2014 Standard Questionnaire for Medical Monitoring Proje
Medical Monitoring Project
MMP 2014 interview v10.0.2 clean
Patients Standard Interview
OMB: 0920-0740
OMB Number: 0920–0740
Expiration Date: 05/31/2015
2014 Standard Questionnaire for
Medical Monitoring Project (MMP)
VERSION 10.0.2
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 30333, ATTN: PRA (0920–0740). Do not send the completed form to this address.
_____________________________________________________________________________________________
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Atlanta, GA 30333
2014 MMP QUESTIONNAIRE
HIV Testing and Care Experiences 15
Stigma and Discrimination (R) 32
HIV Treatment and Adherence (T) 34
Pre-exposure prophylaxis (SR) 119
Aggregate information (SA) 121
Transmission Risk Behaviors (B) 136
Gynecological and Reproductive History (G) 144
General notes for QDS programmer (additional programming notes are located throughout the questionnaire):
Use version 2.6.1 of QDS.
Every question requires a response to move forward in the application unless otherwise noted.
Use the following values: .D = 8, .R = 7, NA = 6.
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”
QDS programming notes are not included in the application; they are merely there to help with coding.
Interviewer instructions and inconsistency checks are notes for the interviewers, but may also include coding instructions.
The QDS codebook should have a brief description of the variable. This includes all calculated variables.
Calculate questionnaire version number using variable name VERSION. This must be updated every time a change is made in the application.
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.
Calculate data collection cycle using variable name CYCYR. CYCYR = 2014.
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
Label module sections in the codebook. Use the Table of Contents for guidance.
PDP start date is January 1, 2014.
PDP end date is April 30, 2014.
Calculate the time to conduct an interview from D1 to C20 (i.e., exclude Preliminary Information and Interview Completion sections.
Calculate time to conduct each module.
Do not include the Response cards and calendars in the QDS program.
Distinguish between English and Spanish versions of the questionnaires.
The maximum size of text values is 100 except for E5 which is 200.
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]
No ☐ 0
Yes ☐ 1
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 won’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.
Have you ever
participated in the MMP interview? [PARTCPT]
No ☐ 0
Yes ☐ 1
Refused to answer ☐ 7
Don’t know ☐ 8
D1a. 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).
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 (2014). 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).
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
Skip to Say box before D3
Refused to answer ☐ 7
Don’t know ☐ 8
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]
Skip to D5
No ☐ 0
Yes ☐ 1
Skip to D5
Refused to answer ☐ 7
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
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 ☐ 77
Don’t know ☐ 88
D6. In what country or territory were you born? [DON’T READ CHOICES. CHECK ONLY ONE.] [CO_BORN]
Skip to D7
United States ☐ 1
Puerto Rico ☐ 2
Mexico ☐ 3
Cuba ☐ 4
Other (Specify: ____________________________) ☐ 5 [OTCTRY]
Skip to D7
Refused to answer ☐ 7
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.
D7. How well do you speak English? [READ CHOICES. CHECK ONLY ONE.] [LANWL1N3]
Very well ☐ 1
Well ☐ 2
Not well ☐ 3
Not at all ☐ 4
Refused to answer ☐ 7
Don’t know ☐ 8
D8. Do you speak a language other than English at home? [LANWL2N3]
Skip to D9
No ☐ 0
Yes ☐ 1
Skip to D9
Refused to answer ☐ 7
Don’t know ☐ 8
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
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 (7) |
Don’t know (8) |
D12a. |
…lived on the street? [HOMEL_9A]
|
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
D12b. |
…lived in a shelter? [HOMEL_9B] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
D12c. |
…lived in a Single Room Occupancy (SRO) hotel? [HOMEL_9C]
|
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
D12d. |
…lived in a car? [HOMEL_9D] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
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
Skip to Say box before D17
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
Yes ☐ 1
Skip to Say box before D17
Refused to answer ☐ 7
Don’t know ☐ 8
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.
|
|
No (0) |
Yes (1) |
Refused to answer (7) |
Don’t know (8) |
D15a. |
Private health insurance [KINDA_3] |
☐ |
☐ |
☐ |
☐ |
D15b. |
Medicaid [KINDB_3] |
☐ |
☐ |
☐ |
☐ |
D15c. |
Medicare [KINDC_3] |
☐ |
☐ |
☐ |
☐ |
D15d. |
Ryan White [KINDD_3] |
☐ |
☐ |
☐ |
☐ |
D15e. |
ADAP [KINDE_3] |
☐ |
☐ |
☐ |
☐ |
D15f. |
Tricare or CHAMPUS [KINDF_3] |
☐ |
☐ |
☐ |
☐ |
D15g. |
Veterans Administration coverage [KINDG_3] |
☐ |
☐ |
☐ |
☐ |
D15h. |
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 D15a-D15i 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.”
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 ☐ 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
Skip to Say box before A1
Illegal or possibly illegal activities ☐ 7
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 to December 31st, 2013. 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.]
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.”
Monthly Income [MTH_IN_3] Yearly Income [YR_IN_3]
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. j. k. l. m. |
$2917 to $3333 $3334 to $4166 $4167 to $4999 $5000 to $6249 $6250 or more |
v. w. x. y. z. |
$35,000 to $39,999 $40,000 to $49,999 $50,000 to $59,999 $60,000 to $74,999 $75,000 or more |
77 |
Refused to answer |
77 |
Refused to answer |
88 |
Don’t know |
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).
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.
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 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.” 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 12 months or earlier than 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.]
Skip to interviewer instructions before A3
A2. Before your positive test in __ __ /__ __ __ __ [INSERT DATE FROM A1], did you ever have a negative HIV test? [HIVBEF_9]
No ☐ 0
Yes ☐ 1
Skip to interviewer instructions before A3
Refused to answer ☐ 7
Don’t know ☐ 8
QDS programming note for A2: Insert date from A1 in question.
A2b. 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: A2b (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 A2b is earlier than March 1985, confirm response.
QDS programming note for inconsistency check after A2b: If A2b 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
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 “OB-GYN 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.
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]
Skip to Say box before A6
No ☐ 0
Yes ☐ 1
Skip to Say box before A6
Not applicable ☐ 6
Refused to answer ☐ 7
Don’t know ☐ 8
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
Skip to A5c
I asked them to tell all of my partners ☐ 3
Skip to Say box before A6
I told them that I didn’t have any partners ☐ 4
Refused to answer ☐ 7
Don’t know ☐ 8
A5b. 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
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 care. Go back to previous question to confirm the date.” Allow the program to advance. If A6 is later than 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 and confirm response.” 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;
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) or later than I4 (interview date).
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
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
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
Skip to A9
Skip to Say
box before A10a
Don’t know ☐ 8
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 2 questions, tell me how strongly you agree or disagree with the following statements about your HIV medical care?”
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
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 [USUAL SOURCE OF CARE FACILITY NAME] for any sort of care? [TIMCR_13]
___ ___ ___ [777 = Refused to answer, 888 = Don’t know]
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 [USE 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]
Skip to A16
Yes ☐ 1
Skip to A16
Don’t know ☐ 8
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]
___ ___ [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
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: |
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: 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 |
CODE: SEE CODE LIST BELOW FOR RESPONSES. [DON’T READ CHOICES. CHECK ONLY ONE.] |
A20. |
HIV case management services
|
a. [______] [HIVC12_9]
|
b. [______] [HIVCMS_9]
|
[HIVCRS_9] Other (Specify:________) [HIVC_9OS] |
A21. |
Counseling about how to prevent the spread of HIV
|
a. [______] [HIVE12_9]
|
b. [______] [HIVEDU_9]
|
[HIVERS_9] Other (Specify:________) [HIVE_9OS] |
Interviewer instructions: If applicable, use the state program name for ADAP when asking A22 (medicine through ADAP). |
||||
A22. |
Medicine through the AIDS Drug Assistance Program (ADAP)
|
a. [______] [GET_ADAP]
|
b. [______] [NED_ADAP]
|
[RS_ADAP] Other (Specify:________) [RS_A_9OS] |
A23. |
Professional help remembering to take your HIV medicines on time or correctly |
a. [______] [ASS12_9]
|
b. [______] [ASS_9]
|
[ASSRS_9] Other (Specify:________) [ASSR_9OS] |
A24. |
HIV peer group support
|
a. [______] [GET_GRP]
|
b. [______] [NED_GRP]
|
[RS_GRP] Other (Specify:________) [RS_G_9OS] |
A25.
|
Dental care
|
a. [______] [DENS12_9] |
b. [______] [DENSER_9] |
[DENSRS_9] Other (Specify:________) [DENS_9OS] |
A26. |
Mental health services
|
a. [______] [MENC12_9] |
b. [______] [MENCON_9] |
[MENCRS_9] Other (Specify:________) [MENC_9OS] |
A27. |
Drug or alcohol counseling or treatment
|
a. [______] [GET_SUBU]
|
b. [______] [NED_SUBU]
|
[RS_SUBU] Other (Specify:________) [RS_U_9OS] |
A28. |
Public benefits including Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)
|
a. [______] [GET_SSDI]
|
b. [______] [NED_SSDI]
|
[RS_SSDI] Other (Specify:________) [RS_S_9OS] |
A29. |
Domestic violence services
|
a. [______] [GET_DOMS] |
b. [______] [NED_DOMS] |
[RS_DOMS] Other (Specify:________) [RS_D_9OS] |
A30. |
Shelter or housing services
|
a. [______] [SHLT12_9] |
b. [______] [SHLTER_9] |
[SHLTRS_9] Other (Specify:________) [SHLT_9OS] |
A31. |
Meal or food services
|
a. [______] [MLSF12_9]
|
b. [______] [MLSFOD_9] |
[MLSFRS_9] Other (Specify:________) [MLSF_9OS] |
A32. |
Home health services
|
a. [______] [HHSA12_9] |
b. [______] [HHSASS_9] |
[HHSARS_9] Other (Specify:________) [HHSA_9OS] |
A33. |
Transportation assistance
|
a. [______] [TRAS12_9] |
b. [______] [TRASAS_9] |
[TRASRS_9] Other (Specify:________) [TRAS_9OS] |
A34. |
Childcare services
|
a. [______] [CHLD12_9] |
b. [______] [CHLDCR_9] |
[CHLDRS_9] Other (Specify:________) [CHLD_9OS] |
A35. |
Interpreter services
|
a. [______] [GET_INTS] |
b. [______] [NED_INTS] |
[RS_INTS] Other (Specify:________) [RS_I_9OS] |
A36. |
Nutritional services |
a. [______] [GET_NUTR] |
b. [______] [NED_NUTR] |
[RS_NUTR] Other (Specify:________) [RS_N10OS] |
A37. |
Eye or vision services |
a. [______] [GET_ICN3] |
b. [______] [NED_ICN3] |
[RS_ICN3] Other (Specify:________) [RS_IN3OS] |
A38. |
A lawyer or legal services |
a. [______] [GET_LAN3] |
b. [______] [NED_LAN3] |
[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
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
Don’t know ☐ 8
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.”
|
|
Disagree (0) |
Agree (1) |
Refused to answer (7) |
Don’t know (8) |
R1a. |
It is difficult to tell people about my HIV infection [STIGMA1A] |
☐ |
☐ |
☐ |
☐ |
R1b. |
Being HIV positive makes me feel dirty [STIGMA1B] |
☐ |
☐ |
☐ |
☐ |
R1c. |
I feel guilty that I am HIV positive [STIGMA1C] |
☐ |
☐ |
☐ |
☐ |
R1d. |
I am ashamed that I am HIV positive [STIGMA1D] |
☐ |
☐ |
☐ |
☐ |
R1e. |
I sometimes feel worthless because I am HIV positive [STIGMA1E] |
☐ |
☐ |
☐ |
☐ |
R1f. |
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? |
No (0) |
Yes (1) |
Refused to answer (7) |
Don’t know (8) |
R2a. |
Exhibited hostility or a lack of respect toward you? [STIGMA2A] |
☐ |
☐ |
☐ |
☐ |
R2b. |
Given you less attention than other patients? [STIGMA2B] |
☐ |
☐ |
☐ |
☐ |
R2c. |
Refused you service? [STIGMA2C] |
☐ |
☐ |
☐ |
☐ |
Interviewer instructions: If any of the responses in R2a–R2c is “yes,” go to R3. Otherwise, skip to Say box before T1.
R3. |
Did the discrimination occur because of |
No (0) |
Yes (1) |
Refused to answer (7) |
Don’t know (8) |
R3a. |
…your HIV infection? [STIGMA3A] |
☐ |
☐ |
☐ |
☐ |
R3b. |
…your gender? [STIGMA3B] |
☐ |
☐ |
☐ |
☐ |
R3c. |
…your sexual orientation and practices? [STIGMA3C] |
☐ |
☐ |
☐ |
☐ |
R3d. |
…your race or ethnicity? [STIGMA3D] |
☐ |
☐ |
☐ |
☐ |
R3e. |
your drug injecting habit? [STIGMA3E] |
☐ |
☐ |
☐ |
☐ |
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
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 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]
Skip
to Say box before T5
Yes ☐
1
Skip
to T14
Don’t know ☐ 8
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 remember, none of this information will be shared with your doctor, nurse, or other health care worker.”
T5. |
a. Are you currently taking [INSERT DRUG NAME]?
CODES: No = 0, Yes = 1, Refused to answer = 7, Don’t know = 8
If “Yes,” go to T5b; otherwise, skip to next drug. |
b. How many pills, spoonfuls, or injections are you supposed to take of [INSERT DRUG NAME] each time you take it?
CODES: Refused to answer = 77,
|
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 [INSERT DRUG NAME]? 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
|
e. The day before yesterday, 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 |
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) |
_____ [COMBCUR]
|
___ ___ [COMBET_9] |
___ ___ [COMBDY_9] |
___ ___ [CBMIS1_9] |
___ ___ [CBMIS2_9] |
___ ___ [CBMIS3_9] |
Trizivir (AZT+3TC+ ABC) |
_____ [TRIZCUR] |
___ ___ [TRIZET_9] |
___ ___ [TRIZDY_9] |
___ ___ [TZMIS1_9] |
___ ___ [TZMIS2_9] |
___ ___ [TZMIS3_9] |
Epzicom (3TC+ABC) |
_____ [EPZICUR] |
___ ___ [EPZIET_9] |
___ ___ [EPZIDY_9] |
___ ___ [EPMIS1_9] |
___ ___ [EPMIS2_9] |
___ ___ [EPMIS3_9] |
Truvada (FTC+TDF) |
_____ [TRUVCUR] |
___ ___ [TRUVET_9] |
___ ___ [TRUVDY_9] |
___ ___ [TRMIS1_9] |
___ ___ [TRMIS2_9] |
___ ___ [TRMIS3_9] |
Atripla (EFV/FTC/TDF) |
_____ [ATRIPLA] |
___ ___ [ATRTIM_9] |
___ ___ [ATRDAY_9] |
___ ___ [ATMIS1_9] |
___ ___ [ATMIS2_9] |
___ ___ [ATMIS3_9] |
Complera (FTC/RPV/TDF) |
_____ [COMPLERA] |
_____ [COMPL_ET] |
_____ [COMPL_DY] |
_____ [COMPL_S1] |
_____ [COMPL_S2] |
_____ [COMPL_S3] |
Stribild (“Quad,” EVG/ COBI/FTC/TDF) |
_____ [STRIBAN3] |
_____ [STRIETN3] |
_____ [STRIDYN3] |
_____ [STRIS1N3] |
_____ [STRIS2N3] |
_____ [STRIS3N3] |
Nucleoside/ Nucleotide Analogue Reverse Transcriptase Inhibitors (NRTI), also known as ‘Nukes’ |
|
|
|
|
|
|
Epivir (lamivudine, 3TC) |
_____ [LAMICUR] |
___ ___ [LAMIET_9] |
___ ___ [LAMIDY_9] |
___ ___ [LAMIS1_9] |
___ ___ [LAMIS2_9]
|
___ ___ [LAMIS3_9] |
Videx EC (didanosine, ddI EC) |
_____ [DAECCUR] |
___ ___ [DAECET_9] |
___ ___ [DAECDY_9] |
___ ___ [DAMIS1_9] |
___ ___ [DAMIS2_9]
|
___ ___ [DAMIS3_9] |
Videx (didanosine, ddI) |
_____ [DIDACUR] |
___ ___ [DIDAET_9] |
___ ___ [DIDADY_9] |
___ ___ [DIMIS1_9] |
___ ___ [DIMIS2_9] |
___ ___ [DIMIS3_9] |
Emtriva (emtricitabine, FTC) |
_____ [EMTRCUR] |
___ ___ [EMTRET_9] |
___ ___ [EMTRDY_9] |
___ ___ [EMMIS1_9] |
___ ___ [EMMIS2_9]
|
___ ___ [EMMIS3_9] |
Viread (tenofovir, TDF) |
_____ [TENOCUR] |
___ ___ [TENOET_9] |
___ ___ [TENODY_9] |
___ ___ [TEMIS1_9] |
___ ___ [TEMIS2_9] |
___ ___ [TEMIS3_9] |
Zerit (stavudine, d4T) |
_____ [STAVCUR] |
___ ___ [STAVET_9] |
___ ___ [STAVDY_9] |
___ ___ [STMIS1_9] |
___ ___ [STMIS2_9] |
___ ___ [STMIS3_9] |
Retrovir (zidovudine, AZT, ZDV) |
_____ [ZIDOCUR] |
___ ___ [ZIDOET_9] |
___ ___ [ZIDODY_9] |
___ ___ [ZIMIS1_9] |
___ ___ [ZIMIS2_9] |
___ ___ [ZIMIS3_9] |
Ziagen (abacavir, ABC) |
_____ [ABACACUR] |
___ ___ [ABACET_9] |
___ ___ [ABACDY_9] |
___ ___ [ABMIS1_9] |
___ ___ [ABMIS2_9] |
___ ___ [ABMIS3_9] |
Protease Inhibitors (PI) |
|
|
|
|
|
|
Invirase (saquinavir hard gel, SQV) |
_____ [SACQCUR] |
___ ___ [SACQT_9] |
___ ___ [SACQDY_9] |
___ ___ [SAMIS1_9] |
___ ___ [SAMIS2_9] |
___ ___ [SAMIS3_9] |
Kaletra (lopinavir/ ritonavir, LPVr) |
_____ [LOPICUR] |
___ ___ [LOPIT_9] |
___ ___ [LOPIDY_9] |
___ ___ [LOMIS1_9] |
___ ___ [LOMIS2_9]
|
___ ___ [LOMIS3_9] |
Crixivan (indinavir, IDV) |
_____ [INDICUR] |
___ ___ [INDIET_9] |
___ ___ [INDIDY_9] |
___ ___ [INMIS1_9] |
___ ___ [INMIS2_9] |
___ ___ [INMIS3_9] |
Lexiva (fosamprenavir, FPV) |
_____ [FUSACUR] |
___ ___ [FUSAET_9] |
___ ___ [FUSADY_9] |
___ ___ [FOMIS1_9] |
___ ___ [FOMIS2_9] |
___ ___ [FOMIS3_9] |
Reyataz (atazanavir, ATV) |
_____ [ATAZCUR] |
___ ___ [ATAZET_9] |
___ ___ [ATAZDY_9] |
___ ___ [ATZIS1_9] |
___ ___ [ATZIS2_9] |
___ ___ [ATZIS3_9] |
Norvir (ritonavir, RTV) |
_____ [RITOCUR] |
___ ___ [RITOET_9] |
___ ___ [RITODY_9] |
___ ___ [RIMIS1_9] |
___ ___ [RIMIS2_9] |
___ ___ [RIMIS3_9] |
Viracept (nelfinavir, NFV) |
_____ [NELFCUR] |
___ ___ [NELFET_9] |
___ ___ [NELFDY_9] |
___ ___ [NEMIS1_9] |
___ ___ [NEMIS2_9] |
___ ___ [NEMIS3_9] |
Aptivus (tipranavir, TPV) |
_____ [TIPRCUR] |
___ ___ [TIPRET_9] |
___ ___ [TIPRDY_9] |
___ ___ [TIMIS1_9] |
___ ___ [TIMIS2_9] |
___ ___ [TIMIS3_9] |
Prezista (darunavir, DRV) |
___ ___ [PREZCUR] |
___ ___ [PREZET_9] |
___ ___ [PREZDY_9] |
___ ___ [PRMIS1_9] |
___ ___ [PRMIS2_9] |
___ ___ [PRMIS3_9] |
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI), also known as ‘Non-nukes’ |
|
|
|
|
|
|
Rescriptor (delavirdine, DLV) |
_____ [DELACUR] |
___ ___ [DELAET_9] |
___ ___ [DELADY_9] |
___ ___ [DEMIS1_9]
|
___ ___ [DEMIS2_9]
|
___ ___ [DEMIS3_9] |
Viramune (nevirapine, NVP) |
_____ [NEVICUR] |
___ ___ [NEVIET_9] |
___ ___ [NEVIDY_9] |
___ ___ [NEVIS1_9] |
___ ___ [NEVIS2_9] |
___ ___ [NEVIS3_9] |
Sustiva (efavirenz, EFV) |
_____ [EFAVCUR] |
___ ___ [EFAVET_9] |
___ ___ [EFAVDY_9] |
___ ___ [EFMIS1_9] |
___ ___ [EFMIS2_9] |
___ ___ [EFMIS3_9] |
Intelence (etravirine ETV)
|
_____ [TMC] |
___ ___ [TMCTIM_9] |
___ ___ [TMCDAY_9] |
___ ___ [TMMIS1_9] |
___ ___ [TMMIS2_9] |
___ ___ [TMMIS3_9] |
Edurant (rilpivirine, RPV) |
_____ [EDURANT] |
___ ___ [EDURA_ET] |
___ ___ [EDURA_DY] |
___ ___ [EDURA_S1]
|
___ ___ [EDURA_S2]
|
___ ___ [EDURA_S3] |
Entry/Fusion Inhibitors |
|
|
|
|
|
|
Fuzeon (enfuvirtide, T–20) |
_____ [ENFUCUR] |
___ ___ [ENFUET_9] |
___ ___ [ENFUND_9] |
___ ___ [ENMIS1_9] |
___ ___ [ENMIS2_9] |
___ ___ [ENMIS3_9] |
Selzentry (maraviroc, MVC) |
_____ [MARAVIRO] |
___ ___ [MARTIM_9] |
___ ___ [MARDAY_9] |
___ ___ [MAMIS1_9] |
___ ___ [MAMIS2_9] |
___ ___ [MAMIS3_9] |
Integrase Inhibitors |
|
|
|
|
|
|
Isentress, (raltegravir, RAL) |
_____ [RALTEGRA] |
___ ___ [RALTIM_9] |
___ ___ [RALDAY_9] |
___ ___ [RAMIS1_9] |
___ ___ [RAMIS2_9] |
___ ___ [RAMIS3_9] |
Tivicay, (dolutegravir, DTG) |
_____ [DOLUCUR3] |
___ ___ [DOLUET3] |
___ ___ [DOLUDY3] |
___ ___ [DOLUMS13] |
___ ___ [DOLUMS23] |
___ ___ [DOLUMS33] |
Other ART Medicines |
|
|
|
|
|
|
Are you currently taking any other antiretroviral medicine? (Specify other ARV:________) |
_____ [OTSPAYN1] |
___ ___ [ODRET1_9] |
___ ___ [ODTDY1_9] |
___ ___ [ODMIS1_9] |
___ ___ [ODMIS2_9] |
___ ___ [ODMIS3_9] |
Are you currently taking any other antiretroviral medicine? (Specify other ARV:________) |
_____ [OTSPAYN2] |
___ ___ [ODRET2_9] |
___ ___ [ODTDY2_9] |
___ ___ [ODMI21_9] |
___ ___ [ODMI22_9] |
___ ___ [ODMS23_9] |
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).
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]
Skip to Say
box before T8
Skip to Say
box before T8
Don’t know….......... ☐ 8
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. CHOOSE 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.”
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. CHOOSE 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. CHOOSE ONLY ONE] [LTMMED10]
Within the past week ☐ 1
1–2 weeks ago ☐ 2
3–4 weeks ago ☐ 3
1–3 months ago ☐ 4
Skip to Say box before T11
More than 3 months ago ☐ 5
Never skip medicines ☐ 6
Refused to answer ☐ 7
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]
Other 1 (Specify:_____________________________) ☐ 11 [MSMD_12K][MSK_12OS]
Other 2 (Specify:_____________________________) ☐ 12 [MSMD_12L] [MSL_12OS]
Refused to answer ☐ 77
Don’t know ☐ 88
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. CHOOSE 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.”
T12a. How sure are you that you will be able to take all or most of your medication as directed? [READ CHOICES. CHOOSE 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. CHOOSE 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. CHOOSE 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. CHOOSE ONLY ONE] [SUPRT_FF]
Very dissatisfied ☐ 0
Somewhat dissatisfied ☐ 1
Somewhat satisfied ☐ 2
Very satisfied ☐ 3
Refused to answer ☐ 7
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. CHOOSE 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]
Skip to T18
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
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]
Skip to T18
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 ☐ 77
Don’t know ☐ 88
T18. During the past 12 months, have you participated in an HIV clinical trial? [CLTREC_9]
No ☐ 0
Yes ☐ 1
Refused to answer ☐ 7
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 from anywhere from 0 to over a hundred.”
Interviewer instructions for SX_TFPN4 (number of female partners):
If BIRTGEN = 7 (refused to answer) or 8 (don’t know), skip to the serosorting section (Say box before SEROSRT1). If BIRTHGEN = 1 (male) and (GENDER = 7 [refused to answer] or 8 [don’t know]), skip to the serosorting section (Say box before SEROSRT1). If BIRTHGEN = 2 (female) and (GENDER = 7 [refused to answer] or 8 [don’t know]), skip to the serosorting section (Say box before SEROSRT1). If BIRTHGEN = 3 (intersex) and (GENDER = 7 [refused to answer] or 8 [don’t know]), skip to the serosorting section (Say box before SEROSRT1).
Our definition of sex only includes vaginal and anal sex. Therefore, if the respondent is female (BIRTGEN = 2 [female] or 3 [intersex] and GENDER = 2 [female], skip to SX_TMPN4 (number of male partners).
Otherwise 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 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 total number of sex partners.
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 respondent is female (BIRTGEN = 2 [female] or 3 [intersex] and GENDER = 2 [female]), go to say box before SX_TWPN4 (number of female-female partners). Otherwise 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]
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 female-female partners) ≥ 1, then SXFFONN4 (female-female only partners) = 1; otherwise SXFFONN4 = 0. Variable label of SXFFONN4 is female-female only partners.
Interviewer instructions before SX_EXCN4 (exchange sex):
Women who only had sex with women: If respondent is female (BIRTGEN = 2 [female] or 3 [intersex] and GENDER = 2 [female]) AND the number of male partners = 0 (SX_TMPN4=0) and the number of transgender partners = 0 (SX_TTPN4=0), 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.
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):
“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):
“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.”
Interviewer instructions after Say box #2 before SX_NM1N4 (name of partner 1):
Go to SX_NM1N4 (name of partner 1).
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_TOTN4 (total number of sex partners) = 1 AND SX_NM1N4 (name of partner 1), is “refused to answer,” remind the respondent that he or she can provide initials, nicknames, or another name to identify the partner. If SX_NM1N4 (name of partner 1), is still “refused to answer,” skip to the serosorting section (Say box before SEROSRT1).
If SX_TOTN4 (total number of sex partners) = 1 AND SX_NM1N4 (name of partner 1) is not “refused to answer,” skip to instructions before SXPGN1N4 (partner’s gender-partner 1). If SX_TOTN4 (total number of sex partners) ≥ 2, go to SX_NM2N4 (name of partner 2).
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_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 (total number of sex partners) = 2, skip to instructions before SXPGN1N4 (partner’s gender-partner 1); If SX_TOTN4 (total number of sex partners) ≥ 3, go to SX_NM3N4 (name of partner 3). 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.
SN.1.2. What shall we call the 3rd person with whom you had sex during the past 12 months?
[SX_NM3N4]
______________________________ [7 = Refused to answer]
Interviewer instructions for SX_NM3N4 (name of partner 3):
If SX_TOTN4 (total number of sex partners) = 3 AND SX_NM1N4 (name of partner 1), SX_NM2N4 (name of partner 2), and SX_NM3N4 (name of partner 3) are all “refused to answer,” skip to the serosorting section (Say box before SEROSRT1).
If SX_TOTN4 (total number of sex partners) = 3, skip to instructions before SXPGN1N4 (partner’s gender-partner 1). If SX_TOTN4 (total number of sex partners) ≥ 4, go to SX_NM4N4 (name of partner 4).
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.
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_TOTN4 (total number of sex partners) = 4 AND SX_NM1N4 (name of partner 1), SX_NM2N4 (name of partner 2), SX_NM3N4 (name of partner 3), and SX_NM4N4 (name of partner 4) are all “refused to answer,” skip to the serosorting section (Say box before SEROSRT1).
If SX_TOTN4 (total number of sex partners) = 4, skip to instructions before SXPGN1N4 (partner’s gender-partner 1). If SX_TOTN4 (total number of sex partners) ≥ 5, go to SX_NM5N4 (name of partner 5).
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.
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_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 instructions before SXPGN1N4 (partner’s gender-partner 1).
QDS programming note for SX_NM5N4:
Use open-ended response.
Character limit = 50.
Do not allow for a “don’t know” response option.
Variable label is name of partner 5.
SN.1.5. So, the total number of people you had 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 partner demographics section. If SXTOVRN4 = 7 (refused to answer), skip to the serosorting section (Say box before SEROSRT1).
Partner demographics (SP)
Questions |
Sexual Partners |
||||
|
Partner 1 [Insert partner name SX_NM1N4] |
Partner 2 [Insert partner name SX_NM2N4] |
Partner 3 [Insert partner name SX_NM3N4] |
Partner 4 [Insert partner name SX_NM4N4] |
Partner 5 [Insert partner name SX_NM5N4] |
Instructions for 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). |
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Interviewer instructions before SXPGN1N4 (partner’s gender-partner 1), SXPGN2N4 (partner’s gender-partner 2), SXPGN3N4 (partner’s gender-partner 3), SXPGN4N4 (partner’s gender-partner 4), SXPGN5N4 (partner’s gender-partner 5):
Skip question series if respondent refuses to provide a partner name: If SX_NM1N4 is 7 (refused to answer), skip to column with partner 2 question series. If SX_NM2N4 is 7 (refused to answer), skip to column with partner 3 question series. If SX_NM3N4 is 7 (refused to answer), skip to column with partner 4 question series. If SX_NM4N4 is 7 (refused to answer), skip to column with partner 5 question series. If SX_NM5N4 is 7 (refused to answer), skip to interviewer instructions for aggregate information section.
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’s gender-partner 1), SXPGN2N4 (partner’s gender-partner 2), SXPGN3N4 (partner’s gender-partner 3), SXPGN4N4 (partner’s gender-partner 4), and SXPGN5N4 (partner’s gender-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. |
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SP.1.0. Is [INSERT PARTNER NAME] male, female, or transgender? [READ CHOICES. CHECK ONLY ONE.]
Male 1
Female 2
Transgender 3
Refused to answer 7
Don’t know 8 |
[SXPGN1N4]
1
2
3
7
8
If response is 1, 2, 3, 7, or 8, go to SXPAG1N4 (partner age-partner 1). |
[SXPGN2N4]
1
2
3
7
8
If response is 1, 2, 3, 7, or 8, go to SXPAG2N4 (partner age-partner 2). |
[SXPGN3N4]
1
2
3
7
8
If response is 1, 2, 3, 4, or 7, go to SXPAG3N4 (partner age-partner 3. |
[SXPGN4N4]
1
2
3
7
8
If response is 1, 2, 3, 4, or 7, go to SXPAG4N4 (partner age-partner 4). |
[SXPGN5N4]
1
2
3
7
8
If response is 1, 2, 3, 4, or 7, go to SXPAG5N4 (partner age-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.
If SX_TMPN4 (number of male partners) ≤ 5, then the number of “male” responses 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) must be = SX_TMPN4 (number of male partners). If SX_TMPN4 (number of male partners) > 5, then the number of “male” responses 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) must be ≤ SX_TMPN4 (number of male partners).
If SX_TFPN4 (number of female partners) ≤ 5, then the number of “female” responses 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) must be = SX_TFPN4 (number of female partners). If SX_TFPN4 (number of female partners) > 5, then the number of “female” responses 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) must be ≤ SX_TFPN4 (number of female partners).
If SX_TTPN4 (number of transgender partners) ≤ 5, then the number of “transgender” responses 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) must be = SX_TTPN4 (number of transgender partners). If SX_TTPN4 (number of transgender partners) > 5, then the number of “transgender” responses 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) must be ≤ SX_TTPN4 (number of transgender partners).
If respondent is female (BIRTGEN = 2 [female] or 3 [intersex] and GENDER = 2 [female]) AND SXPGN1N4, SXPGN2N4, SXPGN3N4, SXPGN4N4, OR SXPGN5N4 are 2 (female), then 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 questions if necessary.” |
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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) “For the next question we will use Response Card K-1.” |
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SP.2.0. Which of the following age groups best describes [INSERT PARTNER NAME]? [READ CHOICES. CHECK ONLY ONE.] ≤24 years old 1
25-29 years old 2
30-34 years old 3
35-39 years old 4
40-44 years old 5
45-49 years old 6
>=50 years old 7
Refused to answer 77
Don’t know 88 |
[SXPAG1N4]
1
2
3
4
5
6
7
77
88
For all responses, go to Say box before SXPEN1N4 (partner ethnicity-partner 1). |
[SXPAG2N4]
1
2
3
4
5
6
7
77
88
For all responses, go to SXPEN2N4 (partner ethnicity-partner 2). |
[SXPAG3N4]
1
2
3
4
5
6
7
77
88
For all responses, go to SXPEN3N4 (partner ethnicity-partner 3).
|
[SXPAG4N4]
1
2
3
4
5
6
7
77
88
For all responses, go to SXPEN4N4 (partner ethnicity-partner 4). |
[SXPAG5N4]
1
2
3
4
5
6
7
77
88
For all responses, go to SXPEN5N4 (partner ethnicity-partner 5). |
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 age-partner 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. |
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SAY: “The next two questions ask about partners’ race and ethnicity. We’re asking them to better understand the health of all groups.” |
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SP.3.0. Is [INSERT PARTNER NAME] Hispanic, Latino/a, or of Spanish origin? If you’re not sure, give me your best guess.
No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[SXPEN1N4]
0
1
7
8
For all responses, go to SXPRC1N4 (partner race-partner 1).
|
[SXPEN2N4]
0
1
7
8
For all responses, go to SXPRC2N4 (partner race-partner 2). |
[SXPEN3N4]
0
1
7
8
For all responses, go to SXPRC3N4 (partner race-partner 3). |
[SXPEN4N4]
0
1
7
8
For all responses, go to SXPRC4N4 (partner race-partner 4). |
[SXPEN5N4]
0
1
7
8
For all responses, go to SXPRC5N4 (partner race-partner 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. |
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SP.4.0. Which of the following 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 THAT APPLY.]
American Indian or Alaskan Native 1
Asian 2
Black or African American 3
Native Hawaiian or Other Pacific Islander 4
White 5
Refused to answer 7
Don’t know 8 |
[SXPRC1N4]
1
2
3
4
5
7
8
For all responses, go to SXPCM1N4 (commitment-partner 1). |
[SXPRC2N4]
1
2
3
4
5
7
8
For all responses, go to SXPCM2N4 commitment-partner 2). |
[SXPRC3N4]
1
2
3
4
5
7
8
For all responses, go to SXPCM3N4 commitment-partner 3). |
[SXPRC4N4]
1
2
3
4
5
7
8
For all responses, go to SXPCM4N4 commitment-partner 4). |
[SXPRC5N4]
1
2
3
4
5
7
8
For all responses, go to SXPCM5N4 commitment-partner 5). |
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. |
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SP.5.0. How would you describe your level of commitment to [INSERT PARTNER NAME]? Are you… [READ CHOICES CHECK ONLY ONE.]
Not at all committed 1
Somewhat committed 2
Very committed 3
Committed to above and beyond anyone else 4
Refused to answer 7
Don’t know 8 |
[SXPCM1N4]
1
2
3
4
7
8
For all responses, go to interviewer instructions before SX_VS1N4 (vaginal sex-partner 1). |
[SXPCM2N4]
1
2
3
4
7
8
For all responses, go to interviewer instructions before SX_VS2N4 (vaginal sex-partner 2). |
[SXPCM3N4]
1
2
3
4
7
8
For all responses, go to interviewer instructions before SX_VS3N4 (vaginal sex-partner 3). |
[SXPCM4N4]
1
2
3
4
7
8
For all responses, go to interviewer instructions before SX_VS4N4 (vaginal sex-partner 3). |
[SXPCM5N4]
1
2
3
4
7
8
For all responses, go to interviewer instructions before SX_VS5N4 (vaginal sex-partner 4). |
QDS programming note for SXPCM1N4 (commitment-partner 1), SXPCM2N4 (commitment-partner 2), SXPCM3N4 (commitment-partner 3), SXPCM4N4 (commitment-partner 4), and SXPCM5N4 (commitment-partner 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. |
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Vaginal sex (SV)
Questions |
Sexual Partners |
||||
|
Partner 1 [Insert partner name SX_NM1N4] |
Partner 2 [Insert partner name SX_NM2N4] |
Partner 3 [Insert partner name SX_NM3N4] |
Partner 4 [Insert partner name SX_NM4N4] |
Partner 5 [Insert partner name SX_NM5N4] |
Instructions for 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). |
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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: If the respondent is transgender (BIRTGEN = 1 [male] and GENDER = 2 [female]) or (BIRTGEN = 2 [female] and GENDER = 1 [male]) or (GENDER = 3 [transgender]), then skip to transgender 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 (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and he reports only male partners (SXMLONN4 = 1) then skip to anal sex partner-by-partner series table (SXANL1N4 [anal sex-partner1], SXANL2N4 [anal sex-partner 2], SXANL3N4 [anal sex-partner 3], SXANL4N4 [anal sex-partner 4], or SXANL5N4 [anal sex-partner 5]).
If the respondent is male (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and SXPGN1N4 (partner gender-partner 1) = 1 (male), then skip to SXANL1N4 [anal sex-partner1].
If the respondent is male (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and SXPGN2N4 (partner gender-partner 2) = 1 (male), then skip to SXANL2N4 [anal sex-partner2].
If the respondent is male (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and SXPGN3N4 (partner gender-partner 3) = 1 (male), then skip to SXANL3N4 [anal sex-partner3].
If the respondent is male (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and SXPGN4N4 (partner gender-partner 4) = 1 (male), then skip to SXANL4N4 [anal sex-partner4].
If the respondent is male (BIRTGEN = 1 [male] or 3 [intersex] or 7 [refused to answer] or 8 [don’t know] and GENDER = 1 [male]), and SXPGN5N4 (partner gender-partner 5) = 1 (male), then skip to SXANL5N4 [anal sex-partner5].
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 [vaginal-partner 5]). |
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SV.1.0. During the past 12 months, did you have vaginal sex with [INSERT PARTNER NAME]? No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[SX_VS1N4]
0 Skip to SXANL1N4 (anal sex-partner 1)
1 Go to SV10+1N4 (vaginal10-partner 1)
7 Skip to SXANL1N4 (anal sex-partner 1)
8 Skip to SXANL1N4 (anal sex-partner 1) |
[SX_VS2N4]
0 Skip to SXANL2N4 (anal sex-partner 2)
1 Go to SV10+2N4 (vaginal10-partner 2)
7 Skip to SXANL2N4 (anal sex-partner 2)
8 Skip to SXANL2N4 (anal sex-partner 2) |
[SX_VS3N4]
0 Skip to SXANL3N4 (anal sex-partner 3)
1 Go to SV10+3N4 (vaginal10-partner 3)
7 Skip to SXANL3N4 (anal sex-partner 3)
8 Skip to SXANL3N4 (anal sex-partner 3) |
[SX_VS4N4]
0 Skip to SXANL4N4 (anal sex-partner 4)
1 Go to SV10+4N4 (vaginal10-partner 4)
7 Skip to SXANL4N4 (anal sex-partner 4)
8 Skip to SXANL4N4 (anal sex-partner 4) |
[SX_VS5N4]
0 Skip to SXANL5N4 (anal sex-partner 5)
1 Go to SV10+5N4 (vaginal10-partner 5)
7 Skip to SXANL5N4 (anal sex-partner 5)
8 Skip to SXANL5N4 (anal sex-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 months, did you have vaginal sex with [INSERT PARTNER NAME] more than 10 times? [READ CHOICES. CHECK ONLY ONE.] No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[SV10+1N4]
0 Go to SXVEN1N4 (times vaginal sex-partner 1).
1 Skip to SXANV1N4 (average number vaginal-partner 1).
7 Skip to Say box before SXVC1AN4 (condom vaginal-partner 1a).
8 Skip to Say box before SXVC1AN4 (condom vaginal-partner 1a). |
[SV10+2N4]
0 Go to SXVEN2N4 (times vaginal sex-partner 2).
1 Skip to SXANV2N4 (average number vaginal-partner 2).
7 Skip to interviewer instructions before SXVC2AN4 (condom vaginal-partner 2a).
8 Skip to interviewer instructions before SXVC2AN4 (condom vaginal-partner 2a). |
[SV10+3N4]
0 Go to SXVEN3N4 (times vaginal sex-partner 3).
1 Skip to SXANV3N4 (average number vaginal-partner 3).
7 Skip to interviewer instructions before SXVC3AN4 (condom vaginal-partner 3a).
8 Skip to interviewer instructions before SXVC3AN4 (condom vaginal-partner 3a). |
[SV10+4N4]
0 Go to SXVEN4N4 (times vaginal sex-partner 4).
1 Skip to SXANV4N4 (average number vaginal-partner 4).
7 Skip to interviewer instructions before SXVC4AN4 (condom vaginal-partner 4a).
8 Skip to interviewer instructions before SXVC4AN4 (condom vaginal-partner 4a). |
[SV10+5N4]
0 Go to SXVEN5N4 (times vaginal sex-partner 5).
1 Skip to SXANV5N4 (average number vaginal-partner 5).
7 Skip to interviewer instructions before SXVC5AN4 (condom vaginal-partner 5a).
8 Skip to interviewer instructions before SXVC5AN4 (condom vaginal-partner 5a). |
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 months, please tell me the exact number of times that you had vaginal sex with [INSERT PARTNER NAME]? __ __
Don’t know 77
Refused to answer 88
|
[SXVEN1N4]
__ __
Skip to Say box before SXVC1AN4 (condom vaginal-partner 1a).
77 Skip to Say box before SXVC1AN4 (condom vaginal-partner 1a).
88 Skip to Say box before SXVC1AN4 (condom vaginal-partner 1a).
|
[SXVEN2N4]
__ __
Skip to instructions before SXVC2AN4 (condom vaginal-partner 2a).
77 Skip to instructions before SXVC2AN4 (condom vaginal-partner 2a).
88 Skip to instructions before SXVC2AN4 (condom vaginal-partner 2a). |
[SXVEN3N4]
__ __
Skip to instructions before SXVC3AN4 (condom vaginal-partner 3a).
77 Skip to instructions before SXVC3AN4 (condom vaginal-partner 3a).
88 Skip to instructions before SXVC3AN4 (condom vaginal-partner 3a). |
[SXVEN4N4]
__ __
Skip to instructions before SXVC4AN4 (condom vaginal-partner 4a).
77 Skip to instructions before SXVC4AN4 (condom vaginal-partner 4a).
88 Skip to instructions before SXVC4AN4 (condom vaginal-partner 4a). |
[SXVEN5N4]
__ __
Skip to instructions before SXVC5AN4 (condom vaginal-partner 5a).
77 Skip to instructions before SXVC5AN4 (condom vaginal-partner 5a).
88 Skip to instructions before SXVC5AN4 (condom vaginal-partner 5a). |
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 SXVEN1N4 (times vaginal sex-partner 1) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN2N4 (times vaginal sex-partner 2) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN3N4 (times vaginal sex-partner 3) “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN4N4 (times vaginal sex-partner 4) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN5N4 (times vaginal sex-partner 5) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXVEN1N4 (times vaginal sex-partner 1) is >10, then display the following message: “You told me that you had vaginal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN2N4 (times vaginal sex-partner 2) is >10, then display the following message: “You told me that you had vaginal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN3N4 (times vaginal sex-partner 3) is >10, then display the following message: “You told me that you had vaginal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN4N4 (times vaginal sex-partner 4) is >10, then display the following message: “You told me that you had vaginal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXVEN5N4 (times vaginal sex-partner 5) is >10, then display the following message: “You told me that you had vaginal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
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. |
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SV.1.3. On average, how many times did you have vaginal sex with [INSERT PARTNER NAME] per month? ___ ___
Refused to answer 77
Don’t know 8 8
|
[SXANV1N4]
___ ___
Go to SXMVG1N4 (months vaginal sex-partner 1).
77 Go to SXMVG1N4 (months vaginal sex-partner 1).
88 Go to SXMVG1N4 (months vaginal sex-partner 1). |
[SXANV2N4]
___ ___
Go to SXMVG2N4 (months vaginal sex-partner 2).
77 Go to SXMVG2N4 (months vaginal sex-partner 2).
88 Go to SXMVG2N4 (months vaginal sex-partner 2). |
[SXANV3N4]
___ ___
Go to SXMVG3N4 (months vaginal sex-partner 3).
77 Go to SXMVG3N4 (months vaginal sex-partner 3).
88 Go to SXMVG3N4 (months vaginal sex-partner 3). |
[SXANV4N4]
___ ___
Go to SXMVG4N4 (months vaginal sex-partner 4).
77 Go to SXMVG4N4 (months vaginal sex-partner 4).
88 Go to SXMVG4N4 (months vaginal sex-partner 4). |
[SXANV5N4]
___ ___
Go to SXMVG5N4 (months vaginal sex-partner 5).
77 Go to SXMVG5N4 (months vaginal sex-partner 5).
88 Go to SXMVG5N4 (months vaginal sex-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 vaginal-partner 4), and SXANV5N4 (average number vaginal-partner 5): Range 1–90.
If SXANV1N4 (average number vaginal-partner 1) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANV2N4 (average number vaginal-partner 2) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANV3N4 (average number vaginal-partner 3) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANV4N4 (average number vaginal-partner 4) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANV5N4 (average number vaginal-partner 5) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXANV1N4 (average number vaginal-partner 1) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANV2N4 (average number vaginal-partner 2) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANV3N4 (average number vaginal -partner 3) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANV4N4 (average number vaginal-partner 4) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANV5N4 (average number vaginal-partner 5) > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” 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. |
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SV.1.4. During the past 12 months, how many months did you have vaginal sex with [INSERT PARTNER NAME]? ___ ___ months
Refused to answer 77
Don’t know 88 |
[SXMVG1N4]
___ ___
77
88
For all responses, go to Say box before SXVC1AN4 (condom vaginal-partner 1a).
|
[SXMVG2N4]
___ ___
77
88
For all responses, skip to instructions before SXVC2AN4 (condom vaginal-partner 2a). |
[SXMVG3N4]
___ ___
77
88
For all responses, skip to instructions before SXVC3AN4 (condom vaginal-partner 3a). |
[SXMVG4N4]
___ ___
77
88
For all responses, skip to instructions before SXVC4AN4 (condom vaginal-partner 4a). |
[SXMVG5N4]
___ ___
77
88
For all responses, skip to instructions before SXVC5AN4 (condom vaginal-partner 5a). |
QDS programming note for SXMVG1N4 (months vaginal sex-partner 1), SXMVG2N4 (months vaginal sex-partner 2), SXMVG3N4 (months vaginal sex-partner 3), SXMVG4N4 (months vaginal sex-partner 4), and SXMVG5N4 (months vaginal sex-partner 5): Range 1–12.
If SXMVG1N4 (months vaginal sex-partner 1) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMVG2N4 (months vaginal sex-partner 2) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMVG3N4 (months vaginal sex-partner 3) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMVG4N4 (months vaginal sex-partner 4), or SXMVG5N4 (months vaginal sex-partner 5) is “0,” then display the following message: “You told me that you had vaginal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXMVG1N4 (months vaginal sex-partner 1) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMVG2N4 (months vaginal sex-partner 2) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMVG3N4 (months vaginal sex-partner 3) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMVG4N4 (months vaginal sex-partner 4) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMVG5N4 (months vaginal sex-partner 5) >12, then display the following message: “Out of range. Interviewer instructions: confirm response.”
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. |
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SAY box before SXVC1AN4 (condom vaginal-partner 1a): “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 vaginal-partner 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 SXVC4AN4 (condom vaginal-partner 5a); otherwise skip to SXVC5BN4 (condom vaginal-partner 5b). |
|||||
SV.1.5.a. During the past 12 months, when you had vaginal sex with [INSERT PARTNER NAME] was a condom used? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[SXVC1AN4]
0
1
7
8
For all responses, skip to SXANL1N4 (anal sex-partner 1). |
[SXVC2AN4]
0
1
7
8
For all responses, skip to SXANL2N4 (anal sex-partner 2). |
[SXVC3AN4]
0
1
7
8
For all responses, skip to SXANL3N4 (anal sex-partner 3). |
[SXVC4AN4]
0
1
7
8
For all responses, skip to SXANL4N4 (anal sex-partner 4). |
[SXVC5AN4]
0
1
7
8
For all responses, skip to SXANL5N4 (anal sex-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 months, when you had vaginal sex with [INSERT PARTNER NAME] was a condom used... [READ CHOICES. CHECK ONLY ONE.] Never- not even once 1
One or more times 2
Absolutely every time 3
Refused to answer 7
Don’t know 8 |
[SXVC1BN4]
1
2
3
7
8
For all responses, go to SXANL1N4 (anal sex-partner 1). |
[SXVC2BN4]
1
2
3
7
8
For all responses, go to SXANL2N4 (anal sex-partner 2). |
[SXVC3BN4]
1
2
3
7
8
For all responses, go to SXANL3N4 (anal sex-partner 3). |
[SXVC4BN4]
1
2
3
7
8
For all responses, go to SXANL4N4 (anal sex-partner 4). |
[SXVC5BN4]
1
2
3
7
8
For all responses, go to SXANL5N4 (anal sex-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. |
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Anal sex (SL)
Question |
Sexual Partners |
||||
|
Partner 1 [Insert partner name SX_NM1N4 |
Partner 2 [Insert partner name SX_NM2N4] |
Partner 3 [Insert partner name SX_NM3N4] |
Partner 4 [Insert partner name SX_NM4N4] |
Partner 5 [Insert partner name SX_NM5N4] |
Instructions for 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 months, did you have anal sex with [INSERT PARTNER NAME]? No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[SXANL1N4]
0 Skip to STATS1N4 (aware status-partner 1).
1 Go to SA10+1N4 (anal 10-partner 1).
7 Skip to STATS1N4 (aware status-partner 1).
8 Skip to STATS1N4 (aware status-partner 1). |
[SXANL2N4]
0 Skip to STATS2N4 (aware status-partner 2).
1 Go to SA10+2N4 (anal 10-partner 2).
7 Skip to STATS2N4 (aware status-partner 2).
8 Skip to STATS2N4 (aware status-partner 2). |
[SXANL3N4]
0 Skip to STATS3N4 (aware status-partner 3).
1 Go to SA10+3N4 (anal 10-partner 3).
7 Skip to STATS3N4 (aware status-partner 3).
8 Skip to STATS3N4 (aware status-partner 3). |
[SXANL4N4]
0 Skip to STATS4N4 (aware status-partner 4).
1 Go to SA10+4N4 (anal 10-partner 4).
7 Skip to STATS4N4 (aware status-partner 4).
8 Skip to STATS4N4 (aware status-partner 4). |
[SXANL5N4]
0 Skip to STATS5N4 (aware status-partner 5).
1 Go to SA10+5N4 (anal 10-partner 5).
7 Skip to STATS5N4 (aware status-partner 5).
8 Skip to STATS5N4 (aware status-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): 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.
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.”
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.”
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.”
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.”
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.” |
|||||
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
Yes 1
Refused to answer 7
Don’t know 8
|
[SA10+1N4]
0 Go to SXAEN1N4 (times anal sex-partner 1).
1 Skip to SXANA1N4 (average number anal-partner 1).
7 Skip to interviewer instructions before SXAC1AN4 (condom anal-partner 1a).
8 Skip to interviewer instructions before SXAC1AN4 (condom anal-partner 1a). |
[SA10+2N4]
0 Go to SXAEN2N4 (times anal sex-partner 2).
1 Skip to SXANA2N4 (average number anal-partner 2).
7 Skip to interviewer instructions before SXAC2AN4 (condom anal-partner 2a).
8 Skip to interviewer instructions before SXAC2AN4 (condom anal-partner 2a). |
[SA10+3N4]
0 Go to SXAEN3N4 (times anal sex-partner 3).
1 Skip to SXANA3N4 (average number anal-partner 3).
7 Skip to interviewer instructions before SXAC3AN4 (condom anal-partner 3a).
8 Skip to interviewer instructions before SXAC3AN4 (condom anal-partner 3a). |
[SA10+4N4]
0 Go to SXAEN4N4 (times anal sex-partner 4).
1 Skip to SXANA4N4 (average number anal-partner 4).
7 Skip to interviewer instructions before SXAC4AN4 (condom anal-partner 4a).
8 Skip to interviewer instructions before SXAC4AN4 (condom anal-partner 4a). |
[SA10+5N4]
0 Go to SXAEN5N4 (times anal sex-partner 5).
1 Skip to SXANA5N4 (average number anal-partner 5).
7 Skip to interviewer instructions before SXAC5AN4 (condom anal-partner 5a).
8 Skip to interviewer instructions before SXAC5AN4 (condom anal-partner 5a). |
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 months, please tell me the exact number of times that you had anal sex with [INSER PARTNER NAME]? __ __
Refused to answer 77
Don’t know 88 |
[SXAEN1N4]
__ __
Skip to interviewer instructions before SXAC1AN4 (condom anal-partner 1a).
77 Skip to interviewer instructions before SXAC1AN4 (condom anal-partner 1a).
88 Skip to interviewer instructions before SXAC1AN4 (condom anal-partner 1a). |
[SXAEN2N4]
__ __
Skip to interviewer instructions before SXAC2AN4 (condom anal-partner 2a).
77 Skip to interviewer instructions before SXAC2AN4 (condom anal-partner 2a).
88 Skip to interviewer instructions before SXAC2AN4 (condom anal-partner 2a). |
[SXAEN3N4]
__ __
Skip to interviewer instructions before SXAC3AN4 (condom anal-partner 3a).
77 Skip to interviewer instructions before SXAC3AN4 (condom anal-partner 3a).
88 Skip to interviewer instructions before SXAC3AN4 (condom anal-partner 3a). |
[SXAEN4N4]
__ __
Skip to interviewer instructions before SXAC4AN4 (condom anal-partner 4a).
77 Skip to interviewer instructions before SXAC4AN4 (condom anal-partner 4a).
88 Skip to interviewer instructions before SXAC4AN4 (condom anal-partner 4a). |
[SXAEN5N4]
__ __
Skip to interviewer instructions before SXAC5AN4 (condom anal-partner 5a).
77 Skip to interviewer instructions before SXAC5AN4 (condom anal-partner 5a).
88 Skip to interviewer instructions before SXAC5AN4 (condom anal-partner 5a). |
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. If SXAEN1N4 (times anal sex-partner 1) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXAEN2N4 (times anal sex-partner 2) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXAEN3N4 (times anal sex-partner 3) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXAEN4N4 (times anal sex-partner 4) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXAEN5N4 (times anal sex-partner 5) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXAEN1N4 (times anal sex-partner 1) is >10, then display the following message: “You told me that you had anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions. SXAEN2N4 (times anal sex-partner 2) is >10, then display the following message: “You told me that you had anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions. If SXAEN3N4 (times anal sex-partner 3) is >10, then display the following message: “You told me that you had anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions. If SXAEN4N4 (times anal sex-partner 4) is >10, then display the following message: “You told me that you had anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions. If SXAEN5N4 (times anal sex-partner 5) >10, then display the following message: “You told me that you had anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.
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. Variable label for SXAEN5N4 is times anal sex-partner 5. |
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SL.1.3. On average, how many times did you have anal sex with [INSERT PARTNER NAME] per month? ___ ___
Refused to answer 77
Don’t know 88
|
[SXANA1N4]
___ ___
77
88
For all responses, go to SXMAN1N4 (months anal sex-partner 1). |
[SXANA2N4]
___ ___
77
88
For all responses, go to SXMAN2N4 (months anal sex-partner 2). |
[SXANA3N4]
___ ___
77
88
For all responses, go to SXMAN3N4 (months anal sex-partner 3). |
[SXANA4N4]
___ ___
77
88
For all responses, go to SXMAN4N4 (months anal sex-partner 4). |
[SXANA5N4]
___ ___
77
88
For all responses, go to SXMAN5N4 (months anal sex-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.
If SXANA1N4 (average number anal-partner1) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANA2N4 (average number anal-partner 2) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANA3N4 (average number anal-partner 3) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANA4N4 (average number anal-partner 4) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXANA1N4 (average number anal-partner 5) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXANA1N4 (average number anal-partner1) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANA2N4 (average number anal-partner 2) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANA3N4 (average number anal-partner 3) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANA4N4 (average number anal-partner 4) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXANA1N4 (average number anal-partner 5) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.”
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. |
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SL.1.4. During the past 12 months, how many months did you have anal sex with [INSERT PARTNER NAME]? ___ ___ months
Refused to answer 77
Don’t know 88 |
[SXMAN1N4]
___ ___
77
88
For all responses, go to interviewer instructions before SXAC1AN4 (condom anal-partner 1a). |
[SXMAN2N4]
___ ___
77
88
For all responses, go to interviewer instructions before SXAC2AN4 (condom anal-partner 2a). |
[SXMAN3N4]
___ ___
77
88
For all responses, go to interviewer instructions before SXAC3AN4 (condom anal-partner 3a). |
[SXMAN4N4]
___ ___
77
88
For all responses, go to interviewer instructions before SXAC4AN4 (condom anal-partner 4a). |
[SXMAN5N4]
___ ___
77
88
For all responses, go to interviewer instructions before SXAC5AN4 (condom anal-partner 5a). |
QDS programming note for SXMAN1N4 (months anal sex-partner 1), SXMAN2N4 (months anal sex-partner 2), SXMAN3N4 (months anal sex-partner 3), SXMAN4N4 (months anal sex-partner 4), and SXMAN5N4 (months anal sex-partner 5): Range 1–12.
If SXMAN1N4 (months anal sex-partner 1) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMAN2N4 (months anal sex-partner 2) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMAN3N4 (months anal sex-partner 3) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMAN4N4 (months anal sex-partner 4) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If SXMAN5N4 (months anal sex-partner 5) is “0,” then display the following message: “You told me that you had anal sex with this partner during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
If the response to SXMAN1N4 (months anal sex-partner 1) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMAN2N4 (months anal sex-partner 2) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMAN3N4 (months anal sex-partner 3) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMAN4N4 (months anal sex-partner 4) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If SXMAN5N4 (months anal sex-partner 5) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” 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. |
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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 (BIRTGEN=2 and GENDER=2) AND partner 1 is male (SXPGN1N4 [partner’s gender-partner 1] = 1 [male]) 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).
Female-male partner #1-anal sex more than once: If the respondent is female (BIRTGEN=2 and GENDER=2) AND partner 1 is male (SXPGN1N4 [partner’s gender-partner 1] = 1 [male]) 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 (BIRTGEN=2 and GENDER=2) AND partners 2, 3, 4, or 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1 [male], SXPGN3N4 [partner’s gender-partner 3] = 1 [male], SXPGN4N4 [partner’s gender-partner 4] = 1 [male], OR SXPGN5N4 [partner’s gender-partner 5] = 1 [male]) 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 (BIRTGEN=2 and GENDER=2) AND partners 2, 3, 4, or 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1 [male], SXPGN3N4 [partner’s gender-partner 3] = 1 [male], SXPGN4N4 [partner’s gender-partner 4] = 1 [male], SXPGN5N4 [partner’s gender-partner 5] = 1 [male]) 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 anal-partner 5b).
Male-female partner #1-anal sex once: If the respondent is male (BIRTGEN=1 and GENDER=1) and partner 1 is female (SXPGN1N4 [partner’s gender-partner 1] = 2 [female]), 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).
Male-female partner #1-anal sex more than once: If the respondent is male (BIRTGEN=1 and GENDER=1) AND partner 1 is female (SXPGN1N4 [partner’s gender-partner 1] = 2 [female]), 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 (BIRTGEN=1 and GENDER=1) and SXFMONN4 (female only partners) = 1 OR SXPGN2N4 (partner’s gender-partner 2) = 2 (female), SXPGN3N4 (partner’s gender-partner 3) = 2 (female), SXPGN4N4 (partner’s gender-partner 4) = 2 (female), SXPGN5N4 (partner’s gender-partner 5) = 2 (female) 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 (BIRTGEN=1 and GENDER=1) and SXFMONN4 (female only partners) = 1 OR SXPGN2N4 (partner’s gender-partner 2) = 2 (female), SXPGN3N4 (partner’s gender-partner 3) = 2 (female), SXPGN4N4 (partner’s gender-partner 4) = 2 (female), SXPGN5N4 (partner’s gender-partner 5) = 2 (female) 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 anal-partner 5b).
Male-male partner(s): If the respondent is male (BIRTGEN=1 and GENDER=1) and partner is male (SXMLONN4 [male only partners] = 1 OR SXPGN1N4 [partner’s gender-partner 1] = 1, SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 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). |
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SAY box before SXAC1AN4 (condom anal-partner 1a): “The next question is about condom use. Please include when a condom was used the entire time, not only part of the time.” |
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SL.1.5.a. During the past 12 months, when you had anal sex with INSERT PARTNER NAME] was a condom used? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[SXAC1AN4]
0
1
7
8
For all responses, skip to STATS1N4 is aware status-partner 1. |
[SXAC2AN4]
0
1
7
8
For all responses, skip to STATS2N4 is aware status-partner 2. |
[SXAC3AN4]
0
1
7
8
For all responses, skip to STATS3N4 is aware status-partner 3. |
[SXAC4AN4]
0
1
7
8
For all responses, skip to STATS4N4 is aware status-partner 4. |
[SXAC5AN4]
0
1
7
8
For all responses, skip to STATS5N4 is aware status-partner 5. |
QDS programming note for SXAC1AN4 (condom anal-partner 1a), SXAC2AN4 (condom anal-partner 2a), SXAC3AN4 (condom anal-partner 3a), SXAC4AN4 (condom anal-partner 4a), SXAC5AN4 (condom anal-partner 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. |
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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): “The next question is about condom use. Please include times when a condom was used the entire time, not only part of the time.” |
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SL.1.5.b.During the past 12 months, when you had anal sex with [PARTNER NAME] was a condom used… [READ CHOICES. CHECK ONLY ONE.]
Never – not even once 1
One or more times 2
Absolutely every time 3
Refused to answer 7
Don’t know 8
|
[SXAC1BN4]
1
2
3
7
8
For all responses, skip to STATS1N4 is aware status-partner 1. |
[SXAC2BN4]
1
2
3
7
8
For all responses, skip to STATS2N4 is aware status-partner 2. |
[SXAC3BN4]
1
2
3
7
8
For all responses, skip to STATS3N4 is aware status-partner 3. |
[SXAC4BN4]
1
2
3
7
8
For all responses, skip to STATS4N4 is aware status-partner 4. |
[SXAC5BN4]
1
2
3
7
8
For all responses, skip to STATS5N4 is aware status-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 anal-partner 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. |
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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 (BIRTGEN=1 and GENDER=1) and partner is male (SXMLONN4 [male only partners] = 1 OR SXPGN1N4 [partner’s gender-partner 1] = 1, SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 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 (BIRTGEN=1 and GENDER=1) and partner is male (SXMLONN4 [male only partners] = 1 OR SXPGN1N4 [partner’s gender-partner 1] = 1, SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 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, THEN skip to 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). |
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SL.1.6.a. During the past 12 months, when you had anal sex with INSERT PARTNER NAME], did you have anal sex where you were a bottom?
No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[ABTM1AN4]
0 Skip to ATP1AN4 (insertive anal-partner 1a).
1 Go to ABTC1AN4 (condom receptive anal-partner 1a).
7 Skip to ATP1AN4 (insertive anal-partner 1a).
8 Skip to ATP1AN4 (insertive anal-partner 1a). |
[ABTM2AN4]
0 Skip to ATP2AN4 (insertive anal-partner 2a).
1 Go to ABTC2AN4 (condom receptive anal-partner 2a).
7 Skip to ATP2AN4 (insertive anal-partner 2a).
8 Skip to ATP2AN4 (insertive anal-partner 2a). |
[ABTM3AN4]
0 Skip to ATP3AN4 (insertive anal-partner 3a).
1 Go to ABTC3AN4 (condom receptive anal-partner 3a).
7 Skip to ATP3AN4 (insertive anal-partner 3a).
8 Skip to ATP3AN4 (insertive anal-partner 3a). |
[ABTM4AN4]
0 Skip to ATP4AN4 (insertive anal-partner 4a).
1 Go to ABTC4AN4 (condom receptive anal-partner 4a).
7 Skip to ATP4AN4 (insertive anal-partner 4a).
8 Skip to ATP4AN4 (insertive anal-partner 4a). |
[ABTM5AN4]
0 Skip to ATP5AN4 (insertive anal-partner 5a).
1 Go to ABTC5AN4 (condom receptive anal-partner 5a).
7 Skip to ATP5AN4 (insertive anal-partner 5a).
8 Skip to ATP5AN4 (insertive anal-partner 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. |
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SL.1.6.b. During the past 12 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.]
Never 1
Sometimes 2
Always 3
Refused to answer 7
Don’t know 8
|
[ABTM1BN4]
1 Skip to interviewer instructions before ATP1AN4 (insertive anal-partner 1a).
2 Go to interviewer instructions before ABTC1AN4 condom receptive anal-partner 1a.
3 Go to interviewer instructions before ABTC1AN4 condom receptive anal-partner 1a.
7 Skip to interviewer instructions before ATP1AN4 (insertive anal-partner 1a).
8 Skip to interviewer instructions before ATP1AN4 (insertive anal-partner 1a). |
[ABTM2BN4]
1 Skip to interviewer instructions before ATP2AN4 (insertive anal-partner 2a).
2 Go to interviewer instructions before ABTC2AN4 condom receptive anal-partner 2a.
3 Go to interviewer instructions before ABTC2AN4 condom receptive anal-partner 2a.
7 Skip to interviewer instructions before ATP2AN4 (insertive anal-partner 2a).
8 Skip to interviewer instructions before ATP2AN4 (insertive anal-partner 2a). |
[ABTM3BN4]
1 Skip to interviewer instructions before ATP3AN4 (insertive anal-partner 3a).
2 Go to interviewer instructions before ABTC3AN4 condom receptive anal-partner 3a.
3 Go to interviewer instructions before ABTC3AN4 condom receptive anal-partner 3a.
7 Skip to interviewer instructions before ATP3AN4 (insertive anal-partner 3a).
8 Skip to interviewer instructions before ATP3AN4 (insertive anal-partner 3a). |
[ABTM4BN4]
1 Skip to interviewer instructions before ATP4AN4 (insertive anal-partner 4a).
2 Go to interviewer instructions before ABTC4AN4 condom receptive anal-partner 4a.
3 Go to interviewer instructions before ABTC4AN4 condom receptive anal-partner 4a.
7 Skip to interviewer instructions before ATP4AN4 (insertive anal-partner 4a).
8 Skip to interviewer instructions before ATP4AN4 (insertive anal-partner 4a). |
[ABTM5BN4]
1 Skip to interviewer instructions before ATP5AN4 (insertive anal-partner 5a).
2 Go to interviewer instructions before ABTC5AN4 condom receptive anal-partner 5a.
3 Go to interviewer instructions before ABTC5AN4 condom receptive anal-partner 5a.
7 Skip to interviewer instructions before ATP5AN4 (insertive anal-partner 5a).
8 Skip to interviewer instructions before ATP5AN4 (insertive anal-partner 5a). |
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 anal-partner 4a), ABTC5AN4 (condom receptive anal-partner 5a):
Male-partner #1 male-anal sex once: If the respondent is male (BIRTGEN=1 and GENDER=1) AND the respondent’s partner # 1 is male SXPGN1N4 [partner’s gender-partner 1] = 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 (BIRTGEN=1 and GENDER=1) AND the respondent’s partners # 2, 3, 4, or 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 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 anal-partner 4a), ABTC5AN4 (condom receptive anal-partner 5a).
Male-partner #1 male-anal sex more than once: if the respondent is male (BIRTGEN=1 and GENDER=1) AND the respondent’s partner #1 is male SXPGN1N4 [partner’s gender-partner 1] = 1 AND the respondent had anal sex with partner #1more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2, 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 (BIRTGEN=1 and GENDER=1) AND the respondent’s partners # 2, 3, 4, 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 1), AND the respondent had anal sex with partners 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, THEN go to ABTC2BN4 (condom receptive anal-partner 2b), ABTC3BN4 (condom receptive anal-partner 2b), ABTC4BN4 (condom receptive anal-partner 4b), ABTC5BN4 (condom receptive anal-partner 5b). |
|||||
SAY box for ABTC1AN4 (condom receptive anal-partner 1a): “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 months, when you had anal sex [INSERT PARTNER NAME] where you were a bottom, was a condom used? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[ABTC1AN4]
0
1
7
8
For all responses, skip to interviewer instructions before ATPC1AN4 (condom insertive anal-partner 1a). |
[ABTC2AN4]
0
1
7
8
For all responses, skip to interviewer instructions before ATPC2AN4 (condom insertive anal-partner 2a). |
[ABTC3AN4]
0
1
7
8
For all responses, skip to interviewer instructions before ATPC3AN4 (condom insertive anal-partner 3a). |
[ABTC4AN4]
0
1
7
8
For all responses, skip to interviewer instructions before ATPC4AN4 (condom insertive anal-partner 4a). |
[ABTC5AN4]
0
1
7
8
For all responses, skip to interviewer instructions before ATPC5AN4 (condom insertive anal-partner 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. |
|||||
SL.1.7.b. During the past 12 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
One or more times 2
Absolutely every time 3
Refused to answer 7
Don’t know 8 |
[ABTC1BN4]
1
2
3
7
8
For all responses, go to interviewer instructions before ATP1AN4 (condom insertive anal-partner 1a). |
[ABTC2BN4]
1
2
3
7
8
For responses for 1, 2, 3, 7, 8, go to interviewer instructions before ATP2AN4 (condom insertive anal-partner 2a). |
[ABTC3BN4]
1
2
3
7
8
For all responses, go to interviewer instructions before ATP3AN4 (condom insertive anal-partner 3a). |
[ABTC4BN4]
1
2
3
7
8
For all responses, go to interviewer instructions before ATP4AN4 (condom insertive anal-partner 4a). |
[ABTC5BN4]
1
2
3
7
8
For all responses, go to interviewer instructions before ATP5AN4 (condom insertive anal-partner 5a). |
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 anal-partner 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 months, when you had anal sex with [INSERT PARTNER NAME], did you have anal sex where you were a top? No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[ATP1AN4]
0 Skip to STATS1N4 (aware status-partner 1).
1 Skip to interviewer instructions before ATPC1AN4 condom insertive anal-partner 1a.
7 Skip to STATS1N4 (aware status-partner 1).
8 Skip to STATS1N4 (aware status-partner 1). |
[ATP1AN4]
0 Skip to STATS2N4 (aware status-partner 2).
1 Skip to interviewer instructions before ATPC2AN4 condom insertive anal-partner 2a.
7 Skip to STATS2N4 (aware status-partner 2).
8 Skip to STATS2N4 (aware status-partner 2). |
[ATP1AN4]
0 Skip to STATS3N4 (aware status-partner 3).
1 Skip to interviewer instructions before ATPC3AN4 condom insertive anal-partner 3a.
7 Skip to STATS3N4 (aware status-partner 3).
8 Skip to STATS3N4 (aware status-partner 3). |
[ATP1AN4]
0 Skip to STATS4N4 (aware status-partner 4).
1 Skip to interviewer instructions before ATPC4AN4 condom insertive anal-partner 4a.
7 Skip to STATS4N4 (aware status-partner 4).
8 Skip to STATS4N4 (aware status-partner 4). |
[ATP1AN4]
0 Skip to STATS5N4 (aware status-partner 5).
1 Skip to interviewer instructions before ATPC5AN4 condom insertive anal-partner 5a.
7 Skip to STATS5N4 (aware status-partner 5).
8 Skip to STATS5N4 (aware status-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 anal-partner 4a), ATPC5AN4 (condom insertive anal-partner 5a): Variable label for ATPC1AN4 insertive anal-partner 1a. Variable label for ATPC2AN4 insertive anal-partner 2a. Variable label for ATPC3AN4 insertive anal-partner 3a. Variable label for ATPC4AN4 insertive anal-partner 4a. Variable label for ATPC5AN4 insertive anal-partner 5a. |
|||||
SL.1.8.b. During the past 12 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.]
Never 1
Sometimes 2
Always 3
Refused to answer 7
Don’t know 8
|
[ATP1BN4]
1 Skip to STATS1N4 (Aware status-partner 1).
2 Go to interviewer instructions before ATPC1AN4 (condom insertive anal-partner 1a).
3 Go to interviewer instructions before ATPC1AN4 (condom insertive anal-partner 1a).
7 Skip to STATS1N4 (Aware status-partner 1).
8 Skip to STATS1N4 (Aware status-partner 1). |
[ATP2BN4]
1 Skip to STATS2N4 (Aware status-partner 2).
2 Go to interviewer instructions before ATPC2AN4 (condom insertive anal-partner 2a).
3 Go to interviewer instructions before ATPC2AN4 (condom insertive anal-partner 2a).
7 Skip to STATS2N4 (Aware status-partner 2).
8 Skip to STATS2N4 (Aware status-partner 2). |
[ATP3BN4]
1 Skip to STATS3N4 (Aware status-partner 3).
2 Go to interviewer instructions before ATPC3AN4 (condom insertive anal-partner 3a).
3 Go to interviewer instructions before ATPC3AN4 (condom insertive anal-partner 3a).
7 Skip to STATS3N4 (Aware status-partner 3).
8 Skip to STATS3N4 (Aware status-partner 3). |
[ATP4BN4]
1 Skip to STATS4N4 (Aware status-partner 4).
2 Go to interviewer instructions before ATPC4AN4 (condom insertive anal-partner 4a).
3 Go to interviewer instructions before ATPC4AN4 (condom insertive anal-partner 4a).
7 Skip to STATS4N4 (Aware status-partner 4).
8 Skip to STATS4N4 (Aware status-partner 4). |
[ATP5BN4]
1 Skip to STATS5N4 (Aware status-partner 5).
2 Go to interviewer instructions before ATPC5AN4 (condom insertive anal-partner 5a).
3 Go to interviewer instructions before ATPC5AN4 (condom insertive anal-partner 5a).
7 Skip to STATS5N4 (Aware status-partner 5).
8 Skip to STATS5N4 (Aware status-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 anal-partner 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. |
|||||
Interviewer instructions for ATPC1AN4 (condom insertive anal-partner 1a), 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 once: If the respondent is male (BIRTGEN=1 and GENDER=1) AND the respondent’s partner # 1 is male SXPGN1N4 [partner’s gender-partner 1] = 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 (BIRTGEN=1 and GENDER=1) AND the respondent’s partners # 2, 3, 4, or 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 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 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 (BIRTGEN=1 and GENDER=1) AND the respondent’s partner #1 is male SXPGN1N4 [partner’s gender-partner 1] = 1 AND the respondent had anal sex with partner #1 more than once (SXAEN1N4 [times anal sex-partner 1] ≥ 2, 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 (BIRTGEN=1 and GENDER=1) AND the respondent’s partners # 2, 3, 4, 5 are male (SXMLONN4 [male only partners] = 1 OR SXPGN2N4 [partner’s gender-partner 2] = 1, SXPGN3N4 [partner’s gender-partner 3] = 1, SXPGN4N4 [partner’s gender-partner 4] = 1, SXPGN5N4 [partner’s gender-partner 5] = 1), AND the respondent had anal sex with partners 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, SXAEN2N4 [times anal sex-partner 2] ≥ 2), THEN go to ATPC2BN4 (condom insertive anal-partner 2b), ATPC3BN4 (condom insertive anal-partner 2b), ATPC4BN4 (condom insertive anal-partner 4b), ATPC5BN4 (condom insertive anal-partner 5b). |
|||||
SAY box before ATPC1AN4: “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 months, when you had anal sex with [INSERT PARTNER NAME], was a condom used when you were a top? No 0
Yes 1
Refused to answer 7
Don’t know 8
|
[ATPC1AN4]
0
1
7
8
For all responses, skip to STATS1N4 (Aware status-partner 1). |
[ATPC1AN4]
0
1
7
8
For all responses, skip to STATS2N4 (Aware status-partner 2). |
[ATPC1AN4]
0
1
7
8
For all responses, skip to STATS3N4 (Aware status-partner 3). |
[ATPC1AN4]
0
1
7
8
For all responses, skip to STATS4N4 (Aware status-partner 4). |
[ATPC1AN4]
0
1
7
8
For all responses, skip to STATS5N4 (Aware status-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 anal-partner 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. |
|||||
SAY box before ATPC1BN4: “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 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
One or more times 2
Absolutely every time 3
Refused to answer 7
Don’t know 8 |
[ATPC1BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
[ATPC2BN4]
1
2
3
7
8
For all responses, go to STATS2N4 (Aware status-partner 2). |
[ATPC3BN4]
1
2
3
7
8
For all responses, go to STATS3N4 (Aware status-partner 3). |
[ATPC4BN4]
1
2
3
7
8
For all responses, go to STATS4N4 (Aware status-partner 4). |
[ATPC5BN4]
1
2
3
7
8
For all responses, go to STATS5N4 (Aware status-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 anal-partner 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. Variable label for ATPC5BN4 condom insertive anal-partner 5b. |
|||||
Transgender sex (SG)
Questions |
Sexual Partners |
||||
|
Partner 1 [INSERT partner name SX_NM1N4] |
Partner 2 [INSERT partner name SX_NM2N4] |
Partner 3 [INSERT partner name SX_NM3N4] |
Partner 4 [INSERT partner name SX_NM4N4] |
Partner 5 [INSERT partner name SX_NM5N4] |
Instructions for 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 months, did you have vaginal or anal sex with [INSERT PARTNER NAME]? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[SX_TG1N4]
0 Skip to STATS1N4
1 Go to TG10+1N4 (transgender 10-partner 1)
7 Skip to STATS1N4
8 Skip to STATS1N4 |
[SX_TG2N4]
0 Skip to STATS2N4
1 Go to TG10+2N4 (transgender 10-partner 2)
7 Skip to STATS2N4
8 Skip to STATS1N4 |
[SX_TG3N4]
0 Skip to STATS3N4
1 Go to TG10+3N4 (transgender 10-partner 3)
7 Skip to STATS3N4
8 Skip to STATS1N4 |
[SX_TG4N4]
0 Skip to STATS4N4
1 Go to TG10+4N4 (transgender 10-partner 4)
7 Skip to STATS4N4
8 Skip to STATS1N4 |
[SX_TG5N4]
0 Skip to STATS5N4
1 Go to TG10+5N4 (transgender 10-partner 5)
7 Skip to STATS5N4
8 Skip to STATS1N4 |
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_TGS1N4 is transgender-partner 1. Variable label for SX_TGS2N4 is transgender-partner 2. Variable label for SX_TGS3N4 is transgender-partner 3. Variable label for SX_TGS4N4 is transgender-partner 4. Variable label for SX_TGS5N4 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.”
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.”
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: return to previous questions to correct error.”
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.”
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.” |
|||||
SG.1.1. During the past 12 months, did you have vaginal or anal sex with [INSERT PARTNER NAME] more than 10 times? [READ CHOICES. CHECK ONLY ONE] Yes 1
No 0
Refused to answer 7
Don’t know 8
|
[TG10+1N4]
1 Skip to TGAN1N4 (average number transgender -partner 1).
0 Go to TGEN1N4 (times transgender -partner 1).
7 Skip to Say box before TGC1AN4 (condom transgender -partner 1a).
8 Skip to Say box before TGC1AN4 (condom transgender -partner 1a).
|
[TG10+2N4]
1 Skip to TGAN2N4 (average number transgender -partner 2).
0 Go to TGEN2N4 (times transgender -partner 2).
7 Skip to interviewer instructions before TGC2AN4 (condom transgender -partner 2a).
8 Skip to interviewer instructions before TGC2AN4 (condom transgender –partner 2a |
[TG10+3N4]
1 Skip to TGAN3N4 (average number transgender -partner 3).
0 Go to TGEN3N4 (times transgender -partner 3).
7 Skip to interviewer instructions before TGC3AN4 (condom transgender -partner 3a).
8 Skip to interviewer instructions before TGC3AN4 (condom transgender -partner 3a). |
[TG10+4N4]
1 Skip to TGAN4N4 (average number transgender -partner 4).
0 Go to TGEN4N4 (times transgender -partner 4).
7 Skip to interviewer instructions before TGC4AN4 (condom transgender -partner 4a).
8 Skip to interviewer instructions before TGC4AN4 (condom transgender -partner 4a). |
[TG10+5N4]
1 Skip to TGAN5N4 (average number transgender -partner 5).
0 Go to TGEN5N4 (times transgender -partner 5).
7 Skip to interviewer instructions before TGC5AN4 (condom transgender -partner 5a).
8 Skip to interviewer instructions before TGC5AN4 (condom transgender -partner 5a). |
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 months, please tell me the exact number of times that you had vaginal or anal sex with [INSERT PARTNER NAME]? __ __
Don’t know 77
Refused to answer 88 |
[TGEN1N4]
__ __
Skip to Say box before TGC1AN4 (condom transgender -partner 1a).
77 Skip to Say box before TGC1AN4 (condom transgender -partner 1a).
88 Skip to Say box before TGC1AN4 (condom transgender -partner 1a). |
[TGEN2N4]
__ __
Skip to instructions before TGC2AN4 (condom transgender -partner 2a).
77 Skip to Say box before TGC2AN4 (condom transgender -partner 2a).
88 Skip to Say box before TGC2AN4 (condom transgender -partner 2a). |
[TGEN3N4]
__ __
Skip to instructions before TGC3AN4 (condom transgender -partner 3a).
77 Skip to Say box before TGC3AN4 (condom transgender -partner 3a).
88 Skip to Say box before TGC3AN4 (condom transgender -partner 3a). |
[TGEN4N4]
__ __
Skip to instructions before TGC4AN4 (condom transgender -partner 4a).
77 Skip to Say box before TGC4AN4 (condom transgender -partner 4a).
88 Skip to Say box before TGC4AN4 (condom transgender -partner 4a). |
[TGEN5N4]
__ __
Skip to instructions before TGC5AN4 (condom transgender -partner 5a).
77 Skip to Say box before TGC5AN4 (condom transgender -partner 5a).
88 Skip to Say box before TGC4AN4 (condom transgender -partner 4a). |
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.
If TGEN1N4 (times 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 response and if necessary change response to previous questions.” If TGEN2N4 (times transgender -partner 2) 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 response and if necessary change response to previous questions.” If TGEN3N4 (times transgender -partner 3) 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 response and if necessary change response to previous questions.” If TGEN4N4 (times transgender -partner 4) 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 response and if necessary change response to previous questions.” If TGEN5N4 (times transgender -partner 5) 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 response and if necessary change response to previous questions.”
If the response to TGEN1N4 (times transgender -partner 1) is >10, then display the following message: “You told me that you had vaginal or anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If TGEN2N4 (times transgender -partner 2) is >10, then display the following message: “You told me that you had vaginal or anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If TGEN3N4 (times transgender -partner 3) is >10, then display the following message: “You told me that you had vaginal or anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If TGEN4N4 (times transgender -partner 4) is >10, then display the following message: “You told me that you had vaginal or anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.” If TGEN5N4 (times transgender -partner 5) is >10, then display the following message: “You told me that you had vaginal or anal sex 10 or fewer times during the past 12 months. Interviewer instructions: confirm response and if necessary change response to previous questions.”
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 times did you have vaginal or anal sex with [INSERT PARTNER NAME] per month? ___ ___
Refused to answer 77
Don’t know 88
|
[TGAN1N4]
___ ___
Go to TGM1N4 (months transgender -partner 1).
77 Go to TGM1N4 (months transgender -partner 1).
88 Go to TGM1N4 (months transgender partner 1). |
[TGAN2N4]
___ ___
Go to TGM2N4 (months transgender -partner 2).
77 Go to TGM2N4 (months transgender -partner 2).
88 Go to TGM2N4 (months transgender -partner 2). |
[TGAN3N4]
___ ___
Go to TGM3N4 (months transgender -partner 3).
77 Go to TGM3N4 (months transgender -partner 3).
88 Go to TGM3N4 (months transgender -partner 3). |
[TGAN4N4]
___ ___
Go to TGM4N4 (months transgender -partner 4).
77 Go to TGM4N4 (months transgender -partner 4).
88 Go to TGM4N4 (months transgender -partner 4). |
[TGAN5N4]
___ ___
Go to TGM5N4 (months transgender -partner 5).
77 Go to TGM5N4 (months transgender -partner 5).
88 Go to TGM5N4 (months transgender -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.
If TGAN1N4 (average number 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 response and if necessary change response to previous questions.” If TGAN2N4 (average number transgender -partner 2) 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 response and if necessary change response to previous questions.” If TGAN3N4 (average number transgender -partner 3) 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 response and if necessary change response to previous questions.” If TGAN4N4 (average number transgender -partner 4) 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 response and if necessary change response to previous questions.” If TGAN5N4 (average number transgender -partner 5) 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 response and if necessary change response to previous questions.”
If the response to TGAN1N4 (average number transgender -partner 1) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGAN2N4 (average number transgender -partner 2) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGAN3N4 (average number transgender -partner 3) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGAN4N4 (average number transgender -partner 4) is > 90, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGAN5N4 (average number transgender -partner 5) is > 90, then display the following message: “Out of range. 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. Variable label for TGAN5N4 is average number transgender -partner 5. |
|||||
SG.1.4. During the past 12 months, how many months did you have vaginal or anal sex with [INSERT PARTNER NAME]?
___ ___ months
Refused to answer 77
Don’t know 88
|
[TGM1N4]
___ ___
77
88
For all responses, go to Say box before TGC1AN4 (condom transgender -partner 1a).
|
[TGM2N4]
___ ___
77
88
For all responses, skip to instructions before TGC2AN4 (condom transgender -partner 2a). |
[TGM3N4]
___ ___
77
88
For all responses, skip to instructions before TGC3AN4 (condom transgender -partner 3a). |
[TGM4N4]
___ ___
77
88
For all responses, skip to instructions before TGC4AN4 (condom transgender -partner 4a). |
[TGM5N4]
___ ___
77
88
For all responses, skip to instructions before TGC5AN4 (condom transgender -partner 5a). |
QDS programming note for TGM1N4 (months transgender-partner 1), TGM2N4 (months transgender-partner 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 response and if necessary change response to previous questions.” If TGM2N4 (months transgender-partner 2) 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 response and if necessary change response to previous questions.” If TGM3N4 (months transgender-partner 3) 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 response and if necessary change response to previous questions.” If TGM4N4 (months transgender-partner 4) 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 response and if necessary change response to previous questions.” If TGM5N4 (months transgender-partner 5) 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 response and if necessary change response to previous questions.”
If the response to TGM1N4 (months transgender-partner 1) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGM2N4 (months transgender-partner 2) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGM3N4 (months transgender-partner 3) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGM4N4 (months transgender-partner 4) is >12, then display the following message: “Out of range. Interviewer instructions: confirm response.” If TGM5N4 (months transgender-partner 5) is >12, then display the following message: “Out of range. 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. |
|||||
SAY box before TGC1AN4 (condom transgender-partner 1a): “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.” |
|||||
Interviewer instructions before TGC1AN4 (condom transgender-partner 1a), TGC2AN4 (condom transgender-partner 2a), TGC3AN4 (condom transgender-partner 3a), TGC4AN4 (condom transgender-partner 4a), TGC5AN4 (condom transgender-partner 5a): If TGEN1N4 (times transgender -partner 1) = 1, then go to TGC1AN4 (condom transgender-partner 1a); otherwise skip to TGC1BN4 (condom transgender-partner 1b).
If TGEN2N4 (times transgender-partner 2) = 1, then go to TGC2AN4 (condom transgender-partner 2a); otherwise skip to TGC2BN4 (condom transgender-partner 2b).
If TGEN3N4 (times transgender-partner 3) =1, then go to TGC3AN4 (condom transgender-partner 3a); otherwise skip to TGC3BN4 (condom transgender-partner 3b).
If TGEN4N4 (times transgender-partner 4) = 1, then go to TGC4AN4 (condom transgender-partner 4a); otherwise skip to TGC4BN4 (condom transgender-partner 4b).
If TGEN5N4 (times transgender-partner 5) = 1, then go to TGC4AN4 (condom transgender-partner 5a); otherwise skip to TGC5BN4 (condom transgender-partner 5b). |
|||||
TG.1.5.a. During the past 12 months, when you had vaginal or anal sex with [INSERT PARTNER NAME] was a condom used? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[TGC1AN4]
0
1
7
8
For all responses, skip to STATS1N4 (Aware status-partner 1). |
[TGC2AN4]
0
1
7
8
For all responses, skip to STATS2N4 (Aware status-partner 2). |
[TGC3AN4]
0
1
7
8
For all responses, skip to STATS3N4 (Aware status-partner 3). |
[TGC4AN4]
0
1
7
8
For all responses, skip to STATS4N4 (Aware status-partner 4). |
[TGC5AN4]
0
1
7
8
For all responses, skip to STATS5N4 (Aware status-partner 5). |
QDS programming note for TGC1AN4 (condom transgender-partner 1a), TGC2AN4 (condom transgender-partner 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. |
|||||
TG.1.5.b. During the past 12 months, when you had vaginal or anal sex with [INSERT PARTNER NAME] was a condom used... [READ CHOICES. CHECK ONLY ONE.] Never- not even once 1
One or more times 2
Absolutely every time 3
Refused to answer 7
Don’t know 8 |
[TGC1BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
[TGC2BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
[TGC3BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
[TGC4BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
[TGC5BN4]
1
2
3
7
8
For all responses, go to STATS1N4 (Aware status-partner 1). |
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. |
|||||
Status (SS)
Questions |
Sexual partners |
||||
|
Partner 1 [INSERT partner name SX_NM1N4] |
Partner 2 [INSERT partner name SX_NM2N4] |
Partner 3 [INSERT partner name SX_NM3N4] |
Partner 4 [INSERT partner name SX_NM4N4] |
Partner 5 [INSERT partner name SX_NM5N4] |
Instructions for 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 PARTNER NAME] know your HIV status? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[STATS1N4]
0 Skip to STPRT1N4 (partner status-partner 1).
1 Go to AWRST1N4 (aware status every sex-partner 1).
7 Skip to STPRT1N4 (partner status-partner 1).
8 Skip to STPRT1N4 (partner status-partner 1). |
[STATS2N4]
0 Skip to STPRT2N4 (partner status-partner 2).
1 Go to AWRST2N4 (aware status every sex-partner 2).
7 Skip to STPRT2N4 (partner status-partner 2).
8 Skip to STPRT2N4 (partner status-partner 2). |
[STATS3N4]
0 Skip to STPRT3N4 (partner status-partner 3).
1 Go to AWRST3N4 (aware status every sex-partner 3).
7 Skip to STPRT3N4 (partner status-partner 3).
8 Skip to STPRT3N4 (partner status-partner 3). |
[STATS4N4]
0 Skip to STPRT4N4 (partner status-partner 4).
1 Go to AWRST4N4 (aware status every sex-partner 4).
7 Skip to STPRT4N4 (partner status-partner 4).
8 Skip to STPRT4N4 (partner status-partner 4). |
[STATS5N4]
0 Skip to STPRT5N4 (partner status-partner 5).
1 Go to AWRST5N4 (aware status every sex-partner 5).
7 Skip to STPRT5N4 (partner status-partner 5).
8 Skip to STPRT5N4 (partner status-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 months, was [INSERT PARTNER NAME] aware of your status every time you had sex? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[AWRST1N4]
0
1
7
8
For all responses, go to STPRT1N4 (Partner status-partner 1). |
[AWRST2N4]
0
1
7
8
For all responses, go to STPRT2N4 (Partner status-partner 2). |
[AWRST3N4]
0
1
7
8
For all responses, go to STPRT3N4 (Partner status-partner 3). |
[AWRS41N4]
0
1
7
8
For all responses, go to STPRT4N4 (Partner status-partner 4). |
[AWRST5N4]
0
1
7
8
For all responses, go to STPRT5N4 (Partner status-partner 5). |
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 [INSERT PARTNER NAME]’s HIV status? No 0
Yes 1
Refused to answer 7
Don’t know 8 |
[STPRT1N4]
0 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2).
1 Go to PRTST1N4 (Partner status first sex-partner 1).
7 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2).
8 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2). |
[STPRT2N4]
0 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3).
1 Go to PRTST2N4 (Partner status first sex-partner 2).
7 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3).
8 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3). |
[STPRT3N4]
0 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4).
1 Go to PRTST3N4 (Partner status first sex-partner 3).
7 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4).
8 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4). |
[STPRT4N4]
0 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5).
1 Go to PRTST4N4 (Partner status first sex-partner 4).
7 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5).
8 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5). |
[STPRT5N4]
0 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section.
1 Go to PRTST5N4 (Partner status first sex-partner 5).
7 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section.
8 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section. |
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 status-partner 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 months, what was [INSERT PARTNERS’ NAME]’s HIV status the first time that you had sex? [DON’T READ RESPONSES. CHECK ONLY ONE.]
HIV Positive 1
HIV Negative 2
Refused to answer 7
Don’t know 8
|
[PRTST1N4]
1 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2).
2 Go to PREP1N4 (PrEP-partner 1).
7 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2).
8 If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2). |
[PRTST2N4]
1 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3).
2 Go to PREP2N4 (PrEP-partner 2).
7 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3).
8 If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3). |
[PRTS31N4]
1 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4).
2 Go to PREP3N4 (PrEP-partner 3).
7 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4).
8 If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4). |
[PRTST4N4]
1 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5).
2 Go to PREP4N4 (PrEP-partner 4).
7 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5).
8 If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5). |
[PRTST5N4]
1 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section.
2 Go to PREP5N4 (PrEP-partner 5).
7 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section.
8 If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section. |
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. |
|||||
Pre-exposure prophylaxis (SR)
Questions |
Sexual partners |
||||
|
Partner 1 [INSERT partner name SX_NM1N4] |
Partner 2 [INSERT partner name SX_NM2N4] |
Partner 3 [INSERT partner name SX_NM3N4] |
Partner 4 [INSERT partner name SX_NM4N4] |
Partner 5 [INSERT partner name SX_NM5N4] |
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
Yes 1
Refused to answer 7
Don’t know 8
|
[PREP1N4]
0
1
7
8
If SX_TOTN4 = 1, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 2, skip to interviewer instructions before SXPGN2N4 (partner’s gender-partner 2). |
[PREP2N4]
0
1
7
8
If SX_TOTN4 = 2, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 3, skip to interviewer instructions before SXPGN3N4 (partner’s gender-partner 3). |
[PREP3N4]
0
1
7
8
If SX_TOTN4 = 3, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN4N4 (partner’s gender-partner 4). |
[PREP4N4]
0
1
7
8
If SX_TOTN4 = 4, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 4, skip to interviewer instructions before SXPGN5N4 (partner’s gender-partner 5). |
[PREP5N4]
0
1
7
8
If SX_TOTN4 = 5, skip to serosorting section (Say box before SEROSRT1). If SX_TOTN4 ≥ 5, skip to interviewer instructions before the aggregate information section. |
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. |
|||||
Aggregate information (SA)
Interviewer instructions for aggregate information section:
If SX_TOTN4 is ≤ 5, then skip to the serosorting section (Say box before SEROSRT1). If SX_TOTN4 is > 5, then go to the Say box below.
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 us- more than 6 partners):
Range is 0–999.
Variable label is 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.
Interviewer instructions for SXAGC2N4 (aggregate condom use more than 6 partners): If SXAGC2N4 (aggregate condom use more than 6 partners) = SX_TOTN4 (total number of partners), then skip to the serosorting section (Say box before SEROSRT1). If SXAGC2N4 (aggregate condom use-more than 6 partners) is “don’t know” or “refused to answer,” then skip to SXAGP2N4. 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.
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.
Variable label for SXAGP2N4 is aggregate concordant partners-more than 6 partners.
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
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
Drug and Alcohol Use (U)
Cigarette and Alcohol Use
SAY: “The next questions are about smoking cigarettes.”
Skip to Say box before U2
U1. Have you smoked at least 100 cigarettes in your entire life? [CIG_EVR]
No ☐ 0
Yes ☐ 1
Skip to Say box before U2
Refused to answer ☐ 7
Don’t know ☐ 8
SAY: “Now we will use Response Card M.”
U1a. How often do you smoke cigarettes now? [READ CHOICES] [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] [ALCOHO_9]
Daily ☐ 1
Weekly ☐ 2
Monthly ☐ 3
Less than monthly ☐ 4
Skip to Say box before U8
Never ☐ 5
Refused to answer ☐ 7
Don’t know ☐ 8
Interviewer instructions:
If S1 (male respondent had sex with a woman during the past 12 months) and S6 (male respondent had sex with a man during the past 12 months) are “No,” “Refused to answer,” or “Don’t know,” skip to Say box before U4.
If S12 (female respondent had sex with a man during the past 12 months) and S16 (female respondent had sex with a woman) are “No,” “Refused to answer,” or “Don’t know,” skip to Say box before U4.
If S21 (transgender respondent had sex during the past 12 months) is “No,” “Refused to answer,” or “Don’t know,” 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. 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]
QDS programming note: If U6 > U4 then READ: “The number of days in the past 30 days that you had 5 or more drinks [DRINK5_9] cannot be greater than the number of days you had a drink in the last 30 days [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 [DRINK4_9] cannot be greater than the number of days you had a drink in the last 30 days [DRINK_9].
Non-Injection Drug Use
SAY: “Now I’m going to ask you about drugs that you may have used, but didn’t inject. 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.”
Skip to Say box before U12
U8. During the past 12 months, did you use any non-injection drugs? [ANID12_9]
No ☐ 0
Yes ☐ 1
Skip to Say
box before U12
Don’t know ☐ 8
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.”
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 use:
|
Daily (1) |
Weekly (2) |
Monthly (3) |
Less than monthly (4) |
Never (5) |
Refused to answer (7) |
Don’t Know (8) |
U9a. |
…methamphetamines, also called crystal meth, tina, crank, or ice? [CRYMTC_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9b. |
…other amphetamines or stimulants? [AMPHET_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9c. |
…crack? [CRACK1_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9d. |
…cocaine that is smoked or snorted? [COCSMO_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9e. |
…downers, such as Valium, Ativan, or Xanax? [DOWNER_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9f. |
…painkillers, such as Oxycontin, Vicodin, or Percocet? [PAINKI_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9g. |
…hallucinogens, such as LSD or mushrooms? [HALLUC_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9h. |
…X, also called Ecstasy? [XECT_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9i. |
…Special K, also called ketamine? [SPECK_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9j. |
…GHB? [GHB_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9k. |
…heroin or opium that is smoked or snorted? [HEROIN_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9l. |
…marijuana? [MARIJU_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9m. |
…poppers, also called amyl nitrate? [POPPER_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9n. |
…steroids or hormones? [STRHOR_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U9o. |
…any other non-injection drug (Specify:___________)? [ONINJD_9] [ONINJ9OS] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
Inconsistency check: If U8 (non-injection drug use) is “Yes” and all of the responses to U9a-U9o are “Never,”, then QDS will display a message saying, “You said that you used non-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 previous questions.
Interview instructions:
If S1 (male respondent had sex with a woman during the past 12 months) and S6 (male respondent had sex with a man during the past 12 months) are “No,” “Refused to answer,” “Don’t know,” skip to Say box before U12.
If S12 (female respondent had sex with a man during the past 12 months) and S16 (female respondent had sex with a woman) are “No,” “Refused to answer,” “Don’t know,” skip to Say box before U12.
If S21 (transgender respondent had sex during the past 12 months) is “No,” “Refused to answer,” “Don’t know,” skip to Say box before U12.
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
Skip to Say box before U12
Refused to answer ☐ 7
Don’t know ☐ 8
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. |
||||||
|
|
During the past 12 months, did you use: [ONLY READ QUESTIONS WHERE THE SHADED BOX (COLUMN 1) IS CHECKED.] |
No (0) |
Yes (1) |
Refused to answer (7) |
Don’t Know (8) |
☐ |
U11a. |
…methamphetamines before or during sex? [CRAMT2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11b. |
…other amphetamines or stimulants before or during sex? [AMPHT2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11c. |
…crack before or during sex? [CRACK2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11d. |
…cocaine that is smoked or snorted before or during sex? [COCSM2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11e. |
…downers, such as Valium, Ativan, or Xanax, before or during sex? [DOWNE2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11f. |
…painkillers, such as Oxycontin, Vicodin, or Percocet before or during sex? [PAINK2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11g. |
…hallucinogens, such as LSD or mushrooms before or during sex? [HALLU2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11h. |
…X, also called Ecstasy before or during sex? [XECT2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11i. |
…Special K, also called ketamine before or during sex? [SPECK2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11j. |
…GHB before or during sex? [GHB2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11k. |
…heroin or opium that is smoked or snorted before or during sex? [HEROI2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11l. |
…marijuana before or during sex? [MARIJ2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11m. |
…poppers, also called amyl nitrate, before or during sex? [POPPE2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11n. |
…steroids or hormones before or during sex? [STRHO2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
☐ |
U11o. |
… [RESPONSE FROM U9o] before or during sex? [ONINJ2_9] |
☐ 0 |
☐ 1 |
☐ 7 |
☐ 8 |
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 previous questions.
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.”
Skip to Say box before B1
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]
No ☐ 0
Yes ☐ 1
Skip to Say box before B1
Refused to answer ☐ 7
Don’t know ☐ 8
Skip to Say box 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]
No ☐ 0
Yes ☐ 1
Skip to Say box before B1
Refused to answer ☐ 7
Don’t know ☐ 8
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: |
Daily (1) |
Weekly (2) |
Monthly (3) |
Less than monthly (4) |
Never (5) |
Refused to answer (7) |
Don’t Know (8) |
U13a. |
…heroin and cocaine together, also called speedballs? [HERCOC_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13b. |
…heroin alone? [HEROII_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13c. |
…cocaine alone? [COCAII_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13d. |
…crack? [CRACKI_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13e. |
…methamphetamines, also called crystal meth, tina, or crank? [CRAMTI_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13f. |
…other amphetamines or stimulants? [AMPHEI_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13g. |
…Oxycontin? [OXYCON_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13h. |
…steroids or hormones? [STRHRI_9] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
U13i. |
…any other drug (Specify:__________)? [OINJDI_9][OINJD9OS] |
☐ 1 |
☐ 2 |
☐ 3 |
☐ 4 |
☐ 5 |
☐ 7 |
☐ 8 |
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 previous questions.
Interview instructions:
If S1 (male respondent had sex with a woman during the past 12 months) and S6 (male respondent had sex with a man during the past 12 months) are “No,” “Refused to answer,” or “Don’t know,” skip to Say box before U16.
If S12 (female respondent had sex with a man during the past 12 months) and S16 (female respondent had sex with a woman) are “No,” “Refused to answer,” or “Don’t know,” skip to Say box before U16.
If S21 (transgender respondent had sex during the past 12 months) is “No,” “Refused to answer,” or “Don’t know,” skip to Say box before U16
U14. During the past 12 months, did you inject drugs before or during sex? [INJ_BFSX]
Skip to Say box before U16
No ☐ 0
Yes ☐ 1
Skip to Say box before U16
Refused to answer ☐ 7
Don’t know ☐ 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 previous questions.
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
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
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]
Skip to say
box before P1 
Yes ☐
1
Refused to answer ☐ 7
Don’t know ☐ 8
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.
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]
Skip to B15
Yes ☐ 1
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
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]
Skip to B15
Yes ☐ 1
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.”
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]
Skip to Say
box before B18
Yes ☐ 1
Skip
to Say box before B18 
Don’t know ☐ 8
B17. Did you ever receive clotting factor before March, 1985? [ICLO85N3]
No ☐ 0
Yes ☐ 1
Refused to answer ☐ 7
Don’t know ☐ 8
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]
Skip to B20
Yes ☐ 1
Skip
to B20 
Don’t know ☐ 8
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
Prevention Activities (P)
Say: “Next I'd like to ask you about HIV prevention activities.”
Skip to instructions before P2
P1. 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]
No ☐
0
Yes ☐ 1
Skip to
instructions before P2
Don’t know ☐ 8
P1a. 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 1 (Specify:______________________________) ☐ 8 [CONF_12H] [COH_12OS]
Other 2 (Specify:______________________________) ☐ 9 [CONF_12I] [COI_12OS]
Refused to answer ☐ 77
Don’t know ☐ 88
Interviewer instructions: If U12a (injection drug use during the past 12 months) is “Yes,” go to P2. If U12a is “No,” “Refused to answer,” or “Don’t know,” 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]
No ☐ 0
Yes ☐ 1
Refused to answer ☐ 7
Don’t know ☐ 8
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
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?
|
Not at all (1) |
Several Days (2) |
More than half the days (3) |
Nearly every day (4) |
Refused to answer (7) |
Don’t know (8) |
M1a. |
Little interest or pleasure in doing things [ANX_DEPA] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
M1b. |
Feeling down, depressed, or hopeless [ANX_DEPB] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
M1c. |
Trouble falling or staying asleep, or sleeping too much [ANX_DEPC] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
M1d. |
Feeling tired or having little energy [ANX_DEPD] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
M1e. |
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. |
Trouble concentrating on things, such as reading the newspaper or watching television [ANX_DEPG] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
M1h. |
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] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
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
Skip to Say
box before G3
No ☐ 0
Yes ☐ 1
Skip to Say box before G3
Refused to answer ☐ 7
Don’t know ☐ 8
Skip to Say
box before G3
Normal ☐ 1
Not normal ☐ 2
Skip to Say box before G3
Refused to answer ☐ 7
Don’t know ☐ 8
G2b. 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? ”
|
|
No (0) |
Yes (1) |
Refused to answer (7) |
Don’t know (8) |
G3a. |
Male condom, also called a “rubber” [BIRCOAN3] |
☐ |
☐ |
☐ |
☐ |
G3b. |
Female condom [BIRCOBN3] |
☐ |
☐ |
☐ |
☐ |
G3c. |
Diaphragm, cervical cap, or cervical sponge[BIRCOCN3] |
☐ |
☐ |
☐ |
☐ |
G3d. |
Spermicidal foam or jelly[BIRCODN3] |
☐ |
☐ |
☐ |
☐ |
G3e. |
Depo-Provera®, which is an injection[BIRCOEN3] |
☐ |
☐ |
☐ |
☐ |
G3f. |
Hormonal implants such as Implanon® or Nexplanon®[BIRCOFN3] |
☐ |
☐ |
☐ |
☐ |
G3g. |
Birth control pills[BIRCOGN3] |
☐ |
☐ |
☐ |
☐ |
G3h. |
Contraceptive patch, for example, Ortho Evra®)[BIRCOHN3] |
☐ |
☐ |
☐ |
☐ |
G3i. |
Contraceptive ring, for example NuvaRing®)[BIRCOIN3] |
☐ |
☐ |
☐ |
☐ |
G3j. |
Intrauterine device or IUD, which comes as a coil or loop, for example, Mirena® or Paraguard®[BIRCOJN3] |
☐ |
☐ |
☐ |
☐ |
G3k. |
Emergency contraception or “morning after pill” [BIRCOKN3] |
☐ |
☐ |
☐ |
☐ |
G3l. |
Withdrawal, also called “pulling out” [BIRCOLN3] |
☐ |
☐ |
☐ |
☐ |
G3m. |
Abstinence, which is not having sex[BIRCOMN3] |
☐ |
☐ |
☐ |
☐ |
G3n. |
Post-menopausal, meaning that you do not have periods anymore[BIRCONN3] |
☐ |
☐ |
☐ |
☐ |
G3o. |
Tubal sterilization, which is having your “tubes tied,” or a hysterectomy, which is having your uterus removed[BIRCOON3] |
☐ |
☐ |
☐ |
☐ |
G3p. |
Partner’s vasectomy[BIRCOPN3] |
☐ |
☐ |
☐ |
☐ |
SAY: “Earlier you told me that you first tested positive for HIV on __ __/__ __ __ __ [INSERT DATE FROM A1].”
G4. Since testing positive for HIV in __ __/__ __ __ __ [INSERT DATE FROM A1], how many times have you been pregnant? [PREG_9]
___ ___ ___ [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
Refused to answer ☐ 7
Don’t know ☐ 8
Skip to G5d
G5a. What was the outcome of this pregnancy? [READ CHOICES. CHECK ONLY ONE.] [OUTCM1N3]
Currently pregnant ☐ 1
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
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]
Skip to G6d
Currently pregnant ☐ 1
Live birth ☐ 2
Stillbirth ☐ 3
Miscarriage ☐ 4
Abortion ☐ 5
Refused to answer ☐ 7
Don’t know ☐ 8
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).
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]
Skip to G7d
Currently pregnant ☐ 1
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 [OUTCM1N3] 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).
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? [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]
Skip to G8d
Currently pregnant ☐ 1
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: [DUDT4N3] 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
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: [PDTE4N3] 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]
Skip to G9d
Currently pregnant ☐ 1
Live birth ☐ 2
Still birth ☐ 3
Miscarriage ☐ 4
Abortion ☐ 5
Refused to answer ☐ 7
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: If outcome [OUTCM5N3] was “Currently pregnant,” then go to G9d; otherwise 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).
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
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.”
Skip to Say
box before C4
No ☐ 0
Yes ☐ 1
Skip to Say box before C4
Refused to answer ☐ 7
Don’t know ☐ 8
C1a. 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 an HIV provider. 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]
50–99 ☐ 2
100–199 ☐ 3
200–349 ☐ 4
350–499 ☐ 5
500 or more ☐ 6
Refused to answer ☐ 7
Don’t know ☐ 8
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. 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: “The date of the most recent CD4 count is earlier than the date of the first CD4 count. Display message to interviewer: Interviewer: Please verify the response. Date cannot be later than I4 (date of interview). Interviewer return to previous question (C1a).
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
Don’t know ☐ 8
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.”
Skip to Say
box before C7
No ☐ 0
Yes ☐ 1
Skip to Say box before C7
Refused to answer ☐ 7
Don’t know ☐ 8
C5. What was the month and year of your most recent viral load? [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]
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
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]
Skip to Say
box before C9
Yes ☐ 1
Skip to Say
box before C9
Don’t know ☐ 8
C8a. 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).
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
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
C14. During the past 12 months, did you get a vaccine or shot to protect you from seasonal flu? [VACFL_10]
Skip to C14b
No ☐ 0
Yes ☐ 1
Skip to C15
Refused to answer ☐ 7
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? [DO NOT READ CHOICES.] [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
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]
No ☐ 0
Yes ☐ 1
Refused to answer ☐ 7
Don’t know ☐ 8
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. Payment made: [PAYMENT]
No ☐ 0
Yes ☐
1 Skip
to E3
E2a. Why was payment not made? [PAYNMAD]
Skip to E4
Other (Specify:_____________________________) ☐ 2
[OPAY]
E3. Receipt signed (or initialed): [RECEIPT]
No ☐ 0
Yes ☐
1 Skip
to E4
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 E4: Include a NA response option if Interviewers do not have any additional comments.
Response cards
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
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
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 |
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
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
Detectable but less than 5,000 viral copies/ml
5,000 to 100,000 viral copies/ml
Greater than 100,000 viral copies/ml
2013 Calendar
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | OMB Number: 0920-0740 |
| Author | chx5 |
| File Modified | 0000-00-00 |
| File Created | 2021-01-25 |
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