Form Approved
OMB No: 0920-XXXX
Exp. Date: xx/xx/xxxx
Mobile Messaging Intervention to Present New HIV Prevention Options for Men who have Sex with Men: Randomized Controlled Trial
4c. Assessment
D1. Were you born in the United States?
Yes
No
77 I don’t know
99 I’d prefer not to answer
D2. [If D1 = 2] What year did you first come to the United States?
YYYY
D3. What language do you speak at home? (select only one)
1 English
2 Spanish
3 Arabic
4 Chinese
5 Italian
6 Korean
7 Russian
8 Vietnamese
9 Other
77 I don’t know
99 I’d prefer not to answer
D4. [If D3=Other] Please specify which language you primarily speak at home.
_______________
D5. Are you currently enrolled in school?
1 Yes, full-time
2 Yes, part-time
0 No
9 I’d prefer not to answer
D6. What is the highest level of education that you have completed?
1 Less than high school
2 High school graduate or obtained GED
3 Some college, Associate’s Degree, or Technical Degree
4 Bachelor’s Degree / College Degree
5 Any post-graduate studies
99 I’d prefer not to answer
D7. Which of the following best describes your employment status? Are you:
1 Employed
full-time
2 Employed part-time
3 On active duty in the U.S. Armed forces, Reserves, or National Guard
4 Retired
5 Unable to work for health reasons
6 Unemployed
7 Other, specify: ___________
77 I don’t know
99 I’d prefer not to answer
D8. [If D7=Other] Please specify what best describes your employment status.
__________________
D9. What was your income last year from all sources before taxes?
1 0 to $4,999
2 $5,000 to $9,999
3 $10,000 to $14,999
4 $15,000 to $19,999
5 $20,000 to $29,999
6 $30,000 to $39,999
7 $40,000 to $49,999
8 $50,000 to $74,999
9 $75,000 or more
77 I don’t know
99 I’d prefer not to answer
D10. Which of the following best represents how you think of yourself?
1 Gay
2 Straight, that is not gay
3 Bisexual
4 Something else
7 I don’t know
D11. What is your HIV status?
0 HIV negative
1 HIV positive
2 Indeterminate
3 I don’t know
D12. In the past 12 months, have you been homeless at any time?
By homeless, we mean living on the street, in a shelter, a Single Room Occupancy hotel (SRO), temporarily staying with friends or relatives, or living in a car.
1 Yes
0 No
9 I’d prefer not to answer
D13. [If D12=1] Are you currently homeless?
1 Yes
0 No
9 I’d prefer not to answer
D14. Do you currently have health insurance or health care coverage (including Medicare or Medicaid)?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
D15. [If D14=1] What kind of health insurance or coverage do you currently have?
[NHBS]
1 A private health plan (through an employer or purchased directly)
2 Medicaid (for people with low incomes)
3 Medicare (for elderly people and people with disabilities)
4 Some other government plan
5 TRICARE (CHAMPUS)
6 Veteran Administration coverage
7 Some other health insurance plan
77 I don’t know
99 I’d prefer not to answer
D16. [If D15=7] Please specify what other health insurance plan you currently have.
___________________
D17. Have you ever been in jail or prison?
1 Yes
0 No
9 I’d prefer not to answer
D18. [If D17=1] In the past 3 months, have you been in jail or prison?
1 Yes
0 No
9 I’d prefer not to answer
HT1. [If D11=1] In what year was your first positive test for HIV?
YYYY
HT2. [If HT1 ≥ YEAR-2] In the past 12 months, that is since [month and year], did you receive your first positive test for HIV?
1 Yes
0 No
7 I don’t know
HT3. [If D11≠1] Have you ever been tested for HIV?
[InvolveMENt, AMIS]
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HT4. [IF D11≠1 AND HT3=1] When was your first HIV test?
yyyy
HT5. [IF D11≠1 AND HT3=1] In the past 12 months, that is since [month and year], have you received an HIV test?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HT6. [IF D11≠1 AND HT5=1] In the past 3 months, that is since [month and year], have you received an HIV test?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HT7. [IF D11≠1 AND HT3=1] What was the result of your most recent HIV test?
0 Negative
1 Positive
2 I never received the results
3 Indeterminate/Inconclusive
7 I don’t know
9 I’d prefer not to answer
HT8. [IF D11≠1 AND HT3=1] When you last got tested, where did you get tested?
1 Private doctor’s office
2 Community health center/ public health clinic
3 HIV counseling and testing site
4 HIV/AIDS street outreach program/ Mobile testing unit
5 Hospital (inpatient)
6 Emergency Room
7 Sexually transmitted disease clinic
8 Drug treatment program
9 Correctional facility (jail or prison)
10 Blood bank/ plasma center
11 Military
12 At home
13 Other
77 I don’t know
99 I’d prefer not to answer
HT9. [IF HT8=Other] Please specify where you last got tested.
__________________
HT10. [IF D11≠1 AND HT3=1] When you last got tested, what prompted you to get tested? Select all that apply.
1 The condom broke
2 I did not use a condom the last time I had sex
3 I was drunk or high the last time I had sex and I don’t remember exactly what happened
4 I found out a partner I had anal sex with was HIV-positive
5 The HIV test was part of a research study
6 I was already at the doctor’s office
7 I was due for an HIV test
8 I wanted to know my status
9 My partner encouraged me to get tested
10 My partner got tested, so I did too
11 It’s a condition of my sexual agreement
12 My partner and I wanted to be monogamous
13 I was beginning a relationship
14 I was feeling sick
15 Someone I had sex with was feeling sick/got sick
16 I shared a needle with someone else
17 I have a lot of risky sex
18 I have a lot of sex partners
19 Other
77 I don’t know
99 I’d prefer not to answer
HT11. [IF HT10=Other] Please specify what other reason prompted you to get tested.
___________________
HT12. [IF D11≠1 AND (HT3≠1 OR HT5≠1)] Which of the following reasons best describes why you have not been tested for HIV in the past 12 months:
1 You think you are at low risk for HIV infection
2 You are afraid of finding out you have HIV
3 You didn’t have time
4 You I don’t know where to get tested
5 Your doctor hasn’t brought it up
6 You’re worried about the cost
7 No particular reason
77 I don’t know
99 I’d prefer not to answer
HT13. [IF D11≠1] How often do you think you should be tested for HIV?
1 Less than once a year
2 Once a year
3 Every 6 months
4 Every 3 months
5 Every month
6 Other
77 I don’t know
99 I’d prefer not to answer
HT14. [IF HT13=Other] Please specify how often you think you should be tested for HIV.
_________________
HT15. [IF D11≠1] When do you plan to next get tested for HIV?
1 Within the next month
2 Within the next 1 to 3 months
3 Within the next 4 to 6 months
4 Within the next 7 to 12 months
5 More than a year from now
6 I’m not planning to get tested
77 I don’t know
99 I’d prefer not to answer
HT16. [IF D11≠1 AND HT15=5 OR 6] Which of the following reasons best describes why you do not plan to be tested in the next 12 months:
1 You think you are at low risk for HIV infection
2 You are afraid of finding out you have HIV
3 You don’t have time
4 You I don’t know where to get tested
5 You’re worried about the cost
6 No particular reason
77 I don’t know
99 I’d prefer not to answer
HT17. [IF D11≠1 AND HT15 ≤ 4] Which of the following reasons best describes why you plan to be tested in the next [number of months] months:
1 I have been feeling sick
2 Someone I had sex with has been feeling sick/is sick
3 I found out a partner I had anal sex with is HIV-positive
4 I am due for an HIV test
5 I want to know my status
6 It’s a condition of my sexual agreement
7 My partner and I want to be monogamous
8 I am beginning a relationship
9 I often share needles
10 I have a lot of risky sex
11 I have a lot of sex partners
12 Other, specify
77 I don’t know
99 I’d prefer not to answer
HT18. [IF HT17=Other] Please specify the reason why you plan to be tested in the next [number of months].
________________
ST1. In the past 3 months, that is since [month and year] have you been tested by a doctor, nurse or other health care provider for any sexually transmitted diseases? This does not include tests for HIV.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
ST2. A vaccine to prevent HPV infection is available and is called the HPV shot, GARDISIL or CERVARIX. Have you ever received the HPV shot?
1 Yes
2 No
7 I don’t know
9 I’d prefer not to answer
ST3. There are vaccines or shots that can prevent some types of hepatitis. Have you ever had a hepatitis vaccine?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
ST4. [IF ST3=1] What types or types of hepatitis vaccine have you had? Select only one.
1 Hepatitis A vaccine
2 Hepatitis B vaccine
3 Both the Hepatitis A and B vaccines
7 I don’t know
9 I’d prefer not to answer
ST5. In the past 3 months, that is since [month and year] has a doctor, nurse or other health care provider told you that you had any of the following STDs? Select all that apply.
|
Selected |
Unselected |
Chlamydia |
1 |
0 |
Gonorrhea |
1 |
0 |
Syphilis |
1 |
0 |
Herpes |
1 |
0 |
Genital warts |
1 |
0 |
Hepatitis A |
1 |
0 |
Hepatitis B |
1 |
0 |
Hepatitis C |
1 |
0 |
Some other STD |
1 |
0 |
ST6. If [ST5=Some Other STD] Please specify which other STD(s).
____________________
ST7. When do you think you should be tested for an STD? Select all that apply.
|
Selected |
Unselected |
When I have symptoms of an STD |
1 |
0 |
When I’ve had sex without a condom |
1 |
0 |
When my partner tests positive for an STD |
1 |
0 |
When it is time for me to be tested |
1 |
0 |
When a doctor or other healthcare provider tells me I should be tested |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
ST8. [IF ST7=Other] When else do you think you should be tested for an STD?
____________________
PAGE LOGIC FOR HC1-HC8: D11=1
HC1. In the past 12 months, that is since [month and year], have you seen a doctor, nurse or other health provider for outpatient HIV care?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HC2. [IF HC1=1] In the past 12 months, how many appointments have you scheduled with a doctor, nurse or other health provider for HIV care?
____
HC3. [IF HC1=1] In the past 12 months, how many of your scheduled appointments did you attend?
____
HC4. [IF HC3<HC2] Why did you not attend [# of missed visits] of your scheduled appointments? [Select all that apply]
|
Selected |
Unselected |
I was busy |
1 |
0 |
I simply forgot |
1 |
0 |
I had a schedule change or was traveling |
1 |
0 |
My provider canceled our appointment |
1 |
0 |
I did not have access to transportation |
1 |
0 |
I was worried others would see or find out |
1 |
0 |
I did not think it was necessary |
1 |
0 |
I do not have insurance |
1 |
0 |
I was worried about receiving HIV care |
1 |
0 |
I felt depressed or overwhelmed |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
HC5. [IF HC4=Other] For what other reasons did you not attend your scheduled appointment(s)?
_______________________
HC6. [IF HC1=1] In the past 3 months, that is since [month and year], have you had a medical visit in an HIV care setting?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HC7. To your knowledge, has your doctor or another provider ordered a viral load test for you in the past 3 months? This would have involved drawing your blood.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
HC8. [IF HC7=1] What was your viral load count the last time it was measured?
______ #copies/mL
1 Undetectable
7 I don’t know
9 I’d prefer not to answer
PAGE LOGIC FOR MA1-MA11: D11=1
MA1. Have you ever been prescribed and taken antiretroviral medications to treat your HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
MA2. [IF MA1=0] What are the reasons you have never taken any antiretroviral medications? Select all that apply.
|
Selected |
Unselected |
My doctor advised to delay treatment |
1 |
0 |
I recently entered medical care/haven’t had time |
1 |
0 |
My CD4 and/or viral load are good |
1 |
0 |
I feel good and don’t need them |
1 |
0 |
I’m worried about the side effects |
1 |
0 |
Because of my drinking or drug use |
1 |
0 |
I didn’t want to think about being HIV positive |
1 |
0 |
I don’t have enough money |
1 |
0 |
I don’t have health insurance |
1 |
0 |
I am worried about my ability to take my medicine, I often forget to take medications |
1 |
0 |
I’m living on the street |
1 |
0 |
I’m taking alternative or complementary medicine |
1 |
0 |
I’m not sure |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
MA3. [IF MA2 selected ≥2 responses] You said you’ve never taken any antiretroviral medications for the following reasons. Of these, which is the most important reason you’ve never taken antiretroviral medications? [List limited to responses selected above]
1 My doctor advised to delay treatment
2 I recently entered medical care/haven’t had time
3 My CD4 and/or viral load are good
4 I feel good and don’t need them
5 I’m worried about the side effects
6 Because of my drinking or drug use
7 I didn’t want to think about being HIV positive
8 I don’t have enough money
9 I don’t have health insurance
10 I am worried about my ability to take my medicine, I often forget to take medications
11 I’m living on the street
12 I’m taking alternative or complementary medicine
MA4. [IF MA1=1] Are you currently prescribed and taking antiretroviral medicines to treat your HIV?
1 Yes
0 No
9 I’d prefer not to answer
MA5. [IF MA4=1] Did you start taking antiretroviral medicines to treat your HIV in the past 3 months? That is since [month and year].
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
MA5. [IF MA4=1] In the past 3 months, did you stop taking your antiretroviral medicines on purpose at any point in time? DO not include times when you accidentally missed one or more doses.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
MA6. [IF MA4=0] In the past 3 months, have you taken any antiretroviral medicines to treat your HIV? That is since [month and year].
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
MA7. [IF MA4=1] In the past 7 days, on how many days did you take all of your doses of your HIV medicines?
____ (7-0 Descending Order Dropdown Menu)
MA8. [IF MA4=1] In the past 30 days, on how many days did you take all of your doses of your HIV medicines?
[Wilson]
____ (30-0 Descending Order Dropdown Menu)
MA9. [IF MA4=1] In the past 30 days, how good a job did you do at taking your HIV medicines in the way you were supposed to?
1 Very poor
2 Poor
3 Fair
4 Good
5 Very good
6 Excellent
77 I don’t know
99 I’d prefer not to answer
MA10. [IF MA4=1] In the past 30 days, how often did you take your HIV medicines in the way you were supposed to?
1 Never
2 Rarely
3 Sometimes
4 Usually
5 Almost always
6 Always
77 I don’t know
99 I’d prefer not to answer
MA11. [IF MA4=1] In the next 30 days, please indicate how confident you feel that you will be able carry out the following.
|
Extremely Unconfident |
Somewhat Unconfident |
Uncertain |
Somewhat Confident |
Extremely confident |
Stick with your treatment plan even when side effects began to interfere with daily activities |
1 |
2 |
3 |
4 |
5 |
Integrate your treatment into your daily routine |
1 |
2 |
3 |
4 |
5 |
Integrate your treatment into your daily routine, even if it means taking medication or doing other things in front of people who I don’t know you have HIV |
1 |
2 |
3 |
4 |
5 |
Stick to your treatment schedule even if your daily routine is disrupted |
1 |
2 |
3 |
4 |
5 |
Stick to your treatment schedule when it means changing your eating habits |
1 |
2 |
3 |
4 |
5 |
Continue with your treatment even if it interferes with daily activities |
1 |
2 |
3 |
4 |
5 |
Continue with the treatment plan your doctor prescribed even if your t-cells drop significantly |
1 |
2 |
3 |
4 |
5 |
Continue with your treatment even when you are feeling discouraged about your health |
1 |
2 |
3 |
4 |
5 |
Continue with your treatment even when getting to clinic appointments is a major hassle |
1 |
2 |
3 |
4 |
5 |
Continue with your treatment even when people close to you tell you that they don’t think that it is doing any good |
1 |
2 |
3 |
4 |
5 |
Get something positive out of your participation in treatment, even if the medication you are taking does not improve your health |
1 |
2 |
3 |
4 |
5 |
PAGE LOGIC FOR PA1-22: D11≠1
PA1. There is a pill HIV-negative men can take to reduce their risk of HIV. This is called pre-exposure prophylaxis, or PrEP. Have you ever heard of PrEP?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA2. [IF PA1=1] Are you currently taking PrEP to prevent HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA3. [IF PA2=1] Did you start taking PrEP in the past 3 months? That is since [month and year].
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA4. [IF PA2=1] In the past 3 months, did you stop taking PrEP on purpose for any period of time? Do not include times when you accidentally missed one or more doses of PrEP.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA5. [IF PA2=0] In the past 3 months, were you taking PrEP but stopped?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA6. [IF PA5=0 AND PA2=0] Have you ever used PrEP to prevent HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA7. [IF PA2=0 AND (PA5 OR PA6)=1] What are some of the reasons you stopped using PrEP to prevent HIV? Select all that apply.
I couldn’t afford it |
Selected |
Unselected |
My insurance wouldn’t cover it |
1 |
0 |
I didn’t know where to get it |
1 |
0 |
My doctor decided PrEP was no longer appropriate for me |
1 |
0 |
I didn’t like the side effects |
1 |
0 |
I was worried about the safety of PrEP |
|
|
My kidney and liver function began to suffer |
|
|
I started a committed relationship |
1 |
0 |
I was using PrEP in a previous relationship with a PLWH |
1 |
0 |
I didn’t think it was worth it |
1 |
0 |
I contracted HIV |
1 |
0 |
It was too inconvenient/didn’t fit my life |
1 |
0 |
I was worried someone would think I had HIV if they saw me take it |
1 |
0 |
I decided I didn’t need it anymore |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
PA8. [IF PA7=Other] Please specify why you stop using PrEP.
___________________
PA9. [IF PA7 selected ≥2 response]. You said you stopped using PrEP for the following reasons. Among these, which is the most important reason you stopped using PrEP? [List limited to those responses selected above]
1 I couldn’t afford it
2 My insurance wouldn’t cover it
3 I didn’t know where to get it
4 My doctor decided PrEP was no longer appropriate for me
5 I didn’t like the side effects
6 I was worried about the safety of PrEP
7 My kidney and liver function began to suffer
8 I started a committed relationship
9 I was using PrEP in a previous relationship with a PLWH
10 I didn’t think it was worth it
11 I contracted HIV
12 It was too inconvenient/didn’t fit my life
13 I was worried someone would think I had HIV if they saw me take it
14 I decided I didn’t need it anymore
PA10. [IF PA2=0 AND PA6=0] What are some of the reasons you’ve never used PrEP. Select all that apply.
I couldn’t afford it |
Selected |
Unselected |
My insurance wouldn’t cover it |
1 |
0 |
I didn’t know where to get it |
1 |
0 |
My doctor did not recommend PrEP for me |
1 |
0 |
I was worried about the side effects |
1 |
0 |
I started a committed relationship |
1 |
0 |
I didn’t think it was worth it |
1 |
0 |
I contracted HIV |
1 |
0 |
It was too inconvenient/didn’t fit my life |
1 |
0 |
I was worried someone would think I had HIV if they saw me take it |
1 |
0 |
I decided I didn’t need it |
1 |
0 |
I have never heard of it |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
PA11. [IF PA10=Other] Please specify why you have never used PrEP.
_____________________
PA12. [IF PA10 selected ≥2 reasons] You said you’ve never used PrEP for the following reasons. Among these, which is the most important reason you’ve never PrEP? [List limited to responses selected above].
1 I couldn’t afford it
2 My insurance wouldn’t cover it
3 I didn’t know where to get it
4 My doctor did not recommend PrEP for me
5 I was worried about the side effects
6 I started a committed relationship
7 I didn’t think it was worth it
8 I contracted HIV
9 It was too inconvenient/didn’t fit my life
10 I was worried someone would think I had HIV if they saw me take it
11 I decided I didn’t need it
12 I have never heard of it
PA13. [IF PA2=1] In the past 7 days, on how many days did you take your dose of PrEP?
____ (Number of days)
PA14. [IF PA2=1] In the past 30 days, on how many days did you take your dose of PrEP?
____ (Number of days)
PA15. [IF PA2=1] In the past 30 days, how good a job did you do at taking your PrEP medication in the way you were supposed to?
1 Very poor
2 Poor
3 Fair
4 Good
5 Very good
6 Excellent
77 I don’t know
99 I’d prefer not to answer
PA16. [IF PA2=1] In the past 30 days, how often did you take your PrEP medication in the way you were supposed to?
1 Never
2 Rarely
3 Sometimes
4 Usually
5 Almost Always
6 Always
77 I don’t know
99 I’d prefer not to answer
PA17. [IF PA2=1] When do you take your PrEP medication?
1 Before you have sex
2 After you have sex
3 Both before and after you have sex
4 Other times
7 I don’t know
9 I’d prefer not to answer
PA18. [IF PA17=Other] Please specify what other times you take your PrEP medication.
_______________
PA19. [IF PA2=1] Have you ever used PrEP “on-demand” or right before you knew you were about to have sex, as opposed to daily?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA20. [IF PA2=1] Have you ever shared your PrEP medication with others?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PA21. [IF PA20=1] Who did you share your PrEP medication with? Select all that apply.
|
Selected |
Unselected |
Sex partner |
1 |
0 |
Friends |
1 |
0 |
Family |
1 |
0 |
Co-workers |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
PA22. [IF PA21=Other] Please specify with whom you have shared your PrEP medication.
_____________________
PAGE LOGIC FOR PC1-2: D11≠1
PC1. [IF PA2=1] In the past 3 months, that is since [month and year], have you seen a doctor, nurse or other health care provider to receive tests or other care related to your PrEP use?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PC2. [IF PA2=0] In the past 3 months, that is since [month and year], have you talked to a doctor, nurse or other health care provider about using PrEP?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
GC1. [IF D11≠1 AND PA2=0 AND PC2=0] In the past 3 months, have you seen a doctor, nurse or other health care provider for any other reason?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
GC2. [IF (D11=1 AND MA4=0) OR (D11≠1 AND PA2=0)] Think about times when you have been prescribed medicine by a doctor because you were sick or for a chronic condition.
|
Yes |
No |
Did you ever forget to take your medicine? |
1 |
0 |
Do you ever have problems taking your medicine? |
1 |
0 |
When you feel better, do you sometimes stop taking your medicine before you should? |
1 |
0 |
Sometimes, if you feel worse when taking your medicine, do you stop taking it? |
1 |
0 |
EI1. [IF D11≠1] On a scale of 0 to 100, where 0 equals no protection and 100 equals complete protection, how much protection do you think each of the following strategies offers in preventing HIV?
Please slide the blue dot on the scale to indicate how much protection you think each strategy offers.
Taking PrEP |
0% --------------------------------------------------------------------------------------100% |
Using Condoms |
0% --------------------------------------------------------------------------------------100% |
An HIV positive partner taking HIV medications |
0% --------------------------------------------------------------------------------------100% |
Getting tested for HIV |
0% --------------------------------------------------------------------------------------100% |
Getting tested for STDs |
0% --------------------------------------------------------------------------------------100% |
Always using condoms with HIV-negative partners |
0% --------------------------------------------------------------------------------------100% |
Always using condoms with HIV-positive partners |
0% --------------------------------------------------------------------------------------100% |
EI2. [IF D11=1] On a scale of 0 to 100, where 0 equals no protection and 100 equals complete protection, how much protection do you think each of the following strategies offers in preventing HIV?
Please slide the blue dot on the scale to indicate how much protection you think each strategy offers.
Your partner taking PrEP |
0% --------------------------------------------------------------------------------------100% |
Using Condoms |
0% --------------------------------------------------------------------------------------100% |
Taking medications to treat your HIV |
0% --------------------------------------------------------------------------------------100% |
Your partner getting tested for HIV |
0% --------------------------------------------------------------------------------------100% |
Getting tested for STDs |
0% --------------------------------------------------------------------------------------100% |
Always using condoms with HIV-negative partners |
0% --------------------------------------------------------------------------------------100% |
Always using condoms with HIV-positive partners |
0% --------------------------------------------------------------------------------------100% |
EI3. [IF D11≠1] In the next 3 months, how likely are you to do each of the following?
|
Definitely not Likely |
Probably not Likely |
Somewhat Likely |
Probably Likely |
Definitely Likely |
Doesn’t apply |
Use condoms every time you have anal sex |
1 |
2 |
3 |
4 |
5 |
99 |
Get tested for HIV |
1 |
2 |
3 |
4 |
5 |
99 |
Get tested for STDs |
1 |
2 |
3 |
4 |
5 |
99 |
Start taking PrEP |
1 |
2 |
3 |
4 |
5 |
99 |
Take all of your PrEP doses exactly as you are supposed to |
1 |
2 |
3 |
4 |
5 |
99 |
See a doctor, nurse or other health care provider |
1 |
2 |
3 |
4 |
5 |
99 |
EI3. [IF D11≠1] In the next 3 months, how likely are you to do each of the following?
|
Definitely not Likely |
Probably not Likely |
Somewhat Likely |
Probably Likely |
Definitely Likely |
Doesn’t apply |
Use condoms every time you have anal sex |
1 |
2 |
3 |
4 |
5 |
99 |
Get tested for STDs |
1 |
2 |
3 |
4 |
5 |
99 |
Start taking PrEP |
1 |
2 |
3 |
4 |
5 |
99 |
Start taking antiretroviral medications to treat your HIV |
1 |
2 |
3 |
4 |
5 |
99 |
Take all of your HIV medications exactly as you are supposed to |
1 |
2 |
3 |
4 |
5 |
99 |
See a doctor, nurse or other health care provider for HIV care |
1 |
2 |
3 |
4 |
5 |
99 |
Get a viral load test |
1 |
2 |
3 |
4 |
5 |
99 |
We want to ask if you have had a primary male partner in the past 3 months, that is since approximately [month and year]. By “primary” partner we mean a man you have lived with or have seen a lot, to whom you have felt a special emotional commitment for at least 3 months.
SX1. Have you had a primary male partner in the past three months?
0 No
1 Yes
Now we want to ask you about all the other men you have had any anal sex with in the past 3 months other than your most recent primary partner.
SX2. In the past 3 months, with how many men other than your most recent primary partner did you have any anal sex? This includes times when you were a top or bottom, used or didn't use a condom, and whether or not there was ejaculation.
____
SX3. [IF SX1=0 AND SEX2=0] You indicated you did not have any sex partners in the past 3 months, is this correct? (Choose one)
1 Yes [SKIP TO NEXT SECTION]
0 No, I want to change my answer [RETURN TO SX1]
SX4. [IF SX1 + SX2≠0] Thanks. So you indicated that in the past 3 months you had a total of [SX1 + SX2] male sex partners, including [SX1] primary partner and [SX2] casual partners. Is that correct?
1 Yes
0 No, I want to change my answer [RETURN to SX1]
SECTION LOGIC FOR SXP1-SXP48: SX1=1
SXP1. Throughout this next group of questions, your recent male primary partner will be referred to by his initials. Please put his initials here. Use AZ if you do not know his name.
_ _
SXP2. How old is [Response to SXP1]? If you are not sure, give it your best guess.
____
SXP3. What is [Response to SXP1]’s primary race/ethnicity? If you are not sure, give it your best guess.
1 African American or Black
2 Asian American or Pacific Islander
3 Latino, Hispanic, or Chicano
4 Native American, American Indian, or Alaska Native
5 White or European American
6 Mixed
7 Other
99 I’d prefer not to answer
SXP4. [IF SXP3=Other] Please specify [Response to SXP1]’s race/ethnicity.
____________
SXP5. Where did you first meet [Response to SXP1]? (Choose one)
1 A dating or hookup app/website for gay men, like Grindr or Jack’d
2 A social networking app or website for gay men (not for dating or hooking up)
3 A social networking app or website, like Facebook, Twitter, Instagram or Snapchat
4 Some other app or website
5 Work or school
6 Through family
7 Through a friend
8 A private party or social event
9 A public festival or community event, like Pride
10 A gay commercial venue, like a gay bar or dance club
11 A straight commercial venue, like a straight bar or dance club
12 A commercial sex venue, like a sex club or bath house
13 A public sex venue, like a park, beach, bathroom or tearoom
14 Other
99 I’d prefer not to answer
SXP6. [IF SXP5=Other] Please specify where you met [Response to SXP1].
___________________
SXP7. When was the first time you had any anal sex with [Response to SXP1]? That is, where you were a top or bottom, with or without a condom, and with or without ejaculation.
1 Less than a week
2 More than a week but less than a month ago
3 One to three months
4 Four to six months
5 Seven to twelve months
6 More than a year
99 I’d prefer not to answer
SXP8. What is [Response to SXP1]’s HIV status?
1 Positive
2 Negative
3 You don’t know / are unsure about his HIV status
99 I’d prefer not to answer
SXP9. Did [Response to SXP1] TELL you his HIV-status?
1 Yes, and I have no reason to doubt him
2 Yes, but I have reason to doubt him
0 No
77 I’m not sure
99 I’d prefer not to answer
SXP10. Have you told [Response to SXP1] your current HIV status?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
PAGE LOGIC FOR SXP11-SXP14: SXP8=1
SXP11. Have you ever talked to [Response to SXP1] about whether he is taking antiretroviral medicines to treat his HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP12. [If SXP11=1] In the past 3 months, that is since [month and year], have you talked to [Response to SXP1] about whether he is taking antiretroviral medicines to treat his HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP13. [SXP11=1] Has [Response to SXP1] told you he was currently taking antiretroviral medicines to treat his HIV?
1 Yes, and I have no reason to doubt him
2 Yes, but I have reason to doubt him
0 No
7 I don’t know
9 I’d prefer not to answer
SXP14. [IF SXP13=1] Has [Response to SXP1] told you his viral load is undetectable?
1 Yes, and I have no reason to doubt him
2 Yes, but I have some reason to doubt him
0 No
7 I don’t know
9 I’d prefer not to answer
PAGE LOGIC FOR SXP15-SXP17: SXP8=2
SXP15. Have you ever talked to [Response to SXP1] about whether he is taking PrEP to prevent HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP16. [IF SXP15=1] In the past 3 months, that is since [month and year], have you talked to [Response to SXP1] about whether he is taking PrEP to prevent HIV?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP17. [IF SXP15=1] Has [Response to SXP1] told you he is currently taking PrEP to prevent HIV?
1 Yes, and I have no reason to doubt him
2 Yes, but I have reason to doubt him
0 No
7 I don’t know
9 I’d prefer not to answer
SXP18. In the past 3 months, that is since [month and year], have you had ANY anal sex with [Response to SXP1] in which a condom was not used from start to finish?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP19. [If SXP18=1 Think of the times in the past 3 months that you had anal sex with [Response to SXP1] and did not use a condom from start to finish. Were you the top (you put your penis in his butt), the bottom (he put his penis in your butt), or both?
1 I was always the top
2 I was always the bottom
3 I was both the top and the bottom
7 I don’t know
9 I’d prefer not to answer
SXP20. [IF SXP18=1] Think of the times in the past 3 months that you had anal sex with [Response to SXP1] and did not use a condom from start to finish. Were you ever drunk or buzzed on alcohol within 2 hours before or during sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP21. [IF SXP18=1] Think of the times in the past 3 months that you had anal sex with [Response to SXP1] and did not use a condom from start to finish. Did you ever use non-prescription drugs within 2 hours before or during sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
The following questions ask about the last time you had sex with your primary partner.
SXP22. How long ago was the last time you had any anal sex with [Response to SXP1]? That is, with or without a condom, and with or without ejaculation.
1 1 day
2 2 days
3 3 days
4 4 days
5 5 days
6 6 days
7 1 week
8 2 weeks
9 3 weeks
10 1 months
11 2 months
12 3 months
13 More than 3 months
99 I’d prefer not to answer
SXP23. During the most recent time you had any anal sex with [Response to SEX5], where did you have sex? (Choose one)
1 Your house or apartment or his house or apartment
2 Someone else's house or apartment
3 Hotel
4 Sex club or bathhouse
5 Bar, night club, or dance club
6 Health club or gym
7 Porn theatre/video arcade
8 Public bathroom
9 Other public place, such as beach
10 Park, woods, street, car or van
11 Other
77 I don’t know
99 I’d prefer not to answer
SXP24. During the most recent time you had anal sex with [Response to SXP1], were you the top (you put your penis in his butt)? This would be with or without a condom and with or without ejaculation.
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP25. [If SXP24=1] Was a condom used from start to finish when you were the top?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP26. During the most recent time you had anal sex with [Response to SXP1], were you the bottom (he put his penis in your butt}? This would be with or without a condom and whether or not you ejaculated.
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP27. [IF SXP26=1] Was a condom used from start to finish when you were the bottom?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
PAGE LOGIC FOR SXP28-SXP30: D11≠1
SXP28. Were you taking PrEP medication to prevent HIV within 24 hours before or after the last time you had sex with [Response to SXP1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP29. [IF SXP28=1] Were you taking your PrEP medication once a day as prescribed by your doctor, without missing any doses, in the 7 days before you last had anal sex with [Response to SEX5]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP30. [If SXP29=0] You mentioned that you were not taking your PrEP medication once a day as prescribed at the time of your last sexual encounter. In the 7 days before you last had anal sex with [Response to SXP1], on how days did you take your dose of PrEP?
____ (Number of days, up to 7)
PAGE LOGIC FOR SXP31-SXP33: SXP8=2
SXP31. Was [Response to SXP1] taking PrEP medication to prevent HIV within 24 hours before or after the time you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP32. [IF SXP31=1] To your knowledge, was [Response to SXP1] taking his PrEP medication once a day as prescribed by his doctor, without missing any doses, in the 7 days before you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP33. [If SXP32=0] You mentioned that [Response to SXP1] was not taking his PrEP medication once a day as prescribed at the time your last sexual encounter. To your knowledge, in the 7 days before had anal sex, on how many days did [Response to SXP1] take his dose of PrEP?
____ (Number of Days up to 7)
PAGE LOGIC FOR SXP34-SXP36: D11=1
SXP34. Were you taking antiretroviral medicines to treat your HIV infection with 24 hours before or after the time you last had anal sex with [Response to SXP1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP35. [IF SXP34=1] Were you taking your HIV medicines exactly as prescribed by your doctor, without missing any doses, in the 7 days before you last had sex with [Response to SXP1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP36. [IF SXP35=0] You mentioned that you were not taking your HIV medicines exactly as prescribed at the time of your last sexual encounter. In the 7 days before you last had anal sex with [Response to SXP1], on how many of the 7 days did you take all of the doses of your HIV medicines?
____ (Number of days up to 7)
PAGE LOGIC FOR SXP37-SXP39: SXP8=1
SXP37. Was [Response to SXP1] taking antiretroviral medicines to treat his HIV infection with 24 hours before or after the time you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP38. [IF SXP37=1] To your knowledge, was [Response to SXP1] taking his HIV medicines exactly as prescribed by his doctor, without missing any doses, in the 7 days before you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP39. [If SXP38=0] You mentioned that [Response to SXP1] was not taking his HIV medicines exactly as prescribed at the time of your last sexual encounter. To your knowledge, in the 7 days before you last had anal sex, on how days did [Response to SXP1] take all of the doses of his HIV medicines?
____ (Number of Days up to 7)
SXP40. [IF SXP37=1] Did [Response to SXP1] tell you his viral load was undetectable before you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXP41. [If SXP40=1] When was the last time [Response to SXP1] told you his viral load was undetectable?
1 Less than a week ago
2 More than a week ago but less than a month ago
3 One to three months ago
4 Four to six months ago
5 Seven to twelve months ago
6 More than a year ago
77 I don’t know
99 I’d prefer not to answer
SXP42. Were you drunk or buzzed on alcohol within two hours before or during the most recent time you had anal sex with [Response to SXP1]?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP43. How many drinks did you have? By a drink, I mean a 12 oz. can or glass of beer, a 4 oz. glass of wine, a 1-1/2 oz. shot of liquor, or a mixed drink with that amount of liquor.
____ (number of drinks)
SXP44. Was [Response to SXP1] drunk or buzzed on alcohol within two hours before or during the most recent time you had anal sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP43. Did you use any drug within two hours before or during the most recent time you had anal sex with [Response to SEX5]?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP44. Which drugs? (Check all that apply)
|
Selected |
Unselected |
Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Downers (Valium, Ativa, Xanax) |
1 |
0 |
Pain killers (Oxycontin, Percocet) |
1 |
0 |
Hallucinogens (LSD, mushrooms, Peyote, Mescaline) |
1 |
0 |
Ecstacy (E, X, MDMA) |
1 |
0 |
Club drugs (GHB, ketamine, special K) |
1 |
0 |
Marijuana (pot, weed) |
1 |
0 |
Poppers (amyl nitrate) |
1 |
0 |
PCP (angel dust, wet, wicky sticks) |
1 |
0 |
Synthetic marijuana (herbal incense, spice, K2) |
1 |
0 |
Crack, injected |
1 |
0 |
Crack, smoked or snorted |
1 |
0 |
Cocaine, injected |
1 |
0 |
Cocaine, smoked or snorted |
1 |
0 |
Heroin, injected |
1 |
0 |
Heroin, smoked or snorted |
1 |
0 |
Heroin and cocaine injected together (speedballs) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
SXP45. [IF SXP44=Other] Please specify which other drugs you used.
_________________
SXP46. Did [Response to SXP1] use any drug within two hours before or during the most recent time you had anal sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXP47. Which drugs? (Check all that apply)
|
Selected |
Unselected |
Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Downers (Valium, Ativa, Xanax) |
1 |
0 |
Pain killers (Oxycontin, Percocet) |
1 |
0 |
Hallucinogens (LSD, mushrooms, Peyote, Mescaline) |
1 |
0 |
Ecstacy (E, X, MDMA) |
1 |
0 |
Club drugs (GHB, ketamine, special K) |
1 |
0 |
Marijuana (pot, weed) |
1 |
0 |
Poppers (amyl nitrate) |
1 |
0 |
PCP (angel dust, wet, wicky sticks) |
1 |
0 |
Synthetic marijuana (herbal incense, spice, K2) |
1 |
0 |
Crack, injected |
1 |
0 |
Crack, smoked or snorted |
1 |
0 |
Cocaine, injected |
1 |
0 |
Cocaine, smoked or snorted |
1 |
0 |
Heroin, injected |
1 |
0 |
Heroin, smoked or snorted |
1 |
0 |
Heroin and cocaine injected together (speedballs) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
SXP48. [IF SXP47=Other] Please specify which other drugs [Response to SXP1] used.
_________________
SECTION LOGIC FOR SXC1-SXC26: SX2 ≥ 1
The following questions ask you about the [Response to SX2] non-primary male partners you have had in the past three months. If you are unsure of any partners HIV status, please do not include them in either group.
SPS1. Of these [Response to SX2] men, how many did you believe were HIV-positive?
____
SPS2. Of these [Response to SX2] men, how many did you believe were HIV-negative?
____
[TOT_UNK = SX2 – SXC1 – SXC2; if TOT_PN = 0, then skip to SEX 49]
SPS3. So, you had [TOT_UNK] partners whose HIV status you did not know or were unsure of? (Choose one)
0 No, I want to change my answer
1 Yes
99 I’d prefer not to answer
SPS4. [IF SPS1 ≥ 1] Of the [Response to SPS1] HIV positive men, how many actually TOLD you they were HIV positive?
____
SPS5. [SPS2 ≥ 1] Of the [Response to SPS2] HIV negative men, how many actually TOLD you they were HIV negative?
_ _ _
99 I’d prefer not to answer
The following questions ask about your HIV-positive partners who were NOT your primary partner.
PAGE LOGIC FOR SXC1-SXC10: SPS1 ≥ 1
SXC1. In the past 3 months, that is since [month and year] with how many of your [Response to SPS1] HIV-positive partners were you the top (you put your penis in his butt)?
____
SXC2. In the past 3 months, with how many of your [Response to SPS1] HIV-positive partners were you the bottom (he put his penis in your butt)?
____
SXC3. In the past 3 months, that is since [month and year], with how many of your [Response to SPS1] HIV-positive partners did you have ANY anal sex in which a condom was not used from start to finish?
____ [IF 0, SKIP to SXC8]
SXC4. [IF SXC3 ≥ 1] Of the [Response to SXC3] HIV-positive partners you had anal sex with and did not use a condom from start to finish, with how many were you the top (you put your penis in his butt) when you had sex without a condom?
____
SXC5. [IF SXC3 ≥ 1] Of those [Response to SXC3] men you had anal sex with and did not use a condom from start to finish, with how many were you the bottom (he put his penis in your butt) when you had sex without a condom?
____
SXC6. [IF SXC3 ≥ 1] Of those [Response to SXC3] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom while you were drunk or buzzed on alcohol within 2 hours before or during sex?
____
SXC7. [IF SXC3 ≥ 1] Of those [Response to SXC3] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom after using non-prescribed drugs within 2 hours before or during sex?
____
SXC8. In the past 3 months, have to talked to any of your HIV-positive male partners about whether they were using antiretroviral medicines to treat their HIV?
1 Yes
0 No
7 I don’t know
9 Refused
SXC9. [IF SXC8=1] Of your [Response to SPS1] HIV-positive partners, how many told you they were currently taking antiretroviral medicines to treat their HIV and you had no reason to doubt it?
____
SXC10. [IF SXC9 ≥ 1] Of your [Response to SPS1] HIV-positive partners, how many told you they were undetectable or virally suppressed and you had no reason to doubt it?
____
The following questions ask about your HIV-NEGATIVe partners who were NOT your primary partner.
SECTION LOGIC FOR SXC11-SXC19: SPS2 ≥ 1
SXC11. In the past 3 months, that is since [month and year], with how many of your [Response to SPS2] HIV-negative partners were you the top (you put your penis in his butt)?
____
SXC12. In the past 3 months, with how many of your [Response to SPS2] HIV-negative partners were you the bottom (he put his penis in your butt)?
____
SXC13. In the past 3 months, with how many of your [Response to SPS2] HIV-negative partners did you have ANY anal sex in which a condom was not used from start to finish?
____ [IF 0 SKIP TO SXC18]
SXC14. [If SXC13 ≥ 1] Of those [Response to SXC13] men you had anal sex with and did not use a condom from start to finish, with how many were you the top (you put your penis in his butt) when you had sex without a condom?
____
SXC15. [IF SXC13 ≥ 1] Of those [Response to SXC13] men you had anal sex with and did not use a condom from start to finish, with how many were you the bottom (he put his penis in your butt) when you had sex without a condom?
____
SXC16. [IF SXC13 ≥ 1] Of those [Response to SXC13] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom while you were drunk or buzzed on alcohol within 2 hours before or during sex?
____
SXC17. [IF SXC13 ≥ 1] Of those [Response to SXC13] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom after using non-prescribed drugs within 2 hours before or during sex?
____
PAGE LOGIC FOR SXC18-SXC19: D11=1
SXC18. In the past 3 months, have you talked to any of your HIV-negative partners about whether they are currently taking PrEP to prevent HIV?
1 Yes
0 No
7 I don’t know
9 Refused
SXC19. [If SXC18=1] Of your [Response to SPS2] HIV-negative partners, how many told you they were currently taking PrEP to prevent HIV and you had no reason to doubt it?
____
The following questions ask about your partners who were not your primary partner and whose HIV status you did not know.
SECTION LOGIC FOR SXC20-SXC: TOT_UNK ≥ 1
SXC20. In the past 3 months, that is since [month and year], with how many of your [TOT_UNK] partners whose HIV status you did not know were you the top (you put your penis in his butt)?
____
SXC21. In the past 3 months, with how many of your [TOT_UNK] partners whose HIV status you did not know were you the bottom (he put his penis in your butt)?
____
SXC22. In the past 3 months, with how many of your [TOT_PN] partners whose HIV status you did not know did you have ANY anal sex in which a condom was not used from start to finish?
____ [IF 0 SKIP TO SXCL1]
SXC23. [If SXC22 ≥ 1] Of those [Response to SXC22] men you had anal sex with and did not use a condom from start to finish, with how many were you the top (you put your penis in his butt) when you had sex without a condom?
____
SXC24. [IF SXC22 ≥ 1] Of those [Response to SXC22] men you had anal sex with and did not use a condom from start to finish, with how many were you the bottom (he put his penis in your butt) when you had sex without a condom?
____
SXC25. [IF SXC22 ≥ 1] Of those [Response to SXC22] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom while you were drunk or buzzed on alcohol within 2 hours before or during sex?
____
SXC26. [IF SXC22 ≥ 1] Of those [Response to SXC22] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom after using non-prescribed drugs within 2 hours before or during sex?
____
SECTION LOGIC FOR SXCL1-SXCL: SX2 ≥ 1
You will now be asked more detailed questions about the last man you had any anal sex with in the last THREE months who was not your male primary partner.
That is, not someone you have lived with or have seen a lot, and to whom you have not felt a special emotional commitment. Think about the very last man you had any anal sex with in the last THREE months who was not your primary partner.
SXCL1. Throughout this next group of questions, this man will be referred to by his initials. Please put his initials here. Use AZ if you do not know his name.
_ _
SXCL2. How old is [Response to SXCL1]? If you are not sure, give it your best guess.
____
SXCL3. What is [Response to SXCL1]’s primary race/ethnicity? If you are not sure, give it your best guess.
1 African American or Black
2 Asian American or Pacific Islander
3 Latino, Hispanic, or Chicano
4 Native American, American Indian, or Alaska Native
5 White or European American
6 Mixed
7 Other
99 I’d prefer not to answer
SXCL4. [IF SXCL3=Other] Please specify [Response to SXCL1]’s race/ethnicity
__________
SXCL5. Where did you first meet [Response to SXCL1]?
1 A dating or hookup app/website for gay men, like Grindr or Jack’d
2 A social networking app or website for gay men (not for dating or hooking up)
3 A social networking app or website, like Facebook, Twitter, Instagram or Snapchat
4 Some other app or website
5 Work or school
6 Through family
7 Through a friend
8 A private party or social event
9 A public festival or community event, like Pride
10 A gay commercial venue, like a gay bar or dance club
11 A straight commercial venue, like a straight bar or dance club
12 A commercial sex venue, like a sex club or bath house
13 A public sex venue, like a park, beach, bathroom or tearoom
14 Other
99 I’d prefer not to answer
SXCL6. [IF SXCL5=Other] Please specify where you first met [Response to SXCL1].
___________________
SXCL7. When was the first time you had any anal sex with [Response to SXCL1]? That is, where you were a top or bottom, with or without a condom, and with or without ejaculation.
1 Less than a week ago
2 More than a week but less than one month ago
3 One to three months ago
4 Four to six months ago
5 Seven to twelve months ago
6 More than a year ago
77 I don’t know
99 I’d prefer not to answer
SXCL8. In the past 3 months, that is since [month and year], have you had ANY anal sex with [Response to SXCL1] in which a condom was not used from start to finish?
1 Yes
0 No [SKIP to SXCL12]
77 I don’t know
99 I’d prefer not to answer
SXCL9. [If SXCL8=1] Think of the times in the past 3 months that you had anal sex with [Response to SXCL1] and did not use a condom from start to finish. Were you the top (you put your penis in his butt), the bottom (he put his penis in your butt), or both?
1 I was always the top
2 I was always the bottom
3 I was both the top and the bottom
7 I don’t know
9 I’d prefer not to answer
SXCL10. [If SXCL8=1] Think of the times in the past 3 months that you had anal sex with [Response to SXCL1] and did not use a condom from start to finish. Were you ever drunk or buzzed on alcohol within 2 hours before or during sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL11. [IF SXCL8=1] Think of the times in the past 3 months that you had anal sex with [Response to SXCL1] and did not use a condom from start to finish. Did you ever use non-prescription drugs within 2 hours before or during sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL12. What is [Response to SXCL1]'s HIV status? (Choose one)
1 Positive
2 Negative
3 I don’t know or am unsure about his HIV status
99 I’d prefer not to answer
SXCL13. [IF SXCL12=1] Did [Response to SXCL1] actually TELL you his HIV status?
1 Yes, and I have no reason to doubt it
2 Yes, but I have reason to doubt it
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL14. Did you tell [Response to SXCL1] your current HIV status before the last time you had anal sex together?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL15. How long ago was the last time you had any anal sex with [Response to SXCL1]? That is, with or without a condom, and with or without ejaculation.
1 1 day
2 2 days
3 3 days
4 4 days
5 5 days
6 6 days
7 1 week
8 2 weeks
9 3 weeks
10 1 months
11 2 months
12 3 months
99 I’d prefer not to answer
SXCL16. During the last time you had any anal sex with [Response to SXCL1], where did you have sex?
1 Your house or apartment or his house or apartment
2 Someone else's house or apartment
3 Hotel
4 Sex club or bathhouse
5 Bar, night club, or dance club
6 Health club or gym
7 Porn theatre/video arcade
8 Public bathroom
9 Other public place, such as beach
10 Park, woods, street, car or van
11 Other
77 I don’t know
99 I’d prefer not to answer
SXCL17. During the last time you had anal sex with [Response to SXCL1], did you also have oral sex where he ejaculated or came in your mouth without a condom?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL18. During the last time you had anal sex with [Response to SXCL1], did you also have oral sex where you ejaculated or came in his mouth without a condom?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL19. During the last time you had anal sex with [Response to SXCL1], were you the top (you put your penis in his butt)? This would be with or without a condom and with or without ejaculation.
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL20. [IF SXCL19=1] Was a condom used from start to finish?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL21. During the last time you had anal sex with [Response to SXCL1], were you the bottom (he put his penis in your butt}? This would be with or without a condom and whether or not you ejaculated.
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL22. [If SXCL21=1] Was a condom used from start to finish?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
PAGE LOGIC FOR SXCL23-SXCL25: D11 ≠ 1
SXCL23. Were you taking PrEP medication to prevent HIV within 24 hours before or after the time you last had anal sex with [Response to SXCL1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL24. [IF SXCL23=1] Were you taking your PrEP medication once a day as prescribed by your doctor, without missing any doses, in the 7 days before you last had anal sex with [Response to SXCL1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL25. [If SXCL24=0] You mentioned that you were not taking your PrEP medication once a day as prescribed at the time of your last sexual encounter. In the 7 days before you last had anal sex with [Response to SXCL1], on how days did you take your dose of PrEP?
____ (Number of days up to 7)
PAGE LOGIC FOR SXCL26-SXCL28: SXCL12=2
SXCL26. Was [Response to SXCL1], taking PrEP medication to prevent HIV within 24 hours before or after the time you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL27. [IF SXCL26=1] To your knowledge, was [Response to SXCL1] taking his PrEP medication once a day as prescribed by his doctor, without missing any doses, in the 7 days before you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL28. [If SXCL27=0] You mentioned that [Response to SXCL1] was not taking his PrEP medication once a day as prescribed at the time of your last sexual encounter. To your knowledge, in the 7 days before you last had anal sex, on how many days did [Response to SXCL1] take his dose of PrEP?
____ (Number of days up to 7)
PAGE LOGIC FOR SXCL29-SXCL31: D11 = 1
SXCL29. Were you taking antiretroviral medicines to treat your HIV infection within 24 hours before or after you last had anal sex with [Response to SXCL1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL30. [IF SXCL29=1] Were you taking your HIV medicines exactly as prescribed by your doctor, without missing any doses, in the 7 days before you last had anal sex with [Response to SXCL1]?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL31. [IF SXCL30=0] You mentioned that you were not taking your HIV medicines exactly as prescribed at the time of your last sexual encounter. In the 7 days before you last had anal sex with [Response to SXCL1], on how many days did you take all of the doses of your HIV medicines?
____ (Number of days up to 7)
PAGE LOGIC FOR SXCL32-SXCL36: SXCL12 = 1
SXCL32. Was [Response to SXCL1] taking antiretroviral medicines to treat his HIV infection within 24 hours before or after the time you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL33. [IF SXCL32=1] To your knowledge, was [Response to SXCL1] taking his HIV medicines exactly as prescribed by his doctor, without missing any doses, in the 7 days before you last had anal sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL34. [If SXCL33=0] You mentioned that [Response to SXCL1] was not taking his HIV medicines exactly as prescribed at the time of your last sexual encounter. To your knowledge, in the 7 days before you last had anal sex, on how many days did [Response to SXCL1] take all of the doses of his HIV medicines?
____ (Number of days up to 7)
SXCL35. [IF SXCL32=1] Did [Response to SXCL1] tell you his viral load was undetectable prior to your last sexual encounter?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SXCL36. [IF SXCL35=1] When was the last time [Response to SXCL1] told you his viral load was undetectable?
1 Less than a week ago
2 More than a week ago but less than a month ago
3 One to three months ago
4 Four to six months ago
5 Seven to twelve months ago
6 More than a year ago
77 I don’t know
99 I’d prefer not to answer
SXCL37. Were you drunk or buzzed on alcohol within two hours before or during the last time you had anal sex with [Response to SXCL1]?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL38. [IF SXCL37=1] How many drinks did you have? By a drink, I mean a 12 oz. can or glass of beer, a 4 oz. glass of wine, a 1-1/2 oz. shot of liquor, or a mixed drink with that amount of liquor.
____
SXCL39. Was [Response to SXCL1] drunk or buzzed on alcohol within two hours before or during the last time you had anal sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL40. Did you use any drug within two hours before or during the last time you had anal sex with [Response to SXCL1]?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL41. [IF SXCL40=1] Which drugs? (Check all that apply)
|
Selected |
Unselected |
Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Downers (Valium, Ativa, Xanax) |
1 |
0 |
Pain killers (Oxycontin, Percocet) |
1 |
0 |
Hallucinogens (LSD, mushrooms, Peyote, Mescaline) |
1 |
0 |
Ecstacy (E, X, MDMA) |
1 |
0 |
Club drugs (GHB, ketamine, special K) |
1 |
0 |
Marijuana (pot, weed) |
1 |
0 |
Poppers (amyl nitrate) |
1 |
0 |
PCP (angel dust, wet, wicky sticks) |
1 |
0 |
Synthetic marijuana (herbal incense, spice, K2) |
1 |
0 |
Crack, injected |
1 |
0 |
Crack, smoked or snorted |
1 |
0 |
Cocaine, injected |
1 |
0 |
Cocaine, smoked or snorted |
1 |
0 |
Heroin, injected |
1 |
0 |
Heroin, smoked or snorted |
1 |
0 |
Heroin and cocaine injected together (speedballs) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
SXCL42. [IF
SXCL41=Other] Please specify which other drugs.
____________________
SXCL43. Did [Response to SXCL1] use any drug within two hours before or during the most recent time you had sex?
1 Yes
0 No
77 I don’t know
99 I’d prefer not to answer
SXCL44. Which drugs? (Check all that apply)
|
Selected |
Unselected |
Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Downers (Valium, Ativa, Xanax) |
1 |
0 |
Pain killers (Oxycontin, Percocet) |
1 |
0 |
Hallucinogens (LSD, mushrooms, Peyote, Mescaline) |
1 |
0 |
Ecstacy (E, X, MDMA) |
1 |
0 |
Club drugs (GHB, ketamine, special K) |
1 |
0 |
Marijuana (pot, weed) |
1 |
0 |
Poppers (amyl nitrate) |
1 |
0 |
PCP (angel dust, wet, wicky sticks) |
1 |
0 |
Synthetic marijuana (herbal incense, spice, K2) |
1 |
0 |
Crack, injected |
1 |
0 |
Crack, smoked or snorted |
1 |
0 |
Cocaine, injected |
1 |
0 |
Cocaine, smoked or snorted |
1 |
0 |
Heroin, injected |
1 |
0 |
Heroin, smoked or snorted |
1 |
0 |
Heroin and cocaine injected together (speedballs) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
SXCL45. Please specify which other drugs.
_________________
SXW1. In the past 3 months, that is since [month and year] with how many women have you had sex? Include only women with whom you had vaginal or anal sex, with or without a condom, and with or without ejaculation.
___ [IF 0 SKIP to SU1]
SXW2. Of the [Response to SXW1] women you have had sex with in the past three months, with how many did you have any sex in which a condom was not used from start to finish?
____
SXW3. Have you been in a primary relationship with a woman in the last three months? This would be a woman you have lived with or have seen a lot, and to whom you have felt a special emotional commitment in the last three months.
1 Yes
0 No
99 I’d prefer not to answer
SXW4. Are you still in this primary relationship with your most recent primary female partner?
1 Yes
0 No
99 I’d prefer not to answer
SXW5. What is your most recent primary female partner's HIV status? (Choose one)
1 I believe she is HIV positive and have no reason to doubt it.
2 I believe she is HIV negative and have no reason to doubt it.
3 I don’t know / am unsure about her HIV status.
9 I’d prefer not to answer
SU1. The following questions ask about your use of alcohol. Please select the response that best describes your use of alcohol.
[AUDIT]
|
0 |
1 |
2 |
3 |
4 |
How often do you have a drink containing alcohol? |
Never |
Monthly or less |
2-4 times per month |
2-3 times per week |
4 or more times per week |
How many drinks containing alcohol do you have on a typical day when you are drinking? |
1 or 2 |
3 or 4 |
5 or 6 |
7 to 9 |
10 or more |
How often do you have six or more drinks on one occasion? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often during the last year have you failed to do what was normally expected of you because of drinking? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often during the last year have you need a first drink in the morning to get yourself going after a heavy drinking session? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often in the last year have you had a feeling of guilt or remorse after drinking? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often in the last year have you been unable to remember what happened the night before because of your drinking? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
Have you or someone else been injured because of your drinking |
No |
|
Yes, but not in the last year |
|
Yes, during the last year |
Has a relative, friend, doctor or other health care worker been concerned about your drinking or suggested you cut down? |
No |
|
Yes, but not in the last year |
|
Yes, during the last year |
SU2. In the past 3 months, have you used any non-prescription drugs?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
SU3. [If SU2=1] Which of the following drugs have you used in the past 3 months? Select all that apply.
|
Selected |
Unselected |
Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice) |
1 |
0 |
Downers (Valium, Ativa, Xanax) |
1 |
0 |
Pain killers (Oxycontin, Percocet) |
1 |
0 |
Hallucinogens (LSD, mushrooms, Peyote, Mescaline) |
1 |
0 |
Ecstacy (E, X, MDMA) |
1 |
0 |
Club drugs (GHB, ketamine, special K) |
1 |
0 |
Marijuana (pot, weed) |
1 |
0 |
Poppers (amyl nitrate) |
1 |
0 |
PCP (angel dust, wet, wicky sticks) |
1 |
0 |
Synthetic marijuana (herbal incense, spice, K2) |
1 |
0 |
Crack, injected |
1 |
0 |
Crack, smoked or snorted |
1 |
0 |
Cocaine, injected |
1 |
0 |
Cocaine, smoked or snorted |
1 |
0 |
Heroin, injected |
1 |
0 |
Heroin, smoked or snorted |
1 |
0 |
Heroin and cocaine injected together (speedballs) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
SU4. [IF SU3=Other] Please specify which other drugs.
__________________
SU5. The following questions about your use of drugs in the past year. Please select the response that best describes your use of drugs.
[DUDIT]
|
0 |
1 |
2 |
3 |
4 |
How often do you use drugs other than alcohol? |
Never |
Monthly or less |
2-4 times per month |
2-3 times per week |
4 or more times per week |
Do you use more than one type of drug on the same occasion? |
Never |
Monthly or less |
2-4 times per month |
2-3 times per week |
4 or more times per week |
How many times do you take drugs on a typical day when you do drugs? |
0 |
1 to 2 |
3 to 4 |
5 to 6 |
7 or more |
How often are you influenced heavily by drugs? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
Over the past year, have you felt that your longing for drugs was so strong that you could not resist it? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
Has it happened, over the past year, that you have not been able to stop taking drugs once you started? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often over the past year have you taken drugs and then neglected to do something you should have done? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often over the past year have you needed to take a drug the morning |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
How often over the past year have you had guilty feelings or a bad conscience because you used drugs? |
Never |
Less than monthly |
Monthly |
Weekly |
Daily or almost daily |
Have you or anyone else been hurt (mentally or physically) because you used drugs? |
No |
|
Yes, but not in the last year |
|
Yes, during the last year |
Has a relative or friend, doctor or nurse, or anyone else been worried about your drug use or said that you should stop using drugs? |
No |
|
Yes, but not in the last year |
|
Yes, during the last year |
MH1. Please choose the answer that best fits how you behaved during the past week.
[CESD]
|
Rarely or none of the time (<1 day) |
Some or little of the time (1-2 days) |
Occasionally or a moderate amount of time (3-4 days) |
Most or all of the time (5-7 days) |
I was bothered by things that usually don’t bother me |
0 |
1 |
2 |
3 |
I had trouble keeping my mind on what I was doing |
0 |
1 |
2 |
3 |
I felt depressed |
0 |
1 |
2 |
3 |
I felt everything was an effort |
0 |
1 |
2 |
3 |
I felt hopeful about the future |
0 |
1 |
2 |
3 |
I felt fearful |
0 |
1 |
2 |
3 |
My sleep was restless |
0 |
1 |
2 |
3 |
I was happy |
0 |
1 |
2 |
3 |
I felt lonely |
0 |
1 |
2 |
3 |
I could not get “going” |
0 |
1 |
2 |
3 |
TU1. Do you access the internet on a cell phone, tablet, laptop or computer at least occasionally?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
TU2. [IF TU1=1] On average, how often have you used the internet in the past 3 months?
1 Almost constantly
2 Several times a day
3 About once a day
4 Several times a week
5 Once a week
6 Less than once a week
77 I don’t know
99 I’d prefer not to answer
TU3. Do you personally own or have access to the following items? [Select all that apply]
|
Selected |
Unselected |
A smartphone like an Android or iPhone |
1 |
0 |
A cell phone that is not a smartphone |
1 |
0 |
A desktop or laptop computer |
1 |
0 |
A tablet like an iPad, Samsung Galaxy or Kindle Fire |
1 |
0 |
A gaming console like an Xbox, Playstation or Wii |
1 |
0 |
None of the above |
1 |
0 |
TU4. On average, how many hours per day do you spend on your cellphone?
1 Less than 1 hour per day
2 1-2 hours per day
3 2-3 hours per day
4 3-4 hours per day
5 More than 4 hours per day
77 Don’t know
99 Refused
TU5. Do you do any of the following online or on your smartphone (e.g., Android or iPhone)? [Select all that apply]
|
Yes |
No |
Use social media, like Facebook or Twitter |
1 |
0 |
Send Email |
1 |
0 |
Send text messages |
1 |
0 |
Use messaging apps, like Whatsapp or Kik |
1 |
0 |
Used health and fitness apps, like MyFitnessPal or Fitbit |
1 |
0 |
Use dating and hookup apps, like Grindr or Jack’d |
1 |
0 |
Read or commented on discussion boards, like Reddit or Digg |
1 |
0 |
Read the news or political blogs |
1 |
0 |
Video call or chat |
1 |
0 |
Use music apps, like Spotify or Pandora |
1 |
0 |
Play video games |
1 |
0 |
Watch videos, TV shows or movies |
1 |
0 |
Use apps that automatically delete the messages you send, like Snapchat |
1 |
0 |
Visit anonymous sharing or questions apps, like Whisper, YikYak or Ask.fm |
1 |
0 |
TU6. [IF TU5 selected ≥ 2 responses] Of the activities you selected, which do you spend most of your time online or on your smartphone doing? [List limited to answers selected above]
1 Using social media, like Facebook or Twitter
2 Sending Email
3 Sending text messages
4 Using messaging apps, like Whatsapp or Kik
5 Using health and fitness apps, like MyFitnessPal or Fitbit
6 Using dating and hookup apps, like Grindr or Jack’d
7 or commenting on discussion boards, like Reddit or Digg
8 Reading the news or political blogs
9 Video calling or chatting
10 Using music apps, like Spotify or Pandora
11 Playing video games
12 Watching videos, TV shows or movies
13 Using apps that automatically delete the messages you send, like Snapchat
14 Visiting anonymous sharing or questions apps, like Whisper, YikYak or Ask.fm
TU7. In the past 3 months, which of the following apps and websites have you used? Please select all that apply.
|
Selected |
Unselected |
1 |
0 |
|
1 |
0 |
|
1 |
0 |
|
Snapchat |
1 |
0 |
Facebook messenger |
1 |
0 |
Gmail |
1 |
0 |
Youtube |
1 |
0 |
Pandora |
1 |
0 |
Netflix |
1 |
0 |
Spotify |
1 |
0 |
1 |
0 |
|
Kik |
1 |
0 |
Match |
1 |
0 |
OK Cupid |
1 |
0 |
Tinder |
1 |
0 |
Craigslist |
1 |
0 |
Adam4Adam |
1 |
0 |
Bareback Real Time (BBRT) |
1 |
0 |
Daddyhunt |
1 |
0 |
Dudesnude |
1 |
0 |
Gay.com |
1 |
0 |
Grindr |
1 |
0 |
Hornet |
1 |
0 |
Manhunt |
1 |
0 |
Jack’d |
1 |
0 |
Growlr |
1 |
0 |
Scruff |
1 |
0 |
SilverDaddies |
1 |
0 |
Squirt |
1 |
0 |
Vine |
1 |
0 |
Tumblr |
1 |
0 |
Whisper |
1 |
0 |
YikYak |
1 |
0 |
Wickr |
1 |
0 |
MyFitnessPal |
1 |
0 |
Fitbit |
1 |
0 |
Some other app |
1 |
0 |
TU8. [IF TU7=Some other app] Please specify which other app(s) you have used.
____________________
TU9. [IF TU7 selected ≥2 responses] Of the apps you selected, which 3 have you used most frequently in the past 3 months? Please select 3.
|
Selected |
Unselected |
1 |
0 |
|
1 |
0 |
|
1 |
0 |
|
Snapchat |
1 |
0 |
Facebook messenger |
1 |
0 |
Gmail |
1 |
0 |
Youtube |
1 |
0 |
Pandora |
1 |
0 |
Netflix |
1 |
0 |
Spotify |
1 |
0 |
1 |
0 |
|
Kik |
1 |
0 |
Match |
1 |
0 |
OK Cupid |
1 |
0 |
Tinder |
1 |
0 |
Craigslist |
1 |
0 |
Adam4Adam |
1 |
0 |
Bareback Real Time (BBRT) |
1 |
0 |
Daddyhunt |
1 |
0 |
Dudesnude |
1 |
0 |
Gay.com |
1 |
0 |
Grindr |
1 |
0 |
Hornet |
1 |
0 |
Manhunt |
1 |
0 |
Jack’d |
1 |
0 |
Growlr |
1 |
0 |
Scruff |
1 |
0 |
SilverDaddies |
1 |
0 |
Squirt |
1 |
0 |
Vine |
1 |
0 |
Tumblr |
1 |
0 |
Whisper |
1 |
0 |
YikYak |
1 |
0 |
Wickr |
1 |
0 |
MyFitnessPal |
1 |
0 |
Fitbit |
1 |
0 |
Some other specified app |
1 |
0 |
TU10. In the past 3 months, did you do any of the following online or through an app on your smartphone? [Select all that apply]
|
Selected |
Unselected |
Chat with men |
1 |
0 |
Make friends |
1 |
0 |
Found long-term partnerships |
1 |
0 |
Met men for casual sex |
1 |
0 |
Had online sex (cyber sex) |
1 |
0 |
Other |
1 |
0 |
I don’t know |
1 |
0 |
I’d prefer not to answer |
1 |
0 |
TU11. [IF TU10=Other] You selected other in the previous question, please specify.
________________
TU12. [IF TU10 selected “Chat with Men” OR “Make Friends” OR “Found long-term partnerships” OR “Met men for casual sex” OR “Had online sex”] In the past 3 months, how often have you used the internet or a smartphone app to meet other gay men?
1 Once a month or less
2 2-3 times per month
3 About once a week
4 2-6 times per week
5 More than once a day
77 I don’t know
99 I’d prefer not to answer
TU13. [(IF TU10 selected “Chat with Men” OR “Make Friends” OR “Found long-term partnerships” OR “Met men for casual sex” OR “Had online sex”) Earlier, you mentioned that you use the following dating or hookup sites. In the past 3 months, which of the following have you used most frequently for meeting other men? Select only one. [List limited to previous selected responses]
1 Match
2 OK Cupid
3 Tinder
4 Craigslist
5 Adam4Adam
6 Bareback Real Time (BBRT)
7 Daddyhunt
8 Dudesnude
9 Gay.com
10 Grindr
11 Hornet
12 Manhunt
13 Jack’d
14 Growlr
15 Scruff
16 SilverDaddies
17 Squirt
18 Other
TU14. [IF TU13=Other] Please specify which other website or smartphone app you have used to most frequently to meet other men.
_____________________
TU15. In the past 3 months, how many sex partners have you met through the internet?
____ (number of partners)
EX1. Have you ever given things, like money or drugs, in exchange for sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
EX2. [IF EX1=1] In the past 3 months, have you given things, like money or drugs, in exchange for sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
EX3. Has anyone ever given you things, like money or drugs, in exchange for sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
EX4 [IF EX3=1] In the past 3 months, has anyone given you things, like money or drugs, in exchange for sex?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
IPV1. In the past 3 months, has your partner pressured or forced you to do something sexual that you didn’t want to do? Examples may include any of the following: oral or anal sex, having sex with others, having sexual partners outside the relationship, or any other sexual activity that made you feel uncomfortable.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
IPV2. In the past 3 months, have arguments in your relationship escalated into any of the following: destruction of property, grabbing, restraining, pushing, kicking, slapping, punching, threats of violence or other acts of physical intimidation?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
IPV3. In the past 3 months, has your partner insulted, criticized, threatened or yelled at you in any way? Examples may include the following: using slurs, calling you names, calling you fat, criticizing your sexual performance, criticizing your clothing, asking you to act more masculine or threatening to out you.
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
IPV4. In the past 3 months, has your partner prevented you from communicating with or seeing your friends, family, or coworkers? Monitored or demanded access to your cell phone, email, social networking sites, finances or spending?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
IPV5. In the past 3 months, have you ever felt afraid, threatened, isolated, trapped or like you are walking on eggshells as a result of your relationship? Have your friends or family raised concerns about your safety within your relationship?
1 Yes
0 No
7 I don’t know
9 I’d prefer not to answer
RS1. How well do the following statements describe how you felt in the past month?
[CD-RISC 2]
|
Not at all true |
Rarely true |
Sometimes true |
Often true |
True nearly all of the time |
I am able to adapt to change |
0 |
1 |
2 |
3 |
4 |
I tend to bounce back after illness or hardship |
0 |
1 |
2 |
3 |
4 |
STG1. Please indicate how much you agree with the following statements:
[Bunn]
|
Strongly Disagree |
Disagree |
Neutral |
Agree |
Strongly Agree |
I have lost friends by telling them I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
I am hurt by how people reacted to learning I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
People avoid touching me if they know I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
I have stopped socializing with some people due to their reactions to me being HIV-positive |
1 |
2 |
3 |
4 |
5 |
People I care about stopped calling me after learning that I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
People seem afraid of me because I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
People have physically backed away from me because I am HIV-positive |
1 |
2 |
3 |
4 |
5 |
Some people who know I am HIV-positive have grown more distant |
1 |
2 |
3 |
4 |
5 |
People who know that I am HIV-positive ignore my good points |
1 |
2 |
3 |
4 |
5 |
People don’t want me around their children once they know that I am HIV-positive. |
1 |
2 |
3 |
4 |
5 |
SEV1. Please indicate how much you agree with the following statements.
|
Strongly Disagree |
Disagree |
Neutral |
Agree |
Strongly Agree |
Contracting HIV would be very serious to me |
1 |
2 |
3 |
4 |
5 |
The thought of contracting HIV scares me |
1 |
2 |
3 |
4 |
5 |
When I think about contracting HIV, I feel nauseous |
1 |
2 |
3 |
4 |
5 |
If I contracted HIV, my career would be endangered |
1 |
2 |
3 |
4 |
5 |
When I think about contracting HIV, it makes me very nervous |
1 |
2 |
3 |
4 |
5 |
Contracting HIV would jeopardize my relationship with my partner |
1 |
2 |
3 |
4 |
5 |
Contracting HIV would jeopardize my relationship with my family |
1 |
2 |
3 |
4 |
5 |
My views of myself would change drastically if I contracted HIV |
1 |
2 |
3 |
4 |
5 |
My financial security would be greatly endangered if I contracted HIV |
1 |
2 |
3 |
4 |
5 |
Contracting HIV would be more serious than other diseases |
1 |
2 |
3 |
4 |
5 |
If I contracted HIV, my whole life would change |
1 |
2 |
3 |
4 |
5 |
Thinking about contracting HIV stops me from sleeping |
1 |
2 |
3 |
4 |
5 |
Thinking about contracting HIV stops me from enjoying sex with my partner |
1 |
2 |
3 |
4 |
5 |
HCTR1. Please indicate how much you agree with the following statements.
[Thompson GBMMS]
|
Strongly Disagree |
Disagree |
Neutral |
Agree |
Strongly Agree |
Doctors and healthcare workers sometimes hide information from patients who belong to my ethnic group |
1 |
2 |
3 |
4 |
5 |
Doctors have the best interests of people of my ethnic group in mind |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group should not confide in doctors and healthcare workers because it will be used against them |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group should be suspicious of information from doctors and healthcare workers |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group cannot trust doctors and healthcare workers |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group should be suspicious of modern medicine |
1 |
2 |
3 |
4 |
5 |
Doctors and healthcare workers treat people of my ethnic group as “guinea pigs” |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group receive the same medical care from doctors and healthcare workers as people from other groups |
1 |
2 |
3 |
4 |
5 |
Doctors and healthcare workers do not take the medical complaints of people of my ethnic group seriously |
1 |
2 |
3 |
4 |
5 |
People of my ethnic group are treated the same as people of other groups by doctors and healthcare workers |
1 |
2 |
3 |
4 |
5 |
In most hospitals, people of different ethnic groups receive the same kind of care |
1 |
2 |
3 |
4 |
5 |
I have personally been treated poorly or unfairly by doctors or healthcare workers because of my ethnicity |
1 |
2 |
3 |
4 |
5 |
Public reporting burden of this collection of information is estimated to average 1.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-XXXX)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Baack, Brittney N. (CDC/OID/NCHHSTP) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |