AN4 (condom insertive anal-partner 3a), ATPC4AN4 (condom insertive anal-partner 4a), ATPC5AN4
(condom insertive anal-partner 5a).
Male-partner #1 male-anal sex more than once: If the respondent is male (SX_GEN=1)
AND partner is male (SXPGN1N4 [partner gender-partner 1]= 1 OR SXMLONN4 [male only partners] = 1)
AND the respondent had anal sex with partner #1 more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2
OR SA10_1N4 = 1), THEN go to Say box before ATPC1BN4 (condom insertive anal-partner 1b).
Male-partner #2, 3, 4, 5, male-anal sex more than once: If the respondent is male (SX_GEN=1)
AND partner is male (SXPGN2N4 [partner gender-partner 2] = 1, SXPGN3N4 [partner gender-partner 3] = 1,
SXPGN4N4 [partner gender-partner 4] = 1, SXPGN5N4 [partner gender-partner 5] = 1) OR SXMLONN4 [male
only partners] = 1), AND the respondent had anal sex with partners 2, 3, 4, or 5 more than one time
(SXAEN2N4 [times anal sex-partner 2] ≥ 2, SXAEN3N4 [times anal sex-partner 3] ≥ 2, SXAEN4N4 [times anal
sex-partner 4] ≥ 2, SXAEN5N4 [times anal sex-partner 5] ≥ 2, OR SA10_2N4 (anal 10-partner 2) =1,
SA10_3N4 (anal 10-partner 3) =1, SA10_4N4 (anal 10-partner 4) =1, SA10_5N4 (anal 10-partner 5) =1, THEN
107
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
go to ATPC2BN4 (condom insertive anal-partner 2b), ATPC3BN4 (condom insertive anal-partner 3b),
ATPC4BN4 (condom insertive anal-partner 4b), ATPC5BN4 (condom insertive anal-partner 5b).
SAY box before ATPC1AN4: SAY: “The next question is about condom use. Please include times when a
condom was used the entire time, not only part of the time during sex.”
SL.1.9.a. During the past 12
[ATPC1AN4] [ATPC2AN4] [ATPC3AN4] [ATPC4AN4] [ATPC5AN4]
months, when you had anal
sex with [INSERT PARTNER
NAME], was a condom used
when you were a top?
No
0
0
0
0
0
0
Yes
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
skip to
skip to
skip to
skip to
skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for ATPC1AN4 (condom insertive anal-partner 1a), ATPC2AN4 (condom insertive
anal-partner 2a), ATPC3AN4 (condom insertive anal-partner 3a), ATPC4AN4 (condom insertive analpartner 4a), ATPC5AN4 (condom receptive anal-partner 5a):
Variable label for ATPC1AN4 condom insertive anal-partner 1a.
Variable label for ATPC2AN4 condom insertive anal-partner 2a.
Variable label for ATPC3AN4 condom insertive anal-partner 3a.
Variable label for ATPC4AN4 condom insertive anal-partner 4a.
Variable label for ATPC5AN4 condom insertive anal-partner 5a.
108
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[Insert
[Insert
[Insert
[Insert
[Insert
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4
SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
SAY box before ATPC1BN4: SAY: “The next question is about condom use. Please include times when a
condom was used the entire time, not only part of the time during sex.”
SL.1.9.b. During the past 12
[ATPC1BN4] [ATPC2BN4] [ATPC3BN4] [ATPC4BN4] [ATPC5BN4]
months, when you had anal
sex with [INSERT PARTNER
NAME] where you were a top,
was a condom used… [READ
CHOICES. CHECK ONLY ONE.]
Never – not even once
1
1
1
1
1
1
One or more times
2
2
2
2
2
2
Absolutely every time
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
go to
go to
go to
go to
go to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for ATPC1BN4 (condom insertive anal-partner 1b), ATPC2BN4 (condom insertive
anal-partner 2b), ATPC3BN4 (condom insertive anal-partner 3b), ATPC4BN4 (condom insertive analpartner 4b), ATPC5BN4 (condom insertive anal-partner 5b):
Variable label for ATPC1BN4 condom insertive anal-partner 1b.
Variable label for ATPC2BN4 condom insertive anal-partner 2b.
Variable label for ATPC3BN4 condom insertive anal-partner 3b.
Variable label for ATPC4BN4 condom insertive anal-partner 4b.
109
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Question
Sexual Partners
Partner 1
Partner 2
[Insert
[Insert
partner
partner
name
name
SX_NM1N4
SX_NM2N4]
Variable label for ATPC5BN4 condom insertive anal-partner 5b.
Partner 3
[Insert
partner
name
SX_NM3N4]
Partner 4
[Insert
partner
name
SX_NM4N4]
Partner 5
[Insert
partner
name
SX_NM5N4]
110
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Transgender and unknown gender sex (SG)
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[INSERT
[INSERT
[INSERT
[INSERT
[INSERT
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Instructions for transgender sex partner-by-partner series table: The questions and response options are in
the far left column of the table. Each question is asked for partners 1–5. Partners 1-5 are labeled in columns
Partner 1, Partner 2, Partner 3, Partner 4, and Partner 5. All Partner 1 questions are asked before moving to
Partner 2 questions. Detailed instructions are provided in each table cell.
When question instructions say “insert partner name,” and the variable is in the Partner 1 column, then insert
response from SX_NM1N4 (name of partner 1).
When question instructions say “insert partner name,” and variable is in the Partner 2 column, insert
response to SX_NM2N4 (name of partner 2).
When question instructions say “insert partner name,” and variable is in the same column as Partner 3, insert
response to SX_NM3N4 (name of partner 3).
When question instructions say “insert partner name,” and variable is in the same column as Partner 4, insert
response to SX_NM4N4 (name of partner 4).
When question instructions say “insert partner name,” and variable is in the same column as Partner 5, insert
response to SX_NM5N4 (name of partner 5).
SG.1.0 During the past 12
[SX_TG1N4] [SX_TG2N4] [SX_TG3N4] [SX_TG4N4] [SX_TG5N4]
months, did you have vaginal or
anal sex with [INSERT PARTNER
NAME]?
No 0
0
0
0
0
0
Skip to
Skip to
Skip to
Skip to
Skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
Yes 1
1
1
1
1
1
Go to
TG10_1N4
(transgender
10-partner
1)
Go to
TG10_2N4
(transgender
10-partner
2)
Go to
TG10_3N4
(transgender
10-partner
3)
Go to
TG10_4N4
(transgender
10-partner
4)
Go to
TG10_5N4
(transgender
10-partner
5)
111
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
Partner 3
[INSERT
partner
name
SX_NM3N4]
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
Refused to answer
7
7
Skip to
STATS1N4
(aware
statuspartner 1).
7
Skip to
STATS2N4
(aware
statuspartner 2).
7
Skip to
STATS3N4
(aware
statuspartner 3).
7
Skip to
STATS4N4
(aware
statuspartner 4).
7
Skip to
STATS5N4
(aware
statuspartner 5).
Don’t know
8
8
Skip to
STATS1N4
(aware
statuspartner 1).
8
Skip to
STATS2N4
(aware
statuspartner 2).
8
Skip to
STATS3N4
(aware
statuspartner 3).
8
Skip to
STATS4N4
(aware
statuspartner 4).
8
Skip to
STATS5N4
(aware
statuspartner 5).
QDS programming note for SX_TGS1N4 (transgender partner 1), SX_TGS2N4 (transgender partner 2),
SX_TGS3N4 (transgender partner 3), SX_TGS4N4 (transgender partner 4), SX_TGS5N4 (transgender partner
5):
Variable label for SX_TG1N4 is transgender-partner 1.
Variable label for SX_TG2N4 is transgender-partner 2.
Variable label for SX_TG3N4 is transgender-partner 3.
Variable label for SX_TG4N4 is transgender-partner 4.
Variable label for SX_TG5N4 is transgender-partner 5.
If SX_TG1N4 (transgender-partner 1) is 0 (no), then display the following message: “Earlier you told me that
you had vaginal or anal sex with [INSERT partner name SX_NM1N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_TG2N4 (transgender-partner 2) is 0 (no), then display the following message: “Earlier you told me that
you had vaginal or anal sex with [INSERT partner name SX_NM2N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_TG3N4 (transgender-partner 3) is 0 (no), then display the following message: “Earlier you told me that
you had vaginal or anal sex with [INSERT partner name SX_NM3N4]. Is this correct? Interviewer instructions:
112
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
[INSERT
[INSERT
[INSERT
partner
partner
partner
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4]
return to previous questions to correct error.” Allow program to move forward.
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
If SX_TG4N4 (transgender-partner 4) is 0 (no), then display the following message: “Earlier you told me that
you had vaginal or anal sex with [INSERT partner name SX_NM4N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
If SX_TG5N4 (transgender-partner 5) is 0 (no), then display the following message: “Earlier you told me that
you had vaginal or anal sex with [INSERT partner name SX_NM5N4]. Is this correct? Interviewer instructions:
return to previous questions to correct error.” Allow program to move forward.
SG.1.1. During the past 12
[TG10_1N4] [TG10_2N4] [TG10_3N4] [TG10_4N4] [TG10_5N4]
months, did you have vaginal or
anal sex with [INSERT PARTNER
NAME] more than 10 times?
[READ CHOICES. CHECK ONLY
ONE.]
Yes 1
1
1
1
1
1
Skip to
Skip to
Skip to
Skip to
Skip to
TGAN1N4
TGAN2N4
TGAN3N4
TGAN4N4
TGAN5N4
(average
(average
(average
(average
(average
number
number
number
number
number
transgender transgender transgender transgender transgender
-partner 1).
-partner 2).
-partner 3).
-partner 4).
-partner 5).
No 0
Refused to answer
7
0
0
0
0
0
Go to
TGEN1N4
(times
transgender
-partner 1).
Go to
TGEN2N4
(times
transgender
-partner 2).
Go to
TGEN3N4
(times
transgender
-partner 3).
Go to
TGEN4N4
(times
transgender
-partner 4).
Go to
TGEN5N4
(times
transgender
-partner 5).
7
Skip to
STATS1N4
(aware
7
Skip to
STATS2N4
(aware
7
Skip to
STATS3N4
(aware
7
Skip to
STATS4N4
(aware
7
Skip to
STATS5N4
(aware
113
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Don’t know
8
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
statusstatuspartner 1).
partner 2).
Partner 3
[INSERT
partner
name
SX_NM3N4]
statuspartner 3).
Partner 4
[INSERT
partner
name
SX_NM4N4]
statuspartner 4).
Partner 5
[INSERT
partner
name
SX_NM5N4]
statuspartner 4).
8
Skip to
STATS1N4
(aware
statuspartner 1).
8
Skip to
STATS3N4
(aware
statuspartner 3).
8
Skip to
STATS4N4
(aware
statuspartner 4).
8
Skip to
STATS5N4
(aware
statuspartner 5).
8
Skip to
STATS2N4
(aware
statuspartner 2).
QDS programming note for TG10_1N4 (transgender 10-partner 1), TG10_2N4 (transgender 10-partner 2),
TG10_3N4 (transgender 10-partner 3), TG10_4N4 (transgender 10-partner 4), and TG10_5N4 (transgender
10-partner 5):
Variable label for TG10_1N4 is transgender 10-partner 1.
Variable label for TG10_2N4 is transgender 10-partner 2.
Variable label for TG10_3N4 is transgender 10-partner 3.
Variable label for TG10_4N4 is transgender 10-partner 4.
Variable label for TG10_5N4 is transgender 10-partner 5.
SG.1.2. During the past 12
[TGEN1N4]
[TGEN2N4]
[TGEN3N4]
[TGEN4N4]
[TGEN5N4]
months, please tell me the exact
number of times that you had
vaginal or anal sex with [INSERT
PARTNER NAME]?
Refused to answer 77
Skip to Say
box before
TGC1AN4
(condom
transgender
-partner 1a).
Skip to
instructions
before
TGC2AN4
(condom
transgender
-partner 2a).
Skip to
instructions
before
TGC3AN4
(condom
transgender
-partner 3a).
Skip to
instructions
before
TGC4AN4
(condom
transgender
-partner 4a).
Skip to
instructions
before
TGC5AN4
(condom
transgender
-partner 5a).
77
77
77
77
77
114
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Don’t know 88
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
Skip
Skip
STATS1N4
STATS2N4
(aware
(aware
statusstatuspartner 1).
partner 2).
Partner 3
[INSERT
partner
name
SX_NM3N4]
Skip
STATS3N4
(aware
statuspartner 3).
Partner 4
[INSERT
partner
name
SX_NM4N4]
Skip
STATS4N4
(aware
statuspartner 4).
Partner 5
[INSERT
partner
name
SX_NM5N4]
Skip
STATS5N4
(aware
statuspartner 5).
88
Skip
STATS1N4
(aware
statuspartner 1).
88
Skip
STATS3N4
(aware
statuspartner 3).
88
Skip
STATS4N4
(aware
statuspartner 4).
88
Skip
STATS5N4
(aware
statuspartner 5).
88
Skip
STATS2N4
(aware
statuspartner 2).
QDS programming note for TGEN1N4 (times transgender -partner 1), TGEN2N4 (times transgender -partner
2), TGEN3N4 (times transgender -partner 3), TGEN4N4 (times transgender -partner 4), TGEN5N4 (times
transgender -partner 5):
Range 1–10.
Variable label for TGEN1N4 is times transgender -partner 1.
Variable label for TGEN2N4 is times transgender -partner 2.
Variable label for TGEN3N4 is times transgender -partner 3.
Variable label for TGEN4N4 is times transgender -partner 4.
Variable label for TGEN5N4 is times transgender -partner 5.
SG.1.3. On average, how many
[TGAN1N4]
[TGAN2N4]
times did you have vaginal or anal
sex with [INSERT PARTNER
NAME] per month?
Go to
TGM1N4
(months
transgender
-partner 1).
Go to
TGM2N4
(months
transgender
-partner 2).
[TGAN3N4]
[TGAN4N4]
[TGAN5N4]
Go to
TGM3N4
(months
transgender
-partner 3).
Go to
TGM4N4
(months
transgender
-partner 4).
Go to
TGM5N4
(months
transgender
-partner 5).
115
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Refused to answer 777
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
Partner 3
[INSERT
partner
name
SX_NM3N4]
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
777
Go to
TGM1N4
(months
transgender
-partner 1).
777
Go to
TGM3N4
(months
transgender
-partner 3).
777
Go to
TGM4N4
(months
transgender
-partner 4).
777
Go to
TGM5N4
(months
transgender
-partner 5).
777
Go to
TGM2N4
(months
transgender
-partner 2).
888
888
888
888
888
Go to
Go to
Go to
Go to
Go to
TGM1N4
TGM2N4
TGM3N4
TGM4N4
TGM5N4
(months
(months
(months
(months
(months
transgender transgender transgender transgender transgender
partner 1).
-partner 2).
-partner 3).
-partner 4).
-partner 5).
QDS programming note for TGAN1N4 (average number transgender-partner 1), TGAN2N4 (average number
transgender-partner 2), TGAN3N4 (average number transgender-partner 3), TGAN4N4 (average number
transgender-partner4), TGAN5N4 (average number transgender-partner 5):
Range 1–90.
Don’t know 888
If the response to TGAN1N4 (average number transgender -partner 1) is > 90, then display the following
message: “Number too big. Interviewer instructions: confirm response.”
If TGAN2N4 (average number transgender -partner 2) is > 90, then display the following message: “Number
too big. Interviewer instructions: confirm response.”
If TGAN3N4 (average number transgender -partner 3) is > 90, then display the following message: “Number
too big Interviewer instructions: confirm response.”
If TGAN4N4 (average number transgender -partner 4) is > 90, then display the following message: “Number
too big. Interviewer instructions: confirm response.”
If TGAN5N4 (average number transgender -partner 5) is > 90, then display the following message: “Number
too big. Interviewer instructions: confirm response.”
Variable label for TGAN1N4 is average number transgender -partner 1.
Variable label for TGAN2N4 is average number transgender -partner 2.
Variable label for TGAN3N4 is average number transgender -partner 3.
Variable label for TGAN4N4 is average number transgender -partner 4.
116
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
[INSERT
[INSERT
[INSERT
partner
partner
partner
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4]
Variable label for TGAN5N4 is average number transgender -partner 5.
SG.1.4. During the past 12
[TGM1N4]
[TGM2N4]
[TGM3N4]
months, how many months did
you have vaginal or anal sex with
[INSERT PARTNER NAME]?
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
[TGM4N4]
[TGM5N4]
months
Refused to answer 77
Don’t know
88
77
77
77
77
77
88
88
88
88
88
For all
responses,
go to
instructions
before
TGC1AN4
(condom
transgender
-partner 1a).
For all
responses,
skip to
instructions
before
TGC2AN4
(condom
transgender
-partner 2a).
For all
responses,
skip to
instructions
before
TGC3AN4
(condom
transgender
-partner 3a).
For all
responses,
skip to
instructions
before
TGC4AN4
(condom
transgender
-partner 4a).
For all
responses,
skip to
instructions
before
TGC5AN4
(condom
transgender
-partner 5a).
QDS programming note for TGM1N4 (months transgender-partner 1), TGM2N4 (months transgenderpartner 2), TGM3N4 (months transgender-partner 3), TGM4N4 (months transgender-partner 4), TGM5N4
(months transgender-partner 5):
Range 1–12.
If TGM1N4 (months transgender-partner 1) is “0,” then display the following message: “You told me that you
had vaginal or anal sex with this partner during the past 12 months. Interviewer instructions: confirm
If the response to TGM1N4 (months transgender-partner 1) is >12, then display the following message:
“Number too big. Interviewer instructions: confirm response.”
If TGM2N4 (months transgender-partner 2) is >12, then display the following message: “Number too big.
117
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[INSERT
[INSERT
[INSERT
[INSERT
[INSERT
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Interviewer instructions: confirm response.”
If TGM3N4 (months transgender-partner 3) is >12, then display the following message: “Number too big.
Interviewer instructions: confirm response.”
If TGM4N4 (months transgender-partner 4) is >12, then display the following message: “Number too big.
Interviewer instructions: confirm response.”
If TGM5N4 (months transgender-partner 5) is >12, then display the following message: “Number too big.
Interviewer instructions: confirm response.”
Variable label for TGM1N4 is months transgender-partner 1.
Variable label for TGM2N4 is months transgender -partner 2.
Variable label for TGM3N4 is months transgender -partner 3.
Variable label for TGM4N4 is months transgender -partner 4.
Variable label for TGM5N4 is months transgender -partner 5.
Interviewer instructions before TGC1AN4 (condom transgender-partner 1a), TGC2AN4 (condom
transgender-partner 2a), TGC3AN4 (condom transgender-partner 3a), TGC4AN4 (condom transgenderpartner 4a), TGC5AN4 (condom transgender-partner 5a):
Transgender/Unknown gender sex-any partner #1 vaginal-anal sex once: If the respondent had vaginal or
anal sex with partner #1 only one time (TGEN1N4 [times transgender-partner 1] = 1), THEN go to Say box
before TGC1AN4 (condom transgender-partner 1a).
Transgender/Unknown gender sex-any partner #2, 3, 4, 5 vaginal-anal sex once :If the respondent had
vaginal or anal sex with partners #2, 3, 4, or 5 only one time (TGEN2N4 [times transgender-partner 2]) = 1,
(TGEN3N4 [times transgender-partner 3]) = 1, (TGEN4N4 [times transgender-partner 4]) = 1, (TGEN5N4 [times
transgender-partner 5]) = 1, THEN go to TGC2AN4 (condom transgender-partner 2a), TGC3AN4 (condom
transgender-partner 3a), TGC4AN4 (condom transgender-partner 4a), TGC5AN4 (condom transgender-partner
5a).
Otherwise, go to Interviewer instructions before TGC1BN4 (condom transgender-partner 1b), TGC2BN4
(condom transgender-partner 2b), TGC3BN4 (condom transgender-partner 3b), TGC4BN4 (condom
transgender-partner 4b), TGC5BN4 (condom transgender-partner 5b).
SAY box before TGC1AN4 (condom transgender-partner 1a): SAY: “The next question is about condom use.
Please include times when a condom was used the entire time, not only part of the time during sex.”
SG.1.5.a. During the past 12
[TGC1AN4]
[TGC2AN4]
[TGC3AN4]
[TGC4AN4]
[TGC5AN4]
118
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
months, when you had vaginal or
anal sex with [INSERT PARTNER
NAME] was a condom used?
No
0
Partner 3
[INSERT
partner
name
SX_NM3N4]
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
0
0
0
0
0
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
Yes
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
skip to
skip to
skip to
skip to
skip to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for TGC1AN4 (condom transgender-partner 1a), TGC2AN4 (condom transgenderpartner 2a), TGC3AN4 (condom transgender-partner 3a), TGC4AN4 (condom transgender-partner 4a),
TGC5AN4 (condom transgender-partner 5a):
Variable label for TGC1AN4 is condom transgender-partner 1a.
Variable label for TGC2AN4 is condom transgender-partner 2a.
Variable label for TGC3AN4 is condom transgender-partner 3a.
Variable label for TGC4AN4 is condom transgender-partner 4a.
Variable label for TGC5AN4 is condom transgender-partner 5a.
119
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[INSERT
[INSERT
[INSERT
[INSERT
[INSERT
partner
partner
partner
partner
partner
name
name
name
name
name
SX_NM1N4] SX_NM2N4] SX_NM3N4] SX_NM4N4] SX_NM5N4]
Interviewer instructions before TGC1BN4 (condom transgender-partner 1b), TGC2BN4 (condom
transgender-partner 2b), TGC3BN4 (condom transgender-partner 3b), TGC4BN4 (condom transgenderpartner 4b), TGC5BN4 (condom transgender-partner 5b):
Transgender/Unknown gender sex-any partner #1 vaginal-anal sex more than once: If the respondent had
vaginal or anal sex with partner #1 more than once (TGEN1N4 [times transgender-partner 1]) ≥ 2, OR
TG10_1N4 (transgender 10-partner 1) =1 THEN go to Say box before TGC1BN4 (condom transgender-partner
1b).
Transgender/Unknown gender sex-any partner #2, 3, 4, 5, vaginal-anal sex more than once: If the
respondent had vaginal or anal sex with partners #2, 3, 4, or 5 more than one time (TGEN2N4 [times
transgender sex-partner 2]) ≥ 2, (TGEN3N4 [times transgender sex-partner 3]) ≥ 2, (TGEN4N4 [times
transgender sex-partner 4]) ≥ 2, (TGEN5N4 [times transgender sex-partner 5]) ≥ 2, OR TG10_2N4 (transgender
10-partner 2) =1, TG10_3N4 (transgender 10-partner 3) =1, TG10_4N4 (transgender 10-partner 4) =1,
TG10_5N4 (transgender 10-partner 5) =1, THEN go to TGC2BN4 (condom transgender-partner 2b), TGC3BN4
(condom transgender-partner 3b), TGC4BN4 (condom transgender-partner 4b), TGC5BN4 (condom
transgender-partner 5b).
SAY box before TGC1BN4 (condom transgender-partner 1b): SAY: “The next question is about condom use.
Please include times when a condom was used the entire time, not only part of the time during sex.”
SG.1.5.b. During the past 12
[TGC1BN4]
[TGC2BN4]
[TGC3BN4]
[TGC4BN4]
[TGC5BN4]
months, when you had vaginal or
anal sex with [INSERT PARTNER
NAME] was a condom used...?
[READ CHOICES. CHECK ONLY
ONE.]
1
1
1
1
1
Never- not even once
1
One or more times
2
2
2
2
2
2
Absolutely every time
3
3
3
3
3
3
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
120
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual Partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
Partner 3
[INSERT
partner
name
SX_NM3N4]
Partner 4
[INSERT
partner
name
SX_NM4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
For all
For all
For all
For all
For all
responses,
responses,
responses,
responses,
responses,
go to
go to
go to
go to
go to
STATS1N4
STATS2N4
STATS3N4
STATS4N4
STATS5N4
(aware
(aware
(aware
(aware
(aware
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for TGC1BN4 (condom transgender 1b), TGC2BN4 (condom transgender 2b),
TGC3BN4 (condom transgender 3b), TGC4BN4 (condom transgender 4b), TGC5BN4 (condom transgender
5b):
Variable label for TGC1BN4 is condom transgender-partner 1b.
Variable label for TGC2BN4 is condom transgender-partner 2b.
Variable label for TGC3BN4 is condom transgender-partner 3b.
Variable label for TGC4BN4 is condom transgender-partner 4b.
Variable label for TGC5BN4 is condom transgender-partner 5b.
121
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Status (SS)
Questions
Sexual partners
Partner 1
Partner 2
Partner 3
Partner 4
Partner 5
[INSERT
[INSERT
[INSERT
[INSERT
[INSERT
partner name partner name partner name partner name partner name
SX_NM1N4]
SX_NM2N4]
SX_NM3N4]
SX_NM4N4]
SX_NM5N4]
Instructions for status partner-by-partner series table: The questions and response options are in the far left
column of the table. Each question is asked for partners 1–5. Partners 1-5 are labeled in columns Partner 1,
Partner 2, Partner 3, Partner 4, and Partner 5. All Partner 1 questions are asked before moving to Partner 2
questions. Detailed instructions are provided in each table cell.
When question instructions say “insert partner name,” and the variable is in the Partner 1 column, then insert
response from SX_NM1N4 (name of partner 1).
When question instructions say “insert partner name,” and variable is in the Partner 2 column, insert
response to SX_NM2N4 (name of partner 2).
When question instructions say “insert partner name,” and variable is in the same column as Partner 3, insert
response to SX_NM3N4 (name of partner 3).
When question instructions say “insert partner name,” and variable is in the same column as Partner 4, insert
response to SX_NM4N4 (name of partner 4).
When question instructions say “insert partner name,” and variable is in the same column as Partner 5, insert
response to SX_NM5N4 (name of partner 5).
SS.1.0. Does [INSERT
[STATS1N4]
[STATS2N4]
[STATS3N4]
[STATS4N4]
[STATS5N4]
PARTNER NAME] know
your HIV status?
No 0
0
0
0
0
0
Skip to
Skip to
Skip to
Skip to
Skip to
STPRT1N4
STPRT2N4
STPRT3N4
STPRT4N4
STPRT5N4
(partner
(partner
(partner
(partner
(partner
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
Yes 1
Refused to answer
7
1
Go to
AWRST1N4
(aware status
every sexpartner 1).
1
Go to
AWRST2N4
(aware status
every sexpartner 2).
1
Go to
AWRST3N4
(aware status
every sexpartner 3).
1
Go to
AWRST4N4
(aware status
every sexpartner 4).
1
Go to
AWRST5N4
(aware status
every sexpartner 5).
7
7
7
7
7
122
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual partners
Skip to
Skip to
STPRT1N4
STPRT2N4
(partner
(partner
statusstatuspartner 1).
partner 2).
Don’t know
Skip to
STPRT3N4
(partner
statuspartner 3).
Skip to
STPRT4N4
(partner
statuspartner 4).
Skip to
STPRT5N4
(partner
statuspartner 5).
8
8
8
8
8
Skip to
Skip to
Skip to
Skip to
Skip to
STPRT1N4
STPRT2N4
STPRT3N4
STPRT4N4
STPRT5N4
(partner
(partner
(partner
(partner
(partner
statusstatusstatusstatusstatuspartner 1).
partner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for STATS1N4 (aware status-partner 1), STATS2N4 (aware status-partner 2),
STATS3N4 (aware status-partner 3), STATS4N4 (aware status-partner 4), STATS5N4 (aware status-partner
5):
Variable label for STATS1N4 is aware status-partner 1.
Variable label for STATS2N4 is aware status-partner 2.
Variable label for STATS3N4 is aware status-partner 3.
Variable label for STATS4N4 is aware status-partner 4.
Variable label for STATS5N4 is aware status-partner 5.
SS.1.1. During the past 12
[AWRST1N4] [AWRST2N4] [AWRST3N4] [AWRST4N4] [AWRST5N4]
months, was [INSERT
PARTNER NAME] aware of
your status every time you
had sex?
No
0
0
0
0
0
0
Yes
8
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
For all
responses, go
to STPRT1N4
(Partner
statuspartner 1).
For all
responses, go
to STPRT2N4
(Partner
statuspartner 2).
For all
responses, go
to STPRT3N4
(Partner
statuspartner 3).
For all
responses, go
to STPRT4N4
(Partner
statuspartner 4).
For all
responses, go
to STPRT5N4
(Partner
statuspartner 5).
123
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual partners
QDS programming note for AWRST1N4 (aware status every sex-partner 1), AWRST2N4 (aware status every
sex-partner 2), AWRST3N4 (aware status every sex-partner 3), AWRST4N4 (aware status every sex -partner
4), AWRST5N4 (aware status every sex -partner 5):
Variable label for AWRST1N4 is Aware status every sex -partner 1.
Variable label for AWRST2N4 is Aware status every sex -partner 2.
Variable label for AWRST3N4 is Aware status every sex -partner 3.
Variable label for AWRST4N4 is Aware status every sex -partner 4.
Variable label for AWRST5N4 is Aware status every sex -partner 5.
SS.2.0. Do you know
[STPRT1N4]
[STPRT2N4]
[STPRT3N4]
[STPRT4N4]
[STPRT5N4]
[INSERT PARTNER NAME]’s
HIV status?
No 0
0
0
0
0
0
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
= 1, skip to
= 2, skip to
= 3, skip to
= 4, skip to
= 5, skip to
serosorting
serosorting
serosorting
serosorting
serosorting
section (Say
section (Say
section (Say
section (Say
section (Say
box before
box before
box before
box before
box before
SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
2, skip to
3, skip to
4, skip to
5, skip to
6, skip to
interviewer
interviewer
interviewer
interviewer
aggregate
instructions
instructions
instructions
instructions
information
before
before
before
before
section.
SXPGN2N4
SXPGN3N4
SXPGN4N4
SXPGN5N4
(partner
(partner
(partner
(partner
gendergendergendergenderpartner 2).
partner 3).
partner 4).
partner 5).
Yes 1
Refused to answer
7
1
1
1
1
1
Go to
PRTST1N4
(Partner
status first
sex-partner
1).
Go to
PRTST2N4
(Partner
status first
sex-partner
2).
Go to
PRTST3N4
(Partner
status first
sex-partner
3).
Go to
PRTST4N4
(Partner
status first
sex-partner
4).
Go to
PRTST5N4
(Partner
status first
sex-partner
5).
7
If SX_TOTN4
= 1, skip to
7
If SX_TOTN4
= 2, skip to
7
If SX_TOTN4
= 3, skip to
7
If SX_TOTN4
= 4, skip to
7
If SX_TOTN4
= 5, skip to
124
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual partners
serosorting
serosorting
section (Say
section (Say
box before
box before
SEROSRT1). If SEROSRT1). If
SX_TOTN4 ≥
SX_TOTN4 ≥
2, skip to
3, skip to
interviewer
interviewer
instructions
instructions
before
before
SXPGN2N4
SXPGN3N4
(partner
(partner
gendergenderpartner 2).
partner 3).
Don’t know
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
4, skip to
interviewer
instructions
before
SXPGN4N4
(partner
genderpartner 4).
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
5, skip to
interviewer
instructions
before
SXPGN5N4
(partner
genderpartner 5).
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
6, skip to
aggregate
information
section.
8
8
8
8
8
8
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
= 1, skip to
= 2, skip to
= 3, skip to
= 4, skip to
= 5, skip to
serosorting
serosorting
serosorting
serosorting
serosorting
section (Say
section (Say
section (Say
section (Say
section (Say
box before
box before
box before
box before
box before
SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
2, skip to
3, skip to
4, skip to
5, skip to
6, skip to
interviewer
interviewer
interviewer
interviewer
aggregate
instructions
instructions
instructions
instructions
information
before
before
before
before
section.
SXPGN2N4
SXPGN3N4
SXPGN4N4
SXPGN5N4
(partner
(partner
(partner
(partner
gendergendergendergenderpartner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for STPRT1N4 (Partner status-partner 1), STPRT2N4 (Partner status-partner 2),
STPRT3N4 (Partner status-partner 3), STPRT4N4 (Partner status-partner 4), STPRT5N4 (Partner statuspartner 5):
Variable label for STPRT1N4 is Partner status-partner 1.
Variable label for STPRT2N4 is Partner status-partner 2.
Variable label for STPRT3N4 is Partner status-partner 3.
Variable label for STPRT4N4 is Partner status-partner 4.
Variable label for STPRT5N4 is Partner status-partner 5.
SS.2.1. During the past 12
[PRTST1N4]
[PRTST2N4]
[PRTST3N4]
[PRTST4N4]
[PRTST5N4]
125
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
months, what was [INSERT
PARTNERS’ NAME]’s HIV
status the first time that
you had sex? [DON’T READ
RESPONSES. CHECK ONLY
ONE.]
Sexual partners
HIV Positive
1
1
If SX_TOTN4
= 1, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
2, skip to
interviewer
instructions
before
SXPGN2N4
(partner
genderpartner 2).
1
If SX_TOTN4
= 2, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
3, skip to
interviewer
instructions
before
SXPGN3N4
(partner
genderpartner 3).
1
If SX_TOTN4
= 3, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
4, skip to
interviewer
instructions
before
SXPGN4N4
(partner
genderpartner 4).
1
If SX_TOTN4
= 4, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
5, skip to
interviewer
instructions
before
SXPGN5N4
(partner
genderpartner 5).
1
If SX_TOTN4
= 5, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
6, skip to
aggregate
information
section.
HIV Negative
2
2
2
2
2
2
Go to
PREP1N4
(PrEP-partner
1).
Go to
PREP2N4
(PrEP-partner
2).
Go to
PREP3N4
(PrEP-partner
3).
Go to
PREP4N4
(PrEP-partner
4).
Go to
PREP5N4
(PrEP-partner
5).
7
If SX_TOTN4
= 1, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
2, skip to
7
If SX_TOTN4
= 2, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
3, skip to
7
If SX_TOTN4
= 3, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
4, skip to
7
If SX_TOTN4
= 4, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
5, skip to
7
If SX_TOTN4
= 5, skip to
serosorting
section (Say
box before
SEROSRT1). If
SX_TOTN4 ≥
6, skip to
Refused to answer
7
126
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual partners
interviewer
interviewer
instructions
instructions
before
before
SXPGN2N4
SXPGN3N4
(partner
(partner
gendergenderpartner 2).
partner 3).
Don’t know
interviewer
instructions
before
SXPGN4N4
(partner
genderpartner 4).
interviewer
instructions
before
SXPGN5N4
(partner
genderpartner 5).
aggregate
information
section.
8
8
8
8
8
8
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
If SX_TOTN4
= 1, skip to
= 2, skip to
= 3, skip to
= 4, skip to
= 5, skip to
serosorting
serosorting
serosorting
serosorting
serosorting
section (Say
section (Say
section (Say
section (Say
section (Say
box before
box before
box before
box before
box before
SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If SEROSRT1). If
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
SX_TOTN4 ≥
2, skip to
3, skip to
4, skip to
5, skip to
6, skip to
interviewer
interviewer
interviewer
interviewer
aggregate
instructions
instructions
instructions
instructions
information
before
before
before
before
section.
SXPGN2N4
SXPGN3N4
SXPGN4N4
SXPGN5N4
(partner
(partner
(partner
(partner
gendergendergendergenderpartner 2).
partner 3).
partner 4).
partner 5).
QDS programming note for PRTST1N4 (Partner status first sex-partner 1), PRTST2N4 (Partner status first
sex-partner 2), PRTST3N4 (Partner status first sex-partner 3), PRTST4N4 (Partner status first sex-partner 4),
PRTST5N4 (Partner status first sex-partner 5):
Variable label for PRTST1N4 is Partner status first sex-partner 1.
Variable label for PRTST2N4 is Partner status first sex-partner 2.
Variable label for PRTST3N4 is Partner status first sex-partner 3.
Variable label for PRTST4N4 is Partner status first sex-partner 4.
Variable label for PRTST5N4 is Partner status first sex-partner 5.
127
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Pre-exposure prophylaxis (SR)
Questions
SR.1.0. Sometimes people who are
HIV negative take antiretroviral
medicine, such as Truvada, to
prevent them from getting HIV. Was
[INSERT PARTNER NAME] taking
antiretroviral medicine to prevent
them from getting HIV when you
last had sex? If you aren’t sure,
that’s okay.
No
0
Sexual partners
Partner 1
Partner 2
[INSERT
[INSERT
partner
partner
name
name
SX_NM1N4] SX_NM2N4]
[PREP1N4]
[PREP2N4]
Partner 3
[INSERT
partner
name
SX_NM3N4]
[PREP3N4]
Partner 4
[INSERT
partner
name
SX_NM4N4]
[PREP4N4]
Partner 5
[INSERT
partner
name
SX_NM5N4]
[PREP5N4]
0
0
0
0
0
Yes
1
1
1
1
1
1
Refused to answer
7
7
7
7
7
7
Don’t know
8
8
8
8
8
8
If SX_TOTN4
= 1, skip to
serosorting
section (Say
box before
SEROSRT1).
If SX_TOTN4
≥ 2, skip to
interviewer
instructions
before
SXPGN2N4
(partner
genderpartner 2).
If SX_TOTN4
= 2, skip to
serosorting
section (Say
box before
SEROSRT1).
If SX_TOTN4
≥ 3, skip to
interviewer
instructions
before
SXPGN3N4
(partner
genderpartner 3).
If SX_TOTN4
= 3, skip to
serosorting
section (Say
box before
SEROSRT1).
If SX_TOTN4
≥ 4, skip to
interviewer
instructions
before
SXPGN4N4
(partner
genderpartner 4).
If SX_TOTN4
= 4, skip to
serosorting
section (Say
box before
SEROSRT1).
If SX_TOTN4
≥ 5, skip to
interviewer
instructions
before
SXPGN5N4
(partner
genderpartner 5).
If SX_TOTN4
= 5, skip to
serosorting
section (Say
box before
SEROSRT1).
If SX_TOTN4
≥ 6, skip to
aggregate
information
section.
128
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Questions
Sexual partners
QDS programming note for PREP1N4 (PrEP-partner 1), PREP2N4 (PrEP-partner 2), PREP3N4 (PrEP-partner 3),
PREP4N4 (PrEP-partner 4), PREP5N4 (PrEP-partner 5):
Variable label for PREP1N4 is PrEP-partner 1.
Variable label for PREP2N4 is PrEP-partner 2.
Variable label for PREP3N4 is PrEP-partner 3.
Variable label for PREP4N4 is PrEP-partner 4.
Variable label for PREP5N4 is PrEP-partner 5.
129
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark red
variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Aggregate information (SA)
SAY: “We just talked about the five people you most recently had sex with. Now I’d like to ask
you about the other partner(s) with whom you had sex with during the past 12 months. For
these next questions, please don’t include partners you have already discussed.”
Interviewer instructions before SXAGC1N4 (aggregate condom use 6 partners):
If respondent reported 7 or more sex partners (SX_TOTN4 ≥ 7), then skip to SXAGC2N4
(aggregate condom use-more than 6 partners). If respondent reported 6 partners
(SX_TOTN4=6), go to SXAGC1N4 (aggregate condom use- 6 partners).
SA.1.0. During the past 12 months, was a condom always used when you had vaginal or anal
sex with your other partner? [SXAGC1N4]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know..................................................................................... ☐ 8
QDS programming note for SXAGC1N4 (aggregate condom use 6 partners):
Variable label is aggregate condom use-6 partners.
SA.1.1. Was your other partner HIV positive? [SXAGP1N4]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know..................................................................................... ☐ 8
QDS programming note for SXAGP1N4 (aggregate partner status-6 partners):
Variable label is aggregate partner status-6 partners.
Interviewer instructions after SXAGP1N4 (aggregate partner status-6 partners):
Skip to the serosorting section (Say box before SEROSRT1).
SA.1.2 During the past 12 months, with how many of these [INSERT SX_TOTN4-5] other
partners was a condom always used when you had vaginal or anal sex? [SXAGC2N4]
[7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for SXAGC2N4 (aggregate condom use-more than 6 partners):
Range is 0–999.
MMP Standard Questionnaire Sexual Behavior
130
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Variable label is aggregate condom use-more than 6 partners.
If SXAGC2N4 (aggregate condom use-more than 6 partners) is greater than SX_TOTN4-5 then
display the following: “The number of additional partners with whom you used a condom
cannot be greater than [insert value from SX_TOTN4-5]. Confirm Answer.” Go back to
SXAGC2N4 (aggregate condom use-more than 6 partners).
Calculated variable SXAGUPN4: Create a calculated variable to indicate the aggregate number
of partners with whom the respondent had unprotected sex. If SX_TOTN4 is > 5, then create
SXAGUPN4 where (SX_TOTN4-5)-SXAGC2N4. (If SXAGC2N4 is don’t know or refuse, assign it a
7777 if refused or 8888 if don’t know.)
Variable label is aggregate number of unprotected sex partners.
Interviewer instructions for SXAGC2N4 (aggregate condom use more than 6 partners): If
SXAGC2N4 (aggregate condom use more than 6 partners) = SX_TOTN4-5 (total number of
partners-5), “don’t know,” or “refused to answer,” then skip to the serosorting section (Say box
before SEROSRT1). Otherwise, go to SXAGC3N4 (aggregate condom use-more than 6 partners).
SA.1.3 So, you had unprotected sex with [INSERT RESPONSE FROM SXAGUPN4] of these other
partners? [SXAGC3N4]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
QDS programming note for SXAGC3N4 (aggregate unprotected sex-more than 6 partners):
Variable label is aggregate unprotected sex-more than 6 partners.
If SXAGC3N4 (aggregate unprotected sex-more than 6 partners) is “no,” “refused to answer” or
“don’t know,” then return to SXAGC2N4 (aggregate condom use-more than 6 partners).
SA.1.4 How many of those [INSERT RESPONSE FROM SXAGUPN4] other partners were HIV
positive? [SXAGP2N4]
[7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for SXAGP2N4 (aggregate concordant partners-more than 6
partners):
Range is 0–999.
SXAGP2N4 cannot be greater than SXAGUPN4. If SXAGP2N4 > SXAGUPN4, then display the
following message, “The response is out of range” and return to SXAGP2N4 (aggregate
MMP Standard Questionnaire Sexual Behavior
131
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
concordant partners-more than 6 partners).
Variable label for SXAGP2N4 is aggregate concordant partners-more than 6 partners.
MMP Standard Questionnaire Sexual Behavior
132
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Serosorting
SAY: “For these next questions, I will read you a statement and then I’ll ask you to tell me if
you strongly disagree, somewhat disagree, are neutral, somewhat agree, or strongly agree.
Some of the statements may not apply to your situation; however, tell me whether you think
you would disagree or agree. We will use Response Card L for these four questions.”
S26.
If my partner tells me he or she is HIV positive, I am more likely to have unprotected
sex with him or her. [CHECK ONLY ONE.] [SEROSRT1]
Strongly disagree ...................................................................☐ 1
Somewhat disagree................................................................☐
2
Neutral ...................................................................................☐ 3
Somewhat agree ....................................................................☐ 4
Strongly agree ........................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
S27.
If my partner tells me he or she is HIV positive, we don’t have to worry about using
condoms. [CHECK ONLY ONE.] [SEROSRT2]
Strongly disagree ...................................................................☐ 1
Somewhat disagree................................................................☐
2
Neutral ...................................................................................☐ 3
Somewhat agree ....................................................................☐ 4
Strongly agree ........................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
S28.
If I have an undetectable HIV viral load, I am more likely to have unprotected sex.
[CHECK ONLY ONE.] [SEROSRT3]
Strongly disagree ...................................................................☐ 1
Somewhat disagree................................................................☐
2
Neutral ...................................................................................☐ 3
Somewhat agree ....................................................................☐ 4
Strongly agree ........................................................................☐ 5
MMP Standard Questionnaire Sexual Behavior
133
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
S29.
Having an undetectable HIV viral load means I can worry less about having to use
condoms. [CHECK ONLY ONE.] [SEROSRT4]
Strongly disagree ...................................................................☐ 1
Somewhat disagree................................................................☐
2
Neutral ...................................................................................☐ 3
Somewhat agree ....................................................................☐ 4
Strongly agree ........................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Sexual Behavior
134
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Drug and Alcohol Use (U)
Cigarette and Alcohol Use
SAY: “The next questions are about smoking cigarettes.”
U1.
Have you smoked at least 100 cigarettes in your entire life? [CIG_EVR]
Skip to Say box
No .................................................................................................. ☐ 0
before U2
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Skip to Say box
Don’t know ................................................................................... ☐ 8
before U2
SAY: “Now we will use Response Card M.”
U1a.
How often do you smoke cigarettes now? [READ CHOICES. CHECK ONLY ONE.] [CIG_OFT]
Daily............................................................................................... ☐ 1
Weekly .......................................................................................... ☐ 2
Monthly ........................................................................................ ☐ 3
Less than monthly ....................................................................... ☐ 4
Never ............................................................................................. ☐ 5
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
SAY: “Now I’m going to ask you about any alcohol that you may have had. We will use
Response Card M.”
U2.
During the past 12 months, how often did you drink alcohol? [READ CHOICES. CHECK ONLY
ONE.] [ALCOHO_9]
Daily............................................................................................... ☐ 1
Weekly .......................................................................................... ☐ 2
Monthly ........................................................................................ ☐ 3
Less than monthly ....................................................................... ☐ 4
Never ............................................................................................. ☐ 5
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Drug and alcohol use
Skip to Say box
before U8
135
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions: If SX_TOTN4 (total number of sex partners) ≥1 OR if SXFFONN4
(female-female partners only) =1, go to U3. Else, skip to Say box before U4.
U3.
During the past 12 months, did you drink alcohol before or during sex? [ALCOHOL1]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “Now I am going to ask you some questions about alcohol use in the past 30 days. We will
use the calendar to refer to the past 30 days.”
U4.
During the past 30 days, on how many days did you have an alcoholic drink? [DRINK_9]
[Refused to answer = 77, Don’t know = 88]
Inconsistency check: U4 (number of days had an alcoholic drink during the past 30 days) must
be between 0 and 30.
Interviewer instructions: If U4 (number of days consumed alcohol during the past 30 days) is
“0,” “Refused to answer,” or “Don’t know,” skip to Say box before U8.
SAY: “We will use the Alcohol Response Card for these next questions. For these questions a
drink of alcohol is a 12 oz beer, a 5 oz glass of wine, or a 1.5 oz shot of liquor .”
U5.
During the past 30 days, how many alcoholic drinks did you have on a typical day when you
were drinking? [NDRINK_9]
[Refused to answer = 77, Don’t know = 88]
Inconsistency check: U5 (number of drinks on a typical day during the past 30 days) must be
between 1 and 30.
Interviewer instructions: If [BIRTGEN] is “Female” or “Intersex/ambiguous,” skip to U7.
U6.
During the past 30 days, on how many days did you have 5 or more alcoholic drinks in one
sitting? [DRINK5_9]
[Refused to answer = 77, Don’t know = 88]
MMP Standard Questionnaire Drug and alcohol use
136
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note: If U6 > U4 then READ: “The number of days in the past 30 days that
you had 5 or more drinks ([response from DRINK5_9]) cannot be greater than the number of
days you had a drink in the last 30 days ([response from DRINK_9])."
Inconsistency check: U6 (number of days had 5 or more drinks during the past 30 days) must
be ≤ 30 and ≤ U4 (number of days had a drink during the past 30 days).
Interviewer instructions: Skip to Say box before U8.
U7.
During the past 30 days, on how many days did you have 4 or more alcoholic drinks in one
sitting? [DRINK4_9]
[Refused to answer = 77, Don’t know = 88]
Inconsistency check: U7 (number of days had 4 or more drinks during the past 30 days) must
be ≤ 30 and ≤ U4 (number of days had a drink during the past 30 days).
QDS programming note: If U7 > U4 then READ: "The number of days in the past 30 days that
you had 4 or more drinks ([response from DRINK4_9]) cannot be greater than the number of
days you had a drink in the last 30 days ([response from DRINK_9]).
Non-Injection Drug Use
SAY: “Now I’m going to ask you about drugs that you may have used, but d id n ’t in je ct . I
will refer to these as non-injection drugs. This includes drugs like marijuana, crack, club drugs,
and painkillers. Tell me about the drugs you used that were not for medical purposes.”
U8.
During the past 12 months, did you use any non-injection drugs? [ANID12_9]
No .................................................................................................. ☐ 0
Skip to Say box
Yes ................................................................................................. ☐ 1
before U12
Refused to answer....................................................................... ☐ 7
Skip to Say box
Don’t know ................................................................................... ☐ 8
before U12
SAY: “I'm going to read you a list of non-injection drugs. For each one I mention, please tell me
how often you used it during the past 12 months. Don’t include drugs you injected or drugs
that were used for medical purposes. For these questions we will use Response Card M.”
MMP Standard Questionnaire Drug and alcohol use
137
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions: If the respondent’s drug use was sporadic during the past 12 months,
ask the respondent to choose the response option that best characterizes his or her use.
Daily
During the past 12
months, how often did (1)
you use:
U9a.
…methamphetamines,
also called crystal meth,
tina, crank, or ice?
Weekly
Monthly
(2)
(3)
Less than
monthly
Never (5)
(4)
Refused
Don’t
to
Know (8)
answer (7)
☐1
☐2
☐3
☐4
☐5
☐7
☐8
stimulants?
☐1
☐2
☐3
☐4
☐5
☐7
☐8
[AMPHET_9]
…crack? [CRACK1_9]
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
[CRYMTC_9]
U9b. …other amphetamines or
U9c.
U9d. …cocaine that is smoked
U9e.
U9f.
U9g.
or snorted? [COCSMO_9]
…downers, such as
Valium, Ativan, or
Xanax? [DOWNER_9]
…painkillers, such as
Oxycontin, Vicodin, or
Percocet? [PAINKI_9]
…hallucinogens, such as
LSD or mushrooms?
[HALLUC_9]
U9h. …X, also called Ecstasy?
[XECT_9]
U9i.
U9j.
U9k.
…Special K, also called
ketamine? [SPECK_9]
…GHB? [GHB_9]
…heroin or opium that is
smoked or snorted?
[HEROIN_9]
U9l.
…marijuana?
[MARIJU_9]
U9m. …poppers, also called
amyl nitrate?
[POPPER_9]
U9n. …steroids or hormones?
[STRHOR_9]
U9o. …any other noninjection drug
MMP Standard Questionnaire Drug and alcohol use
138
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Daily
During the past 12
months, how often did (1)
you use:
(Specify:
Weekly
Monthly
(2)
(3)
Less than
monthly
Never (5)
Refused
Don’t
to
Know (8)
answer (7)
(4)
)?
[ONINJD_9] [ONINJ9OS]
Inconsistency check: If U8 (non-injection drug use) is “Yes” and all of the responses to U9aU9o are “Never,”, then QDS will display a message saying, “You said that you used noninjection drugs during the past 12 months. Please tell me the name of the drug you used and
how often you used it during the past 12 months.” Interviewer return to Say box after U8.
Interviewer instructions: If SX_TOTN4 (total number of sex partners) ≥1 OR if SXFFONN4
(female-female partners only) =1, go to U10. Else, skip to Say box before U12.
U10.
During the past 12 months, did you use any non-injection drugs before or during sex?
[NID_BFSX]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to Say box
before U12
Skip to Say box
before U12
Interview instructions: If U9a is “Daily,” “Weekly,” “Monthly,” or “Less than monthly,”
check the shaded box (column 1) in U11a. Follow the same pattern for b–o. If no shaded
boxes (column 1) are checked in U11a–o, skip to Say box before U12.
No (0)
Yes (1)
Refused Don’t
During the past 12 months, did you
to
Know (8)
use: [ONLY READ QUESTIONS
☐
☐
☐
☐
☐
WHERE THE SHADED BOX
(COLUMN 1) IS CHECKED.]
U11a. …methamphetamines before or during
sex? [CRAMT2_9]
U11b. …other amphetamines or stimulants
before or during sex? [AMPHT2_9]
U11c. …crack before or during sex? [CRACK2_9]
U11d. …cocaine that is smoked or snorted
before or during sex? [COCSM2_9]
U11e. …downers, such as Valium, Ativan, or
Xanax, before or during sex?
answer (7)
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
[DOWNE2_9]
☐
U11f. …painkillers, such as Oxycontin, Vicodin,
or Percocet before or during sex?
[PAINK2_9]
MMP Standard Questionnaire Drug and alcohol use
139
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
☐
U11g. …hallucinogens, such as LSD or
mushrooms before or during sex?
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
[HALLU2_9]
☐
U11h. …X, also called Ecstasy before or during
sex? [XECT2_9]
…Special K, also called ketamine before
or during sex? [SPECK2_9]
…GHB before or during sex? [GHB2_9]
☐
U11i.
☐
☐
U11j.
U11k. …heroin or opium that is smoked or
snorted before or during sex?
[HEROI2_9]
☐
U11l. …marijuana before or during sex?
[MARIJ2_9]
☐
☐
☐
U11m …poppers, also called amyl nitrate,
before or during sex? [POPPE2_9]
U11n. …steroids or hormones before or during
sex? [STRHO2_9]
U11o. … [RESPONSE FROM U9o; if response
from U9o is “refused” or “don’t know”
then skip to inconsistency box after
U11o.] before or during sex? [ONINJ2_9]
Inconsistency check: If U10 (non-injection drug use before or during sex) is “Yes” and all of the
responses to U11a–U11o are “No,” then QDS will display a message saying, “You said that
you used non-injection drugs before or during sex during the past 12 months. Please tell me
the name of the drug you used and how often you used it before or during sex during the past
12 months.” Interviewer return to U11a.
MMP Standard Questionnaire Drug and alcohol use
140
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Injection Drug Use
SAY: “The next questions are about injection drug use. This means injecting drugs yourself or
having someone else inject you. Remember, your answers will be kept confidential.”
U12.
Have you ever shot up or injected any drugs that weren’t used for medical purposes? By
shooting up, I mean anytime you might have used drugs with a needle, either by mainlining,
skin popping or muscling. [EVERINJ]
Skip to Say box
No ...........................................................................................☐ 0
before B1
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Skip to Say box
Don’t know.............................................................................☐ 8
before B1
U12a. During the past 12 months, have you shot up or injected any drugs that weren’t used for
medical purposes? By shooting up, I mean anytime you might have used drugs with a
needle, either by mainlining, skin popping, or muscling. [INJECT12]
Skip to Say box
No ...........................................................................................☐ 0
before B1
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Skip to Say box
Don’t know.............................................................................☐ 8
before B1
SAY: “Now I'm going to read you a list of drugs. For each drug I mention, please tell me how
often you injected it during the past 12 months. We will use Response Card M for these
questions.”
Interviewer instructions: If the respondent’s drug use was sporadic during the past 12 months,
ask the respondent to choose the response option that best characterizes his or her use.
During the past 12
months, how often
did you inject:
U13a. …heroin and cocaine
together, also called
speedballs?
Daily
Weekly
Monthly
(1)
(2)
(3)
Less than
monthly
Never (5)
(4)
Refused
Don’t
to
Know (8)
answer (7)
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
[HERCOC_9]
U13b. …heroin alone?
[HEROII_9]
U13c. …cocaine alone?
[COCAII_9]
U13d. …crack? [CRACKI_9]
MMP Standard Questionnaire Drug and alcohol use
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Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
During the past 12
months, how often
did you inject:
Daily
Weekly
Monthly
(1)
(2)
(3)
Less than
monthly
Never (5)
(4)
Refused
Don’t
to
Know (8)
answer (7)
U13e. …methamphetamines,
also called crystal meth,
tina, or crank?
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
☐1
☐2
☐3
☐4
☐5
☐7
☐8
[CRAMTI_9]
U13f. …other amphetamines
or stimulants?
[AMPHEI_9]
U13g. …Oxycontin?
[OXYCON_9]
U13h. …steroids or
hormones?
[STRHRI_9]
U13i. …any other drug
(Specify:
)?
[OINJDI_9][OINJD9OS]
Inconsistency check: If U12 (injection drug use) is “Yes” and all of the responses to U13a–U13i
are “Never,”, then QDS will display a message saying, “You said that you used injection drugs
during the past 12 months. Please tell me the name of the drug you used and how often you
used it during the past 12 months.” Interviewer return to say box after U12a.
Interviewer instructions: If SX_TOTN4 (total number of sex partners) ≥1 OR if SXFFONN4
(female-female partners only) =1, go to U14 (INJ_BFSX). Else, skip to Say box before B1
(transmission risk behaviors).
U14.
During the past 12 months, did you inject drugs before or during sex? [INJ_BFSX]
No ...........................................................................................☐ 0
Skip to Say box
Yes ..........................................................................................☐ 1
before U16
Refused to answer .................................................................☐ 7
Skip to Say box
Don’t know.............................................................................☐ 8
before U16
Interview instructions: If U13a is “Daily,” “Weekly,” “Monthly,” or “Less than monthly,”
check the shaded box (column 1) in U15a. Follow the same pattern for b–i. If no shaded boxes
are checked in U13, skip to Say box before U16.
No (0)
Yes (1)
Refused Don’t
During the past 12 months, did you
to
Know (8)
inject: [ONLY READ QUESTIONS
WHERE THE SHADED BOX (COLUMN 1) IS
CHECKED.]
MMP Standard Questionnaire Drug and alcohol use
answer (7)
142
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interview instructions: If U13a is “Daily,” “Weekly,” “Monthly,” or “Less than monthly,”
check the shaded box (column 1) in U15a. Follow the same pattern for b–i. If no shaded boxes
are checked in U13, skip to Say box before U16.
No (0)
Yes (1)
Refused Don’t
During the past 12 months, did you
to
Know (8)
inject: [ONLY READ QUESTIONS
answer (7)
☐
U15a.
☐
☐
U15b.
WHERE THE SHADED BOX (COLUMN 1) IS
CHECKED.]
…heroin and cocaine together before or
during sex? [HERCO2_9]
…heroin alone before or during sex? [HERII2_
U15c.
…cocaine alone before or during sex?
☐
☐
U15d. …crack before or during sex? [CRACI2_9]
☐0
☐1
☐7
☐8
U15e. …methamphetamines before or during
☐0
☐1
☐7
☐8
☐
U15f.
☐0
☐1
☐7
☐8
☐
☐
U15g.
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐
U15i.
☒0
☐1
☐7
☐8
[COCAI2_9]
sex? [CRAMI2_9]
…other amphetamines or stimulants before
or during sex? [AMPHI2_9]
…Oxycontin before or during sex? [OXYCO2_
U15h. …steroids or hormones before or during
sex? [STRHI2_9]
…[RESPONSE FROM U13i; if response from
U13i is “refused” or “don’t know” then skip
Inconsistency check after U15i.] before or
during sex? [OINJI2_9]
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
☐0
☐1
☐7
☐8
Inconsistency check: If U14 (injection drug use before or during sex) is “Yes” and all of the
responses to U15a–U15i are “No,” then QDS will display a message saying, “You said that you
used injection drugs before or during sex during the past 12 months. Please tell me the name
of the drug you used and how often you used it before or during sex during the past 12
months.” Interviewer return to U15a.
SAY: “Now I am going to ask you some questions about sharing needles and equipment.”
U16.
When you injected during the past 12 months, did someone use the same needle after
you used it? [SHR_NDL]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Drug and alcohol use
143
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
U17.
When you injected during the past 12 months, did someone use the same cookers,
cotton, or rinse water after you used it? [SHR_WRKS]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
U18.
When you injected during the past 12 months, did you use drugs that had been divided
with a syringe? [DIV_SYRN]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Drug and alcohol use
144
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Transmission Risk Behaviors (B)
SAY: “Next I'd like to ask you some questions about how you might have gotten HIV. Some
questions may ask you to remember things that happened a long time ago or ask for
information about your past partners’ behaviors. If you can’t remember or don’t know the
answer to the questions, it is fine to tell me that you don’t know. Also, some of these questions
may not apply to your situation, but I need to ask you all of the questions.”
B1.
Were you born with HIV? [IPERINN3]
No ..........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to say box
before P1
SAY: “Earlier I asked you about things that have been going on in your life in the past 12
months. Now I’m going to ask you about things you did between 1977—around when HIV was
recognized in the United States—and when you tested positive for HIV on [INSERT DATE FROM
A1].
B2.
Before you first tested positive for HIV, did you have sex with a male? [ISEXMAN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B3.
Before you first tested positive for HIV, did you have sex with a female? [ISEXFEN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Interviewer instructions: If the person was female at birth (BIRTGEN=2) and had sex with a
man (ISEXMAN3=1) then go to B4. If the person was male at birth (BIRTGEN=1) and had sex
with a woman (ISEXFEN3=1) then go to B10; otherwise skip to B15.
QDS programming note: If [BIRTGEN] is “Don’t know” or “Refused to answer,” skip to
B15. If [BIRTGEN] =2 and [ISEXMAN3] is “Don’t know” or “Refused to answer,” skip to
B15. If [BIRTGEN] =1 and [ISEXFEN3] is “Don’t know” or “Refused to answer,” skip to B15.
MMP Standard Questionnaire Transmission risk
145
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
B4.
Before you first tested positive for HIV, did any of your male partners use needles to
inject heroin, cocaine, steroids, or any other drug that was not prescribed by a doctor?
[IFSXIDN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B5.
Before you first tested positive for HIV, did any of your male sex partners have sex with
other men? [IFSXBIN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B6.
Before you first tested positive for HIV, did any of your male sex partners have HIV or
AIDS? [IFSXHIN3]
No ...........................................................................................☐ 0
Skip to B15
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Skip to B15
Don’t know.............................................................................☐ 8
B7.
Before you first tested positive for HIV, did any of your male sex partners who had HIV
or AIDS have hemophilia or any other bleeding disorder before they found out they had
HIV or AIDS? [IFSXHEN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “The next question asks about whether your male partners with HIV have ever had a
transfusion of blood products. By this I mean something made from someone else’s blood—
such as blood, red blood cells, plasma, or platelets—that was given to him by IV.”
B8.
Before you first tested positive for HIV, did any of your male sex partners who had HIV
or AIDS receive a transfusion of blood products before they were diagnosed with HIV or
AIDS? [IFSXTXN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
MMP Standard Questionnaire Transmission risk
146
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know.............................................................................☐ 8
B9.
Before you first tested positive for HIV, did any of your male sex partners who had HIV
or AIDS receive an organ or tissue transplant before they were diagnosed with HIV or
AIDS? [IFSXTPN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Interviewer instructions: Skip to B15
B10.
Before you first tested positive for HIV, did any of your female sex partners use needles
to inject heroin, cocaine, steroids, or any other drug that was not prescribed by a
doctor? [IMSXIDN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B11.
Before you first tested positive for HIV, did any of your female sex partners have HIV or
AIDS? [IMSXHIN3]
No ..........................................................................................☐ 0
Skip to B15
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Skip to B15
Don’t know.............................................................................☐ 8
B12.
Before you first tested positive for HIV, did any of your female sex partners who had HIV
or AIDS have hemophilia or any other bleeding disorder before they found out they had
HIV or AIDS? [IMSXHEN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “The next question asks about whether your female partners with HIV have ever had a
transfusion of blood products. By this I mean something made from someone else’s blood—
such as blood, red blood cells, plasma, or platelets—that was given to her by IV.”
MMP Standard Questionnaire Transmission risk
147
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
B13.
Before you first tested positive for HIV, did any of your female sex partners who had HIV
or AIDS receive a transfusion of blood products before they found out they had HIV or
AIDS? [IMSXTXN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B14.
Before you first tested positive for HIV, did any of your female sex partners who had HIV
or AIDS receive an organ or tissue transplant before they found out they had HIV or
AIDS? [IMSXTPN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B15.
Before you first tested positive for HIV, did you use needles to inject heroin, cocaine,
steroids, or any other drug that was not prescribed by a doctor? [IIDUN3]
No ..........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “People who have blood clotting problems like hemophilia sometimes need to get treated
with something to prevent bleeding called clotting factor.”
B16.
Before you first tested positive for HIV, did you ever receive clotting factor? [ICLOTN3]
No ...........................................................................................☐ 0
Skip to Say box
Yes ..........................................................................................☐ 1
before B18
Refused to answer .................................................................☐ 7
Skip to Say box
Don’t know.............................................................................☐ 8
before B18
B17.
Did you ever receive clotting factor before March, 1985? [ICLO85N3]
No ..........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Transmission risk
148
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
SAY: “The next question asks about whether you have ever had a transfusion of blood products.
By this I mean something made from someone else’s blood—such as blood, red blood cells,
plasma, or platelets—that was given to you by IV.”
B18.
Before you first tested positive for HIV, did you ever receive a transfusion of blood
products besides clotting factor? [ITRANN3]
No ...........................................................................................☐ 0
Skip to B20
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to B20
B19.
Did you ever receive a transfusion of blood products before March, 1985? [ITRA85N3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B20.
Before you first tested positive for HIV, did you receive an organ or tissue transplant or
artificial insemination? [ITRPLTN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
B21.
Before you first tested positive for HIV, did you work in a health care or laboratory
setting where you might have been exposed to human blood or other body fluids?
[IHCWRN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Transmission risk
149
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Prevention Activities (P)
SAY: “Next I'd like to ask you about HIV prevention activities.”
P1.
P1a.
During the past 12 months, have you gotten any free condoms, not counting those
given to you by a friend, relative, or sex partner? [COND12_9]
Skip to instructions
No ...........................................................................................☐ 0
before P2
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Skip to instructions
Don’t know.............................................................................☐ 8
before P2
From what type of place or places did you get these free condoms?
[DON’T READ CHOICES. CHECK ALL THAT APPLY.] [CONF_12]
Community-based organization.............................................☐ 1 [CONF_12A]
Family planning clinic .............................................................☐ 2 [CONF_12B]
STD clinic ................................................................................☐ 3 [CONF_12C]
Doctor’s office or other health clinic .....................................☐ 4 [CONF_12D]
IDU outreach organization (including needle exchange) ......☐ 5 [CONF_12E]
Social venue (bar, club, bathhouse, gym, bookstore) ...........☐ 6 [CONF_12F]
Special event ..........................................................................☐ 7 [CONF_12G]
Other ......................................................................................☐ 8 [CONF_12H]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
Interviewer instructions: If “Other” is selected for P1a, go to P1a_1os. Otherwise, skip to
Interviewer Instructions before P2.
P1a_1os. Specify other place where you got these free condoms:
[COH_12OS]
[7 = Refused, 8 = Don’t know]
P1a_2o. Is there another place where you got free condoms? [CONF_12I]
Yes .........................................................................................☐ 1
No ..........................................................................................☐ 0
Interviewer instructions: If P1a_2o is “Yes,” go to P1a_2os. Otherwise, skip to Interviewer
Instructions before P2.
MMP Standard Questionnaire Prevention Activities
150
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
P1a_2os. Specify other place where you got these free condoms:
[COI_12OS]
[7 = Refused, 8 = Don’t know]
Interviewer instructions: If U12a (injection drug use during the past 12 months) is “Yes,” go to
P2. If U12a is “No,” “Refused to answer,” “Don’t know,” or skipped, then skip to P3.
P2.
During the past 12 months, have you gotten any new sterile needles for free, not
including those given to you by a friend, relative, or drug-using partner? [STENEE_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
P2a.
During the past 12 months, have you gotten any new cookers, cotton, or rinse water for
free, not including those given to you by a friend, relative, or drug-using partner? [KITS_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
P3.
During the past 12 months, have you seen or received any informational/educational
materials such as posters, leaflets, pamphlets, or videos that tell you how to protect you
or your partners from HIV or other STDs? [HIVINFN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
P4.
During the past 12 months, not including when you may have been tested for HIV, have
you had a one-on-one conversation with an outreach worker, counselor, or prevention
program worker about ways to protect yourself or your partners from getting HIV or
other sexually transmitted diseases? [TALKHI_9]
Label: Talked to counselor about HIV prevention
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Prevention Activities
151
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
P5.
During the past 12 months, not including when you may have been tested for HIV, have
you had a one-on-one conversation with a doctor, nurse, or other health care worker
about ways to protect yourself or your partners from getting HIV or other sexually
transmitted diseases? [PRTLK_12]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
P6.
During the past 12 months, not including when you may have been tested for HIV, have
you participated in an organized session involving a small group of people to discuss
ways to protect yourself or your partners from getting HIV or other sexually transmitted
diseases? [GROU1_12]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Prevention Activities
152
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Depression (M)
SAY: “Now I’m going to ask you some questions about your mood. When answering, please
think about how often the following has occurred during the past 2 weeks. We will use
Response Card N for these questions. We will also use the calendar to refer to the past 2
weeks.”
Over the past 2 weeks,
how often have you been
bothered by any of the
following problems?
M1a.
M1b.
M1c.
M1d.
M1e.
Little interest or pleasure
in doing things [ANX_DEPA]
Feeling down, depressed,
or hopeless [ANX_DEPB]
Trouble falling or staying
asleep, or sleeping too
much [ANX_DEPC]
Feeling tired or having
little energy [ANX_DEPD]
Poor appetite or
overeating
[ANX_DEPE]
M1f.
Feeling bad about
yourself—or that you are a
failure or have let yourself
or your family down
[ANX_DEPF]
M1g.
M1h.
Trouble concentrating on
things, such as reading the
newspaper or watching
television [ANX_DEPG]
Moving or speaking so
slowly that other people
could have noticed, or the
opposite - being so fidgety
or restless that you have
been moving around a lot
more than usual
[ANX_DEPH]
MMP Standard Questionnaire Depression
Not at
all (1)
Several
Days (2)
More
Nearly
than
every
half the day (4)
days (3)
Refuse
d to
answer
Don’t
know (8)
(7)
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153
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Gynecological and Reproductive History (G)
Interviewer instructions: If [BIRTGEN] and [GENDER] are “Female,” go to Say box before G1;
otherwise, skip to say box before C1.
SAY: “I’m now going to ask some questions about pelvic exams and Pap smears. A pelvic exam
is a vaginal examination. A Pap smear, also called a cervical cancer test or Pap test, is a test
used to check for cancer of the cervix. Often a pelvic exam and Pap smear are performed at the
same time.”
G1.
During the past 12 months, have you had a pelvic examination? [PLV_EX_9]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G2.
G2a.
G2b.
During the past 12 months, have you had a Pap smear? [PAP_EX_9]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Were the results of this Pap smear normal or not normal? [PAP2_12]
Normal .......................................................................................... ☐ 1
Not normal ................................................................................... ☐ 2
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Skip to Say box
before G3
Skip to Say box
before G3
Skip to Say box
before G3
Skip to Say box
before G3
Did you receive a follow-up exam or tests for this abnormal result? [PAP2A_12]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
SAY: “I am going to read a list of ways that people prevent pregnancy. As I read each one, tell
me if you have used it in the past 12 months. Please answer "YES" or "NO.” Answer “YES”
even if you have only used it once. Have you used this method to prevent pregnancy in the
past 12 months? ”
MMP Standard Questionnaire Gynecological and Reproductive History
154
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
G3f.
G3g.
G3h.
G3i.
G3j.
G3k.
G3l.
G3m.
G3n.
G3o.
(8)
G3e.
Don’t know
G3d.
Refused to
answer (7)
G3b.
G3c.
Male condom, also called a
“rubber” [BIRCOAN3]
Female condom [BIRCOBN3]
Diaphragm, cervical cap, or
cervical sponge[BIRCOCN3]
Spermicidal foam or
jelly[BIRCODN3]
Depo-Provera®, which is an
injection[BIRCOEN3]
Hormonal implants such as
Implanon® or
Nexplanon®[BIRCOFN3]
Birth control pills[BIRCOGN3]
Contraceptive patch, for
example, Ortho
Evra®[BIRCOHN3]
Contraceptive ring, for
example NuvaRing®[BIRCOIN3]
Intrauterine device or IUD,
which comes as a coil or loop,
for example, Mirena® or
Paraguard®[BIRCOJN3]
Emergency contraception or
“morning after pill” [BIRCOKN3]
Withdrawal, also called
“pulling out” [BIRCOLN3]
Abstinence, which is not
having sex[BIRCOMN3]
Post-menopausal, meaning
that you do not have periods
anymore[BIRCONN3]
Tubal sterilization, which is
having your “tubes tied,” or a
hysterectomy, which is having
your uterus
removed[BIRCOON3]
Yes (1)
No (0)
G3a.
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MMP Standard Questionnaire Gynecological and Reproductive History
155
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
G3p.
Partner’s vasectomy[BIRCOPN3]
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SAY: “Earlier you told me that you first tested positive for HIV on
☐
__/
[INSERT
DATE FROM A1].”
G4.
Since testing positive for HIV in
/
times have you been pregnant? [PREG_9]
[INSERT DATE FROM A1], how many
[777 = Refused to answer, 888 = Don’t know]
QDS programming note: Range is 0–100. If A1 (date first tested positive) is “don’t know” or
“refused to answer,” then G4 should read as follows: “Since testing positive for HIV, how many
times have you been pregnant?” and Say box before G4 should NOT be read.
QDS programming note: Range is 0–100.
QDS programming note: If G4 is 1, 2, 3, or 4, program G5-G8 accordingly to skip “extra”
pregnancy questions.
If G4=1, then after G5a or b or c skip to Say box before G10.
If G4=2, then after G6a or b or c skip to Say box before G10.
If G4=3, then after G7a or b or c skip to Say box before G10.
If G4=4, then after G8a or b or c skip to Say box before G10.
If G4=”don’t know” or “refused to answer,” then skip to Say box before G10.
Interviewer instructions: If G4 = 0, then skip to Say box before G10; otherwise go to Say box
before G5.
If number of times pregnant [PREG_9] is 1–5, SAY: “Now I would like to ask you about all of your
pregnancies since testing positive for HIV, starting with your first one.”
If number of times pregnant [PREG_9] is greater than 5 pregnancies, SAY: “Now I would like to
ask you about your first 5 pregnancies since testing positive for HIV.”
G5.
For your 1st pregnancy since testing positive for HIV, were you trying to get pregnant?
[INTNT1N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
MMP Standard Questionnaire Gynecological and Reproductive History
156
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G5a.
What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM1N3]
Currently pregnant.................................................................☐ 1
Skip to G5d
Live birth ................................................................................☐ 2
Stillbirth..................................................................................☐ 3
Miscarriage.............................................................................☐ 4
Abortion .................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
G5b.
In what month and year did this outcome occur? [PDTE1N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If outcome [OUTCM1N3] was “Live birth,” then go to G5c; otherwise
skip to G6 if G4>1 or skip to Say box before G10 if G4=1.
Inconsistency check: [PDTE1N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive).
QDS programming note:
Allow a blank response for month.
If [PDTE1N3] < [DOB_13] then READ: “The outcome date cannot be earlier than respondent's
date of birth. Please re-enter date." Do not allow the program to advance.
If [PDTE1N3] < [POS1S_9] then READ: “The outcome date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance. If month is blank for PDTE1N3, use the year values for the validation.
G5c.
Was the child diagnosed with HIV? [READ CHOICES. CHECK ONLY ONE.] [KID1HVN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Indeterminate .............................................................................. ☐ 2
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Gynecological and Reproductive History
157
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interviewer instructions: If G4>1 go to G6, else skip to Say box before G10.
G5d.
What is your due date? [DUDT1N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If G4>1 go to G6, else skip to Say box before G10.
Inconsistency check: [DUDT1N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive) or greater than 10 months after [IDATE] (interview date).
QDS programming note:
If [DUDT1N3] < [DOB_13] then READ: “The due date cannot be earlier than respondent's date
of birth. Please re-enter date." Do not allow the program to advance.
If [DUDT1N3] < [POS1S_9] then READ: “The due date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance.
If [DUDT1N3] > 10 months after [IDATE] then READ: “The due date cannot be more than 10
months after the interview date. Please re-enter date." Do not allow the program to advance.
G6.
For the 2nd pregnancy since testing positive for HIV, were you trying to get pregnant?
[INTNT2N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G6a.
What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM2N3]
Currently pregnant.................................................................☐ 1
Skip to G6d
Live birth ................................................................................☐ 2
Stillbirth..................................................................................☐ 3
Miscarriage.............................................................................☐ 4
Abortion .................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Gynecological and Reproductive History
158
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
G6b.
In what month and year did this outcome occur? [PDTE2N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If outcome [OUTCM2N3] was “Live birth,” then go to G6c; otherwise
skip to G7 if G4>2 or skip to Say box before G10 if G4=2.
Inconsistency check: [PDTE2N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive).
QDS programming note:
Allow a blank response for month.
If [PDTE2N3] < [DOB_13] then READ: “The outcome date cannot be earlier than respondent's
date of birth. Please re-enter date." Do not allow the program to advance.
If [PDTE2N3] < [POS1S_9] then READ: “The outcome date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance. If month is blank for PDTE2N3, use the year values for the validation.
G6c.
Was the child diagnosed with HIV? [READ CHOICES. CHECK ONLY ONE.] [KID2HVN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Indeterminate .............................................................................. ☐ 2
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Interviewer instructions: If G4>2 go to G7, else skip to Say box before G10.
G6d.
What is your due date? [DUDT2N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If G4>2 go to G7, else skip to Say box before G10.
Inconsistency check: [DUDT2N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive) or greater than 10 months after [IDATE] (interview date).
MMP Standard Questionnaire Gynecological and Reproductive History
159
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note:
If [DUDT2N3] < [DOB_13] then READ: “The due date cannot be earlier than respondent's date
of birth. Please re-enter date." Do not allow the program to advance.
If [DUDT2N3] < [POS1S_9] then READ: “The due date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance.
If [DUDT2N3] > 10 months after [IDATE] then READ: “The due date cannot be more than 10
months after the interview date. Please re-enter date." Do not allow the program to advance.
G7.
For the 3rd pregnancy since testing positive for HIV, were you trying to get pregnant?
[INTNT3N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G7a.
What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM3N3]
Currently pregnant.................................................................☐ 1
Skip to G7d
Live birth ................................................................................☐ 2
Stillbirth..................................................................................☐ 3
Miscarriage.............................................................................☐ 4
Abortion .................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
G7b.
In what month and year did this outcome occur? [PDTE3N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If outcome [OUTCM3N3] was “Live birth,” then go to G7c; otherwise
skip to G8 if G4>3 or skip to Say box before G10 if G4=3.
Inconsistency check: [PDTE3N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive).
MMP Standard Questionnaire Gynecological and Reproductive History
160
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note:
Allow a blank response for month.
If [PDTE3N3] < [DOB_13] then READ: “The outcome date cannot be earlier than respondent's
date of birth. Please re-enter date." Do not allow the program to advance.
If [PDTE3N3] < [POS1S_9] then READ: “The outcome date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance. If month is blank for PDTE3N3, use the year values for the validation.
G7c.
Was the child diagnosed with HIV? [READ CHOICES. CHECK ONLY ONE.] [KID3HVN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Indeterminate .............................................................................. ☐ 2
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Interviewer instructions: If G4>3 go to G8, else skip to Say box before G10.
G7d.
What is your due date? [DUDT3N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If G4>3 go to G8, else skip to Say box before G10.
Inconsistency check: [DUDT3N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive) or greater than 10 months after [IDATE] (interview date).
QDS programming note:
If [DUDT3N3] < [DOB_13] then READ: “The due date cannot be earlier than respondent's date
of birth. Please re-enter date." Do not allow the program to advance.
If [DUDT3N3] < [POS1S_9] then READ: “The due date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance.
If [DUDT3N3] > 10 months after [IDATE] then READ: “The due date cannot be more than 10
months after the interview date. Please re-enter date." Do not allow the program to advance.
G8.
For the 4th pregnancy since testing positive for HIV, were you trying to get pregnant?
MMP Standard Questionnaire Gynecological and Reproductive History
161
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
[INTNT4N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G8a.
What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM4N3]
Currently pregnant.................................................................☐ 1
Skip to G8d
Live birth ................................................................................☐ 2
Stillbirth..................................................................................☐ 3
Miscarriage.............................................................................☐ 4
Abortion .................................................................................☐ 5
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
G8b.
In what month and year did this outcome occur? [PDTE4N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If outcome [OUTCM4N3] was “Live birth,” then go to G8c; otherwise
skip to G9 if G4>4 or skip to Say box before G10 if G4=4.
Inconsistency check: [PDTE4N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive).
QDS programming note:
Allow a blank response for month.
If [PDTE4N3] < [DOB_13] then READ: “The outcome date cannot be earlier than respondent's
date of birth. Please re-enter date." Do not allow the program to advance.
If [PDTE4N3] < [POS1S_9] then READ: “The outcome date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance. If month is blank for PDTE4N3, use the year values for the validation.
G8c.
Was the child diagnosed with HIV? [READ CHOICES. CHECK ONLY ONE.] [KID4HVN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Indeterminate .............................................................................. ☐ 2
MMP Standard Questionnaire Gynecological and Reproductive History
162
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Interviewer instructions: If G4>4 go to G9, else skip to Say box before G10.
G8d.
What is your due date? [DUDT4N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If G4>4 go to G9, else skip to Say box before G10.
Inconsistency check: [DUDT4N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive) or greater than 10 months after [IDATE] (interview date).
QDS programming note:
If [DUDT4N3] < [DOB_13] then READ: “The due date cannot be earlier than respondent's date
of birth. Please re-enter date." Do not allow the program to advance.
If [DUDT4N3] < [POS1S_9] then READ: “The due date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance.
If [DUDT4N3] > 10 months after [IDATE] then READ: “The due date cannot be more than 10
months after the interview date. Please re-enter date." Do not allow the program to advance.
G9.
For the 5th pregnancy since testing positive for HIV, were you trying to get pregnant?
[INTNT5N3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
G9a.
What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM5N3]
Currently pregnant.................................................................☐ 1
Skip to G9d
Live birth ................................................................................☐ 2
Still birth .................................................................................☐ 3
Miscarriage.............................................................................☐ 4
Abortion .................................................................................☐ 5
Refused to answer .................................................................☐ 7
MMP Standard Questionnaire Gynecological and Reproductive History
163
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know.............................................................................☐ 8
G9b.
In what month and year did this outcome occur? [PDTE5N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Interviewer instructions: If outcome [OUTCM5N3] was “Live birth,” then go to G9c; otherwise
skip to Say box before G10.
Inconsistency check: [PDTE5N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive).
QDS programming note:
Allow a blank response for month.
If [PDTE5N3] < [DOB_13] then READ: “The outcome date cannot be earlier than respondent's
date of birth. Please re-enter date." Do not allow the program to advance.
If [PDTE5N3] < [POS1S_9] then READ: “The outcome date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance. If month is blank for PDTE5N3, use the year values for the validation.
G9c.
Was the child diagnosed with HIV? [READ CHOICES. CHECK ONLY ONE.] [KID5HVN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Indeterminate .............................................................................. ☐ 2
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
Interviewer instructions: Skip to Say box before G10.
G9d.
What is your due date? [DUDT5N3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 888= Don’t know]
Inconsistency check: [DUDT5N3] cannot be earlier than [DOB_13] or earlier than [POS1S_9]
(date first tested positive) or greater than 10 months after [IDATE] (interview date).
MMP Standard Questionnaire Gynecological and Reproductive History
164
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note:
If [DUDT5N3] < [DOB_13] then READ: “The due date cannot be earlier than respondent's date
of birth. Please re-enter date." Do not allow the program to advance.
If [DUDT5N3] < [POS1S_9] then READ: “The due date cannot be earlier than the date of
respondent's first positive HIV test. Please re-enter date." Do not allow the program to
advance.
If [DUDT5N3] > 10 months after [IDATE] then READ: “The due date cannot be more than 10
months after the interview date. Please re-enter date." Do not allow the program to advance.
SAY: “Now I’m going to switch gears and ask you a question about HIV care.”
G10.
During the past 12 months, have you received HIV care at an OBGYN or gynecological
clinic? [GYNECARE]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Gynecological and Reproductive History
165
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Health Conditions and Preventive Therapy (C)
SAY: “Now I’m going to ask you some questions about your CD4 counts, also called T–cell
counts. A CD4 test measures how your body is fighting HIV.”
C1.
C1a.
Have you ever had a CD4 test? [CD4_DO_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to Say box
before C4
Skip to Say box
before C4
What was the month and year of your first CD4 count? [CD4FM_9]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency check: Confirm response if C1a (date of first CD4 count) is earlier than A6 (date
of first visit to a provider for HIV care) or later than A7 (date of most recent visit to a provider
for HIV care.)
QDS programming note for C1a: If C1a (date of first CD4 count) is earlier than the A6 (date of
first visit to a provider for HIV care), display the following confirmatory response: “Respondent
said that date of first CD4 count was earlier than date first went to a HIV provider. Confirm
response.” Allow program to advance. If C1a (date of first CD4 count) is later than the A7 (most
recent care visit), display the following confirmatory response: “Respondent said that date of
first CD4 count was later than date of most recent visit to a provider for HIV care. Confirm
response.” Allow program to advance. Allow a blank response for month.
SAY: “For the next two questions we will use Response Card O.”
C1b.
What was the result of your first CD4 count? [CD4FCT_9]
0–49 .......................................................................................☐ 1
50–99 .....................................................................................☐ 2
100–199 .................................................................................☐ 3
200–349 .................................................................................☐ 4
350–499 .................................................................................☐ 5
500 or more ...........................................................................☐ 6
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Health Conditions and Preventive Therapy
166
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
C1c.
What was the result of your lowest CD4 count? [CD4LOW_9]
0–49 .......................................................................................☐ 1
50–99 .....................................................................................☐ 2
100–199 .................................................................................☐ 3
200–349 .................................................................................☐ 4
350–499 .................................................................................☐ 5
500 or more ...........................................................................☐ 6
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Inconsistency check: C1c CD4LOW_9 cannot be higher than C1b CD4FCT_9.
QDS programming note: If C1c is higher than C1b, display the following message: “The result of
lowest CD4 count cannot be higher than the result of first CD4 count.” Display message to
interviewer: “Interviewer: Please verify the response.” Interviewer return to previous question
(C1c.). Allow a blank response for month for C2.
C2.
What was the month and year of your most recent CD4 count? [CD4MR11]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
Inconsistency check: Date cannot be earlier than C1a [CD4FM_9]. If date of most recent CD4
count is earlier than C1a [CD4FM_9], display following message: “Date of most recent CD4
count cannot be earlier than date of first CD4 count. Interviewer: Please verify the response.”
Date cannot be later than I4 (date of interview). Interviewer return to previous question (C2).
SAY: “Please use Response Card O again.”
C2a.
What was the result of your most recent CD4 count? [CDRMR_11]
0–49 .......................................................................................☐ 1
50–99 .....................................................................................☐ 2
100–199 .................................................................................☐ 3
200–349 .................................................................................☐ 4
350–499 .................................................................................☐ 5
500 or more ...........................................................................☐ 6
Refused to answer .................................................................☐ 7
MMP Standard Questionnaire Health Conditions and Preventive Therapy
167
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know.............................................................................☐ 8
Interviewer instructions: If C2 is greater than 12 months ago, skip to Say box before C4
(VL_DO_9).
SAY: “Now I’m going to ask you about CD4 counts during the past 12 months. Remember, that
is from last year, (DATE WITH PREVIOUS YEAR) to now (INTERVIEW DATE).”
QDS programming note for Say box before C3: The QDS program should enter the appropriate
dates. EXAMPLE: If IDATE is 11/11/2014 then the program should read “That is from last year,
11/11/2013 to now 11/11/2014.”
C3.
During the past 12 months, how many CD4 counts have you had? [CD12_N_9]
[77=Refused to answer, 88=Don’t know]
Inconsistency check: C3 (number of CD4 counts in the past 12 months) must be ≤ 76. C3 cannot
be 0 if C1a or C2 responses were during the past 12 months.
QDS programming note, If C3 is 0 and C1a or C2 are during the past 12 months, then display
the following message: “You said earlier that you had a CD4 count during the past 12
months.” Display message to interviewer: “Interviewer, please verify the response.”
Interviewer return to previous question (C2).
SAY: “Now I’m going to ask you some questions about HIV viral load tests. HIV viral load tests
measure the amount of HIV in your blood.”
C4.
C5.
Have you ever had an HIV viral load test? [VL_DO_9]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Skip to Say box
before C7
Skip to Say box
before C7
What was the month and year of your most recent viral load test? [VLMR_11]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
MMP Standard Questionnaire Health Conditions and Preventive Therapy
168
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
QDS programming note for C5: allow a blank response for month.
SAY: “Please use Response Card P.”
C5a.
What was the result of your most recent viral load test? [CDRRV_11]
Below the level of detection, undetectable ..........................☐ 1
Detectable but less than 5,000 viral copies/ml .....................☐ 2
5,000 to 100,000 viral copies/ml ...........................................☐ 3
Greater than 100,000 viral copies/ml ....................................☐ 4
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “Now I’m going to ask you about your viral load tests during the past 12 months. That is
from last year (DATE WITH PREVIOUS YEAR) to now (INTERVIEW DATE).”
QDS programming note for Say box before C6: The QDS program should enter the appropriate
dates. EXAMPLE: If IDATE is 11/11/2014 then the program should read “That is from last year,
11/11/2013 to now 11/11/2014.”
C6.
During the past 12 months, how many viral load tests have you had? [VL12_N_9]
[77=Refused to answer, 88=Don’t know]
Inconsistency check: C6 (number of viral load tests) must be ≤ 76.
QDS programming note, If C6 is 0 and C5 is during the past 12 months, then display the
following message: “You said earlier that you had a viral load test during the past 12
months.” Display message to interviewer: “Interviewer, please verify the response.”
Interviewer return to previous question (C5).
SAY: “The next question is about hepatitis, an infection of the liver. There are vaccines or shots
to prevent hepatitis. I’m going to ask you whether you’ve had these vaccines. Don’t include
shots that you may have had after contact with someone who had Hepatitis A or B.”
C7.
Have you ever had a vaccine or shot to prevent hepatitis? [HEPVAC_9]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
MMP Standard Questionnaire Health Conditions and Preventive Therapy
169
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Don’t know ................................................................................... ☐ 8
SAY: “Now I am going to ask you about tuberculosis, also called TB.”
C8.
Have you ever had a skin test for TB, sometimes called a PPD, or a blood test for TB?
[TESTPN13]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
C8a.
Skip to Say box
before C13
Skip to Say box
before C13
What month and year did you have your most recent TB skin or blood test? [PPDMYN3]
/
(M M / Y
Y
Y Y)
[Month: 77 = Refused to answer, 88= Don’t know;
Year: 7777 = Refused to answer, 8888 = Don’t know]
QDS programming note for C8a: allow a blank response for month.
Inconsistency check: C8a (date of most recent TB test) cannot be earlier than the [DOB_13] or
later than the I4 (date of interview). Display the following message: “ The date of the most
recent TB test cannot be earlier than the date of birth. Please confirm the date.”
C8b.
Have you ever had a positive skin test or blood test for TB? [PP_PSN13]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
SAY: “TB can live in the body for a long time without making a person sick, and the only way
we might know about it is through a skin or blood test. When TB does make a person sick, we
call it 'active TB.'"
C8c.
Have you ever been diagnosed with active TB? [ACTVTBN3]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
MMP Standard Questionnaire Health Conditions and Preventive Therapy
170
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
SAY: “Now I’m going to ask about vaccinations. To begin, I’m going to ask about the human
papillomavirus or HPV vaccine. Other names for this vaccine are Gardasil and Cervarix.”
C13.
Have you ever had a vaccine for HPV? [HPV_EVR]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C14.
During the past 12 months, did you get a vaccine or shot to protect you from seasonal
flu? [VACFL_10]
No .................................................................................................. ☐ 0
Skip to C14b
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Skip to Say box before C15
Don’t know ................................................................................... ☐ 8
C14a. Where did you get your most recent seasonal flu vaccine? [READ CHOICES. CHECK ONLY
ONE.] [LOCVA_10]
Doctor’s office ........................................................................☐ 1
Health department clinic .......................................................☐ 2
Drugstore or store (i.e. CVS, Walgreens, Target)...................☐ 3
Employer ................................................................................☐ 4
Other (Specify:
) ....................☐ 5 [LOC_10OS]
Refused to answer .................................................................☐ 7
Don’t know.............................................................................☐ 8
Interviewer instructions: Skip to C15.
C14b. What was the main reason you did not get a seasonal flu vaccine during the past 12
months? [DON’T READ CHOICES. CHECK ONLY ONE.] [C13B_FLU]
I could not find a place that offered the vaccine…………… .....☐ 1
My provider did not offer me the vaccine………………… .........☐ 2
I was concerned about side effects from the vaccine ...........☐ 3
I was concerned about the safety of the vaccine…………… ....☐ 4
I did not think I needed it.......................................................☐ 5
I did not have enough insurance or money ...........................☐ 6
Other (Specify
_)
☐ 7 [C13B_FOS]
Refused to answer .................................................................☐ 77
Don’t know.............................................................................☐ 88
MMP Standard Questionnaire Health Conditions and Preventive Therapy
171
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
SAY: “For the last few questions of the interview, I’m going to ask about different conditions
you may or may not have and difficulties that you may or may not experience. Some of these
things may seem obvious to you, but please answer the following questions.”
C15.
Are you deaf or do you have serious difficulty hearing? [DISDEFN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C16.
Are you blind or do you have serious difficulty seeing, even when wearing glasses?
[DISBLNN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C17.
Because of a physical, mental, or emotional condition, do you have serious difficulty
concentrating, remembering, or making decisions? [DISCONN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C18.
Do you have serious difficulty walking or climbing stairs? [DISWLKN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C19.
Do you have difficulty dressing or bathing? [DISDRSN3]
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
C20.
Because of a physical, mental, or emotional condition, do you have difficulty doing
errands alone such as visiting a doctor's office or shopping? [DISERRN3]
MMP Standard Questionnaire Health Conditions and Preventive Therapy
172
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
No .................................................................................................. ☐ 0
Yes ................................................................................................. ☐ 1
Refused to answer....................................................................... ☐ 7
Don’t know ................................................................................... ☐ 8
MMP Standard Questionnaire Health Conditions and Preventive Therapy
173
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Interview Completion (E)
End of Interview
SAY: “Thank you again for taking part in this interview. Please remember that all the
information you have given me will be kept confidential.”
Interviewer instructions:
Offer assistance with information and resources, according to local protocol.
Don’t pay the respondent if the respondent already participated in an MMP interview during
the 2014 data collection cycle OR the respondent is less than 18 years old.
Pay the respondent if the respondent’s first HIV positive test was after the PDP, OR the
interview was partially or fully completed.
Payment Verification
Interviewer instructions: if I5 is “telephone interview,” go to E1; otherwise skip to E2.
E1.
Have arrangements for payment been made? [ARRANGE]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Interviewer instructions: Skip to E4.
E2.
E2a.
Payment made: [PAYMENT]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
Why was payment not made? [PAYNMAD]
Participant refused payment ................................................☐ 1
Other (Specify:
_) ............☐ 2
Skip to E3
Skip to E4
[OPAY]
E3.
Receipt signed (or initialed): [RECEIPT]
No ...........................................................................................☐ 0
Yes ..........................................................................................☐ 1
MMP Standard Questionnaire Interview Completion
Skip to E4
174
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
E3a.
Why was receipt not signed? [RECNS]
Participant refused to sign ....................................................☐ 1
Other (Specify:
_) ............☐ 2
[ORECEI]
Data Validity
E4.
How confident are you of the validity of the respondent’s answers? [CONF]
Confident ...............................................................................☐ 1
Some doubts ..........................................................................☐ 2
Not confident at all ...............................................................☐ 3
E5.
Record any additional comments, including disruptions that might have taken place
during the interview, reason the interview might have been stopped, or why the
respondent’s answers may not have been reliable. [ADDCOM1]
QDS programming note for E5: Include a NA response option if Interviewers do not have any
additional comments.
MMP Standard Questionnaire Interview Completion
175
Key: grey box = interviewer instructions; blue box = inconsistency check; orange box = QDS program note; dark
red variable = previously used variable; green variable = new variable; grey font for response set = do not read
responses
Response cards
RESPONSE CARD A
Monthly Income
Yearly Income
a.
$0 to $416
n.
$0 to $4,999
b.
$417 to $833
o.
$5,000 to $9,999
c.
$834 to $1041
p.
$10,000 to $12,499
d.
$1042 to $1249
q.
$12,500 to $14,999
e.
$1250 to $1666
r.
$15,000 to $19,999
f.
$1667 to $2083
s.
$20,000 to $24,999
g.
$2084 to $2499
t.
$25,000 to $29,999
h.
$2500 to $2916
u.
$30,000 to $34,999
i.
$2917 to $3333
v.
$35,000 to $39,999
j.
$3334 to $4166
w.
$40,000 to $49,999
k.
$4167 to $4999
x.
$50,000 to $59,999
l.
$5000 to $6250
y.
$60,000 to $74,999
m.
$6250 or more
z.
$75,000 or more
`
RESPONSE CARD B
I asked them not to tell any of my partners
I asked them to tell only some of my partners
I asked them to tell all of my partners
I told them that I didn’t have any partners
RESPONSE CARD C
Always
Often
Sometimes
Occasionally
Never
MMP Standard Questionnaire Response cards
176
RESPONSE CARD D
Extremely
Quite a bit
Somewhat
A little bit
Not at all
RESPONSE CARD E
Never
Occasionally
Sometimes
Often
Always
RESPONSE CARD F
Never
Rarely
About half of the time
Most of the time
Always
RESPONSE CARD G
Within the past week
1–2 weeks ago
3–4 weeks ago
1–3 months ago
More than 3 months ago
Never skip medicines
MMP Standard Questionnaire Response cards
177
RESPONSE CARD H
Never
Rarely
About half of the time
Most of the time
Always
Been on medications less than 30 days
RESPONSE CARD I
Not at all sure
Somewhat sure
Very sure
Extremely sure
RESPONSE CARD J
Very dissatisfied
Somewhat dissatisfied
Somewhat satisfied
Very satisfied
RESPONSE CARD K
Not at all A
little
Somewhat
A lot
MMP Standard Questionnaire Response cards
178
RESPONSE CARD K-1
≤24 years old
25-29 years old
30-34 years old
35-39 years old
40-44 years old
45-49 years old
>=50 years old
RESPONSE CARD L
Strongly disagree
Somewhat disagree
Neutral
Somewhat agree
Strongly agree
RESPONSE CARD M
Daily
Weekly
Monthly
Less than Monthly
Never
ALCOHOL RESPONSE CARD
MMP Standard Questionnaire Response cards
179
RESPONSE CARD N
Not at all
Several days
More than half the days
Nearly every day
RESPONSE CARD O
0–49
50–99
100–199
200–349
350–499
500 or more
RESPONSE CARD P
Below the level of detection, undetectable
MMP Standard Questionnaire Response cards
180
Detectable but less than 5,000 viral copies/ml
5,000 to 100,000 viral copies/ml
Greater than 100,000 viral copies/ml
MMP Standard Questionnaire Response cards
181
2013 Calendar
S
M
6
13
20
27
7
14
21
28
S
7
14
21
28
S
7
14
21
28
January
T W R
1
2
3
8
9 10
15 16 17
22 23 24
29 30 31
April
W
3
10
17
24
M
1
8
15
22
29
T
2
9
16
23
30
M
1
8
15
22
29
July
T W
2
3
9 10
16 17
23 24
30 31
S
M
6
13
20
27
7
14
21
28
R
4
11
18
25
R
4
11
18
25
October
T W R
1
2
3
8
9 10
15 16 17
22 23 24
29 30 31
F
4
11
18
25
F
5
12
19
26
F
5
12
19
26
F
4
11
18
25
S
5
12
19
26
S
6
13
20
27
S
6
13
20
27
S
5
12
19
26
MMP Standard Questionnaire Calendar
S
M
3
10
17
24
4
11
18
25
February
T W R
5
12
19
26
S
M
T
5
12
19
26
6
13
20
27
7
14
21
28
6
13
20
27
May
W
1
8
15
22
29
7
14
21
28
R
2
9
16
23
30
S
M
4
11
18
25
5
12
19
26
August
T W R
1
6
7
8
13 14 15
20 21 22
27 28 29
S
M
November
T W R
3
10
17
24
4
11
18
25
5
12
19
26
6
13
20
27
7
14
21
28
F
1
8
15
22
F
3
10
17
24
31
F
2
9
16
23
30
F
1
8
15
22
29
S
2
9
16
23
S
4
11
18
25
S
3
10
17
24
31
S
2
9
16
23
30
S
M
3
10
17
24
31
4
11
18
25
S
M
2
9
16
23
30
3
10
17
24
S
1
8
15
22
29
S
1
8
15
22
29
M
2
9
16
23
30
M
2
9
16
23
30
March
T W R
7
14
21
28
F
1
8
15
22
29
S
2
9
16
23
30
June
T W R
F
5
12
19
26
6
13
20
27
6
13
20
27
7
14
21
28
S
1
8
15
22
29
September
T W R
3
4
5
10 11 12
17 18 19
24 25 26
F
6
13
20
27
S
7
14
21
28
F
6
13
20
27
S
7
14
21
28
4
11
18
25
5
12
19
26
December
T W R
3
4
5
10 11 12
17 18 19
24 25 26
31
182
2014 Calendar
January
S
M
T
5
12
19
26
6
13
20
27
7
14
21
28
W
1
8
15
22
29
T
1
8
15
22
29
April
W
2
9
16
23
30
S
M
6
13
20
27
7
14
21
28
S
M
6
13
20
27
7
14
21
28
July
T
W
1
2
8
9
15 16
22 23
29 30
R
2
9
16
23
30
R
3
10
17
24
R
3
10
17
24
31
F
3
10
17
24
31
F
4
11
18
25
F
4
11
18
25
S
4
11
18
25
S
5
12
19
26
S
5
12
19
26
S
M
2
9
16
23
3
10
17
24
M
T
5
12
19
26
6
13
20
27
7
14
21
28
W
1
8
15
22
29
R
2
9
16
23
30
F
3
10
17
24
31
S
4
11
18
25
MMP Standard Questionnaire Calendar
4
11
18
25
5
12
19
26
6
13
20
27
F
7
14
21
28
S
M
4
11
18
25
5
12
19
26
May
T W R
1
6
7
8
13 14 15
20 21 22
27 28 29
S
M
August
T
W R
3
10
17
24
31
4
11
18
25
5
12
19
26
S
M
November
T
W R
F
2
9
16
23
30
3
10
17
24
4
11
18
25
7
14
21
28
October
S
February
T W R
6
13
20
27
5
12
19
26
7
14
21
28
6
13
20
27
F
2
9
16
23
30
F
1
8
15
22
29
S
1
8
15
22
S
3
10
17
24
31
S
2
9
16
23
30
S
M
2
9
16
23
30
3
10
17
24
31
S
1
8
15
22
29
S
7
14
21
28
M
2
9
16
23
30
M
1
8
15
22
29
March
T W R
F
4
11
18
25
5
12
19
26
6
13
20
27
7
14
21
28
S
1
8
15
22
29
T
3
10
17
24
June
W
4
11
18
25
R
5
12
19
26
F
6
13
20
27
S
7
14
21
28
September
T
W R
2
3
4
9
10 11
16 17 18
23 24 25
30
F
5
12
19
26
S
6
13
20
27
F
5
12
19
26
S
6
13
20
27
December
S
1
8
15
22
29
S
7
14
21
28
M
1
8
15
22
29
T
2
9
16
23
30
W
3
10
17
24
31
R
4
11
18
25
183
| File Type | application/pdf |
| Author | CDC User |
| File Modified | 2015-03-24 |
| File Created | 2015-03-24 |