Male CAPI-lite Questionnaire
National Survey of Family Growth
ATT_K-2017 Male Ques 040918
Male Questionnaire
OMB: 0920-0314
DRAFT
Form Approved
OMB No. 0920-0314
Exp. Date xx/xx/20xx
Male CAPI-lite Questionnaire
NOTE: CAPI is Computer-Assisted Personal Interviewing. This is the "CAPI-Lite" version of the 2011-2019 NSFG, Year 7 (2017) showing basic question wording and routing. The full specifications, used to program the questionnaire, are included in the CAPI Reference Questionnaire ("CRQ").
NOTE: Questions are numbered sequentially in each sub-series. However, due to the addition and removal of questions over questionnaire versions, there may be gaps in numbering or numbers followed by letters in a sub-series. In some instances, entire subsections have been removed.
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SECTION A
Demographic characteristics; Household roster; Childhood background; Marital/cohabiting status
INTRO_1
AA_0. Now we can begin.
THIS ITALICIZED TEXT CURRENTLY APPEARS ON SCREEN, IN COMPLIANCE WITH OMB GUIDELINES.
Public reporting burden of this collection of information is estimated to average 60 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 aspects 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, GA 30333; ATTN: PRA (OMB No. 0920-0314)
Assurance of Confidentiality – We take your privacy very seriously. All information that relates to or describes identifiable characteristics of individuals, a practice, or an establishment will be used only for statistical purposes. NCHS staff, contractors, and agents will not disclose or release responses in identifiable form without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act of 2002 (CIPSEA, Title 5 of Public Law 107-347). In accordance with CIPSEA, every NCHS employee, contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of up to $250,000, or both if he or she willfully discloses ANY identifiable information about you. In addition, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 & 151 note). This law requires the federal government to protect federal computer networks by using computer security programs to identify cybersecurity risks like hacking, internet attacks, and other security weaknesses. If information sent through government networks triggers a cyber threat indicator, the information may be intercepted and reviewed for cyber threats by computer network experts working for, or on behalf of, the government.
I’ll begin with some basic questions about your background.
{ NOTE:
{ FOR EVERY ITEM IN THE QUESTIONNAIRE, RESPONDENTS CAN REFUSE TO ANSWER OR
{ CAN ANSWER AS “DON’T KNOW.” THE INTERVIEWER ENTERS “Control-R” FOR A
{ REFUSAL AND “Control-D” FOR A “DON’T KNOW” RESPONSE.
Age and Date of Birth (AA)
AGE_A
AA-1. (First, I’d like to know your age and date of birth.) How old are you?
ENTER age at last birthday in years ________
BIRTHDAY
AA-2. What is the date of your birth?
ENTER MM/DD/YYYY, with or without dividers ____________
(This is the only date in the interview that is asked for as month/day/year. All others are asked for only as month & year.)
(ASKED IF RESPONDENT DID NOT KNOW OR REFUSED TO PROVIDE AGE AND BIRTHDAY MISSBRTH:
AA-2A. In order to proceed with this interview, we need to know either your age or your date of birth. I’d like to assure you that all information collected in this survey will remain confidential and be used only for statistical tabulations. Would you please give me your age or date of birth?
Yes ............1 RETURN TO AGE_A AA-1
No .............5 GO TO TERMINATION SCRIPT TERMAGE AA-3A.
{ IF R IS BETWEEN THE AGES OF 15 and 49, GO TO AC SERIES
TERMINATION SCRIPTS:
TERMAGE That’s all the questions I have for you. Thank you for your
AA-3A. time.
ENTER [1] to exit interview
EXIT APPLICATION {age not given}
TERM In this survey we are only interviewing men who are between the
AA-3. ages of 15 and 49. Therefore, that's all the questions I have for you. Thank you for your time.
ENTER [1] to exit interview
EXIT APPLICATION {age ineligible}
Hispanic Origin and Race (AC)
HISP
AC-1. Now I have some questions about your ethnic background and your race. (You may have already told me this, but) Are you Hispanic or Latino, or of Spanish origin?
[HELP AVAILABLE]
Yes.....................1
No......................5
INTROCARD
AC-1a. For many questions on this survey, I’ll ask you to look at numbered cards that list answer choices. After you’ve read the choices on the card, you can tell me your answer or, if you prefer, you can just tell me the number next to the answer you choose.
{ASKED IF HISPANIC
HISPGRP
AC-2. Looking at card 1a, are you Puerto Rican; Cuban; Mexican, Mexican American or Chicana; Central or South American; or another Hispanic, Latina, or Spanish origin? One or more categories may be selected.
ENTER all that apply
Puerto Rican...................................1
Cuban..........................................2
Mexican, Mexican American, or Chicano..........3
Central or South American......................4
Another Hispanic, Latino, or Spanish origin....7
RRACE
AC-3. Looking at Card 1b, what is your race? One or more races may be selected.
[HELP AVAILABLE]
ENTER all that apply
NOTE: If R reports a mixture of several races (biracial, mixed, mulatto, etc.), ENTER all groups that are part of the mixture.
White 1
Black or African American 2
American Indian or Alaska Native 3
Asian Indian 4
Chinese 5
Filipino 6
Japanese 7
Korean 8
Vietnamese 9
Other Asian 10
Native Hawaiian 11
Guamanian or Chamorro 12
Samoan 13
Other Pacific Islander 14
{ASKED ONLY IF MULTIPLE RACE GROUPS MENTIONED
RACEBEST
AC-4. Which of these groups,that is (RACE GROUPS SELECTED ABOVE) would you say best describes your racial background?
[HELP AVAILABLE]
{ DISPLAY ONLY THOSE GROUPS MENTIONED IN RRACE AC-3
{ ASKED ONLY IF R REFUSED OR DIDN’T KNOW RACE
OBSERVE
AC-5. ENTER race of respondent by observation
Black............1
White............2
Other............7
{ Asked of all Rs
PRIMLANG
AC-6. What languages do you usually speak at home?
ENTER all that apply.
English............1
Spanish............2
Other..............7
Household Roster and Marital/Cohabiting Status (AD)
{THE BELOW TABLE WILL BE PRE-FILLED (EXCEPT FOR “Relar” and “RowDone”) WITH INFORMATION ON EACH HOUSEHOLD MEMBER MENTIONED IN THE SCREENER.
{QUESTIONS AD-0 THROUGH AD-6 APPEAR WHEN THE CURSOR IS IN THE CORRESPONDING CELL OF THE TABLE.
{(NOTE: IF THE RESPONDENT HIMSELF PROVIDED THE SCREENER INFORMATION, (IS THE “SCREENER INFORMANT”), HE ONLY PROVIDES RELATIONSHIP (“Relar”) OF EACH PRE-FILLED HOUSEHOLD MEMBER. IF HE IS NOT THE SCREENER INFORMANT, HE VERIFIES THE INFORMATION OF EACH PRE-FILLED HOUSEHOLD MEMBER AND PROVIDES RELATIONSHIP.)
|
Verify |
Name |
UsualRes |
Sex |
Age |
Relar |
RowDone |
HHL[1] |
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HHL[2] |
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HHL[3] |
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HHL[4] |
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HHL[5] |
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HHL[6] |
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HHL[7] |
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HHL[8] |
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HHL[9] |
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{ASKED OF ALL RESPONDENTS:
Verify[X]
AD-0. I would like to get some additional information about the people in this household. / I would like to go over the information that I have about the people in this household.
There’s you and you are [AGE_R] years old. / There’s [Name[X]] and [he/she] is (less than 1 year old/1 year old/[Age[X]] years old). (Is this correct?)
If information is not correct, PROBE if necessary:
(What should be changed?)
{IF THE RESPONDENT HAS GOTTEN TO AN EMPTY ROW (THE END OF THE ROSTER)
Is there anyone else who lives here?
If no, GO TO AD-7 ENDROSTER
If yes, CONTINUE
{ IF THE ROW IS NON-EMPTY, AND IF THE INFORMATION IS CORRECT OR IF RESPONDENT
{ IS THE SCREENER INFORMANT,
{ GO TO AD-5 RELAR
Name[X]
AD-1. Enter name or initials of person who usually lives here.
Name or initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
UsualRes[X]
AD-2. Is this address considered to be (NAME[X])’s usual residence?
Yes ............1
No .............5
Sex[X]
AD-3. If necessary, ASK: (Is (NAME) a male or female?)
Male ................1
Female ..............2
Age[X]
AD-4. How old is (Name[X])?
If necessary, ASK: (How old was (Name[X]) on (his/her) last birthday?)
Age ____________
Relar[X]
AD-5. Please look at Card (3a/3b). What is (Name[X])’s relationship to you?
[HELP AVAILABLE]
NOTE: If R says “child,” PROBE for whether he means biological child or something else.
If R says ‘foster sister’ or ‘foster brother’, enter 23, ‘Other non relative’.
(IF HOUSEHOLD MEMBER IS MALE, DISPLAY:)
Husband/spouse.......................................1
Male unmarried partner ..............................2
Biological son ......................................3
Step-son (son of spouse) ............................4
Adopted son .........................................5
Legal ward ..........................................6
Foster child ........................................7
Partner’s son .......................................8
Grandson ............................................9
Nephew ..............................................10
Biological father ...................................11
Step-father (husband of mother)......................12
Adoptive father .....................................13
Legal guardian ......................................14
Foster parent .......................................15
Your parent’s male partner ..........................16
Grandfather .........................................17
Uncle ...............................................18
Brother .............................................19
Other male relative .................................20
Roommate (male)......................................21
Tenant or boarder (male).............................22
Other male nonrelative ..............................23
(IF HOUSEHOLD MEMBER IS FEMALE, DISPLAY:)
Wife/spouse..........................................1
Female unmarried partner ............................2
Biological daughter .................................3
Step-daughter (daughter of spouse) ..................4
Adopted daughter ....................................5
Legal ward ..........................................6
Foster child ........................................7
Partner’s daughter ..................................8
Granddaughter ......................................9
Niece ...............................................10
Biological mother ...................................11
Step-mother (wife of father) ........................12
Adoptive mother .....................................13
Legal guardian ......................................14
Foster parent .......................................15
Your parent’s female partner ........................16
Grandmother .........................................17
Aunt ................................................18
Sister ..............................................19
Other female relative ...............................20
Roommate (female) ...................................21
Tenant or boarder (female) ..........................22
Other female nonrelative ............................23
{ASKED IF R IS MARRIED TO OR COHABITING WITH A MALE
SMSEXMAR
AD-5a. For the next several parts of our interview, the questions about marriage and other sexual relationships are limited to those with opposite-sex spouses or partners. You will still be asked questions that may apply to you about children you have fathered or raised, and health services you have received. In the final section of the interview, some questions will ask about sexual experience with same-sex spouses or partners. For this part of the interview, please answer as many questions as are relevant to you.
{ASKED OF ALL RESPONDENTS:
RowDone[X]
AD-6. ENTER [1] to VERIFY next row or to add additional HH members
{ASKED OF ALL RESPONDENTS:
ENDROSTER
AD-7. You have reached the end of the roster, ENTER [1] when ready to proceed.
MARSTAT
AD-7b. Now I’d like to ask about marital status and living together. Please look at Card 4. What is your current marital or cohabiting status?
[HELP AVAILABLE]
ENTER [2] if R is living together with a partner of the opposite sex to whom she is not married, even if she is also widowed, divorced, separated, or never-married
IF R volunteers living in a same-sex marriage or with a same-sex partner, probe for R’s marital or cohabitation status with respect to opposite sex spouses or cohabiting partners. If R has not had an opposite sex marriage and is not currently cohabiting with an opposite sex partner, enter [6].
Married to a person of the opposite sex................1
Not married but living together with a partner
of the opposite sex .............................2
Widowed ...............................................3
Divorced or annulled ..................................4
Separated, because you and your spouse are
not getting along ...................................5
Never been married ....................................6
{ ASKED IF COHABITING (MARSTAT = 2)
FMARSTAT
AD-7c. What is your formal marital status? That is, are you widowed, divorced, separated, or have you never been married?
[HELP AVAILABLE]
Widowed..............................................3
Divorced or annulled ................................4
Separated, because you and your spouse are
not getting along..................................5
Never been married...................................6
{ASKED IF R IS MARRIED/COHABITING BUT WIFE/PARTNER NOT LISTED IN HH ROSTER
WPLOCATN
AD-8. Please look at Card 5. Where is your (wife/partner) currently living?
Friend’s home.............................1
Relative’s home...........................2
College/university........................3
Armed forces..............................4
Employed in another city..................5
Medical institution (hospital,
rehabilitation facility).................6
Correctional institution (jail, prison)...7
Other ....................................8
{ASKED IF THERE IS A WIFE/PARTNER AND CHILD/REN IN HOUSEHOLD)
RELWOM[X]
AD-9. I need to find out about [WIFE/PARTNER’S NAME]’s relationship to the children who live here. Please look at Card 7. What is [WIFE/PARTNER’S NAME]’s relationship to [CHILD’s NAME]?
Biological mother .............................1
Stepmother ....................................2
Adoptive mother ...............................3
Aunt, grandmother, or some other relation .....4
Foster mother or legal guardian................5
Not related (legally or by blood)..............6
Regular school and GED (AE)
{ASKED OF ALL RESPONDENTS
GOSCHOL
AE-1. I'd like to talk about your education in regular school. By regular school I mean elementary, junior high or middle school, high school, college, or graduate school.
Are you now going to, or on vacation from, regular school?
[HELP AVAILABLE]
If R says he is taking GED courses now, or “taking a semester or quarter off”, or in “vocational school”, enter [5].
Yes ....................1
No .....................5 (GO TO HIGRADE AE-3)
{ ASKED IF R IN SCHOOL, AGED 15-19, and INTERVIEW IS CONDUCTED IN MAY-SEPT
VACA
AE-2. Are you currently on vacation from regular school?
[HELP AVAILABLE]
Yes ....................1
No .....................5
HIGRADE
AE-3. Please look at Card 8. What (is the highest grade or year of (regular) school you have ever attended?) /(grade or year of school are you in/were you in before vacation began)?
[HELP AVAILABLE]
No formal schooling .............................0
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1 year of college or less .......................13
2 years of college ..............................14
3 years of college ..............................15
4 years of college/grad school ..................16
5 years of college/grad school ..................17
6 years of college/grad school ..................18
7 or more years of college and/or grad school ...19
{IF HIGHEST GRADE ATTENDED IS DON’T KNOW OR REFUSED, GO TO AE-6 DIPGED
{IF HIGHEST GRADE ATTENDED IS 0, GO TO AFINTRO
{ASKED IF HIGHEST GRADE ATTENDED IS 1 THROUGH 19)
COMPGRD
AE-4. (Did you complete/Have you completed) (that/your highest) (grade/year) of school?
Yes ....................1
No .....................5
{IF R IS IN SCHOOL AND HIGHEST GRADE <= 12, AND HASN’T COMPLETED 12TH, GO TO AE-8 HISCHGRD
{ASKED IF R HAS 12 YRS OF SCHOOLING
DIPGED
AE-6. Do you have a high school diploma, a GED certificate, or both?
High school diploma only ...1
GED only....................2 (GO TO AE-8 HISCHGRD)
Both .......................3
Neither.....................5 (GO TO AE-8 HISCHGRD)
{ ALL DATES IN THE INTERVIEW ARE ASKED IN THE SAME MANNER AS SHOWN BELOW FOR EARNHS_M and EARNHS_Y
{ ASKED IF R HAS A HIGH SCHOOL DIPLOMA
EARNHS_M
AE-7. In what month and year did you get your high school diploma?
ENTER month.
PROBE for season if DK month.
1. January 5. May 9. September 13. Winter
2. February 6. June 10. October 14. Spring
3. March 7. July 11. November 15. Summer
4. April 8. August 12. December 16. Fall
{ ASKED IF R HAS A HIGH SCHOOL DIPLOMA
EARNHS_Y
AE-7. (In what month and year did you get your high school diploma?)
ENTER year in 4 digits __________
{ASKED IF R DOES NOT HAVE A H.S. DIPLOMA AND HIGHEST GRADE IS > 12 or DK/RF
HISCHGRD
AE-8. (Not counting your GED classes,) what is the highest grade of elementary, junior high or middle school, or high school you have ever attended?
[HELP AVAILABLE]
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade.......................................12
{ ASKED IF R’s HIGHEST GRADE IS 1-12, HE IS NOT IN SCHOOL, AND DOES NOT HAVE
{ H.S. DIPLOMA, OR R’s HIGHEST GRADE IS 13-19, AND HE DOES NOT HAVE A DIPLOMA
MYSCHOL_M, MYSCHOL_Y
AE-9. In what month and year did you last attend ((HIGHEST H.S. GRADE) grade/regular school)?
[HELP AVAILABLE]
{ASKED IF HIGHEST GRADE >12
HAVEDEG
AE-10. Do you have any college or university degrees?
If R indicates he has a trade-school degree, such as cosmetology or truck driving, ENTER [5].
Yes ....................1
No .....................5 (GO TO AF SERIES)
{ASKED IF R HAS A COLLEGE OR UNIVERSITY DEGREE
DEGREES
AE-11. Please look at Card 9. What is the highest college or university degree you have?
Associate’s degree ...........1 (GO TO AF SERIES)
Bachelor’s degree ............2
Master’s degree ..............3
Doctorate degree .............4
Professional School degree ...5
{ ASKED IF R HAS AT LEAST A BACHELOR’S DEGREE
EARNBA_M, EARNBA_Y
AE-12. In what month and year did you get your Bachelor’s degree?
{ ASKED IF R IS NOT CURRENTLY GOING TO SCHOOL AND HAS LESS THAN A BACHELOR’S { DEGREE
EXPSCHL
AE-13. Do you expect to go back to regular school at any time in the future?
[HELP AVAILABLE]
Yes ....................1 (ASK AE-13a)
No .....................5 (GO TO AF-0)
{ ASKED IF R EXPECTS TO GO BACK TO SCHOOL OR IS CURRENTLY ENROLLED
EXPGRADE
AE-14. Please look at Card 8. What is the highest grade or degree you expect to complete?
[HELP AVAILABLE]
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1 year of college or less .......................13
2 years of college ..............................14
3 years of college ..............................15
4 years of college/grad school ..................16
5 years of college/grad school ..................17
6 years of college/grad school ..................18
7 or more years of college and/or grad school ...19
Childhood background (AF)
AFINTRO
AF-0. Now I have a few questions about your parents or parent-figures.
{IF R IS UNDER 18 AND HAS NO PARENT OR PARENT-LIKE PEOPLE IN THE HOUSEHOLD, GO TO AF-1 INTACT
{ ASKED IF AGE >=18 OR IF (AGE<18 AND R HAS A PARENT OR PARENT-LIKE PERSON IN
{ THE HOUSEHOLD
ONOWN
AF-0a. (Before you turned 18, did you ever live/Have you ever lived) away from your parents or guardians?
Please include times you were away at college or in the Armed Forces. But, do not include times you were away at boarding school for elementary, middle, or high school, or living in an institution or jail or group home. Also, please do not include temporary supervised arrangements such as summer camp.
Yes ...........1
No ............5
{IF R NEVER LIVED AWAY FROM PARENT(S), IS UNDER AGE 18, AND IS LIVING IN NONINTACT FAMILY HH, GO TO PARMARR AF-2
INTACT
AF-1. Between your birth/adoption and (the present time/the time you first started living on your own/your 18th birthday), (have you always lived/did you always live) with both your (biological/adoptive) mother and (biological/adoptive) father?
If R volunteers that he never lived on his own, ask him whether he has always lived with both parents between his birth or adoption and the present time.
Yes........1
No.........5
{ASKED OF ALL
PARMARR
AF-2. Were your biological parents married to each other at the time you were born?
Yes........1
No.........5
{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP
LVSIT14F
AF-3. Now, think about when you were 14 years old. Looking at Card 10, what female and male parents or parent-figures were you living with at age 14?
[HELP AVAILABLE]
ENTER female adult first
No female parent or parent-figure present...1
Biological mother...........................2
Stepmother..................................3
Adoptive mother.............................4
Father's girlfriend.........................5
Foster mother...............................6
Grandmother.................................7
Aunt........................................8
Other female ...............................9
{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP
LVSIT14M
AF-4. Ask if necessary:
Now tell me who was the male parent or parent-figure you were living with when you were 14 years old.
[HELP AVAILABLE]
ENTER male adult
No male parent or parent-figure present....1
Biological father..........................2
Stepfather.................................3
Adoptive father............................4
Mother's boyfriend.........................5
Foster father..............................6
Grandfather................................7
Uncle......................................8
Other male ................................9
{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP
WOMRASDU
AF-5. Who, if anyone, do you think of as the woman who mostly raised you when you were growing up?
Biological mother........1
Adoptive mother..........2
Step‑mother..............3
Father's girlfriend......4
Foster mother............5
Grandmother..............6
Other female relative....7
Female non‑relative......8
No such person...........9
Other ..................10
{IF R DID NOT HAVE A MOTHER OR MOTHER FIGURE, GO TO AF-11 MANRASDU
{ASKED IF R HAD A MOTHER OR ANY MOTHER-FIGURE WHO RAISED HIM
MOMDEGRE
AF-6. Please look at Card 11. What is the highest level of education (she/your mother) completed?
Less than high school ...........................1
High school graduate or GED .....................2
Some college but no degree ......................3
2-year college degree (e.g., Associates degree)..4
4-year college graduate (e.g., BA, BS) ..........5
Graduate or professional school..................6
{ASKED IF R HAD A MOTHER OR ANY MOTHER-FIGURE WHO RAISED HIM
MOMWORKD
AF-7. During most of the time you were growing up, that is when you were between the ages of 5 and 15, did she usually work full time, part time or did she not work for pay at all?
[HELP AVAILABLE]
Full-time ..................................1
Part-time...................................2
Equal amounts full time and part time.......3
Not at all (for pay)........................4
{ASKED IF R HAD A MOTHER OR ANY MOTHER-FIGURE WHO RAISED HIM
MOMFSTCH
AF-9. How old was (she/your biological mother) when she had her first child who was born alive?
ENTER 96 if R says that her mother or mother-figure did not have any children
Age in years
{ ASKED IF R’s MOTHER/MOTHER-FIGURE HAD AT LEAST ONE CHILD AND R DOESN’T KNOW
{ AGE AT FIRST BIRTH
MOM18
AF-10. Was she under 18, 18 to 19, 20 to 24, or 25 or older?
Under 18.... ....1
18‑19 ...........2
20‑24 ...........3
25 or older......4
{ASKED IF R DID NOT LIVE WITH BOTH PARENTS WHILE GROWING UP
MANRASDU
AF-11. Who, if anyone, do you think of as the man who mostly raised you when you were growing up?
Biological father........1
Adoptive father..........2
Step‑father..............3
Mother's boyfriend.......4
Foster father............5
Grandfather..............6
Other male relative......7
Male non‑relative........8
No such person...........9
Other ...................10
{ NOW ASKED OF ALL Rs
FOSTEREV
AF-13. Did you ever live in state-sponsored foster care? This includes settings such as a family foster home, a relative foster home, a group home, institution, or supervised independent living.
If necessary say: If someone from the state or from family services arranged for you to live there, it is considered foster care.
Yes........1
No.........5
{ ASKED IF R EVER LIVED WITH A FOSTER PARENT
MNYFSTER
AF-14. In how many different foster care settings or locations have you lived?
ENTER number
{ ASKED IF R EVER LIVED WITH A FOSTER PARENT
DURFSTER
AF-15. Looking at Card 11a, approximately how much time did you spend in foster care during your life?
Less than six months 1
At least six months, but less than a year 2
At least a year but less than two years 3
At least two years but less than three years 4
Three years or more 5
{ ASKED IF R EVER LIVED WITH A FOSTER PARENT BUT DOES NOT CURRENTLY DO SO
AGEFSTER
AG-16. The last time you left foster care, how old were you?
ENTER age in years
UNDERLYING RANGE: 0 to 21
Marriage and Cohabitation (AG)
{ASKED OF ALL RESPONDENTS
AGINTRO
AG-1. Now I have some questions about marriage and cohabitation.
{IF R HAS NEVER BEEN MARRIED, GO TO AG-5 EVCOHAB2
{ ASKED IF EVER MARRIED
TIMESMAR
AG-2. (Including your present marriage,) how many times have you been married?
[HELP AVAILABLE]
Number
{ IF R IS COHABITING, GO TO NUMCOH1 AG-4.
{ ASKED IF EVER MARRIED
EVCOHAB1
AG-3. Not including the (woman/women) you married, have you ever lived together with any other female sexual partner? By living together, I mean having a sexual relationship while sharing the same usual residence.
IF NECESSARY SAY: Remember, do not include the woman/women who you married.
Do not count 'dating' or 'sleeping over' as living together.
Yes.............1
No..............5
{IF R NEVER COHABITED, GO TO SECTION B
{ ASKED IF EVER MARRIED AND EVER COHABITED WITH ANY OTHER WOMEN, EVCOHAB1=1
NUMCOH1
AG-4. Not including the (woman/women) you married, how many other female sexual partners have you lived together with in your life? (Please include the woman you live with now.)
[HELP AVAILABLE]
Number (GO TO SECTION B)
{ IF R IS CURRENTLY COHABITING, GO TO NUMCOH2 AG-6.
{ ASKED IF NEVER MARRIED AND NOT CURRENTLY COHABITING
EVCOHAB2
AG-5. Have you ever lived together with a female sexual partner? By living together, I mean having a sexual relationship while sharing the same usual residence.
Yes.............1
No..............5
{IF R NEVER COHABITED, GO TO SECTION B
{ ASKED IF NEVER MARRIED AND EVER COHABITED, EVCOHAB2 AG-5 = 1
NUMCOH2
AG-6. (Including the woman you live with now,) How many female sexual partners have you lived with in your life?
[HELP AVAILABLE]
Number ___________
SECTION B
SEX COMMUNICATION, EVER SEX, NUMBER OF SEXUAL PARTNERS
Ever had Sex; Sex Communication (BA)
{ ASKED IF R NEVER MARRIED, NEVER COHABITED
EVERSEX
BA-1. The next section is about relationships with females.
Have you ever had sexual intercourse with a female (sometimes this is called making love, having sex, or going all the way)?
[HELP AVAILABLE]
Yes........1
No.........5
{ ASKED IF R NEVER MARRIED, NEVER COHABITED BUT HAD SEX
SXMTONCE
BA-2. Have you had sexual intercourse more than once?
[HELP AVAILABLE]
Yes .........................1
No ..........................5
{ ASKED IF R NEVER MARRIED AND NEVER COHABITED AND SAID HE NEVER HAD SEX
YNOSEX
BA-3. As you know, some people have had sexual intercourse by your age and others have not. Please look at Card 13 which lists some reasons that people give for not having sexual intercourse.
[HELP AVAILABLE]
What would you say is the most important reason why you have not had sexual intercourse up to now?
Against religion or morals............................1
Don’t want to get a female pregnant...................2
Don’t want to get a sexually transmitted disease......3
Haven’t found the right person yet....................4
In a relationship, but waiting for the right time.....5
Other ................................................6
{ BA SERIES IS ONLY ASKED OF 15-24 YEAR OLDS.
{ IF R IS OLDER THAN 24 YEARS, GO TO BB-1 EVEROPER
TALKPAR
BA-4. The next questions are about how you learned about sex and birth control. (Before you were 18 years old,) which, if any, of the topics shown on Card 23 did you ever talk with a parent or guardian about?
ENTER all that apply.
How to say no to sex ............1
Methods of birth control ........2
Where to get birth control ......3
Sexually transmitted diseases ...4
How to prevent HIV/AIDS..........5
How to use a condom .............6
Waiting until marriage to have
sex 8
None of the above ...............95
SEDNO
BA-5. Now I’m interested in knowing about formal sex education you may have had. (Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about how to say no to sex?
Yes............1
No.............5 (GO TO BA-8 SEDBC)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDNOLC
BA-5a. Looking at card 23a, where did you receive that instruction about how to say no to sex?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDNOG
BA-6. What grade were you in when you first received instruction on how to say no to sex?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-8 SEDBC.
SEDNOSX
BA-7. Did you receive instruction about how to say no to sex before or after the first time you had sex?
Before..........1
After...........2
SEDBC
BA-8. (Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about methods of birth control?
Yes............1
No.............5 (BA-11 SEDWHBC)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDBCLC
BA-8a. Looking at card 23a, where did you receive that instruction about methods of birth control?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDBCG
BA-9. What grade were you in when you first received instruction on methods of birth control?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-11 SEDWHBC.
SEDBCSX
BA-10. Did you receive instruction about methods of birth control
before or after the first time you had sex?
Before..........1
After...........2
SEDWHBC
BA-11. Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about where to get birth control?
Yes............1
No.............5 (BA-14 SEDCOND)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDWHLC
BA-11a. Looking at card 23a, where did you receive that instruction about where to get birth control?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
SEDWHBCG
BA-12. What grade were you in when you first received instruction on where to get birth control?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-14 SEDCOND.
SEDWHBCSX
BA-13. Did you receive instruction about where to get birth control before or after the first time you had sex?
Before..........1
After...........2
SEDCOND
BA-14. Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about how to use a condom?
Yes............1
No.............5 (BA-17 SEDSTD)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDCONLC
BA-14a. Looking at card 23a, where did you receive that instruction about how to use a condom?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
SEDCONDG
BA-15. What grade were you in when you first received instruction on how to use a condom?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-17 SEDSTD.
SEDCONDSX
BA-16. Did you receive instruction about how to use a condom before or after the first time you had sex?
Before..........1
After...........2
SEDSTD
BA-17. Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about sexually transmitted diseases?
Yes............1
No.............5 (BA-20 SEDHIV)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDSTDLC
BA-17a. Looking at card 23a, where did you receive that instruction about sexually transmitted diseases?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
SEDSTDG
BA-18. What grade were you in when you first received instruction on
sexually transmitted diseases?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-20 SEDHIV.
SEDSTDSX
BA-19.Did you receive instruction about sexually transmitted diseases before or after the first time you had sex?
Before..........1
After...........2
SEDHIV
BA-20.(Have you ever had/Before you were 18, did you ever have) any formal instruction at school, church, a community center or some other place about how to prevent HIV/AIDS?
Yes............1
No.............5 (BA-23 SEDABST)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDHIVLC
BA-20a. Looking at card 23a, where did you receive that instruction about how to prevent HIV/AIDS?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
SEDHIVG
BA-21. What grade were you in when you first received instruction
on how to prevent HIV/AIDS?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BA-23 SEDABST.
SEDHIVSX
BA-22. Did you receive instruction about how to prevent HIV/AIDS before or
after the first time you had sex?
Before..........1
After...........2
SEDABST
BA-23.(Before you were 18, did you ever have/ Have you ever had) any formal instruction at school, church, a community center or some other place about waiting until marriage to have sex?
Yes............1
No.............5 (BB-1 EVEROPER)
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDBCLC
BA-23a. Looking at card 23a, where did you receive that instruction about methods of birth control?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
{ ASKED IF R REPORTED HAVING SEX ED ON THIS TOPIC
SEDABLC
BA-23a. Looking at card 23a, where did you receive that instruction about waiting until marriage to have sex?
ENTER all that apply
School 1
Church 2
A community center 3
Some other place 4
SEDABSTG
BA-24. What grade were you in when you first received instruction about waiting until marriage to have sex?
1st grade .......................................1
2nd grade .......................................2
3rd grade .......................................3
4th grade .......................................4
5th grade .......................................5
6th grade .......................................6
7th grade .......................................7
8th grade .......................................8
9th grade .......................................9
10th grade ......................................10
11th grade ......................................11
12th grade ......................................12
1st year of college .............................13
2nd year of college .............................14
3rd year of college .............................15
4th year of college .............................16
Not in school when received instruction .........96
{ IF R HAS NEVER HAD SEX, GO TO BB-1 EVEROPER.
SEDSABSSX
BA-25. Did you receive instruction about waiting until marriage to have sex before or after the first time you had sex?
Before..........1
After...........2
Vasectomy/other sterilizing operations; Ability to reproduce (BB)
{ ASKED OF ALL
EVEROPER
BB-1. Some men have operations that make it impossible for them to father a child.
[HELP AVAILABLE]
Have you ever had a vasectomy or any other operation that makes it impossible for you to father a child?
ENTER [1] if the respondent had a vasectomy for any reason.
ENTER [1] if respondent says he had a vasectomy and had a reversal.
Yes.......1
No........5 (GO TO FATHPOSS BB-8)
{ ASKED IF HAD ANY STERILIZING OPERATION
TYPEOPER
BB-2. What type of operation did you have? Was it a vasectomy or some other operation?
Vasectomy..................................1 (GO TO BB-4 YRVASEC)
Other operation ...........................2
Vasectomy failed...........................3 (GO TO BB-4 YRVASEC)
Vasectomy already surgically reversed......4 (GO TO BB-4 YRVASEC)
{ ASKED IF HAD OTHER OPERATION OR DK/RF TO TYPE OF OPERATION
STEROPER
BB-3. As far as you know, are you completely sterile from this operation; that is, does it make it impossible for you to father a baby in the future?
Yes ...........1
No ............5 (GO TO FATHDIFF BB-9)
{ ASKED IF HAD VASECTOMY OR HAD OTHER OPERATION THAT MADE IMPOSSIBLE TO FATHER A CHILD
VASEC_M/VASEC_Y
BB-4. In what month and year did you have your (vasectomy / sterilizing operation)?
{ ASKED IF VASECTOMY/STERILIZING OPERATION WAS IN LAST FIVE YEARS
PLCSTROP
BB-5. Please look at Card 25 and tell me where (your vasectomy / your sterilizing operation) was performed.
Private doctor's office..............................1
HMO facility ........................................2
Community health clinic, community clinic,
public health clinic .............................3
Family planning or Planned Parenthood clinic ........4
Employer or company clinic ..........................5
School or school-based clinic .......................6
Hospital outpatient clinic ..........................7
Hospital emergency room .............................8
Hospital regular room ...............................9
Urgent care center, urgi-care, or walk-in facility ..10
Some other place ....................................20
{ IF R HAD OPERATION OTHER THAN VASECTOMY, GO TO SECTION BC
{ ASKED IF R HAD VASECTOMY
RVRSVAS
BB-6. (Have you ever had surgery to reverse your vasectomy? / You said that you had surgery to reverse your vasectomy, is that right? )
[HELP AVAILABLE]
Yes.........1
No..........5 (GO TO SECTION BC)
{ ASKED IF R HAD VASECTOMY AND REVERSAL
VASREV_M/VASREV_Y
BB-7. In what month and year did you have the reversal?
{ ASKED IF R DID NOT HAVE STERILIZING OPERATION OR HAD A VASECTOMY THAT FAILED OR HAD AN OPERATION FOR WHICH HE ANSWER NO, DK, OR RF ON WHETHER IT WAS FULLY STERILIZING
FATHPOSS
BB-8. Some men are not physically able to father children. As far as you know, is it physically possible for you, yourself to biologically father a child in the future?
[HELP AVAILABLE]
Yes ...........1
No ............5 (GO TO BC SERIES)
{ ASKED IF R DID NOT HAVE STERILIZING OPERATION AND PHYSICALLY POSSIBLE
{ (OR DK/RF) TO FATHER CHILD OR HAD OTHER STERILIZING OPERATION BUT NOT
{ IMPOSSIBLE TO HAVE CHILD
FATHDIFF
BB-9. Some men are physically able to father a child, but would have difficulty doing so. As far as you know, would you have any difficulty fathering a child?
[HELP AVAILABLE]
Yes ...........1
No ............5
Number of Sexual Partners (BC)
{ IF R NEVER HAD SEX, GO TO SECTION F
{ ASKED IF R EVER MARRIED, EVER COHABITED, OR HAS HAD SEX MORE THAN ONCE IN THEIR LIFE
LIFEPRT
BC-6. The next questions are about relationships with females.
Please look at Card 14. How many different females have you ever had intercourse with? This includes any female you had intercourse with, even if it was only once or if you did not know her well.
[HELP AVAILABLE]
One ...............1
Two ...............2 (GO TO BC-8 MON12PRT)
Three .............3 (GO TO BC-8 MON12PRT)
Four ..............4 (GO TO BC-8 MON12PRT)
Five ..............5 (GO TO BC-8 MON12PRT)
Six ...............6 (GO TO BC-8 MON12PRT)
7 or more .........7 (GO TO BC-8 MON12PRT)
{ ASKED IF R HAS ONLY HAD SEX ONCE
SXMON12
BC-7. (The next questions are about relationships with females. You said that you had sexual intercourse with a female once in your life. Was that in the last 12 months,/ Have you had sexual intercourse with this female in the last 12 months,) that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?
[HELP AVAILABLE]
Yes..........1
No...........5 (GO TO SECTION BD)
{ ASKED IF R HAD MORE THAN ONE PARTNER IN LIFE
MON12PRT
BC-8. Please look at Card 15. How many different females have you had sexual intercourse with in the past 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?
[HELP AVAILABLE]
None ..............0 (GO TO SECTION BD)
One ...............1
Two ...............2
Three .............3
Four ..............4
Five ..............5
Six ...............6
7 or more .........7
{ ASKED IF R HAD SEX PARTNER IN THE LAST 12 MONTHS, ONLY HAD SEX ONCE IN LIFE
P12MOCONO
BC-8a.Did you use a condom that time?
Yes......................1
No.......................5
{ ASKED IF R HAD AT LEAST ONE SEX PARTNER IN THE LAST 12 MONTHS AND
{ HAS HAD SEX MORE THAN ONCE, OR (SEXSTAT=NULL/BLANK)
P12MOCON
BC-8b.Please look at card 48. Thinking back over the past 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), would you say you used a condom with your partner or partners for sexual intercourse every time, most of the time, about half of the time, some of the time, or none of the time?
Every time......................1
Most of the time................2
About half of the time..........3
Some of the time................4
None of the time................5
{ IF R NEVER HAD SEX, GO TO SECTION F
{ IF R DIDN’T HAVE SEX IN THE LAST 12 MONTHS, GO TO SECTION BD
{ ASKED IF R HAD AT LEAST ONE SEX PARTNER IN THE LAST 12 MONTHS
SEXFREQ
BC-9. Now please think about the last four weeks. How many times have you had sexual intercourse with a female in the last four weeks?
[HELP AVAILABLE]
Number of times
{ ASKED IF R HAD AT LEAST ONE SEX PARTNER IN THE LAST 12 MONTHS
{ AND HAD SEX IN THE LAST 4 WEEKS
CONFREQ
BC-10. And, in the last four weeks, how many of the times that you had sexual intercourse with a female did you use a condom?
[HELP AVAILABLE]
Number of times
Enumeration of recent sex partner(s) or last partner ever (BD)
{ ASKED OF ALL WHO HAD SEX, EVEN IF MORE THAN 12 MONTHS AGO
P1NAME
BD-1. So, that I can refer to her in the interview, please give me the name or initials of the female with whom you (most recently) had sexual intercourse.
[HELP AVAILABLE]
Name/initials (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ ASKED IF R EVER MARRIED
P1RLTN1
BD-2. Were you ever married to (PARTNER’S NAME)?
Yes ...................1
No ....................5
{ ASKED IF R CURRENTLY MARRIED
P1CURRWIFE
BD-3. If necessary, ASK: (Is she your current wife?)
Yes ..........1
No ...........5
{ ASKED IF R CURRENTLY SEPARATED
P1CURRSEP
BD-4. If necessary, ASK: (Is she the woman you are separated from now?)
Yes ..........1
No ...........5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER BUT HE EVER COHABITED
P1RLTN2
BD-5. Did you ever live together with (PARTNER’S NAME)?
[HELP AVAILABLE]
Yes ...........1
No ............5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER AND HE EVER LIVED WITH THIS
{ PARTNER AND HE IS CURRENTLY COHABITING
P1COHABIT
BD-6. If necessary, ASK: (Is she the woman you live with now?)
Yes ..........1
No ...........5
P1SXLAST_M/P1SXLAST_Y
BD-7/8. (Please think of the last time that you had sexual intercourse with her./That time that you had sexual intercourse with her,) in what month and year was that?
[HELP AVAILABLE]
{ IF R HAD NONE OR ONE PARTNER IN LAST 12 MONTHS, GO TO END OF SECTION B
P2NAME
BD-9. Now think of the last female with whom you had sexual intercourse before (LAST PARTNER’S NAME). Please give me her name or initials.
[HELP AVAILABLE]
Name/ initials (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
P2RLTN1
BD-10. Were you ever married to (PARTNER’S NAME)?
Yes ............1
No .............5
{ ASKED IF R CURRENTLY MARRIED AND CURRENT WIFE NOT YET IDENTIFIED
P2CURRWIFE
BD-11. If necessary, ASK: (Is she your current wife?)
Yes ..........1
No ...........5
{ ASKED IF R CURRENTLY SEPARATED AND THAT WIFE NOT IDENTIFIED YET
P2CURRSEP
BD-12. If necessary, ASK: (Is she the woman you are separated from now?)
Yes ..........1
No ...........5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER BUT HE EVER COHABITED
P2RLTN2
BD-13. Did you ever live together with (PARTNER’S NAME)?
[HELP AVAILABLE]
Yes ...........1
No ............5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER AND HE EVER LIVED WITH THIS
{ PARTNER AND HE IS CURRENTLY COHABITING AND THIS COHABITING PARTNER NOT YET
{ IDENTIFIED
P2COHABIT
BD-14. If necessary, ASK: (Is she the woman you live with now?)
Yes ..........1
No ...........5
P2SXLAST_M/P2SXLAST_Y
BD-15/16. (Please think of the last time that you had sexual intercourse with her./That time that you had sexual intercourse with her,) in what month and year was that?
[HELP AVAILABLE]
{ IF R HAD 2 SEXUAL PARTNERS IN THE LAST 12 MONTHS, GO TO END OF SECTION B
P3NAME
BD-17. Think of the last female with whom you had sexual intercourse before (2ND TO LAST PARTNER’S NAME). Please give me her name or initials.
[HELP AVAILABLE]
Name/ initials (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
P3RLTN1
BD-18. Were you ever married to (PARTNER’S NAME)?
Yes ............1
No .............5
{ ASKED IF R CURRENTLY MARRIED AND CURRENT WIFE NOT YET IDENTIFIED
P3CURRWIFE
BD-19. If necessary, ASK: (Is she your current wife?)
Yes ..........1
No ...........5
{ ASKED IF R CURRENTLY SEPARATED AND THAT WIFE NOT IDENTIFIED YET
P3CURRSEP
BD-20. If necessary, ASK: (Is she the woman you are separated from now?)
Yes ..........1
No ...........5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER BUT HE EVER COHABITED
P3RLTN2
BD-21. Did you ever live together with (PARTNER’S NAME)?
[HELP AVAILABLE]
Yes ...........1
No ............5
{ ASKED IF R WAS NEVER MARRIED TO THIS PARTNER AND HE EVER LIVED WITH THIS
{ PARTNER AND HE IS CURRENTLY COHABITING AND THIS COHABITING PARTNER NOT YET
{ IDENTIFIED
P3COHABIT
BD-22. If necessary, ASK: (Is she the woman you live with now?)
Yes ..........1
No ...........5
P3SXLAST_M/P3SXLAST_Y
BD-23/24. (Please think of the last time that you had sexual intercourse with her./That time that you had sexual intercourse with her,) in what month and year was that?
[HELP AVAILABLE]
{ ASKED IF TWO OR THREE PARTNERS BOTH IN LIFETIME AND IN THE LAST 12 MONTHS
FIRST
BD-25. Were (either/any) of the females we’ve talked about, [DISPLAY PARTNER NAMES HERE], the first female with whom you ever had sexual intercourse?
[HELP AVAILABLE]
Yes, (PARTNER 1 NAME)...........1 (GO TO SECTION C)
Yes, (PARTNER 2 NAME)...........2 (GO TO SECTION C)
Yes, (PARTNER 3 NAME)...........3 (GO TO SECTION C)
No .............................5 (GO TO BD-26 FIRST2)
{ ASKED IF TWO OR THREE PARTNERS BOTH IN LIFETIME AND IN THE LAST 12 MONTHS NONE OF THEM WAS FIRST PARTNER EVER
FIRST2
BD-26. So that I can refer to her in the interview, please tell me the name or initials of the first female with whom you ever had sexual intercourse.
[HELP AVAILABLE]
Name/ initials (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
SECTION C
CURRENT WIFE OR COHABITING PARTNER
{ IF MARRIED OR COHABITING, CONTINUE WITH CA SERIES
{ ELSE GO TO SECTION D
Key Dates in Current Marriage or Cohabitation (CA)
CAINTRO
CA-0. Now I have some questions about your relationship with your (wife/partner).
{ ASKED IF SHE WAS NOT NAMED IN SECTION B
CA_NAME
CA-1. You may have already told me this, but please tell me her name or initials so that I can refer to her during the interview.
Name/ initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
[IF COHABITING, GO TO CA-5 STRTWFCP_M]
MARRDATE_M/MARRDATE_Y
CA-2. In what month and year were you and (WIFE/PARTNER) married?
[HELP AVAILABLE]
{ASKED IF R DOESN’T KNOW THE DATE OF MARRIAGE
HISAGEM
CA-3. How old were you when you and (WIFE/PARTNER) got married?
Age in years ____________
{ ASKED IF R MARRIED TO THIS WOMAN
LIVTOGWF
CA-4. Some couples live together without being married. By living together, we mean having a sexual relationship while sharing the same usual address. Did you and your wife live together before you got married?
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO SECTION CB)
{ ASKED IF R [IS MARRIED TO AND DID COHABIT WITH] OR [IS COHABITING WITH]
{ THIS WOMAN
STRTWFCP_M/STRTWFCP_Y
CA-5. In what month and year did you and (WIFE/PARTNER) first start living together?
[HELP AVAILABLE]
{ ASKED IF R [IS MARRIED TO AND DID COHABIT WITH] OR [IS COHABITING WITH]
{ THIS WOMAN AND START DATE OF COHABITATION = DK/RF
HISAGEC
CA-6. How old were you when you and (WIFE/PARTNER) first started living together?
Age in years ____________
{ ASKED IF R [IS MARRIED TO AND DID COHABIT WITH] OR [IS COHABITING WITH]
{ THIS WOMAN
ENGATHEN
CA-7. At the time you began living together, were you and she engaged to be married or did you have definite plans to get married?
Yes, engaged to be married ...........................1
Not engaged but had definite plans to get married ....3
No, neither engaged nor had definite plans ...........5
{ ASKED IF R IS COHABITING WITH THIS WOMAN
WILLMARR
CA-8. Please look at Card 58. Do you think that you and (PARTNER) will marry each other?
If R insists he does not know, enter [Ctrl] + [D]
Definitely yes 1
Probably yes 2
Probably no 3
Definitely no 4
Characteristics of Wife/Partner (CB)
CWPDOB_M/CWPDOB_Y
CB-1. In what month and year was she born?
{ ASKED IF R DOESN’T KNOW HER BIRTH DATE
CWPAGE
CB-2. How old is (WIFE/PARTNER) now?
Age in years at last birthday ________
CWPHISP
CB-3. Is your (wife/partner) Hispanic or Latino, or of Spanish origin?
Yes ........1
No .........5
CWPRACE
CB-4. Which of the groups shown on Card 2 describes (WIFE/PARTNER)’s racial background? Please select one or more groups.
[HELP AVAILABLE]
NOTE: If the respondent mentions a mixture of multiple races (e.g. biracial, mixed, mulatto), probe for and code all racial groups that are part of the mix.
American Indian or Alaska Native ...............1
Asian ..........................................2
Native Hawaiian or Other Pacific Islander ......3
Black or African American ......................4
White ..........................................5
{ ASKED IF MORE THAN ONE RACE GROUP MENTIONED
CWPRACEB
CB-5. Which of these groups, that is (responses from CWPRACE), would you say best describes your (wife/partner)’s racial background?
[HELP AVAILABLE]
{ DISPLAY THOSE GROUPS MENTIONED IN CWPRACE CB-4
CWPEDUCN
CB-6. Please look at Card 11. What is the highest level of education (WIFE/PARTNER) has completed?
Less than high school ...........................1
High school graduate or GED .....................2
Some college but no degree ......................3
2-year college degree (e.g., Associate’s degree).4
4-year college graduate (e.g., BA, BS) ..........5
Graduate or professional school .................6
CWPBORN
CB-7. Was (WIFE/PARTNER) born outside the United States?
[HELP AVAILABLE]
Yes ........1
No .........5
CWPMARBF
CB-8. (At the time you and she were married, had / Has) (WIFE/PARTNER) been married before?
[HELP AVAILABLE]
Yes ........1
No .........5
First Sex with Current Wife/Partner (CC)
CWPSX1WN_M/CWPSX1WN_Y
CC-1. Now I have some questions about the beginning of your relationship with your (wife/partner).
Think back to the very first time that you had sexual intercourse with your (wife/partner). In what month and year was that?
[HELP AVAILABLE]
{ ONLY ASKED IF DK/RF DATE OF FIRST SEX
CWPSX1AG
CC-2. The very first time that you had sexual intercourse with your (wife/partner), how old were you?
[HELP AVAILABLE]
Age in years __________
{ ONLY ASKED IF THIS WOMAN IS FIRST SEX PARTNER EVER
CWPSX1RL
CC-3. Please look at Card 44. At the time you first had sexual intercourse with (WIFE/PARTNER), how would you describe your relationship with her?
Married to her ...............................................1
Engaged to her, and living together ..........................2
Engaged to her, but not living together ......................3
Living together in a sexual relationship, but not engaged ....4
Going with her or going steady ...............................5
Going out with her once in a while ...........................6
Just friends .................................................7
Had just met her .............................................8
Something else ...............................................9
CWPFUSE
CC-4. That first time that you had sexual intercourse with (WIFE/PARTNER), did you or she use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 45a for some examples of methods, before answering “yes” or “no.”
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO SECTION CD)
{ASKED IF METHODS WERE USED
CWPFMET
CC-5. Looking at Card 45b, that first time, what methods did you and she use to prevent pregnancy or sexually transmitted disease?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber ..............................................1
Withdrawal or pulling out .....................................2
Vasectomy or male sterilization ...............................3
Pill ..........................................................4
Tubal sterilization (“tubes tied”) or other female
Sterilization 5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository .................7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period .........................................9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
Sterilization and Impaired Fecundity (CD)
{ ASKED IF THEY DID NOT USE FEMALE STERILIZATION AT FIRST SEX
CWPOPSTR
CD-1. As far as you know, has your (wife/partner) ever had an operation that made it impossible for her to have a baby?
Yes ........1
No .........5 (GO TO CWPPOSS CD-5)
CWPTYPOP
CD-2. (You said that your (wife/partner) has had a sterilizing operation.) Which of these types of sterilizing operations did she have? Did she have a tubal ligation or tubal sterilization, a hysterectomy, or something else?
[HELP AVAILABLE]
ENTER all that apply.
Tubal ligation or tubal sterilization ......1
Hysterectomy ...............................2
Something else .............................3
{ ASKED IF STERILIZING OPERATION WAS “SOMETHING ELSE”
CWPTOTST
CD-3. As far as you know, did the operation make your (wife/partner) completely sterile, that is, is it completely impossible for her to have a baby?
Yes ..........1
No ...........5
{ ASKED IF R’s W/CP HAD TUBAL AND NO OTHER STERILIZING OPERATION
CWPREVST
CD-4. Has your (wife/partner) ever had surgery to reverse her tubal sterilization?
[HELP AVAILABLE]
Yes ........1 (GO TO SECTION CE)
No .........5 (GO TO SECTION CE)
{ ASKED IF W/CP DID NOT HAVE STERILIZING OPERATION
CWPPOSS
CD-5. Some women are not physically able to have children. As far as you know, is it physically possible for (WIFE/PARTNER) to have a baby?
[HELP AVAILABLE]
Yes .................1
No ..................5 (GO TO SECTION CE)
{ ASKED IF W/CP DID NOT HAVE OPERATION AND IS PHYSICALLY ABLE TO HAVE
{ CHILDREN (OR DK/RF TO CWPPOSSB) OR IF W/CP HAD OPERATION THAT DID
{ NOT MAKE IT COMPLETELY IMPOSSIBLE FOR HER TO HAVE CHILDREN
CWPDIFF
CD-6. Some women are physically able to have another baby, but have difficulty getting pregnant or carrying the baby to term. As far as you know, would (WIFE/PARTNER) have any difficulty getting pregnant or carrying a baby?
[HELP AVAILABLE]
Yes ........1
No .........5
Most Recent Sex with Current Wife/Partner (CE)
{ ASKED IF CURRENTLY MARRIED OR COHABITING BUT CWP WAS NOT THE RECENT PARTNER(S)
CWPLSXWN_M, CWPLSXWN_Y
CE-2. Think back to the most recent time that you had sexual intercourse with your (wife/partner). In what month and year was that?
[HELP AVAILABLE]
CWPLUSE1
CE-5. That last time that you had sexual intercourse with your (wife/partner), did you, yourself use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 46a for some examples of methods for males, before answering “yes” or “no.”
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO CE-7 CWPLUSE2)
{ ASKED IF HE USED A METHOD
CWPLMET1
CE-6. Looking at Card 46b, that last time, what methods did you use?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber ..............................................1
Withdrawal or pulling out .....................................2
Vasectomy or male sterilization ...............................3
Something else ...............................................10
CWPLUSE2
CE-7. That last time that you had sexual intercourse with your (wife/partner), did she use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 47a for some examples of methods for females, before answering “yes” or “no.”
[HELP AVAILABLE]
Do not probe a DK response
Yes ........1
No .........5 (GO TO CF SERIES)
{ ASKED IF CE-7 CWPLUSE2 IS DON’T KNOW
DKCWPLUSE
CE-7b. Is it that you don’t recall right now, or that you never knew?
Don’t recall.....1
Never knew.......2
{ ASKED IF SHE USED A METHOD
CWPLMET2
CE-8. Looking at Card 47b, that last time, what methods did she use?
[HELP AVAILABLE]
ENTER all that apply.
Do not probe a DK response
Pill 4
Tubal sterilization or other female sterilization 5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository 7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period 9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ ASKED IF CE-8 CWPLMET2 IS DON’T KNOW
DKCWPLMET
CE-8b. Is it that you don’t recall right now, or that you never knew?
Don’t recall.....1
Never knew.......2
Methods Used in the Last 12 Months (CF)
CFINTRO
CF-0. Now I have some questions about methods that you and (WIFE/PARTNER) used in the past 12 months, that is since (INTERVIEW MONTH, INTERVIEW YEAR - 1), to prevent pregnancy or sexually transmitted disease.
(If you were not involved with her for the whole 12 months, please think of only that time that you were involved with her during the past 12 months.)
{ ASKED IF CAN’T TELL IF THEY USED A METHOD IN LAST 12 MONTHS
CWPRECBC
CF-1. During the last 12 months, did you or your (wife/partner) use any methods to prevent pregnancy or sexually transmitted disease when you had intercourse together? Please answer yes if you used a method even once. (If necessary: Please look at Card 45a for some examples of methods, before answering “yes” or “no.”)
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO SECTION CG)
CWPALLBC
CF-2. Please look at Card 45b. Including any methods you may have already told me about and methods you may have used only once, during the last 12 months, which of these methods did you and she use to prevent pregnancy or sexually transmitted diseases?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber 1
Withdrawal or pulling out .....................................2
Vasectomy or male sterilization ...............................3
Pill ..........................................................4
Tubal sterilization or other female sterilization .............5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository 7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period .........................................9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ ASKED IF MORE THAN ONE METHOD USED IN THE LAST 12 MONTHS
CWPBCMST
CF-3. During the last 12 months, when you and your (wife/partner) had sex together, which method did you and she use most of the time?
[HELP AVAILABLE]
{ DISPLAY ONLY THOSE METHODS MENTIONED IN CWPALLBC CF-2
{ ASKED OF ALL WHO USED ANY METHOD IN 12 MONTHS EVEN IF CONDOM NOT LISTED
CONDFREQ
CF-4. During the last 12 months, what percent of the times that you and she had sex together did you use a condom?
[HELP AVAILABLE]
Percentage (IF 100%, GO TO SECTION CG)
{ ASKED OF ALL WHO USED ANY METHOD IN 12 MOS, EXCEPT 100% CONDOM USERS
CWPNOFRQ
CF-5. Please look at Card 48. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR-1), how often did you or she use any method when you had sex together?
Every time .........................1
Most of the time....................2
About half of the time .............3
Some of the time....................4
None of the time....................5
Biological Children (CG)
{ ASKED DIRECTLY FOR MARRIED/COHABITING MEN WHO DID NOT REPORT BIO KIDS IN THEIR HOUSEHOLD ROSTER; AUTOMATICALLY CODED YES FOR THOSE WHO DID
CWPBIOKD
CG-1. Now I have some questions about children that you and your (wife/partner) may have had together. By this I mean, you were the biological father and she was the biological mother.
Have you and (WIFE/PARTNER) ever had a child together?
Include all children R and his wife/partner have had together, regardless of whether they were married at the time or whether they are raising the child(ren) themselves or have placed the child(ren) for adoption.
Yes ........1
No .........5 (GO TO SECTION CH)
{ ASKED IF CWPBIOKD = YES
CWPNUMKD
CG-2. Altogether, how many children have you had together?
[HELP AVAILABLE]
Number of children _________
CWPCHNAM
CG-3. IF NUMBER OF CHILDREN =1, ASK:
What is the child’s first name or initials?
ELSE IF NUMBER OF CHILDREN >1, ASK:
What is the first name or initials of each of the children?
Name or initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ BEGIN LOOP TO ASK ABOUT EACH CHILD
{ ASKED IF MORE THAN ONE CHILD
TALKBC
CG-4. Let’s talk about [CHILD’S NAME].
CWPCHSEX
CG-5. If necessary, ASK: (Is this child male or female?)
Male .......1
Female .....2
CWPCHDOB_M/CWPCHDOB_Y
CG-6. In what month and year was (CHILD’S NAME) born?
{ ASKED IF DOB OF THIS CHILD = DOB OF CHILD DESCRIBED EARLIER
MULTBIRT
CG-7. The birthday of this child is the same as (ANOTHER CHILD’S NAME). Was this a multiple birth?
Yes ............1 (GO TO CWPCHLIV CG-11)
No .............5
{ ASKED IF R MARRIED AND CAN’T TELL FROM DATES WHETHER MARRIAGE OR
{ CHILDBIRTH CAME FIRST
CWPCHMAR
CG-8. Were you married to (WIFE/PARTNER) at the time of [CHILD NAME]’s birth?
Yes ........1 (GO TO CWPCHLIV CG-11)
No .........5
{ ASKED IF COHABITING WITH THIS WOMAN NOW OR (IF MARRIED TO HER NOW) NOT
{ MARRIED TO HER AT CHILDBIRTH, BUT HAD PREMARITALLY COHABITED
CWPCHRES
CG-9. Were you living together with (WIFE/PARTNER) at the time of the birth?
[HELP AVAILABLE]
Yes ........1 (GO TO CWPCHLIV CG-11)
No .........5
{ ASKED IF NOT MARRIED TO OR LIVING WITH WOMAN AT TIME OF BIRTH
CWPCHLRN
CG-10. When did you find out that (WIFE/PARTNER) was pregnant? Was it during the pregnancy or after the child was born?
During the pregnancy .........1
After the child was born .....2
{ ASKED ABOUT ALL CHILDREN
CWPCHLIV
CG-11. Please look at Card 57. Where does (CHILD NAME) usually live now?
[HELP AVAILABLE]
ENTER all that apply.
Only probe AO for responses 2-5
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
Away at school or college ...................3
Living on own ...............................4
Living with other relatives .................5
Deceased ....................................6
Placed for adoption or adopted ..............7
Placed in foster care .......................8
Someplace else ..............................9
RANGE CHECK: 1,6,7,8, DK/RF CANNOT BE COMBINED WITH ANY OTHER RESPONSES.
{ ASKED IF CHILD’S DATE OF BIRTH IS MISSING
CWPCHAGE
CG-12. How old is (CHILD) now? Is [he/she] less than 5 years old, 5 to 18 years old, or 19 years or older?
Less than 5 years old ..........1
5-18 years old .................2
19 years or older ..............3
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
CWPCHSIG
CG-13a. Did you ever sign the application for [CHILD’S NAME]’s birth certificate or sign a statement that legally says you are [CHILD’S NAME]’s father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
CWPCHCRT
CG-13b.
Did you have to go to court to establish that you are [CHILD’S NAME]’s legal father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
CWPCHGEN
CG-14. Were you legally identified by a blood test or other genetic test as [CHILD’S NAME]’s father?
Yes ........1
No .........5
{ IF RESPONDENT LIVES WITH CHILD, GO TO CWPCHWNT CG-17
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED, OR IN FOSTER CARE, AND
{ R DIDN’T LIVE WITH CHILD AT BIRTH, AND DOESN’T LIVE WITH CHILD NOW
CWPCHEVR
CG-15. Did you ever live with [CHILD NAME]?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED OR IN FOSTER CARE AND
{ DOESN’T LIVE WITH R NOW
CWPCHFAR
CG-16. About how many miles away from here does (CHILD) live?
Number of miles ________
ENTER 0 if less than 1 mile
{ IF CHILD IS AGE 19 OR OLDER, GO TO END OF SECTION CG
{ ASKED IF CHILD IS AGE 18 OR YOUNGER AND R WAS MARRIED
{ TO/LIVING WITH MOTHER OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
CWPCHWNT
CG-17. Please look at Card 58. Right before (WIFE/PARTNER) became pregnant with [CHILD], did you, yourself, want to have a child at some time in the future?
[HELP AVAILABLE]
NOTE: If R says that he already had a child, SAY: Right before she became pregnant, did you, yourself, want to have another child at some time in the future.
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO CG-19 CWPCHHPY)
Definitely no .................4 (GO TO CG-19 CWPCHHPY)
{ ASKED IF CHILD IS AGE 18 OR YOUNGER AND R WAS MARRIED
{ TO/LIVING WITH MOTHER OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ AND R DEFINITELY OR PROBABLY WANTED A CHILD
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
CWPCHSON
CG-18. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF THE PREGNANCY CAME TOO SOON
{ R CAN ANSWER IN MONTHS OR YEARS
CWPSOONN/CWPSOONMY2
CG-18a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
CWPLATEN/ CWPLATEMY
CG-18c. How much later than you wanted did the pregnancy occur?
Number and (Months/Years)________
{ ASKED IF CHILD IS AGE 18 OR YOUNGER AND R WAS MARRIED
{ TO/LIVING WITH MOTHER OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
CWPCHHPY
CG-19. Please look at Card 59. On this scale, a zero means that you were very unhappy about that pregnancy, and a ten means that you were very happy about that pregnancy. Tell me which number on the card best describes how you felt when you found out that your (wife/partner) was pregnant that time.
Number from 0 to 10
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY
Current Pregnancy (CH)
{ IF SHE IS STERILE, GO TO SECTION CI
{ ASKED IF W/CP NOT STERILE AND R HAD SEX WITH HER IN LAST 12 MOS
CWPPRGNW
CH-1. Is your (wife/partner) pregnant with your child now?
Yes ........1 (GO TO CH-4 CWPCPWNT)
No .........5
{ ASKED IF R’S W/CP NOT PREGNANT NOW
CWPTRYPG
CH-2. Are you and your (wife/partner) currently trying to get pregnant?
Yes ........1
No .........5 (GO TO SECTION CI)
{ ASKED IF R’S W/CP NOT PREGNANT NOW AND THEY’VE BEEN TRYING TO GET PREGNANT
CWPTRYLG
CH-3. How long have you and she been trying to get pregnant?
Number of months ________ (GO TO SECTION CI)
{ ASKED IF R’S W/CP IS PREGNANT NOW
CWPCPWNT
CH-4. Please look at Card 58. Right before (WIFE/PARTNER) became pregnant, did you, yourself, want to have a child at some time in the future?
[HELP AVAILABLE]
NOTE: If R says that he already had children, say “Right before she became pregnant, did you, yourself, want to have another child at some time in the future?”
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO CH-6 CWPCPHPY)
Definitely no .................4 (GO TO CH-6 CWPCPHPY)
{ ASKED IF R’S W/CP IS PREGNANT NOW AND R DEFINITELY OR PROBABLY WANTED CHILD
CWPCPSON
CH-5. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF R’S CWP IS PREGNANT NOW AND THE PREGNANCY CAME TOO SOON.
{ R CAN ANSWER IN MONTHS OR YEARS
CWPCPSNN/CWPCPSNMY
CH-5a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
CWPCPLATEN/ CWPCPLATEMY
CH-5c. How much later than you wanted did the pregnancy occur?
Number and (Months/Years)___________
{ ASKED IF R’S W/CP IS PREGNANT NOW
CWPCPHPY
CH-6. Please look at Card 59. On this scale, a zero means that you were very unhappy about that pregnancy, and a ten means that you were very happy about that pregnancy. Tell me which number on the card best describes how you felt when you found out that your (wife/partner) was pregnant that time.
Number from 0 to 10
Other Children -- Wife/Partner’s Children from Her Previous Relationships (CI)
{ ASKED FOR ALL CURRENTLY MARRIED OR COHABITING MEN
CWPOTKID
CI-1. Now I would like to ask you about any other children, whether biological, adopted, foster or legally guarded children, that (WIFE/PARTNER’S NAME) may have had. Please be sure to include all of her children, even if they never lived with you.
When you began living with (WIFE/PARTNER’S NAME), did she have any other children?
Yes ........1
No .........5 (GO TO SECTION CJ)
CWPOKNUM
CI-2. How many children did she have?
Number of children _____________
CWPOKWTH
CI-3. (Did this child/Did any of these children) ever live with you?
Yes ........1
No .........5 (GO TO SECTION CJ)
{ ASKED IF HIS CURRENT WIFE OR PARTNER HAD MORE THAN ONE CHILD AND HER
{ CHILDREN LIVED WITH R
CWPOKWTHN
CI-4. How many of these children lived with you?
Number of children _____________
{ ASKED IF R LIVED WITH ANY OF HER CHILDREN
CWPOKNAM
CI-5. What is the first name or initials of (this child/the children who lived with you/one of the children who lived with you)?
Name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH CHILD REPORTED IN CI-5 CWPOKNAM
{ ASKED FOR EACH NAMED CHILD
CWPOKSEX
CI-6. (Thinking now of (CHILD’S NAME), is/Is) this child male or female?
Male ........1
Female ......2
CWPOKAD
CI-7. Did you legally adopt this child or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .............. 1(GO TO CI-10 CWPOKLIV)
Yes, became guardian ...... 3
No, neither ............... 5(GO TO CI-9 CWPOKTHR)
{ ASKED IF R BECAME LEGAL GUARDIAN TO THIS CHILD
CWPOKTRY
CI-8. Are you in the process of trying to legally adopt (CHILD’S NAME)?
[HELP AVAILABLE]
Yes ...........1 (GO TO CI-10 CWPOKLIV)
No ............5 (GO TO CI-10 CWPOKLIV)
{ ASKED IF R NEITHER ADOPTED NOR BECAME LEGAL GUARDIAN TO THIS CHILD
CWPOKTHR
CI-9. Are you in the process of trying to legally adopt (CHILD’S NAME) or to become this child’s legal guardian?
[HELP AVAILABLE]
Yes, trying to adopt ................1
Yes, trying to become guardian ......3
No, neither .........................5
{ ASKED FOR EACH NAMED CHILD
CWPOKLIV
CI-10. Please look at Card 60. Where does this child usually live now?
[HELP AVAILABLE]
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
If child lives with other parent (i.e., biological father), enter [5].
In this household full-time .................1
In this household part-time .................2
Away at school or college ...................3
Living on own ...............................4
Living with other relatives .................5
Deceased ....................................6
Someplace else ..............................7
RANGE CHECK: 1, 6 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASKED IF CHILD IS NOT DECEASED AND DOES NOT LIVE WITH R NOW
CWPOKFAR
CI-11. About how many miles away from here does (CHILD’S NAME) live?
Number of miles _____________
ENTER 0 if less than 1 mile
{ ASKED IF R EVER LIVED WITH CHILD AND CHILD IS NOT DECEASED
CWPOKAGE
CI-12. How old is (CHILD’S NAME) now?
Age in years at last birthday _________
ENTER 0 if less than 1 year
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY
{ IF NO OTHER CHILD TO BE DISCUSSED, GO TO CJ-1 CWPNBEVR
Other Children (CJ)
{ ASKED FOR ALL CURRENTLY MARRIED OR COHABITING MEN
CWPNBEVR
CJ-1. Besides any children that we may have talked about, have you and your (wife/partner) ever had any other children live with you under your care and responsibility? Please do not include any of your biological children, your (wife/partner)’s biological children, or children from previous relationships.
[HELP AVAILABLE]
If necessary, say: By this I mean that neither you nor your (wife/partner) are the child’s biological parents, but you served as a formal or informal guardian to the child or that you were chiefly responsible for the child’s care.
R’s own biological children from any previous relationships should not be included here. For example, any biological children that he had with a former wife, cohabiting partner, girlfriend, and so forth will be discussed in later questions.
Yes .........1
No ..........5 (GO TO SECTION D)
CWPNBNUM
CJ-2. How many children?
Number of children ________
CWPNBNAM
CJ-3. What is the first name or initials of (this child/each of these children)?
Name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH CHILD REPORTED IN CJ-3 CWPNBNAM
{ ASKED FOR EVERY CHILD UNDER R’s AND CURRENT WIFE/PARTNER’S CARE
CWPNBREL
CJ-4. When (CHILD’S NAME) began living with you, was he or she the child of a relative by blood or by marriage?
[HELP AVAILABLE]
Yes, by blood .........1
Yes, by marriage.......3
No ....................5
CWPNBFOS
CJ-5. Was this child a foster child who was placed in your home by a court, child welfare department, or social service agency?
[HELP AVAILABLE]
Yes .............1
No ..............5
CWPNBSEX
CJ-6. Is this child male or female?
Male ..........1
Female ........2
CWPNBAD
CJ-7. Did you legally adopt this child or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .........1 (GO TO CJ-10 CWPNBLIV)
Yes, became guardian..3 (GO TO CJ-8 CWPNBTRY)
No, neither...........5 (GO TO CJ-9 CWPNBTHR)
{ ASKED IF R BECAME LEGAL GUARDIAN TO THIS CHILD
CWPNBTRY
CJ-8. Are you in the process of trying to legally adopt (CHILD’S NAME)?
[HELP AVAILABLE]
Yes ...........1 (GO TO CJ-10 CWPNBLIV)
No ............5 (GO TO CJ-10 CWPNBLIV)
{ ASKED IF R NEITHER ADOPTED NOR BECAME LEGAL GUARDIAN TO THIS CHILD
CWPNBTHR
CJ-9. Are you in the process of trying to legally adopt (CHILD’S NAME) or to become this child’s legal guardian?
[HELP AVAILABLE]
Yes, trying to adopt ................1
Yes, trying to become guardian ......3
No, neither .........................5
CWPNBLIV
CJ-10. Please look at Card 60. Where does (CHILD’S NAME) usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
If child lives with a parent, enter [5]
In this household full-time .................1
In this household part-time .................2
Away at school or college ...................3
Living on own ...............................4
Living with other relatives .................5
Deceased ....................................6
Someplace else ..............................7
RANGE CHECK: 1, 6 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASK IF CHILD NOT DECEASED AND NOT IN R’S HH
CWPNBFAR
CJ-11. About how many miles away from here does (CHILD’S NAME) live?
Number of miles _________
ENTER 0 if less than 1 mile
{ ASKED IF CHILD NOT DECEASED
CWPNBAGE
CJ-12. How old is (CHILD’S NAME) now?
Age in years at last birthday _________
ENTER 0 if less than 1 year
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY.
{ ELSE, IF NO MORE CHILDREN TO DISCUSS, GO TO SECTION D.
SECTION D
RECENT (OR LAST) SEXUAL PARTNER(S) AND FIRST SEXUAL PARTNER
Screener to identify partner (DA)
Establish routing for up to 3 recent partners in last 12 months or last partner ever (if none in last 12 months) (DA)
If partner is current wife (not separated) or current cohabiting partner, skip to end of loop and check next most recent partner. If no more partners to describe, go to "First sex ever" series (DL)
If partner is former wife (including separated) or cohab(never wife), ask next series (DB)
If partner is someone R was never in marr/cohab union, go to flow check before "stability of curr rel'p" series (DC)
Key Dates for Former Wives & Cohabiting Partners (DB)
DINTRO_1
DB-0. Now I have some questions about [PxNAME].
{ ASKED IF R EVER MARRIED TO THIS WOMAN
MARDATEN_M/MARDATEN_Y
DB-1. In what month and year were you and she married?
[HELP AVAILABLE]
{ ASKED IF R EVER MARRIED TO THIS WOMAN BUT MARRIAGE DATE = DK/RF
AGEMARR
DB-2. How old were you when you and (PARTNER’S NAME) got married?
Age in years _______
{ ASKED IF R EVER MARRIED TO THIS WOMAN
LIVTOGN
DB-3. Some couples live together without being married. By living together, we mean having a sexual relationship while sharing the same usual address. Did you and (PARTNER’S NAME) live together before you got married?
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO MARREND DB-7)
{ ASKED IF R EVER COHABITED WITH THIS WOMAN
STRTLIVE_M/STRTLIVE_Y
DB-4. In what month and year did you and she first start living together?
[HELP AVAILABLE]
{ ASKED IF R EVER COHABITED WITH THIS WOMAN, BUT START DATE = DK/RF
AGELIV
DB-5. How old were you when you and (PARTNER’S NAME) first started living together?
[HELP AVAILABLE]
Age in years __________
{ ASKED IF R EVER COHABITED WITH THIS WOMAN
ENGAGTHN
DB-6. At the time you first began living together, were you and she engaged to be married or did you have definite plans to get married?
Yes, engaged to be married ...........................1
Not engaged but had definite plans to get married ....3
No, neither engaged nor had definite plans ...........5
{ ASKED IF R EVER MARRIED TO THIS WOMAN
MARREND
DB-7. (You may have told me this already, but) How did your marriage end?
[HELP AVAILABLE]
Death of wife ...........1
Divorce .................2 (GO TO DIVORFIN DB-9)
Annulment ...............3 (GO TO DIVORFIN DB-10)
Separation ..............4 (GO TO DIVORFIN DB-11)
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY HER DEATH
WIFEDIED_M/WIFEDIED_Y
DB-8. In what month and year did (WIFE/PARTNER) die?
ENTER DATE, THEN GO TO PXMOLAST DD-2
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY DIVORCE
DIVORFIN_M/DIVORFIN_Y
DB-9. In what month and year did your divorce become final?
[HELP AVAILABLE]
ENTER DATE, THEN GO TO STOPLIVE DB-11
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY ANNULMENT
ANNULLED_M/ANNULLED_Y
DB-10. In what month and year did your annulment take place?
{ ASKED IF [R EVER MARRIED TO THIS WOMAN AND [[MARRIAGE ENDED IN DIVORCE OR
{ ANNULMENT] OR [R IS CURRENTLY SEPARATED FROM HER]]] OR IF R NEVER MARRIED
{ TO THIS WOMAN BUT DID COHABIT WITH HER
STOPLIVE_M/STOPLIVE_Y
DB-11. In what month and year did you and (PARTNER’S NAME) last stop living together?
[HELP AVAILABLE]
Stability of Relationship with Current Partner (DC)
{ ASKED FOR ALL R’s WHO HAD AT LEAST 1 PARTNER IN THE LAST 12 MONTHS AND
{ ABOUT ALL RECENT PARTNERS, EXCEPT IF SHE WAS A WIFE AND SHE DIED
PXCURR
DC-1. (Now I have some more questions about (PARTNER’S NAME)). Do you consider (PARTNER’S NAME) a current sexual partner?
[HELP AVAILABLE]
Yes ..........1
No ...........5 (GO TO PXLAST DD-1)
{ ASKED IF R WAS NEVER MARRIED TO THIS WOMAN AND SHE IS A CURRENT PARTNER
PXMARRY
DC-2. Please look at Card 58. Do you think that you and (PARTNER’S NAME) will marry each other?
If R insists he does not know, enter [Ctrl] + [D]
Definitely yes 1
Probably yes 2
Probably no 3
Definitely no 4
Last Sex with Recent Partner (DD)
PXLRUSE
DD-5. That (last) time that you had sexual intercourse with (PARTNER’S NAME), did you, yourself, use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 46a for some examples of methods for males, before answering “yes” or “no”.
[HELP AVAILABLE]
Yes .................1
No ..................5 (GO TO DD-7 PXLPUSE)
{ ASKED IF HE USED METHOD AT LAST SEX
PXLRMETH
DD-6. Looking at Card 46b that (last) time, what methods did you, yourself, use to prevent pregnancy or sexually transmitted disease?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber ............................................1
Withdrawal or pulling out ...................................2
Vasectomy or male sterilization .............................3
Something else .............................................10
PXLPUSE
DD-7. That (last) time that you had sexual intercourse with (PARTNER’S NAME), did she use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 47a for some examples of methods for females, before answering “yes” or “no”.
[HELP AVAILABLE]
Do not probe a DK response
Yes .................1
No ..................5 (GO TO DD-9 PXLSXPRB)
{ ASKED IF DD-7 PXLPUSE IS DON’T KNOW
DKPXLPUSE
DD-7b. Is it that you don’t recall right now, or that you never knew?
Don’t recall.....1
Never knew.......2
{ ASKED IF SHE USED A METHOD AT LAST SEX
PXLPMETH
DD-8. Looking at Card 47b, that (last) time, what methods did she use to prevent pregnancy or sexually transmitted disease?
[HELP AVAILABLE]
ENTER all that apply.
Do not probe a DK response
Pill 4
Tubal sterilization or other female sterilization 5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository 7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period 9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ ASKED IF DD-8 PXLPMETH=19
DKPXLPMETH
DD-8b. Is it that you don’t recall right now, or that you never knew?
Don’t recall.....1
Never knew.......2
{ ASKED IF NEVER MARRIED TO OR LIVED WITH THIS PARTNER AND
{ NO METHOD OR ONLY A MALE METHOD REPORTED AT LAST SEX
PXLSXPRB
DD-9. That (last) time, could [PARTNER’S NAME] have used a method that you didn’t know about?
Do not probe a DK response
Yes .........1
No ..........5
{ ASKED IF R NEVER MARRIED TO OR COHABITED WITH THIS WOMAN AND
{ IF R HAD MORE THAN ONE PARTNER IN LIFE
PXMTONCE
DD-10. Have you had (did you have) sexual intercourse with (PARTNER’S NAME) more than once?
[HELP AVAILABLE]
Yes ..........1
No ...........5
{ IF AGE <18, GO TO PXFRLTN DD-14
{ ASKED IF R IS 18 OR OLDER OR IF R IS <18 AND PARTNER NOT CURRENT.
PXPAGE
DD-11. How old was (PARTNER’S NAME) when you last had sex with her?
[HELP AVAILABLE]
Age in years ________
{ ASKED IF R DIDN’T KNOW HER AGE AT LAST SEX
PXRELAGE
DD-12. Is she older than you, younger than you, or about the same age?
Older................1
Younger..............2
About the same age...3
{ ASKED IF R DIDN’T KNOW HER AGE AT LAST SEX AND SHE WAS OLDER OR YOUNGER
PXRELYRS
DD-13. By how many years?
1-2 years............1
3-5 years............2
6-10 years...........3
More than 10 years...4
{ ASKED IF R NEVER MARRIED TO AND NEVER LIVED WITH THIS PARTNER
PXFRLTN
DD-14. Please look at Card 44. At the time you (first / last) had sexual intercourse with (PARTNER’S NAME), how would you describe your relationship with her?
Married to her ..............................................1
Engaged to her, and living together..........................2
Engaged to her, but not living together......................3
Living together in a sexual relationship, but not engaged ...4
Going with her or going steady ..............................5
Going out with her once in a while ..........................6
Just friends ................................................7
Had just met her ............................................8
Something else...............................................9
{ ASKED OF CURRENT PARTNERS, MOST RECENT PARTNER, AND OF FORMER WIFE/COHAB
PXHISP
DD-15. Is (PARTNER’S NAME) Hispanic or Latino, or of Spanish origin?
Yes ..........1
No ...........5
{ ASKED OF CURRENT PARTNERS, MOST RECENT PARTNER, AND OF FORMER WIFE/COHAB
PXRACE
DD-16. Which of the groups shown on Card 2 describes (PARTNER’S NAME)’s racial background? Please select one or more groups.
[HELP AVAILABLE]
ENTER all that apply.
NOTE: If the respondent mentions a mixture of multiple races (e.g. biracial, mixed, mulatto), probe for and code all racial groups that are part of the mix.
American Indian or Alaska Native.................1
Asian............................................2
Native Hawaiian or other Pacific Islander........3
Black or African American........................4
White............................................5
{ ASKED IF MULTIPLE RACE GROUPS SELECTED
PXBEST
DD-17. Which of these groups, that is (RESPONSES TO DD-16), would you say best describes (PARTNER’S NAME)’s racial background?
[HELP AVAILABLE]
{ ONLY DISPLAY RESPONSES FROM DD-16.
{ IF NEVER MARRIED TO OR LIVED WITH THIS PARTNER AND
{ PARTNER IS NOT CURRENT OR MOST RECENT, GO TO SECTION DF.
Other Characteristics of Current or Most Recent Partner or Former Wife/Cohab (DE)
{ ASKED IF EVER MARRIED TO OR EVER LIVED WITH THIS WOMAN
PXDOB_M/PXDOB_Y
DE-1. In what month and year was (PARTNER’S NAME) born?
{ ASKED THIS PARTNER IS CURRENT OR THE MOST RECENT
PXEDUC
DE-2. Please look at Card 11. What is the highest level of education she has completed?
Less than high school ...........................1
High school graduate or GED .....................2
Some college but no degree ......................3
2-year college degree (e.g., Associate’s degree).4
4-year college graduate (e.g., BA, BS) ..........5
Graduate or professional school .................6
{ ASKED IF EVER MARRIED TO OR COHABITED WITH THIS PARTNER OR IF SHE IS
{ CURRENT OR THE MOST RECENT
PXMARBF
DE-3. (Has (PARTNER) ever been married/ At the time you and (PARTNER) (were married/started living together), had she been married before?
[HELP AVAILABLE]
Yes ......1
No .......5
{ ASKED IF NEVER MARRIED TO OR LIVED WITH THIS PARTNER AND SHE IS CURRENT
{ OR MOST RECENT
PXANYCH
DE-4. When your relationship with (PARTNER’S NAME) began, did she have any biological, adopted, or foster children?
Yes ..............1
No ...............5 (GO TO DE-6 PXABLECH)
{ ASKED IF NEVER MARRIED TO OR LIVED WITH THIS PARTNER AND SHE IS CURRENT
{ OR MOST RECENT AND SHE HAD CHILD/REN
PXANYCHN
DE-5. Altogether, how many children did she have?
Number of children __________
{ ASKED IF PARTNER IS CURRENT AND NO METHOD USE AT LAST SEX OR
{ METHOD WAS NOT FEMALE STERILIZATION
PXABLECH
DE-6. Some women are not physically able to have children. As far as you know, is it physically possible for (PARTNER’S NAME) to have a baby?
[HELP AVAILABLE]
Yes .................1
No ..................5
{ IF R HAD SEX WITH THIS PARTNER ONLY ONCE, GO TO SECTION DH
First Sex with Recent Partner (DF)
{ ASKED IF R HAD SEX WITH THIS WOMAN MORE THAN ONCE
PXSXFRST_M/PXSXFRST_Y
DF-1. Now I have some questions about the very first time that you had sexual intercourse with (PARTNER’S NAME).
[HELP AVAILABLE]
That very first time, in what month and year was that?
{ ASKED IF DATE OF FIRST SEX MISSING
PXAGFRST
DF-2. The very first time that you had sexual intercourse with (PARTNER’S NAME), how old were you?
[HELP AVAILABLE]
Age in years ____________
{ ASKED IF R HAD SEX WITH HER
{ MORE THAN ONCE
PXFRLTN2
DF-3. Please look at Card 44. At the time you first had sexual intercourse with (PARTNER’S NAME), how would you describe your relationship with her?
Married to her ..............................................1
Engaged to her, and living together..........................2
Engaged to her, but not living together......................3
Living together in a sexual relationship, but not engaged ...4
Going with her or going steady ..............................5
Going out with her once in a while ..........................6
Just friends ................................................7
Had just met her ............................................8
Something else...............................................9
{ ASKED IF R HAD SEX WITH THIS WOMAN MORE THAN ONCE
PXFUSE
DF-4. That first time that you had sexual intercourse with (PARTNER’S NAME), did you or she use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 45a for some examples of methods, before answering “yes” or “no.”
[HELP AVAILABLE]
Yes ..............1
No ...............5 (GO TO SECTION DG)
{ ASKED IF R HAD SEX WITH THIS WOMAN MORE THAN ONCE AND USED METHOD AT 1ST SEX
PXFMETH
DF-5. Looking at Card 45b, that first time, what methods did you and she use to prevent pregnancy or sexually transmitted disease?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber 1
Withdrawal or pulling out 2
Vasectomy or male sterilization 3
Pill 4
Tubal sterilization or other female sterilization 5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository .................7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period .........................................9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ IF NO SEX WITH THIS PARTNER IN LAST 12 MONTHS, GO TO SECTION DH
Methods Used in Past 12 Months (DG)
{ ASKED IF R HAD SEX WITH THIS PARTNER IN LAST 12 MONTHS AND HAD SEX MORE
{ THAN ONCE WITH PARTNER
DGINTRO
DG-0. Now I have some questions about methods that you and (PARTNER’S NAME) used in the past 12 months, that is since (INTERVIEW MONTH, INTERVIEW YEAR - 1), to prevent pregnancy or sexually transmitted disease.
(If you were not involved with her for the whole 12 months, please think of only that time that you were involved with her during the past 12 months.)
{ ASKED OF CURRENT OR MOST RECENT PARTNER AND IF CAN’T TELL IF THEY USED
{ A METHOD IN LAST 12 MONTHS
PXANYUSE
DG-1. During the past 12 months, did you or she use any methods to prevent pregnancy or sexually transmitted disease when you had intercourse together? Please answer yes if you used a method even once. Please look at Card 45a for some examples of methods, before answering “yes” or “no”.
[HELP AVAILABLE]
Yes ...............1
No ................5 (GO TO SECTION DH)
{ ASKED OF CURRENT OR MOST RECENT PARTNER IF USED ANY METHOD IN LAST 12 MONTHS
PXMETHOD
DG-2. Please look at Card 45b. Including any methods you may have already told me about and methods you may have used only once, during the past 12 months, which of these methods did you and she use to prevent pregnancy or sexually transmitted diseases?
[HELP AVAILABLE]
ENTER all that apply.
Condom or rubber 1
Withdrawal or pulling out .....................................2
Vasectomy or male sterilization ...............................3
Pill ..........................................................4
Tubal sterilization or other female sterilization .............5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository .................7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period .........................................9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ ASKED IF MORE THAN ONE METHOD USED IN THE LAST 12 MONTHS
PXMSTUSE
DG-3. During the past 12 months, when you had sex together which method did you and she use most of the time?
[HELP AVAILABLE]
{ DISPLAY ONLY METHODS REPORTED IN PXMETHOD DG-2
{ ASKED OF ALL WHO USED ANY METHOD IN 12 MONTHS EVEN IF CONDOM NOT LISTED
PXCONFRQ
DG-4. During the past 12 months, what percent of the times that you and she had sex together did you use a condom?
[HELP AVAILABLE]
Percent from 0 to 100 (IF 100%, GO TO SECTION DH)
{ ASKED OF ALL WHO USED ANY METHOD IN 12 MOS, EXCEPT 100% CONDOM USERS
PXNOFREQ
DG-5. Please look at Card 48. During the last 12 months, that is since (INTERVIEW MONTH, INTERVIEW YEAR - 1), how often did you or she use any method to prevent pregnancy or disease when you had sex together?
[HELP AVAILABLE]
Every time .........................1
Most of the time....................2
About half of the time .............3
Some of the time....................4
None of the time....................5
Biological Children with Recent Partner or Last Partner (DH)
{ ASKED OF ALL WHO HAD ANY SEXUAL PARTNER OTHER THAN THEIR CURRENT W/P
PXCHILD
DH-1. Now I have some questions about children that you and (PARTNER’S NAME) may have had together. By this I mean that you were the biological father and she was the biological mother.
(Have you and (PARTNER’S NAME) ever had / Did you and (PARTNER’S NAME) ever have) a child together?
Include all children R and his wife/partner have had together, regardless of whether they were married at the time or whether they are raising the child(ren) themselves or have placed the child(ren) for adoption.
Yes .............1
No ..............5 (GO TO SECTION DI)
PXCHILDN
DH-2. Altogether, how many children have you had together?
Number of children ________
[HELP AVAILABLE]
PXCXNAM
DH-3. What is the first name or initials of (this child/each of these children)?
Name/ initials __________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH CHILD
{ ASKED IF MORE THAN ONE CHILD
DHINTRO2
DH-4. Let’s talk about (CHILD)
PXCXSEX
DH-5. If necessary, ASK: (Is (CHILD) male or female?)
Male.................1
Female...............2
PXCXBORN_M/PXCXBORN_Y
DH-6. In what month and year was (CHILD) born?
{ ASKED IF DOB OF THIS CHILD = DOB OF CHILD DESCRIBED EARLIER
MULTBIRT
DH-7. The birthday of this child is the same as (ANOTHER CHILD’S NAME). Was this a multiple birth?
Yes .........1
No ..........5
{ ASKED IF R MARRIED AND CAN’T TELL FROM DATES WHETHER MARRIAGE OR
{ CHILDBIRTH CAME FIRST
PXCXMARB
DH-8. Were you married to (PARTNER’S NAME) at the time of the birth?
[HELP AVAILABLE]
Yes ......1 (GO TO DH-11 PXCXLIV)
No .......5
{ ASKED IF COHABITING WITH THIS WOMAN OR (IF MARRIED) NOT MARRIED TO
{ HER AT CHILDBIRTH, BUT HAD PREMARITALLY COHABITED
PXCXRES
DH-9. Were you living together with (PARTNER’S NAME) at the time of the birth?
[HELP AVAILABLE]
Yes ......1 (GO TO DH-11 PXCXLIV)
No .......5
{ ASKED IF NOT MARRIED TO OR LIVING WITH WOMAN AT TIME OF BIRTH OR DK/RF
PXCXKNOW
DH-10. When did you find out that (PARTNER’S NAME) was pregnant? Was it during the pregnancy or after the child was born?
During the pregnancy..............1
After the child was born..........2
PXCXLIV
DH-11. Please look at Card 61. Where does [CHILD NAME] usually live now?
[HELP AVAILABLE]
ENTER all that apply.
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her mother .........................3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Placed for adoption or adopted ..............8
Placed in foster care .......................9
Someplace else ..............................10
RANGE CHECK: 1,7,8,9 CANNOT BE COMBINED WITH ANY OTHER RESPONSES.
{ IF CHILD IS ALIVE, BUT CHILD’S DATE OF BIRTH IS MISSING
PXCXAGE
DH-12. How old is [CHILD NAME] now? Is [he/she] less than 5 years old, 5 to 18 years old, or 19 years or older?
Less than 5 years old ..........1
5-18 years old .................2
19 years or older ..............3
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
PXCXSIG
DH-13a. Did you ever sign the application for [CHILD NAME]’s birth certificate or sign a statement that legally says you are [CHILD’S NAME]’s father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{
OR IN FOSTER CARE
PXCXCRT
DH-13b. Did you have to go to court to establish that you are [CHILD NAME]’s legal father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
PXCXGEN
DH-14. Were you legally identified by a blood test or other genetic test as [CHILD NAME]’s father?
Yes ........1
No .........5
{ IF RESPONDENT LIVES WITH CHILD, GO TO PXRWANT DH-18
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED, OR IN FOSTER CARE AND
{ R DIDN’T LIVE WITH CHILD AT BIRTH AND DOESN’T LIVE WITH CHILD NOW
PXCXEVER
DH-15. Did you ever live with [CHILD NAME]?
Yes ................1
No .................5
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED OR IN FOSTER CARE AND
{ DOESN’T LIVE WITH R NOW
PXCXFAR
DH-16. About how many miles away from here does [CHILD NAME] live?
Number of miles ___________
ENTER 0 if less than 1 mile
{ ASKED IF R CHILD IS < 19 AND R WAS MARRIED TO/LIVING WITH MOTHER
{ OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
PXWANT
DH-17. Please look at Card 58. Right before (PARTNER’S NAME) became pregnant with (CHILD’S NAME), did you, yourself, want to have a child at some time in the future?
[HELP AVAILABLE]
NOTE: If R says that he already had a child, SAY “Right before she became pregnant, did you, yourself, want to have another child at some time in the future?”
ENTER [Ctrl+D] if R insists
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO DH-19 PXHPYPG)
Definitely no .................4 (GO TO DH-19 PXHPYPG)
{ ASKED IF R CHILD IS < 19 AND R WAS MARRIED TO/LIVING WITH MOTHER
{ OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH AND R DEFINITELY OR PROBABLY
{ WANTED A CHILD
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
PXSOON
DH-18. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF THE PREGNANCY CAME TOO SOON.
{ R CAN ANSWER IN MONTHS OR YEARS
PXSOONN/PXSOONMY
DH-18a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
PXLATEN/ PXLATEMY
DH-18c. How much later than you wanted did the pregnancy occur?
Number and (Months/Years) __________
{ ASKED IF CHILD IS AGE 18 OR YOUNGER AND R WAS MARRIED
{ TO/LIVING WITH MOTHER OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
PXHPYPG
DH-19. Please look at Card 59. On this scale, a zero means that you were very unhappy about that pregnancy, and a ten means that you were very happy about that pregnancy. Tell me which number on the card best describes how you felt when you found out that (PARTNER’S NAME) was pregnant that time.
Number from 0 to 10
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT ANOTHER CHILD, IF ANY
Current Pregnancy (DI)
{ IF PARTNER STERILE, GO TO END OF SECTION DI
{ ASKED IF PARTNER IS CURRENT, IS ABLE TO HAVE CHILDREN (OR DK/RF),
{ HAD SEX WITH R IN LAST YEAR, AND DID NOT USE “TUBAL” AT LAST SEX
PXCPREG
DI-1. Is (PARTNER’S NAME) pregnant with your child now?
Yes ..............1 (GO TO DI-4 PXRWANT)
No ...............5
PXTRYING
DI-2. Are you and (PARTNER’S NAME) currently trying to get pregnant?
Yes ..............1
No ...............5 (GO TO END OF SECTION DI)
PTRYLONG
DI-3. How long have you and she been trying to get pregnant?
Number of months (GO TO END OF SECTION DI)
PXRWANT
DI-4. Please look at Card 58. Right before (PARTNER’S NAME) became pregnant, did you, yourself, want to have a child at some time in the future?
If R says that he already had a child, SAY “Right before she became pregnant, did you, yourself, want to have another child at some time in the future?”
[HELP AVAILABLE]
ENTER [Ctrl+D] if R insists.
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO DI-6 PXCPFEEL)
Definitely no .................4 (GO TO DI-6 PXCPFEEL)
{ IF R DEFINITELY OR PROBABLY WANTED A CHILD
PXRSOON
DI-5. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF THE PREGNANCY CAME TOO SOON.
{ R CAN ANSWER IN MONTHS OR YEARS
PXRSOONN/PXRSOONMY
DI-5a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
PXRLATEN/PXRLATEMY
DI-5a. How much later than you wanted did the pregnancy occur?
Number and (Months/Years) __________
PXCPFEEL
DI-6. Please look the scale on Card 59. On this scale, a zero means that you were very unhappy about this pregnancy, and a ten means that you were very happy about this pregnancy. Please tell me which number on the card best describes how you felt when you found out that (PARTNER’S NAME) was pregnant this time.
Number from 0 to 10
{ IF R WAS NEVER MARRIED TO AND NEVER LIVED WITH THIS PARTNER,
{ GO TO SECTION DL
Other Children -- Former Wife/Partner’s Children from her Previous Relationships (former w/p’s who were also recent or last partners) (DJ)
{ ASKED IF R EVER MARRIED TO OR LIVED WITH THIS PARTNER AND SHE IS A RECENT PARTNER OR HIS LAST PARTNER
PXOTKID
DJ-1. Now I would like to ask you about any other children, whether biological, adopted, foster or legally guarded children, that (PARTNER’S NAME) may have had. Please be sure to include all of her children, even if they never lived with you.
When you began living with (PARTNER’S NAME), did she have any other children?
Yes ........1
No .........5 (GO TO SECTION DK)
{ ASKED IF THIS PARTNER HAD CHILDREN WHEN R BEGAN LIVING WITH HER
PXOKNUM
DJ-2. How many children did she have?
Number of children ___________
DJ-3. (Did this child/Did any of these children) ever live with you?
Yes ........1
No .........5 (GO TO SECTION DK)
{ ASKED IF THIS PARTNER HAD MORE THAN 1 CHILD WHEN R BEGAN LIVING WITH HER
PXOKWTHN
DJ-4. How many of these children lived with you?
Number of children ________
{ ASKED IF R EVER LIVED WITH ANY OF THIS WIFE/PARTNER’S CHILDREN
PXOKNAM
DJ-5. What is the first name or initials of (this child/each of these children/one of these children)?
Name/initials _____________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK FOR EACH CHILD WITH WHOM HE LIVED
PXOKSEX
DJ-6. (Thinking now of (CHILD’S NAME), is/Is) this child male or female?
Male ........1
Female ......2
PXOKAD
DJ-7. Did you legally adopt (CHILD’S NAME) or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .............. 1
Yes, became guardian ...... 3
No, neither ............... 5 (GO TO DJ-10 PXOKAGE)
{ ASKED IF R ADOPTED OR BECAME LEGAL GUARDIAN FOR THIS CHILD
PXOKLIV
DJ-8. Please look at Card 62. Where does this child usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her biological parent(s) ...........3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Someplace else ..............................8
RANGE CHECK: 1, 7 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASKED IF R ADOPTED OR BECAME LEGAL GUARDIAN FOR THIS CHILD,
{ THE CHILD IS NOT DECEASED, AND DOES NOT LIVE IN R’S HH
PXOKFAR
DJ-9. About how many miles away from here does (CHILD’S NAME) live?
Number of miles _____________
ENTER 0 if less than 1 mile
{ ASKED IF CHILD LIVED WITH R
PXOKAGE
DJ-10. How old is (CHILD’S NAME) now?
Age in years at last birthday ___________
ENTER 0 if less than 1 year
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY.
{ ELSE, IF NO MORE CHILDREN TO DISCUSS, GO TO SECTION DK.
Other Nonbiological Children (DK)
{ ASKED IF R EVER MARRIED TO OR LIVED WITH THIS WOMAN AND SHE IS A RECENT OR
{ HIS LAST PARTNER
PXNBEVR
DK-1. Besides any children that we may have talked about already, did you and this (wife/partner) ever have any other children live with you under your care and responsibility? Please do not include any of your biological children, your (wife/partner)’s biological children, or children from previous relationships.
If necessary, say: By this I mean that neither you nor your (wife/partner) are the child’s biological parents, but you served as a formal or informal guardian to the child or that you were chiefly responsible for the child’s care.
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO SECTION DL)
{ ASKED IF R AND PREVIOUS WIFE/PARTNER HAD OTHER CHILDREN LIVE WITH THEM
PXNBNUM
DK-2. How many children?
Number of children ________
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE/PARTNER’S CARE
PXNBNAM
DK-3. What is the first name or initials of (this child/each of these children)?
Name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK FOR EACH CHILD WITH WHOM HE LIVED
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE/PARTNER’S CARE
PXNBREL
DK-4. (Thinking now of (CHILD’S NAME), when/When) (CHILD’S NAME) began living with you, was he or she the child of a relative by blood or by marriage?
[HELP AVAILABLE]
Yes .......... 1
No ........... 5
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE/PARTNER’S CARE
PXNBFOS
DK-5. Was (CHILD’S NAME) a foster or related child who was placed in your home by a court, child welfare department, or social service agency?
[HELP AVAILABLE]
Yes .............. 1
No ............... 5
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE/PARTNER’S CARE
PXNBSEX
DK-6. Is (CHILD’S NAME) male or female?
Male ..........1
Female ........2
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE/PARTNER’S CARE
PXNBAD
DK-7. Did you legally adopt (CHILD’S NAME) or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
Yes, adopted .........1
Yes, became guardian..3
No, neither...........5
{ ASKED IF R ADOPTED THIS CHILD OR BECAME THIS CHILD’S LEGAL GUARDIAN
PXNBLIV
DK-8. Please look at Card 62. Where does (CHILD’S NAME) usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her biological parent(s)............3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Someplace else ..............................8
RANGE CHECK: 1, 7 CANNOT BE COMBINED WITH ANY OTHER ANSWERS
{ ASK IF ADOPTED OR LEGALLY GUARDED CHILD IS NOT DECEASED AND NOT IN R’s HH PXNBFAR
DK-9. About how many miles away from here does (CHILD’S NAME) live?
Number of miles ______________
ENTER 0 if less than 1 mile
{ ASKED IF CHILD LIVED WITH R
PXNBAGE
DK-10. How old is (CHILD’S NAME) now?
Age in years at last birthday ___________
ENTER 0 if less than 1 year
ENTER [96] if R volunteers that child is deceased
{ IF ANOTHER CHILD TO DESCRIBE, RETURN TO DK-4 PKNBREL.
{ ELSE, IF NO MORE CHILDREN, RETURN TO BEGINNING OF SECTION D TO DISCUSS NEXT
{ PARTNER.
{ ELSE, IF NO MORE PARTNERS TO DISCUSS, GO TO SECTION DL.
First sex ever (DL)
{ IF FIRST PARTNER ALREADY DISCUSSED, GO TO END OF SECTION D
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPFIRST_M/FPFIRST_Y
DL-1. The next section is about your first sexual experience with a female.
[HELP AVAILABLE]
Please think back to the very first time in your life that you ever had sexual intercourse with a female. In what month and year was that?
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPAGE
DL-2. That very first time that you had sexual intercourse with a female, how old were you?
[HELP AVAILABLE]
Age in years (GO TO FPNAME DL-6)
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER AND R DOESN’T
{ KNOW HIS AGE AT FIRST SEX
FPAGE18
DL-3. Were you less than 18 or were you 18 years old or older?
Less than 18.........1
18 years or older....2 (GO TO FPAGE20 DL-5)
FPAGE15
DL-4. Were you less than 15 or were you 15 years old or older?
Less than 15 ...........1 (GO TO FPNAME DL-6)
15 years or older ......2 (GO TO FPNAME DL-6)
FPAGE20
DL-5. Were you less than 20 or were you 20 years old or older?
Less than 20 ...........1
20 years or older ......2
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPNAME
DL-6. Please tell me the name or initials of your first sexual partner so that I can refer to her during the interview.
Name or initials __________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPPAGE
DL-7. How old was (FPNAME/your first partner) when you had sexual intercourse with her that first time?
[HELP AVAILABLE]
Age in years (GO TO FPRLTN DL-10)
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER AND R DOESN’T
{ KNOW HER AGE AT FIRST SEX
FPRELAGE
DL-8. Was she older than you, younger than you or the same age?
Older ............1
Younger ..........2
About same age ...3 (GO TO FPRLTN DL-10)
FPRELYRS
DL-9. By how many years?
1-2 years.............1
3-5 years.............2
6-10 years............3
More than 10 years....4
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPRLTN
DL-10. Please look at Card 44. At the time you first had sexual intercourse with (FPNAME/your first partner), how would you describe your relationship with her?
Married to her ..............................................1
Engaged to her, and living together..........................2
Engaged to her, but not living together......................3
Living together in a sexual relationship, but not engaged ...4
Going with her or going steady ..............................5
Going out with her once in a while ..........................6
Just friends ................................................7
Had just met her ............................................8
Something else...............................................9
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER
FPUSE
DL-11. That first time that you had sexual intercourse with (FPNAME/your first partner), did you or she use any methods to prevent pregnancy or sexually transmitted disease? Please look at Card 45a for some examples of methods, before answering “yes” or “no.”
[HELP AVAILABLE]
Yes ..............1
No ...............5 (GO TO DL-13 FPPROBE)
{ ASKED IF VERY FIRST SEX PARTNER WAS NOT A RECENT PARTNER AND METHOD
{ USED AT FIRST SEX
FPMETH
DL-12. Looking at Card 45b, that first time, what methods did you and she use to prevent pregnancy or sexually transmitted disease?
[HELP AVAILABLE]
ENTER all that apply
Condom or rubber 1
Withdrawal or pulling out .....................................2
Vasectomy or male sterilization ...............................3
Pill ..........................................................4
Tubal sterilization or other female sterilization .............5
Injection (Depo-ProveraTM or LunelleTM) 6
Spermicidal foam/jelly/cream/film/suppository .................7
Hormonal implant (NorplantTM or ImplanonTM) 8
Rhythm or safe period .........................................9
Contraceptive patch (Ortho-EvraTM) 10
Vaginal contraceptive ring (Nuva RingTM) 11
IUD, coil, loop 12
Something else 13
{ ASKED IF NO METHOD USED OR ONLY MALE METHOD USED AT FIRST SEX
FPPROBE
DL-13. That first time, could (FPNAME/she) have used a method that you didn’t know about?
Do not probe a DK response
Yes ............1
No .............5
{ IF NEVER MARRIED OR COHABITED, GO TO SECTION F.
SECTION E
FORMER WIVES AND FIRST COHABITING PARTNER
Enumeration of former wives and first cohabiting partner (EA)
{ IF NO FORMER WIVES OR FIRST COHABITING PARTNER TO DISCUSS HERE,
{ GO TO SECTION F
{ ASKED IF R HAS AT LEAST ONE FORMER WIFE AND/OR ONE FORMER COHAB
EAINTRO1
EA-0. You’ve said that you have been married to one woman. In this section, I’ll ask you about your former wife.
{ THIS INTRO HAS MANY OTHER VARIANTS BASED ON THE NUMBER OF FORMER WIVES OR
{ COHABITING PARTNERS R HAS HAD.
{ IF R HAS HAD MORE THAN 1 FORMER COHABITING PARTNER, HE WILL BE ASKED ONLY
{ ABOUT THE FIRST ONE.
{ ASKED IF R HAS AT LEAST ONE FORMER WIFE
FWNAME[X]
EA-1. So that I can refer to her in the interview, please tell me the first name or initials of your (former wife / wife / (first/second/third/etc) wife).
Name/ initials (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ ASKED IF R WAS MARRIED TO AT LEAST ONE OF HIS 3 MOST RECENT PARTNERS REPORTED IN SECTION B
FWVERIFY[X]
EA-2. I need to check whether we’ve already talked about (WIFE). We talked about (your recent / some of your recent) sexual partners, that is, women you had sex with in the past 12 months. Is (WIFE) one of your recent sexual partners that we already talked about?
Yes ............1
No .............5
{ ASKED IF R HAS AT LEAST ONE FORMER COHABITING PARTNER
FCNAME
EA-3. You may have already told me this, but please tell me the first name or initials of (first of the other women / other woman / first of the women / woman) you lived with.
Name or initials
{ ASKED IF R HAS R HAS AT LEAST ONE FORMER COHABITING PARTNER and COHABITED WITH ANY OF HIS 3 MOST RECENT PARTNERS IN THE LAST 12 MONTHS REPORTED IN SECTION B
FCVERIFY
EA-4. I need to check whether we’ve already talked about (PARTNER). We talked about (your recent / some of your recent) sexual partners, that is, women you had sex with in the past 12 months. Is (PARTNER) one of your recent sexual partners that we already talked about?
Yes ............1 (GO TO SECTION F)
No .............5
{ IF THERE ARE ANY FORMER WIVES OR FIRST COHABITING PARTNER TO DISCUSS HERE
{ IN SECTION E, CONTINUE; ELSE GO TO SECTION F.
Key Dates for Former Wives & First Cohabiting Partner (EB)
EBINTRO
EB-1. Now I’ll ask you about your relationship with (WIFE/PARTNER).
{ ASKED IF R WAS EVER MARRIED TO THIS WOMAN
FWMAREND_M/FWMAREND_Y
EB-2. In what month and year were you and she married?
[HELP AVAILABLE]
{ ASKED IF R EVER MARRIED TO THIS WOMAN BUT MARRIAGE DATE = DK/RF
AGEMARRN
EB-3. How old were you when you and (WIFE/PARTNER) got married?
Age in years _______
{ ASKED IF R EVER MARRIED TO THIS WOMAN
LIVTOGN
EB-4. Some couples live together without being married. By living together, we mean having a sexual relationship while sharing the same usual address. Did you and (WIFE/PARTNER) live together before you got married?
[HELP AVAILABLE]
Yes ........1
No .........5 (GO TO EB-8 MARREND)
{ ASKED IF R EVER COHABITED WITH THIS WOMAN
STRTLIVE_M/STRTLIVE_Y
EB-5. In what month and year did you and she first start living together?
[HELP AVAILABLE]
{ ASKED IF R EVER COHABITED WITH THIS WOMAN, BUT START DATE = DK/RF
AGELIV
EB-6. How old were you when you and (WIFE/PARTNER) first started living together?
Age in years ________
{ COMPARE DATES OF FIRST MARRIAGE AND FIRST COHABITATION. IF RESPONDENT NEVER
{ MARRIED OR IF FIRST COHABITATION CAME BEFORE FIRST MARRIAGE, GO TO ENGAGTHN
{ EB-7. ELSE, IF FIRST COHABITATION CAME AFTER FIRST MARRIAGE, GO TO SECTION
{ F. ELSE, IF CAN’T TELL, ASK FSTUNION EB-6a.
{ ASKED IF R EVER COHABITED WITH THIS WOMAN
ENGAGTHN
EB-7. At the time you first started living together, were you and she engaged to be married or did you have definite plans to get married?
ENTER [1] if R both engaged and had definite plans to get married
Yes, engaged to be married ...........................1
Not engaged but had definite plans to get married ....3
No, neither engaged nor had definite plans ...........5
{ IF NEVER MARRIED TO THIS WOMAN, GO TO STOPLIVE EB-12
{ ASKED IF R EVER MARRIED TO THIS WOMAN
MARREND
EB-8. How did your marriage end?
[HELP AVAILABLE]
Death of wife ..........1
Divorce ................2 (GO TO EB-10 DIVORFIN)
Annulment ..............3 (GO TO EB-11 ANNULLED)
Separation .............4 (GO TO EB-12 STOPLIVE)
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY HER DEATH
WIFEDIED_M/WIFEDIED_Y
EB-9. In what month and year did (WIFE/PARTNER) die?
ENTER DATE, THEN GO TO EC SERIES
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY DIVORCE
DIVORFIN_M/DIVORFIN_Y
EB-10. In what month and year did your divorce become final?
[HELP AVAILABLE]
ENTER DATE, THEN GO TO STOPLIVE EB_12
{ ASKED IF R EVER MARRIED TO THIS WOMAN AND MARRIAGE ENDED BY ANNULMENT
ANNULLED_M/ANNULLED_Y
EB-11. In what month and year did your annulment take place?
{ ASKED IF [R EVER MARRIED TO THIS WOMAN AND [[MARRIAGE ENDED IN DIVORCE OR
{ ANNULMENT] OR [R IS CURRENTLY SEPARATED FROM HER]]] OR IF R NEVER MARRIED
{ TO THIS WOMAN BUT DID COHABIT WITH HER
STOPLIVE_M/STOPLIVE_Y
EB-12. In what month and year did you and (WIFE/PARTNER) last stop living together?
[HELP AVAILABLE]
Characteristics Wife/Partner (EC)
{ ASKED IF R EVER MARRIED TO OR LIVED WITH THIS WOMAN
FWPDOB_M/FWPDOB_Y
EC-1. Now I have some more questions about (WIFE/PARTNER).
In what month and year was she born?
{ ASKED IF R EVER MARRIED TO OR LIVED WITH THIS WOMAN AND
{ HER BIRTH DATE = DK/RF
FWPAGE
EC-2. How old was (WIFE/PARTNER) when (she died/ your divorce became final/your annulment took place/ you and she last stopped living together)?
Age in years ________
{ ASKED IF THIS WOMAN WAS R’s FIRST WIFE OR COHABITING PARTNER
FWPHISP
EC-3. (Was/Is (WIFE/PARTNER) Hispanic or Latino, or of Spanish origin)?
Yes ....1
No .....5
{ ASKED IF THIS WOMAN WAS R’s FIRST WIFE OR COHABITING PARTNER
FWPRACE
EC-4. Which of the groups shown on Card 2 describes (WIFE/PARTNER)’s racial background? Please select one or more groups.
[HELP AVAILABLE]
ENTER all that apply.
NOTE: If the respondent mentions a mixture of multiple races (e.g. biracial, mixed, mulatto), PROBE for and CODE all racial groups that are part of the mix.
American Indian or Alaska Native ...............1
Asian ..........................................2
Native Hawaiian or Other Pacific Islander ......3
Black or African American ......................4
White ..........................................5
{ ASKED IF THIS WOMAN WAS R’s FIRST WIFE OR COHABITING PARTNER AND MORE THAN
{ ONE RACE GROUP MENTIONED
FWPRACEB
EC-5. Which of these groups, that is (RESPONSES IN FWPRACE), would you say best describes your (WIFE/PARTNER)’s racial background?
[HELP AVAILABLE]
{DISPLAY ONLY CATEGORIES MENTIONED FROM FWPRACE EC-4
{ ASKED IF R EVER MARRIED TO OR LIVED WITH THIS WOMAN
FWPMARBF
EC-6. At the time you and she (were married/ started living together), had she ever been married (before)?
[HELP AVAILABLE]
Yes ......1
No .......5
Biological Children with Former Wife/Cohabiting Partner (ED)
{ ASKED OF ALL WHO HAVE A FORMER WIFE OR COHABITING PARTNER COVERED IN SECTION E
FWPBIOKID
ED-1. Now I have some questions about children that you and (WIFE/PARTNER) may have had together. By this I mean that you were the biological father and she was the biological mother.
Did you and (WIFE/PARTNER) ever have a child together?
Include all children R and his former wife/partner had together, regardless of whether they were married at the time or whether they raised the child(ren) themselves or placed the child(ren) for adoption.
Yes ......1
No .......5 (GO TO SECTION EE)
{ ASKED IF THEY HAD CHILD/REN
FWPNUMKD
ED-2. Altogether, how many children did you have together?
[HELP AVAILABLE]
Number of children ________
{ ASKED IF THEY HAD CHILD/REN
FWPCHNAM
ED-3. What is the first name or initials of (this child/each of these children)?
Name or initials ____________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{SET UP LOOP TO ASK ABOUT EACH CHILD
{ ASKED IF MORE THAN ONE CHILD
EDINTRO2
ED-4. Let’s talk about (CHILD NAME).
FWPCHSEX
ED-5. If necessary, ASK: (Is (CHILD) male or female?)
Male ......1
Female ....2
FWPCHDOB_MO/FWPCHDOB_YR
ED-6. In what month and year was (CHILD) born?
{ ASKED IF BIRTHDAY OF THIS CHILD IS SAME AS PREVIOUSLY MENTIONED CHILD
MULTBIRT
ED-7. The birthday of this child is the same as (ANOTHER CHILD’S NAME), was this a multiple birth?
Yes ................1 (GO TO ED-11 FWPCHLIV)
No .................5
{ ASKED IF THEY WERE MARRIED AND CAN’T TELL FROM DATES WHETHER MARRIAGE OR
{ CHILDBIRTH CAME FIRST
FWCHMARB
ED-8. Were you married to (WIFE/PARTNER) at the time of the birth?
[HELP AVAILABLE]
Yes ......1 (GO TO ED-11 FWPCHLIV)
No .......5
{ ASKED IF COHABITED WITH THIS WOMAN OR (IF MARRIED) NOT MARRIED TO
{ HER AT CHILDBIRTH, BUT HAD PREMARITALLY COHABITED
FWPCHRES
ED-9. Were you living together with (WIFE/PARTNER) at the time of the birth?
[HELP AVAILABLE]
Yes ......1 (GO TO ED-11 FWPCHLIV)
No .......5
{ ASKED IF NOT MARRIED TO OR LIVING WITH WOMAN AT TIME OF BIRTH OR DK/RF
FWPCHLRN
ED-10. When did you find out that (WIFE/PARTNER) was pregnant? Was it during the pregnancy or after the child was born?
During the pregnancy ............1
After the child was born ........2
{ ASKED ABOUT ALL CHILDREN
FWPCHLIV
ED-11. Please look at Card 61. Where does (CHILD) usually live now?
[HELP AVAILABLE]
ENTER all that apply.
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her mother .........................3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Placed for adoption or adopted ..............8
Placed in foster care .......................9
Someplace else ..............................10
{ ASKED IF CHILD IS ALIVE AND CHILD’S DATE OF BIRTH IS MISSING
FWPCHAGE
ED-12. How old is (CHILD NAME) now? Is [he/she] less than 5 years old, 5 to 18 years old, or 19 years or older?
Less than 5 years old ..........1
5-18 years old .................2
19 years or older ..............3
{ ASKED IF CHILD < 19 YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
FWPCHSIG
ED-13a. Did you ever sign the application for {CHILD’S NAME}’s birth certificate or sign a statement that legally says you are {CHILD’S NAME}’s father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
FWPCHCRT
ED-13b. Did you have to go to court to establish that you are {CHILD’S NAME}’s legal father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19YEARS AND BORN OUT OF WEDLOCK, BUT NOT DEAD, ADOPTED,
{ OR IN FOSTER CARE
FWPCHGEN
ED-14. Were you legally identified by a blood test or other genetic test as {CHILD’S NAME}’s father?
Yes ........1
No .........5
{ IF RESPONDENT LIVES WITH CHILD, GO TO FWPRWANT ED-18
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED, OR IN FOSTER CARE AND
{ R DIDN’T LIVE WITH CHILD AT BIRTH AND DOESN’T LIVE WITH CHILD NOW
FWPCHEVR
ED-15. Did you ever live with (CHILD)?
Yes ....1
No .....5
{ ASKED IF CHILD <19 AND NOT DEAD, ADOPTED OR IN FOSTER CARE AND
{ DOESN’T LIVE WITH R NOW
FWPCHFAR
ED-16. About how many miles away from here does (child) live?
Number of miles _____________
ENTER 0 if less than 1 mile
{ ASKED IF R CHILD LE 18 AND R WAS MARRIED TO/LIVING WITH MOTHER
{ OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH;
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
FWPRWANT
ED-17. Please look at Card 58. Right before (WIFE/PARTNER) became pregnant with (CHILD’S NAME), did you, yourself, want to have a child at some time in the future?
[HELP AVAILABLE]
NOTE: If R says that he already had a child, SAY Right before she became pregnant, did you, yourself, want to have another child at some time in the future?
ENTER [Ctrl+D] if R insists.
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO ED-19 FWPHPYPG)
Definitely no .................4 (GO TO ED-19 FWPHPYPG)
{ ASKED IF R CHILD < 19 AND R WAS MARRIED TO/LIVING WITH MOTHER
{ OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH AND R DEFINITELY OR
{ PROBABLY WANTED A CHILD
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
FWPSOON
ED-18. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF THE PREGNANCY CAME TOO SOON
{ R CAN ANSWER IN MONTHS OR YEARS.
FWPSOONN/FWPSOONMY
ED-18a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
FWPLATEN/ FWPLATEMY
ED-18c. How much later than you wanted did the pregnancy occur?
Number and (Months/Years) __________
{ ASKED IF CHILD IS AGE 18 OR YOUNGER AND R WAS MARRIED
{ TO/LIVING WITH MOTHER OR KNEW ABOUT PREGNANCY BEFORE THE BIRTH
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
FWPHPYPG
ED-19. Please look at Card 59. On this scale, a zero means that you were very unhappy about that pregnancy, and a ten means that you were very happy about that pregnancy. Tell me which number on the card best describes how you felt when you found out that (WIFE/PARTNER) was pregnant that time.
Number from 0 to 10
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY
Other Children -- Former Wife/Partner’s Children (EE)
{ ASKED IF INFORMATION ABOUT THIS FORMER WIFE OR THE 1ST COHABITING
{ PARTNER NOT COLLECTED IN PREVIOUS SECTIONS
FWPOTKID
EE-1. Now I would like to ask you about any other children, whether biological, adopted, foster or legally guarded children, that (WIFE/PARTNER) may have had. Please be sure to include all of her children, even if they never lived with you.
When you began living with (WIFE/PARTNER), did she have any other children?
Yes ........1
No .........5 (GO TO SECTION EF)
{ ASKED IF THIS WIFE/PARTNER HAD CHILDREN WHEN R BEGAN LIVING WITH HER
FWPOKNUM
EE-2. How many children did she have?
Number of children __________
{ ASKED IF THIS WIFE/PARTNER HAD CHILDREN WHEN R BEGAN LIVING WITH HER
FWPOKWTH
EE-3. (Did this child/Did any of these children) ever live with you?
Yes ........1
No .........5 (GO TO SECTION EF)
{ ASKED IF THIS WIFE/PARTNER HAD MORE THAN 1 CHILD WHEN R BEGAN LIVING
{ WITH HER
FWPOKWTHN
EE-4. How many of these children lived with you?
Number of children ________
{ SET UP LOOP TO ASK FOR EACH CHILD WITH WHOM HE LIVED
{ ASKED IF R LIVED EVER WITH ANY OF THIS WIFE/1st COHABITING PARTNER’S
{ CHILDREN
FWPOKNAM
EE-5. What is the first name or initials of (this child/each of these children/one of these children)?
Name/ initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ ASKED FOR EACH CHILD OF R’S FORMER WIFE/PARTNER WHO LIVED WITH HIM
FWPOKSEX
EE-6. (Thinking now of (CHILD’S NAME), is/Is) this child male or female?
Male ........1
Female ......2
FWPOKAD
EE-7. Did you legally adopt (CHILD’S NAME) or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .............. 1
Yes, became guardian ...... 3
No, neither ............... 5 (GO TO FWPOKAGE)
{ ASKED IF R ADOPTED OR BECAME LEGAL GUARDIAN FOR THIS CHILD
FWPOKLIV
EE-8. Please look at Card 62. Where does this child usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her biological parent(s)............3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Someplace else ..............................8
RANGE CHECK: 1, 7 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASKED IF R ADOPTED OR BECAME LEGAL GUARDIAN FOR THIS CHILD,
{ THE CHILD IS NOT DECEASED, AND CHILD DOES NOT LIVE IN R’s HH
FWPOKFAR
EE-9. About how many miles away from here does (CHILD’S NAME) live?
Number of miles _______
ENTER 0 if less than 1 mile
{ ASKED IF CHILD LIVED WITH R
FWPOKAGE
EE-10. How old is (CHILD’S NAME) now?
Age in years at last birthday __________
ENTER 0 if less than 1 year old.
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY
Other Nonbiological Children (EF)
FWPNBEVR
EF-1. Besides any children that we may have talked about already, did you and (WIFE/PARTNER) ever have any other children live with you under your care and responsibility? Please do not include any of your biological children, (WIFE/PARTNER)’s biological children, or children from previous relationships.
[HELP AVAILABLE]
IF NECESSARY, SAY: By this I mean that neither you nor (WIFE/PARTNER) are the child’s biological parents, but you served as a formal or informal guardian to the child or that you were chiefly responsible for the child's care.
Yes ........1
No .........5 (GO TO SECTION F)
FWPNBNUM
EF-2. How many children?
Number of children ___________
FWPNBNAM
EF-3. What is the first name or initials of (this child/each of these children)?
Name/ initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH CHILD WITH WHOM HE LIVED
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE’S CARE
FWPNBREL
EF-4. When (CHILD’S NAME) began living with you, was he or she the child of a relative by blood or by marriage?
[HELP AVAILABLE]
Yes .......... 1
No ........... 5
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE’S CARE
FWPNBFOS
EF-5. Was (CHILD’S NAME) a foster or related child who was placed in your home by a court, child welfare department, or social service agency?
[HELP AVAILABLE]
Yes .............. 1
No ............... 5
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE’S CARE
FWPNBSEX
EF-6. Is (CHILD’S NAME) male or female?
Male ..........1
Female ........2
{ ASKED FOR EVERY CHILD UNDER R’S AND PREVIOUS WIFE’S CARE
FWPNBAD
EF-7. Did you legally adopt (CHILD’S NAME) or become (CHILD’S NAME) legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .........1
Yes, became guardian..3
No, neither...........5
{ ASKED IF R ADOPTED THIS CHILD OR BECAME THIS CHILD’S LEGAL GUARDIAN
FWPNBLIV
EF-8. Please look at Card 62. Where does (CHILD’S NAME) usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her biological parent(s) ...........3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Someplace else ..............................8
RANGE CHECK: 1,7 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASKED IF ADOPTED OR LEGALLY GUARDED CHILD IS NOT DECEASED AND NOT IN R’s HH
FWPNBFAR
EF-9. About how many miles away from here does (CHILD’S NAME) live?
Number of miles ____________
ENTER 0 if less than 1 mile
{ ASKED IF CHILD LIVED WITH R
FWPNBAGE
EF-10. How old is (CHILD’S NAME) now?
Age in years _________
ENTER 0 if less than 1 year old.
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO DISCUSS NEXT CHILD, IF ANY.
{ ELSE, RETURN TO BEGINNING OF SECTION EB TO DISCUSS NEXT FORMER WIFE OR
{ COHABITING PARTNER, IF ANY.
{ ELSE, IF NO OTHER FORMER WIFE OR COHABITING PARTNER TO DISCUSS, GO TO
{ SECTION F
SECTION F
OTHER BIOLOGICAL CHILDREN, OTHER ADOPTED CHILDREN, OTHER PREGNANCIES
{ IF ALL SEXUAL PARTNERS OF THE RESPONDENT HAVE BEEN DISCUSSED ALREADY AND:
{ AGE < 18, GO TO SECTION FC
{ AGE >= 18, GO TO SECTION FB
{ IF NEVER HAD SEX AND:
{ AGE < 18 GO TO SECTION H
{ AGE >=18 GO TO SECTION FB
Other biological children with nonmarital partners (FA)
{ ASKED IF R HAS HAD SEX AND HAS MORE SEXUAL PARTNERS THAN HAVE BEEN { DISCUSSED IN SECTIONS C-E
OTBCHIL
FA-1. Now, I would like to ask you about (other) biological children you may have had with any other sexual partners you never married. (Not counting any children we already talked about, as/As) far as you know, have you had any other biological children?
Yes ............1
No .............5 (GO TO FA-2 OTBPROBE)
{ ASKED IF OTBCHIL=NO OR DK/RF
OTBPROBE
FA-2. Could you have fathered a child with a sexual partner and you didn’t know about it?
Yes ............1 (GO TO SECTION FB)
No .............5 (GO TO SECTION FB)
{ ASKED IF R HAS HAD CHILDREN WITH OTHER SEXUAL PARTNERSOTBCHILN
FA-3. How many (biological/ other biological) children have you had?
Number of children __________
OTBCHNAM
FA-4. What is the first name or initials of (this child/each of these children)?
Child’s name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ ASKED IF MORE THAN ONE CHILD REPORTED
OTBSAME
FA-5. Do these children have the same biological mother?
Yes............1
No.............5
OTBMOMX
FA-6. What is the first name or initials of (CHILD’S NAME /THEIR) biological mother?
Mother’s name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH CHILD
DISPLAY FOR INTERVIEWER:
These children are displayed for the interviewer’s reference only.
[CHILD’s NAME} is the child of [MOTHER’s NAME]
FAINTRO
FA-7. Let’s talk about (CHILD’S NAME)
OBCSEXX
FA-8. If necessary, ASK: (Is (CHILD’S NAME) male or female?)
Male.............1
Female...........2
OBCDOB_M/OBCDOB_Y
FA-9. In what month and year was (CHILD’S NAME) born?
{ ASKED IF BIRTHDAY OF THIS CHILD SAME AS PREVIOUS CHILD
MULTBIRT
FA-10. The birthday of this child is the same as (ANOTHER CHILD’S NAME). Was this a multiple birth?
Yes ............1 (GO TO FA-12 OBCLIVE)
No .............5
OBCMAGEX
FA-11. When (CHILD’S NAME) was born, how old was (MOTHER’S NAME)?
Age in years __________
OBCMLIV
FA-12. Were you living together with (MOTHER’S NAME) at the time of the birth?
[HELP AVAILABLE]
Yes ........1 (GO TO FA-14 OBCLIVEX)
No .........5
{ ASKED IF NOT LIVING WITH WOMAN AT TIME OF BIRTH
OBCKNOWX
FA-13. When did you find out that (MOTHER’S NAME) was pregnant? Was it during the pregnancy or after the child was born?
During the pregnancy.........1
After the child was born.....2
{ ASKED ABOUT ALL CHILDREN
OBCLIVEX
FA-14. Please look at Card 61. Where does (CHILD’S NAME) usually live now?
[HELP AVAILABLE]
ENTER all that apply.
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her mother .........................3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Placed for adoption or adopted ..............8
Placed in foster care .......................9
Someplace else ..............................10
RANGE CHECK: 1,7,8,9 CANNOT BE COMBINED WITH ANY OTHER RESPONSES.
{ ASKED IF CHILD ALIVE AND CHILD’S DATE OF BIRTH MISSING
OBCAGE
FA-15. How old is (CHILD’S NAME) now? Is [he/she] less than 5 years old, 5 to 18 years old, or 19 years or older?
Less than 5 years old ..........1
5-18 years old .................2
19 years or older ..............3
{ ASKED IF CHILD < 19 YEARS AND BUT NOT DEAD, ADOPTED, OR IN FOSTER CARE
OBCCHSIG
FA-16a. Did you ever sign the application for {CHILD’S NAME}’s birth certificate or sign a statement that legally says you are {CHILD’S NAME}’s father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS AND BUT NOT DEAD, ADOPTED, OR IN FOSTER CARE
OBCCHCRT
FA-16b. Did you have to go to court to establish that you are {CHILD’S NAME}’s legal father?
Yes ........1
No .........5
{ ASKED IF CHILD < 19 YEARS BUT NOT DEAD, ADOPTED, OR IN FOSTER CARE
OBCCHGEN
FA-17. Were you legally identified by a blood test or other genetic test as {CHILD’S NAME}’s father?
Yes ........1
No .........5
{ IF RESPONDENT LIVES WITH CHILD, GO TO OBCRWANX FA-21
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED, OR IN FOSTER CARE AND
{ DOESN’T LIVE WITH R NOW
OBCEVER
FA-18. Did you ever live with (CHILD’S NAME)?
Yes...............1
No................5
{ ASKED IF CHILD < 19 AND NOT DEAD, ADOPTED OR IN FOSTER CARE AND
{ DOESN’T LIVE WITH R NOW
OBCFAR
FA-19. About how many miles away from here does (CHILD’S NAME) live?
Number of miles _____________
ENTER 0 if less than 1 mile
{ ASKED IF R CHILD IS < 19 AND R WAS LIVING WITH MOTHER OR KNEW ABOUT
{ PREGNANCY BEFORE THE BIRTH;
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
OBCRWANX
FA-20. Please look at Card 58. Right before (PARTNER) became pregnant with (CHILD’S NAME), did you, yourself, want to have a child at some time in the future?
[HELP AVAILABLE]
If R insists he does not know, enter [Ctrl] + [D]”
NOTE: If R says that he already had a child, SAY: Right before she became pregnant, did you, yourself, want to have another child at some time in the future?
Definitely yes ................1
Probably yes ..................2
Probably no ...................3 (GO TO FA-22 OBCHPYX)
Definitely no .................4 (GO TO FA-22 OBCHPYX)
{ ASKED IF R CHILD IS < 19 AND R WAS LIVING WITH MOTHER OR KNEW ABOUT
{ PREGNANCY BEFORE THE BIRTH AND R DEFINITELY OR PROBABLY WANTED A CHILD;
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
OBCSOONX
FA-21. Would you say that the pregnancy came sooner than you wanted, at about the right time, or later than you wanted?
[HELP AVAILABLE]
Too soon ......................1
Right time ....................2
Later .........................3
Didn’t care ...................4
{ ASKED IF THE PREGNANCY CAME TOO SOON
{ R CAN ANSWER IN MONTHS OR YEARS
OBCSOONN/OBCSOONMY
FA-21a. How much sooner than you wanted did the pregnancy occur?
Number and (Month/years) __________
{ ASKED IF THE PREGNANCY CAME LATER THAN WANTED
{ R CAN ANSWER IN MONTHS OR YEARS
OBCLATEN/OBCLATEMY
FA-21c. How much later than you wanted did the pregnancy occur?
Number and (Months/Years)________
{ ASKED IF R CHILD IS < 19 AND R WAS LIVING WITH MOTHER OR
{ KNEW ABOUT PREGNANCY BEFORE THE BIRTH;
{ ASKED EVEN IF CHILD IS DEAD, ADOPTED, IN FOSTER CARE
OBCHPYX
FA-22. Please look at Card 59. On this scale, a zero means that you were very unhappy about that pregnancy, and a ten means that you were very happy about that pregnancy. Tell me which number on the card best describes how you felt when you found out that (MOTHER’S NAME) was pregnant that time.
Number from 0 to 10
{ RETURN TO BEGINNING OF LOOP TO DISCUSS NEXT CHILD, IF ANY
Other Nonbiological Children (FB)
{ ASKED OF Rs 18 AND OLDER
OTACHIL
FB-1. The next question is about (children/ other children) who may have lived with you under your care and responsibility, but you were not their biological father. By this I mean that you served as a formal or informal guardian to the child or that you were chiefly responsible for the child’s care.
[HELP AVAILABLE]
(Besides any children that we may have talked about already, have/Have) you ever had any (children/other children) like this under your care and responsibility?
Yes ..............1
No ...............5 (GO TO SECTION FC)
OTACHILN
FB-2. (Besides any children that we may have talked about already, how/How) many (children/other children), who were not your biological children, have ever lived with you under your care and responsibility?
Number of children __________
OTNBNAM
FB-3. What is the first name or initials of (this child/each of these children)?
Child’s name/initials ___________ (NO NAMES OR INITIALS ARE PLACED ON THE FINAL DATA FILE.)
{ SET UP LOOP TO ASK ABOUT EACH NAMED CHILD
{ ASKED FOR EVERY CHILD UNDER R’S CARE
OTNBREL
FB-4. (Thinking now of (CHILD’S NAME), when/When) (CHILD’S NAME) began living with you, was he or she the child of a relative by blood or by marriage?
[HELP AVAILABLE]
Yes .......... 1
No ........... 5
{ ASKED FOR EVERY CHILD UNDER R’S CARE
OTNBFOS
FB-5. Was (CHILD’S NAME) a foster or related child who was placed in your home by a court, child welfare department, or social service agency?
[HELP AVAILABLE]
Yes .............. 1
No ............... 5
{ ASKED FOR EVERY CHILD UNDER R’S CARE
OTNBSEX
FB-6. Is (CHILD’S NAME) male or female?
Male ..........1
Female ........2
{ ASKED FOR EVERY CHILD UNDER R’S CARE
OTNBAD
FB-7. Did you legally adopt (CHILD’S NAME) or become (CHILD’S NAME)’s legal guardian?
[HELP AVAILABLE]
ENTER [1] if R both adopted and became legal guardian to this child.
Yes, adopted .........1
Yes, became guardian..3
No, neither...........5
{ ASKED IF R ADOPTED THIS CHILD OR BECAME THIS CHILD’S LEGAL GUARDIAN
OTNBLIV
FB-8. Please look at Card 62. Where does (CHILD’S NAME) usually live now?
ENTER all that apply
If child lives with R part-time, PROBE: Where else does this child live?
In this household full-time .................1
In this household part-time .................2
With his/her biological parent(s) ...........3
Away at school or college ...................4
Living on own ...............................5
Living with other relatives .................6
Deceased ....................................7
Someplace else ..............................8
RANGE CHECK: 1, 7 CANNOT BE COMBINED WITH ANY OTHER RESPONSES
{ ASKED IF ADOPTED OR LEGALLY GUARDED CHILD IS NOT DECEASED AND NOT IN R’s HH
OTNBFAR
FB-9. About how many miles away from here does (CHILD’S NAME) live?
Number of miles __________
ENTER 0 if less than 1 mile
{ ASKED IF CHILD LIVED WITH R
OTNBAGE
FB-10. How old is (CHILD’S NAME) now?
Age in years ___________
ENTER 0 if less than 1 year
ENTER [96] if R volunteers that child is deceased
{ RETURN TO BEGINNING OF LOOP TO ASK ABOUT NEXT CHILD, IF ANY
{ IF NO MORE CHILDREN TO DISCUSS, GO TO SECTION FC
Other Pregnancies, Total Pregnancies, and Number of Sexual Partners (FC)
{ IF R NEVER HAD SEX, BUT DOES HAVE ADOPTED CHILD/REN GO TO SECTION G
{ ELSE GO TO SECTION H
OTPREG
FC-1. Sometimes pregnancies do not result in a live birth, but end in miscarriage, stillbirth, or abortion. As far as you know, have you ever had a pregnancy with a woman that ended in miscarriage, stillbirth, or abortion?
[HELP AVAILABLE]
Yes ....................1 (GO TO FC-3 OTPRGN)
No .....................5
{ ASKED IF OTPREG= NO OR DK/RF
OTPRGPRB
FC-2. Could you have ever had a pregnancy like this with a woman that you didn’t know about?
Yes .............1 (GO TO FC-8 TOTPRG)
No ..............5 (GO TO FC-8 TOTPRG)
OTPRGN
FC-3. How many pregnancies (did you have that did not result in live birth)?
Number of pregnancies _________
{ ASKED IF ONLY ONE PREGNANCY
OTPRGEND
FC-4. Please look at Card 63. In which of the ways shown on this card did that pregnancy end?
Miscarriage..........1 (GO TO FC-7a AGENONLB)
Stillbirth...........2 (GO TO FC-7a AGENONLB)
Abortion.............3 (GO TO FC-7a AGENONLB)
{ ASKED IF MORE THAN ONE PREGNANCY
OTMSN
FC-5. How many pregnancies ended in miscarriage?
[HELP AVAILABLE]
Number of pregnancies _____________
{ ASKED IF MORE THAN ONE PREGNANCY
OTSTN
FC-6. How many pregnancies ended in stillbirth?
[HELP AVAILABLE]
Number of pregnancies_____________
{ ASKED IF MORE THAN ONE PREGNANCY
OTABN
FC-7. How many pregnancies ended in abortion?
[HELP AVAILABLE]
Number of pregnancies ____________
{ Asked if R has ever fathered a nonlivebirth pregnancy
AGENONLB
FC-7a. IF OTPREGS = 1, ASK:
When you had this pregnancy that did not end with a live birth, how old were you when the pregnancy ended?
ELSE IF OTPREGS > 1, ASK:
Thinking of the first time you ever had a pregnancy with a woman that did not end with a live birth, how old were you when this pregnancy ended?
Age in years ___________
{ Asked if R has ever fathered a nonlivebirth pregnancy
HERAGENLB
FC-7b. Thinking of this same pregnancy, how old was the mother when this pregnancy ended?
Age in years ___________
TOTPRG
FC-8. Altogether, including pregnancies that ended in live birth, pregnancies that ended in miscarriage, stillbirth, or abortion, and pregnancies that are ongoing, as far as you know, how many times have you ever made someone pregnant?
[HELP AVAILABLE]
Number of pregnancies _____________
Establishment of Duplicate Children and Chronologically Arranged Variables for Biological Children (FD)
DUPLIST
FD-1. Before we move on to some other questions about the children you've told me about, let's make sure we have things right.
These are some children that may have been listed more than once. There's ...
(BKIDNAM[X]) is your biological (daughter/son), age (BKIDAGE[X])
(BKIDNAM[X]) is your biological (daughter/son), age (BKIDAGE[X])
ALLOW AS MANY ENTRIES AS THERE ARE DUPLICATE CHILDREN AMONG THE BIOKIDS NUMBER OF CHILDREN
Have we listed any of these children more than once?
Yes ....................1
No .....................5 (Flow Check F-23)
{ ASKED IF CHILD LISTED MORE THAN ONCE
DUPCHECK
FD-2. Which child has been listed more than once?
1. (BKIDNAM[X]) is your biological (daughter/son), age (BKIDAGE[X])
2. (BKIDNAM[X]) is your biological (daughter/son), age (BKIDAGE[X])
ENTER all that apply.
Numbers of partners in lifetime & last 12 months (FE)
{ IF RESPONDENT HAD FEWER THAN 7 SEX PARTNERS IN HIS LIFE, GO TO SECTION G
{ ASKED ONLY IF RESPONDENT HAD 7 OR MORE SEXUAL PARTNERS IN HIS LIFETIME
NUMLIFE
FE-1. Altogether, how many different females have you ever had intercourse with? This includes any female you had intercourse with, even if it was only once or if you did not know her well.
[HELP AVAILABLE]
Number of partners _______________
{ IF RESPONDENT HAD FEWER THAN 7 SEXUAL PARTNERS IN THE LAST 12 MONTHS,
{ GO TO SECTION G
{ ASKED ONLY IF RESPONDENT HAD 7 OR MORE SEXUAL PARTNERS IN LAST 12 MONTHS
NUM12MO
FE-2. Altogether, how many different females have you had sexual intercourse with in the past 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?
[HELP AVAILABLE]
Number of partners _________________
SECTION G
FATHERING
{ IF RESPONDENT HAS NO CHILDREN UNDER AGE 19 IN HIS HH AND NO BIOLOGICAL
{ OR ADOPTED CHILDREN UNDER AGE 19 WHO LIVE ELSEWHERE, GO TO SECTION H
{ IF RESPONDENT HAS NO CHILDREN UNDER AGE 19 IN HIS HH, BUT HAS BIOLOGICAL
{ OR ADOPTED CHILDREN UNDER AGE 19 WHO LIVE ELSEWHERE, GO TO SECTION GB
{ Up to two focal children are selected in this series, one residential and one nonresidential. If more than one child fits either category, then the focal child is the youngest one.
Residential Children (GA)
INTRO_G
GA-00. Now I would like to ask you some questions about the child/children who live(s) with you. (To make it easier for you, the computer will select 1 child to ask about.)
{ FOR R WITH ANY RESIDENTIAL CHILD(REN)
GAINTRO
GA-0. I would like to ask some questions about your [son/daughter/child].[NAME] who is [AGE] years old.
{ IF [Residential Focal Child] is aged 0-4 then go to GA-1 ROUTG04
{ IF [Residential Focal Child] is aged 5-18 then go to GA-14 ROUTG518
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
ROUTG04
GA-1. Please look at card 65.(In the last four weeks, how often did you... ) Spend time with [NAME] on an outing away from home to places such as museums, zoos, movies, sports, playground, park, etc.?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RMEAL04
GA-2. (In the last four weeks, how often did you... )
Eat evening meals together with [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RERRAND04
GA-3. (In the last four weeks, how often did you... )
Take [NAME] along while doing errands like going to the grocery
store, post office, or bank?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RPLAY04
GA-4. (In the last four weeks, how often did you... )
Play with [NAME] or play games with [him/her]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RREAD04
GA-5. (In the last four weeks, how often did you... )
Read to [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RAFFECT04
GA-6. (In the last four weeks, how often did you... )
Show [NAME] physical affection (kiss, hug, stroke hair, etc.)?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RPRAISE04
GA-7. (In the last four weeks, how often did you... )
Praise [NAME] for doing something worthwhile?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RFEED04
GA-8. (In the last four weeks, how often did you... )
Feed [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RBATH04
GA-9. (In the last four weeks, how often did you... )
Give [NAME] a bath?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RDIAPER04
GA-10. (In the last four weeks, how often did you... )
Diaper or help [him/her] use the toilet?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RBED04
GA-11. (In the last four weeks, how often did you... )
Put [him/her] to bed?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RAPPT04
GA-12. (In the last four weeks, how often did you... )
Take [NAME] to or from appointments such as a doctor’s visit?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
RDISC04
GA-13. Most children misbehave from time to time. In the last 4 weeks, how often did you discipline [NAME] by putting [him/her] in time out, taking away privileges, or spanking him/her?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
ROUTG518
GA-14. Please look at card 65. (In the last four weeks, how often did you...)
Spend time with [NAME] on an outing away from home to places such as museums, zoos, movies, sports, playground, park, etc.?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RMEAL518
GA-15. (In the last four weeks, how often did you...)
Eat evening meals together with [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RERRAND518
GA-16. (In the last four weeks, how often did you...)
Take [NAME] along while doing errands like going to the grocery
store, post office, or bank?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RAFFECT518
GA-17. (In the last four weeks, how often did you...)
Show [NAME] physical affection (kiss, hug, stroke hair, etc.)?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RPRAISE518
GA-18. (In the last four weeks, how often did you...)
Praise [NAME] for doing something worthwhile?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RTAKE518
GA-19. (In the last four weeks, how often did you...)
Take [NAME] to or from activities?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RAPPT518
GA-20. (In the last four weeks, how often did you...)
Take [NAME] to/from appointments such as doctor’s visits?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RHELP518
GA-21. (In the last four weeks, how often did you...)
Help your child with [his/her] homework or check that [he/she] did it?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RDISC518
GA-22. Most children misbehave from time to time. In the last 4 weeks, how often did you discipline [NAME] by putting [him/her] in time out, taking away privileges, or spanking [him/her]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS
RCLFR518
GA-23. Please look at card 65a. How much would you say that you know about [NAME]’s close friends?
Knows everything ...................................1
Knows most things ..................................2
Knows some things ..................................3
Knows a little .....................................4
Knows nothing ......................................5
{ ASKED IF RESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
RDO518
GA-24. How much would you say that you know about what [NAME] is doing when not at home?
Knows everything ...................................1
Knows most things ..................................2
Knows some things ..................................3
Knows a little .....................................4
Knows nothing ......................................5
Nonresidential Children (GB)
{ GB SERIES ASKED ONLY IF R HAS A NON-RESIDENTIAL BIOLOGICAL OR ADOPTED CHILD
{ WHO IS LESS THAN 18 YEARS OLD. IF R HAS NO BIOLOGICAL OR ADOPTED CHILDREN
{ LIVING ELSEWHERE (NOT IN THE HH), GO TO SECTION H.
INTRO
GA-0a. I would like to ask you some questions about the children who do not live with you. To make it easier for you, the computer will select 1 child to ask about.
GBINTRO
GB-0. Here are some questions about your [AGE] [son/daughter/child], who does not live with you.
{ IF Nonresidential Focal Child is aged 0-4 then go to GB-1 NRVISIT04
{ IF Nonresidential Focal Child is aged 5-18 then go to GB-17 NRVISIT518
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
NRVISIT04
GB-1. Please look at card 65. During the last 4 weeks, about how often did you see or have a visit with [NAME]?
Not at all .......................................1
Less than once a week ............................2
About once a week ................................3
Several times a week .............................4
Every day (at least once a day) ..................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD
NRSATVIS04
GB-2. Please look at card 67. On this scale, 0 means very dissatisfied and 10 means very satisfied. Overall, how satisfied are you with how often you see or have a visit with [NAME]?
Number from 0 to 10
{ IF R HAS NOT SEEN OR VISITED [Nonresidential Focal Child] IN LAST 4 WEEKS,
{ THEN GO TO GC-1 NRMONEY
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NROUTG04
GB-3. Please look at card 65. (In the last four weeks, how often did you...)
Spend time with [NAME] on an outing away from home to places such
as museums, zoos, movies, sports, playground, park, etc.?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRMEAL04
GB-4. (In the last four weeks, how often did you...)
Eat evening meals together with [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRERRAND04
GB-5. (In the last four weeks, how often did you...)
Take [NAME] along while doing errands like going to the grocery store, post office, or bank?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NROVRNT04
GB-6 . (In the last four weeks, how often did ...)
[NAME] stay overnight with you?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRPLAY04
GB-7. (In the last four weeks, how often did you...)
Play with [NAME] or play games with [him/her]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRREAD04
GB-8. (In the last four weeks, how often did you...)
Read to [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRAFFECT04
GB-9. (In the last four weeks, how often did you...)
Show [NAME] physical affection (kiss, hug, stroke hair, etc.)?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRPRAISE04
GB-10. (In the last four weeks, how often did you...)
Praise [NAME] for doing something worthwhile?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRFEED04
GB-11. (In the last four weeks, how often did you...)
Feed [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRBATH04
GB-12. (In the last four weeks, how often did you...)
Give [NAME] a bath?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRDIAPER04
GB-13. (In the last four weeks, how often did you...)
Diaper or help [him/her] use the toilet?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRBED04
GB-14. (In the last four weeks, how often did you...)
Put [him/her] to bed?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRAPPT04
GB-15. (In the last four weeks, how often did you...)
Take [NAME] to or from appointments such as a doctor’s visit?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 0-4 YEARS OLD AND R HAS HAD AT LEAST
{ SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRDISC04
GB-16. Most children misbehave from time to time. In the last 4 weeks, how often did you discipline [NAME] by putting [him/her] in time out, taking away privileges, or spanking him/her?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ Go to GC-1 NRMONEY (child support)
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
NRVISIT518
GB-17. Please look at card 65. During the last 4 weeks, about how often did you see or have a visit with [NAME]?
Not at all .......................................1
Less than once a week ............................2
About once a week ................................3
Several times a week .............................4
Every day (at least once a day) ..................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD
NRSATVIS518
GB-18. Please look at card 67. On this scale, 0 means very dissatisfied and 10 means very satisfied. Overall, how satisfied are you with how often you see or have a visit with [NAME]?
Number from 0 to 10
{ IF R HAS NOT SEEN OR VISITED [Nonresidential Focal Child] IN LAST 4 WEEKS,
{ THEN GO TO NRMONEY
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NROUTG518
GB-19. Please look at card 65. (In the last four weeks, how often did you...)
Spend time with [NAME] on an outing away from home to places such as museums, zoos, movies, sports, playground, park, etc.?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRMEAL518
GB-20. (In the last four weeks, how often did you...)
Eat evening meals together with [NAME]?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRERRAND518
GB-21. (In the last four weeks, how often did you...)
Take [NAME] along while doing errands like going to the grocery store, post office, or bank?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NROVRNT518
GB-22. (In the last four weeks, how often did...)
[NAME] stay overnight with you?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRAFFECT518
GB-23. (In the last four weeks, how often did you...)
Show [NAME] physical affection (kiss, hug, stroke hair, etc.)?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRPRAISE518
GB-24. (In the last four weeks, how often did you...)
Praise [NAME] for doing something worthwhile?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRTAKE518
GB-25. (In the last four weeks, how often did you...)
Take [NAME] to or from activities?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRAPPT518
GB-26. (In the last four weeks, how often did you...)
Take [NAME] to or from appointments such as doctor’s visits?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRHELP518
GB-27. (In the last four weeks, how often did you... )
Help your child with [his/her] homework or check that [he/she] did it?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRDISC518
GB-28. Most children misbehave from time to time. In the last 4 weeks, how often did you discipline [NAME] by putting [him/her] in time out, taking away privileges, or spanking him/her?
Not at all .........................................1
Less than once a week ..............................2
About once a week ..................................3
Several times a week ...............................4
Every day (at least once a day) ....................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRCLFR518
GB-29. Please look at card 65a. How much would you say that you know about [NAME]’s close friends?
Knows everything ...................................1
Knows most things ..................................2
Knows some things ..................................3
Knows a little .....................................4
Knows nothing ......................................5
{ ASKED IF NONRESIDENTIAL FOCAL CHILD IS 5-18 YEARS OLD AND R HAS HAD AT
{ LEAST SOME CONTACT WITH THE CHILD IN THE LAST 4 WEEKS
NRDO518
GB-30. How much would you say that you know about what [NAME] is doing when not at home?
Knows everything ...................................1
Knows most things ..................................2
Knows some things ..................................3
Knows a little .....................................4
Knows nothing ......................................5
{Go to GC-1 NRMONEY (child support)
Nonresidential children -- Financial Support (GC)
{ GC SERIES ASKED ONLY IF [nonresidential focal child] is under age 18
{ ASKED IF HAS NONRESIDENTIAL FOCAL CHILD AGED 0-18
NRMONEY
GC-1. Now I have a few questions about your financial support of [NAME].
In the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR
- 1), did you contribute money or child support for [NAME]’s upbringing?
[HELP AVAILABLE]
Yes....1
No.....5
{IF DID NOT CONTRIBUTE MONEY OR FINANCIAL SUPPORT IN THE PAST 12 MONTHS GO TO HA-1 HAINTR
{ ASKED IF CONTRIBUTED CHILD SUPPORT IN THE PAST 12 MONTHS
NREG
GC-2. Did you do this on a regular basis, or once in a while?
[HELP AVAILABLE]
Regular basis.....1
Once in a while...5
{ ASKED IF CONTRIBUTED CHILD SUPPORT IN THE PAST 12 MONTHS
NRAMOUNT
GC-3a. In the last 12 months, how much did you give?
R can report weekly, monthly, or yearly amount
If R says that the payments are not always the same, say:
How much do you “usually” give? OR How much did you give total?
Amount in dollars ___________
Enter ‘0’ for none
{ If GAVE NO MONETARY SUPPORT (NRAMOUNT = 0), THEN GO TO SECTION H
{ ASKED IF CONTRIBUTED CHILD SUPPORT IN THE PAST 12 MONTHS
NRUNIT
GC-3b. (In the last 12 months, how much did you give?)
$[NRAMOUNT] per (Week, Month, Year)
Week ..........1
Month .........2
Year ..........3
{ ASKED IF CONTRIBUTED CHILD SUPPORT IN THE PAST 12 MONTHS
NRAGREE
GC-4. Was any of this/the amount paid as the result of a child support
order?
Yes .............1
No ..............5
{
ASKED IF HAS NONRESIDENTIAL FOCAL CHILD AGED 0-18
COPARENT
GD-1. The next question is about you and [NAME]’s mother as parents for [NAME]. For the following statement, please tell me if you strongly agree, agree, are not sure, disagree, or strongly disagree. [NAME]’s mother and I are a good parenting team....
STRONGLY AGREE............. 1
AGREE...................... 2
NOT SURE................... 3
DISAGREE................... 4
STRONGLY DISAGREE.......... 5
SECTION H
Desires and Intentions for Future Children
Desires for future children Series (HA)
HCINTR
HA-1. Now, I would like to know your feelings about having (a/another) child, whether or not you are able to, or plan to have one.
By “having a child,” I mean that you are the biological father of that child.
RWANT
HA-2. (Looking to the future, do / If it were possible, would) you, yourself, want to have (a/another) child at some time in the future (after this pregnancy is over)?
Yes .........................1
No ..........................5
{ IF R SAYS ANYTHING BESIDES “DON’T KNOW” TO RWANT, GO TO HB SERIES
{ ASKED IF R SAYS “DON’T KNOW” TO RWANT
PROBWANT
HA-3. (If it were possible, do you think you would / Do you think you) probably want or would probably not want to have (a/another child) at some time (in the future / after this pregnancy is over)?
Probably want .......................1
Probably do not want ................2
{ IF R IS MARRIED OR COHABITING AND BOTH HE AND HIS WIFE/PARTNER ARE ABLE TO { HAVE CHILDREN, ASK JOINT INTENTION SERIES (HB)
{ ELSE IF R IS MARRIED OR COHABITING AND EITHER HE OR HIS WIFE/PARTNER ARE
{ UNABLE TO HAVE CHILDREN, GO TO SECTION I, INTRO_I1
{ ELSE IF R IS NOT MARRIED OR COHABITING AND HE IS ABLE TO HAVE CHILDREN, GO
{ TO HC SERIES
{ ELSE IF R IS NOT MARRIED OR COHABITING AND HE IS UNABLE TO HAVE CHILDREN,
{ GO TO SECTION I, INTRO_I1
Joint Intention Series (HB)
{ R IS CURRENTLY MARRIED OR COHABITING AND HE AND HIS WIFE/PARTNER ARE BOTH
{ ABLE TO HAVE CHILDREN.
HCINTRO2
HB-1. Sometimes what people want and what they intend are different because they are not able to do what they want. The next questions are about your and (WIFE/PARTNER)’s intentions to have (a/another) child in the future.
By “have a child,” I mean that you are the biological father and she is the biological mother of that child.
JINTEND
HB-2. Do you and (WIFE/PARTNER) intend to have (a/another) child at some time (in the future/after this pregnancy is over)?
If Necessary, SAY: Intend refers to what you and she are actually going to try to do.
Do not count intended adoptions or stepchildren.
Yes ...................1
No ...................5
{ IF JINTEND = “DON’T KNOW” GO TO HB-5 JEXPECTL.
{ IF JINTEND = “REFUSED” GO TO SECTION I.
{ ASKED IF JINTEND = YES OR NO
JSUREINT
HB-3. Of course, sometimes things do not work out exactly as we intend them to or something makes us change our minds. In your case, how sure are you that you and (WIFE/PARTNER) will (not) have (a/another) child (after this pregnancy is over)? Would you say very sure, somewhat sure, or not sure at all?
Very sure ....................1
Somewhat sure ................2
Not at all sure ...............3
{ IF R INTENDS NO MORE CHILDREN, GO TO SECTION I.
{ ASKED IF JINTEND = YES
JINTENDN
HB-4. (Not counting her current pregnancy, how / How) many (more) children do you and (WIFE/PARTNER) intend to have?
If Necessary, SAY: Intend refers to what you and she are actually going to try to do.
Do not count intended adoptions or stepchildren.
Number of children (IF A NUMBER GIVEN, GO TO SECTION I)
{IF R GIVES THE NUMBER OF CHILDREN THEY INTEND TO HAVE OR REFUSES TO GIVE A NUMBER, GO TO HB-7 JINTNEXT
{ ASKED IF R DOESN’T KNOW THE NUMBER OF CHILDREN THEY INTEND
JEXPECTL
HB-5. Many people aren’t sure, but still have some idea about the future. As you expect things to work out for you and (WIFE/PARTNER), what is the largest number of (additional) children you and she expect to have (after this pregnancy is over)?
Number of children (IF ZERO, GO TO SECTION I)
{ ASKED IF NUMBER OF (ADDITIONAL) BABIES EXPECTED IS > ZERO
JEXPECTS
HB-6. What is the smallest number of (additional) children you and (WIFE/PARTNER) expect to have (after this pregnancy is over)?
Number of children
JINTNEXT
HB-7. When do you and [WIFE/PARTNER] expect your first/next child to be born (after this pregnancy)? Would you say, within the next 2 years, 2–5 years from now, or more than 5 years from now?
Within the next 2 years .........1
2 - 5 years from now ............2
More than 5 years from now ......3
Individual Intention for Future Children (HC)
{ HC SERIES IS ASKED IF R IS NOT MARRIED OR COHABITING AND IS ABLE TO HAVE A
{ CHILD AND WANTS A CHILD
HCINTRO3
HC-1. Sometimes what people want and what they intend are different because they are not able to do what they want. The next questions are about your intentions to have (a/another) child in the future.
By “have a child,” I mean that you are the biological father of that child.
INTEND
HC-2. Please look at Card 58. Looking to the future, do you intend to have (a/another) child at some time (after this pregnancy is over)?
If necessary, SAY: Intend refers to what you are actually going to try to do.
Please do not count intended adoptions or stepchildren.
Definitely Yes ...................1
Probably Yes......................2
Probably No.......................3 (GO TO SECTION I)
Definitely No.....................4 (GO TO SECTION I)
{ASKED IF INTENDS TO HAVE A/NOTHER CHILD
INTENDN
HC-3. (Not counting the current pregnancy, how / How) many (more) children do you intend to have?
If Necessary, Say: Intend refers to what you are actually going to try to do.
Do not count intended adoptions or stepchildren.
Number of children (IF A NUMBER IS GIVEN, GO TO HC-6 INTNEXT)
{ ASKED IF R DOESN’T KNOW WHETHER HE INTENDS TO HAVE CHILDREN OR DOESN’T KNOW
{ THE NUMBER OF CHILDREN HE INTENDS
EXPECTL
HC-4. Many people aren’t sure, but still have some idea about the future. As you expect things to work out for you, what is the largest number of (additional) children you, yourself, expect to have (after this pregnancy is over)?
Number of children (IF ZERO, GO TO SECTION I)
{ ASKED IF NUMBER OF (ADDITIONAL) BABIES EXPECTED IS > ZERO
EXPECTS
HC-5. What is the smallest number of (additional) children you, yourself, expect to have (after this pregnancy is over)?
Number of children ___
INTNEXT
HC-6. When do you expect your first/next child to be born (after this
pregnancy)? Would you say, within the next 2 years, 2–5 years from now, or more than 5 years from now?
Within the next 2 years .........1
2 - 5 years from now ............2
More than 5 years from now ......3
SECTION I
HEALTH CONDITIONS AND HEALTH SERVICES
{ ASKED FOR ALL
INTRO_I1
IA-0. The next questions are about your experiences with health care providers, health insurance, and health problems.
Access to Health Care (IA)
{ ASKED FOR ALL
USUALCAR
IA-1. Is there a place that you usually go to when you are sick or need advice about health?
Yes .............1
No ..............5 (IA-3 CURRCOV)
{ ASKED IF R HAS A USUAL PLACE FOR HEALTH CARE
USLPLACE
IA-2. Please look at Card 25a. What kind of place is it?
Private doctor's office or HMO..........................1
Community health clinic, community clinic,
public health clinic ................................2
Family planning or Planned Parenthood clinic ...........3
Employer or company clinic .............................4
School or school-based clinic ..........................5
Hospital outpatient clinic .............................6
Hospital emergency room ................................7
Hospital regular room ..................................8
Urgent care center, urgi-care, or walk-in facility .....9
Sexually transmitted disease (STD) clinic..............10
In-store health clinic (like CVS, Target, or Walmart)..11
Some other place ......................................20
{ ASKED IF R REPORTED A USUAL SOURCE OF CARE IN USUALCAR
USL12MOS
IA-2a. Have you gone to this place in the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?
Yes .............1
No ..............5
{Asked for all Rs
CURRCOV
IA-3. Are you currently covered by any kind of health insurance or some other kind of health care plan?
[HELP AVAILABLE]
Yes .............1
No ..............5 (GO TO IA-8 COVER12)
{ASKED IF R IS COVERED BY HEALTH INSURANCE (CURRCOV = 1)
COVERHOW
IA-4.Card 76 shows different types of health care coverage. Which of these are you covered by?
[HELP AVAILABLE]
ENTER all that apply
A private health insurance plan (from employer or workplace; purchased directly; through a state or local government program or community program) 1
Medicaid-additional name(s) for Medicaid in this state: [DISPLAY STATE MEDICAID PROGRAM NAME(S)] 2
Medicare 3
Medi-Gap 4
Military health care, including: the VA, CHAMPUS, TRICARE, CHAMP-VA 5
Indian Health Service 6
CHIP (Children’s Health Insurance Program-additional name(s) for CHIP in this state: [DISPLAY STATE CHIP PROGRAM NAME(S)] 7
Single-service plan (e.g., dental, vision, prescriptions) 8
State-sponsored health plan (called [DISPLAY STATE PLAN NAME] in this state) 9
Other government health care 10
{ ASKED IF R IS 18-25 AND CURRENTLY HAS PRIVATE INSURANCE COVERAGE
PARINSUR
IA-5. Are you covered on your parents' private health insurance plan?
Yes .............1
No ..............5
{ We may narrow this universe further to specific types, as in NHIS series: private, Medicaid, CHIP, state-sponsored, and other government health care
{ ASKED IF R CURRENTLY COVERED BY HEALTH INSURANCE
INS_EXCH
IA-6. (Was/Were any of your) your health insurance plan(s) obtained through Healthcare.gov or the [DISPLAY STATE MARKETPLACE NAME]?
Yes .............1
No ..............5
{ ASKED IF R CURRENTLY HAS HEALTH INSURANCE
INS_PREM
IA-7. A health insurance premium is the amount you or a family member pays each month for health care coverage. Do you or a family member pay a premium for (any of) your health insurance plan(s)?
Yes .............1
No ..............5
{ ASKED FOR ALL
COVER12
IA-8.Looking at Card 75 for examples of types of health insurance coverage, in the past 12 months, that is, since [INTERVIEW MONTH, INTERVIEW YEAR – 1], was there any time that you did not have any health insurance or coverage?
[HELP AVAILABLE]
Yes .............1
No ..............5 (GO TO IB-1 YOUGOFPC)
{ ASKED IF R HAD NO HEALTH INSURANCE AT SOME TIME IN THE PAST YEAR
NUMNOCOV
IA-9. In how many of the past 12 months were you without coverage?
Number of months _________
Use of Family Planning Clinic (IB)
{ ASKED OF ALL RESPONDENTS
YOUGOFPC
IB-1. Now please look at Card 69, which shows some family planning and health services. Have you, yourself, ever received services such as these from a family planning clinic or Planned Parenthood clinic?
Yes .............1
No ..............5 (IC-1 DEAF)
{ ASKED IF RECEIVED SERVICES FROM A FAMILY PLANNING CLINIC
WHENGOFP
IB-2. When was the last time you received services from a family planning clinic or Planned Parenthood clinic? Was it within the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), or more than 12 months ago?
Within the last 12 months ...........1
More than 12 months ago .............2 (IC-1 DEAF)
{ ASKED IF R RECEIVED SERVICES FROM A FAMILY PLANNING CLINIC WITHIN THE LAST
{ 12 MONTHS
YOUFPSVC
IB-3. Please look again at Card 69. Which of these services did you receive at that visit?
w ENTER all that apply
Physical exam ....................................................1
HIV testing ......................................................3
Testing for sexually transmitted diseases other than
HIV...............................................................4
Treatment for sexually transmitted diseases other than HIV ..................................................................5
Information or advice on strategies to prevent pregnancy, for
example, birth control methods ...................................7
Information or advice on strategies to prevent STDs or HIV, for
example, using condoms or reducing your number of partners........8
Some other service................................................9
Health Problems or Impairments (IC)
{ ASKED OF ALL RESPONDENTS
DEAF
IC-1. The following questions are about health problems or impairments you may have. Do you have serious difficulty hearing?
Yes .............1
No ..............5
BLIND
IC-2. Do you have serious difficulty seeing, even when wearing glasses?
Contact lenses should be considered in the same way as glasses.
Yes .............1
No ..............5
DIFDECIDE
IC-3. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering or making decisions?
Yes .............1
No ..............5
DIFWALK
IC-4. Do you have serious difficulty walking or climbing stairs?
Yes .............1
No ..............5
DIFDRESS
IC-5. Do you have difficulty dressing or bathing?
Yes .............1
No ..............5
DIFOUT
IC-6. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?
Yes .............1
No ..............5
{ ASKED OF ALL
EVRCANCER
IC-7. Now I would like to ask you about cancer. Have you ever been told by a doctor or other health care provider that you had cancer?
Yes .............1
No ..............5 (IC-8 ALCORISK)
{ ASKED IF R HAS EVER BEEN TOLD HE HAS CANCER
AGECANCER
IC-7a. At what age were you first told that you had cancer?
w READ if necessary: If you have had more than one cancer, please tell me about your first cancer.
________ Age in years
{ ASKED IF R HAS EVER BEEN TOLD HE HAS CANCER
CANCTYPE
IC-7b. What type of cancer was? If you had cancer more than once, please say what your first cancer was.
INTERVIEWER NOTE: Code based on what respondent reports for his first type of cancer. The list is alphabetical. Read the list only if necessary. You may stop reading the list when the respondent states a cancer.
Bladder cancer 01
Blood ..............................02
Bone cancer 03
Brain cancer or tumor, spinal cord
cancer, or other cancer of the
central nervous system 04
Breast cancer 05
BLANK 06
Colon cancer 07
Esophageal (Esophagus) cancer.......08
BLANK ........................ 09
Gallbladder Cancer................. 10
Head and neck cancer 11
Heart cancer 12
Laryngeal (Larynx/Windpipe)cancer.. 13
Leukemia 14
Liver cancer 15
Lung cancer 16
Lymphoma including Hodgkins disease/
Lymphoma and non-Hodgkins
lymphomas 17
Melanoma 18
Neuroblastoma 19
Oral (mouth/tongue/lip) cancer 20
BLANK 21
Pancreatic (pancreas) cancer 22
Pharyngeal (throat/pharynx) cancer. 23
Prostate cancer.................... 24
Rectal (rectum) cancer 25
Renal (kidney) cancer 26
Skin cancer (non-melanoma) 27
Skin cancer (DK what kind) 28
Soft Tissue (muscle or fat)sarcoma 29
Stomach cancer 30
Testicular (testis) cancer 31
Thyroid cancer 32
Other …………………………………………………………………………….33
{IF CODE 33 NOT REPORTED, GO TO ID-1 VISIT12MO
{ASKED IF R REPORT HAVING ‘OTHER’ CANCER, CANCTYPE
SP_CANCTYPE
IC-7sp. INTERVIEWER: Record verbatim what R reports for his type of cancer.
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ ASKED FOR ALL
ALCORISK
IC-8. Do you think that
drinking more than 1 alcoholic beverages
a day
increases one’s chances of getting cancer a lot, a little, or not at
all or do you have no opinion?
A lot .........1
A little ......2
Not at all ....3
No opinion ....4
Health Services (ID)
{ ASKED FOR ALL
VISIT12MO
ID-1. Please look at card 69a. In the past 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), did you have any of these types of visits to a doctor or health care provider?
w ENTER all that apply
A routine physical exam .....................1
A physical exam for sports or work.......... 2
A doctor visit when you were sick or hurt....3
Did not have any visits to a doctor .........4 (ID-9 BARRIER)
RANGE CHECK: Code 4 cannot be entered with any other code.
{ ASKED ONLY IF ID-1 VISIT12MO= 1,2,3
SVC12MO
ID-2. Please look at Card 69b. Did you receive any of the services shown on this card at those visits in the past 12 months?
w ENTER all that apply
A testicular exam (had your testicles examined) ........1
Testing for sexually transmitted disease ...............2
Treatment for sexually transmitted disease .............3
Information or advice about your partner using female
methods of birth control .............................5
Information or advice about you getting a vasectomy
(surgically sterilized) ................................6
Information or advice about HIV or AIDS ................7
Information or advice about other sexually transmitted
diseases, such as gonorrhea, chlamydia,
syphilis, herpes or AIDS..............................8
Information or advice about using condoms to prevent
pregnancy...............................................10
Information or advice about using condoms to prevent
STDs....................................................11
None of the above ......................................12
{Asked only if ID-1 VISIT12MO=1,2,3
NUMVISIT
ID-3. How many visits did you have in the last 12 months in order to receive all of these services from a doctor or other health care provider?
w ENTER number of visits
{Asked only if ID-1 VISIT12MO=1,2,3
PLACEVIS
ID-4. Please look at Card 25a. What place or places did you go for these service(s)?
ENTER all that apply
Private doctor's office or HMO........................1
Community health clinic, community clinic,
public health clinic ..............................2
Family planning or Planned Parenthood clinic..........3
Employer or company clinic ...........................4
School or school-based clinic ........................5
Hospital outpatient clinic ...........................6
Hospital emergency room ..............................7
Hospital regular room ................................8
Urgent care center, urgi-care, or walk-in facility ...9
Sexually transmitted disease (STD) clinic............10
Some other place ....................................20
{Asked only if ID-1 VISIT12MO=1,2,3
SVCPAY
ID-5. Please look at Card 16a. In which of the ways shown on this card was the bill for these visits paid?
ENTER all that apply.
Insurance ..................................1
Co-payment .................................2
Out-of-pocket payment ......................3
Medicaid ...................................4
No payment required.........................5
Some other way .............................6
{Asked only if ID-1 VISIT12MO=1,2,3
TALKSA
ID-6. During your visit(s) in the past 12 months did a doctor or health care provider ask if you were sexually active?
Yes .........................................1
No ..........................................5
IF VOL: Provider already knew R’s status ....7
{Asked only if ID-1 VISIT12MO=1,2,3
TALKEC
ID-7. During your visit in the past 12 months, did a doctor or health care provider talk with you about emergency contraception?
Yes .............1
No ..............5
{Asked only if ID-1 VISIT12MO=1,2,3
TALKDM
ID-8. During your visit in the past 12 months, did a doctor or health care provider talk with you about using a condom at the same time
as a female method of contraception?
Yes .............1
No ..............5
{ IF R RECEIVED TEST FOR STD IN LAST 12 MONTHS (ID-2 SVC12MO=2)
WHYPSTD
ID-8a. Please look at Card XX. In the past 12 months you received a test for a sexually transmitted disease from a [Display response to where received STD test]. What is the main reason that you chose this place for care?
Could walk in or get same-day appointment.........1
Cost................... ..........................2
Privacy concern...................................3
Expert care here..................................4
Embarrassed to go to usual provider...............5
Other.............................................6
{ASKED IF R DID NOT REC’D STD TEST IN LAST 12 MONTHS
WHYNOSTD
ID-8b. In the past 12 months you did not receive a test for a sexually transmitted disease. Which one of these reasons would you say is the MAIN reason why you have not been tested for a sexually transmitted disease?
Didn’t want parents to find out....... ..................1
Concerned about confidentiality.............. ...........2
Doctor or health care provider never suggested it........3
Embarrassed or difficult to ask to be tested ............4
Cost or lack of insurance.............. .................5
Other....................................................6
{ ASKED OF R’s WHO DID NOT SEE A DOCTOR IN PAST 12 MONTHS, VISIT12MO=4
BARRIER
ID-9. You reported that you did not go to a doctor in the past 12 months. Please look at Card 69c. Which of the reasons shown on this card explain why you did not see a doctor?
• ENTER all that apply
I did not need to see a doctor in the last year.......1
I did not know where to go for care...................2
I could not afford to pay for a visit.................3
I was afraid to hear bad news.........................4
I had privacy/confidentiality concerns. ..............5
I could not take time off from work...................6
Something else (please specify) ......................20
{ ASKED IF BARRIER=20 (”something else”)
BARRIER_SP
ID-9sp. What other reason(s) made it difficult for you to see a doctor in
past 12 months?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ Asked for all Rs
BLDPRESS
ID-10. The next couple of questions are about your blood pressure. In the past 12 months, that is, since (CMLSTYR_FILL), have you had your blood pressure checked by a doctor or other medical care provider?
Yes.......................1
No........................5 (ID-13 ASKSMOKE)
{ Asked if BLDPRESS=yes
HIGHBP
ID-11. During your visit in the past 12 months, did a doctor or other medical care provider tell you that you had hypertension, also called high blood pressure?
Yes.......................1
No........................5
Not told..................3
{ Asked if R was told her blood pressure was high
BPMEDS
ID-12. Are you currently taking any medicine prescribed by a doctor for your high blood pressure?
Yes.......................1
No........................5
ASKSMOKE
ID-13. The next question is about things your doctor or other medical care provider may have asked you about in the past 12 months either in person, or via a computerized or paper form.
During the last 12 months, has a doctor or other medical care provider asked you whether you smoke cigarettes or use other kinds of tobacco?
Yes.......................1
No........................5
Infertility Services (IE)
{ IE SERIES ONLY ASKED IF R HAS EVER HAD SEX WITH A FEMALE.
{ IF R HAS NEVER HAD SEX, GO TO IF SERIES.
{ ASKED IF R EVER HAD SEX WITH A FEMALE
INFHELP
IE-1. (Did you or your wife ever go / Have you or your partner ever been / During any of your relationships, have you or your (wife or) partner at the time ever been) to a doctor or other medical care provider to talk about ways to help you have a baby together?
NOTE: Do not code yes if main purpose of visit was for something other than seeking help to have a baby.
Yes ............1
No .............5 (INTRO-I2)
{ ASKED IF R EVER HAD SEX WITH A FEMALE AND SAW A DOCTOR ABOUT WAYS TO
{ BECOME PREGNANT
INFSVCS
IE-2. (Think about all of the medical help you or your partners have ever received to help you have a baby together.) Which of the services shown on Card 70 (did / have) you or (they/your wife/your partner) (have / had) to help you have a baby together?
ENTER all that apply
Advice....................................1
Infertility testing ......................2
Drugs to improve ovulation ...............3
Surgery to correct blocked tubes .........4
Artificial insemination ..................5
Treatment for varicocele .................6
Other types of medical help ..............7
{ ASKED IF INFERTILITY TESTING WAS MENTIONED
INFTEST
IE-3. Who was it that had infertility testing? Was it you, her, or both of you?
You ................1
Her ................2
Both of you ........3
{ ASKED IF ARTIFICIAL INSEMINATION WAS MENTIONED
WHOINSEM
IE-4. Was your wife or partner inseminated with sperm from you only, from some other donor only, or from both?
You only ..................1
Some other donor only .....2
Both ......................3
{ IF R IS NOT CURRENTLY MARRIED OR COHABITING, GO TO IE-6 LASTVIS.
{ ASKED IF R IS CURRENTLY MARRIED OR COHABITING
INFHLPNW
IE-5. Are you and your (wife/partner) currently pursuing medical help to have a baby together?
NOTE: "Currently pursuing help" means that R or his (wife/partner) plan to visit the doctor or infertility clinic again.
Yes .............1
No ..............5
LASTVIS_M/LASTVIS_Y
IE-6m/IE-6y. In what month and year was your (most recent/last) visit for medical help to have a baby together?
INFRTHIS
IE-7. When you and your wife or partner went for medical help to have a baby together, were you ever told that you had any of the following male infertility problems shown on Card 71?
ENTER all that apply
Low sperm count or no sperm .....................1
Varicocele ......................................2
Genetic disorder that alters sperm production ...3
Low testosterone level ..........................4
Other ...........................................5
None of the above ...............................6
CODE 6 CANNOT BE ENTERED WITH ANY OTHER CODE.
HIV TESTING AND AIDS KNOWLEDGE/COUNSELING (IF)
{ ASKED FOR ALL
INTRO_I2
IF-0. Now I would like to ask you about testing for HIV, the virus that causes AIDS.
{ ASKED FOR ALL
DONBLOOD
IF-1. First, I'll ask you about blood and blood product donations you may have made to the Red Cross or other blood banks. By blood products, we mean such things as plasma, platelets, and marrow. Have you ever donated blood or blood products at the Red Cross, at a bloodmobile, at a blood drive, or at other blood banks?
[HELP AVAILABLE]
Yes ........... 1
No ............ 5
{ ASKED FOR ALL
HIVTEST
IF-2. (Not counting tests you may have had as part of donating blood or blood products,) Have you ever been tested for HIV?
NOTE: Explain, if necessary, that you will not be asking for the results of any test he may have ever had.
Yes ...................... 1
No ....................... 5
{ IF HIVTEST = DK or RF, GO TO HE-5c PREPHIV.
{ IF HIVTEST = 1, GO TO IF-3 WHENHIV_M/_Y
{ ASEDK IF R NEVER HAD AN HIV TEST, HIVTEST=5
NOHIVTST
IF-2b. IF IF-2 HIVTEST = NO ASK:
Which one of these reasons shown on Card 88 would you say is the MAIN reason why you have not been tested for HIV?
You have never been offered an HIV test 1
You are worried about what other people would think if you
got tested for HIV 2
It's unlikely you've been exposed to HIV 3
You were afraid to find out if you were HIV positive (that
you had HIV) 4
You don't like needles 5
Some other reason 20
{ ASKED IF R REPORTED SOME OTHER REASON FOR NOT HAVING AN HIV TEST,
{ NOHIVTST=20
SP_NOHIVTST
IF-2sp. What was the MAIN reason why you have not been tested for HIV?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ ASKED IF R HAD ANY HIV TEST OUTSIDE OF BLOOD DONATION
WHENHIV_M/WHENHIV_Y
IF-3m/IF-3y. (Not including tests you may have had as part as part of donating blood or blood products,) in what month and year was your last test for HIV, the virus that causes AIDS?
{ ASKED IF R DOES NOT REPORT SPECIFIC MONTH AND YEAR
HIVTSTYR
IF-3b. Did you have this last HIV test since (INTERVIEW MONTH, INTERVIEW YEAR - 1)?
Yes ...................... 1
No ....................... 5
{ ASKED IF R REPORTED ANY HIV TESTING APART FROM BLOOD DONATION,
{ HIVTEST=1
HIVRESULT
IF-3d. After your last test for HIV, did you find out your test result?
Yes............1
No.............5 (IF-3e WHYNOGET)
{ IF R ANSWERED YES, DK, OR RF TO FINDING OUT TEST RESULT, GO TO PLCHIV
{ ASKED IF R NEVER RECEIVED TEST RESULT
WHYNOGET
IF-3e. What was the main reason why you did not find out your test
result?
You thought the testing site would contact you 1
You were afraid to find out if you were HIV positive (that
you had HIV) 2
You didn't want to know your HIV test result 3
You didn't know where or how to get your test result 4
Some other reason 20
{ ASKED IF SOME OTHER REASON GIVEN FOR NOT RECEIVING TEST RESULT,
{ WHYNOGET=20
SP_WHYNOGET
IF3e_sp. IF IF-3e WHYNOGET=20, ASK:
What was this other reason that you did not find out your HIV test result?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ ASKED IF R REPORTED ANY HIV TESTING APART FROM BLOOD DONATION
PLCHIV
IF-4. Please look at Card 72. (Not including tests you may have had as part of donating blood or blood products,) Where did you have that last test for HIV?
Private doctor's office..............................1
HMO facility ........................................2
Community health clinic, community clinic,
public health clinic .............................3
Family planning or Planned Parenthood clinic ........4
Employer or company clinic ..........................5
School or school-based clinic (including college or
university) ......................................6
Hospital outpatient clinic ..........................7
Hospital emergency room .............................8
Hospital regular room ...............................9
Urgent care center, urgi-care, or walk-in facility .10
Your worksite ......................................11
Your home ..........................................12
Military induction or military service site.........13
Sexually transmitted disease (STD) clinic...........14
Laboratory or blood bank............................15
Some other place ...................................20
{ ASKED IF SOME OTHER PLACE GIVEN FOR TESTING SITE, PLCHIV=20
SP_PLCHIV
IF-4sp . Where was this other place that you had your last HIV test?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ Asked if R reported their last HIV test was done at their home (PLCHIV=12)
RHHIVT1
IF-4a. A rapid home HIV test is a test you can use to test yourself that can provide results in about 20 minutes or less. The last time you had an HIV test, did you use a rapid home HIV test?
Yes..........................1
No...........................5 (IF-5 HIVTST)
{ Asked if R reported their last HIV test was a rapid home HIV test
RHHIVT2
IF-4b. People use a rapid home HIV test for many different reasons. Looking at Card XX, which of these reasons did you have for using the rapid home HIV test?
ENTER all that apply
I didn’t want to get tested by a doctor or
at an HIV testing site ................................1
I didn’t want other people to know I am getting tested ...2
I wanted to get tested together with someone, before
we had sex ............................................3
I wanted to get tested by myself, before having sex ......4
I wanted to get tested by myself, after having sex .......5
A sex partner asked me to take a rapid home HIV test .....6
Other reason ............................................20
{ ASKED IF R HAD ANY HIV TEST OUTSIDE OF BLOOD DONATION, HIVTEST=1
HIVTST
IF-5. Please look at Card 73b. I am going to show you a list of reasons why some people have been tested for HIV, the virus that causes AIDS. (Not including tests you may have had as part of donating blood or blood products), which of these would you say was the main reason for your last HIV test?
Part of a medical checkup or surgical procedure (a doctor or
medical provider asked for the test).....................1
Required for health or life insurance coverage.................2
Required for marriage license or to get married................3
Required for military service or a job ........................4
You wanted to find out if infected or not (you were the one
who asked for the test)..................................5
Someone else suggested you should be tested ...................6
INTENTIONALLY BLANK ...........................................7
You might have been exposed through sex or drug use ...........8
You might have been exposed in some other way .................9
Some other reason – specify ..................................20
{ ASKED IF REPORTED “SOME OTHER REASON” GIVEN FOR HIV TEST, HIVTST=20
SP-HIVTST
IF-5sp. What was the main reason for your last HIV test?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
{ASKED FOR ALL
/ ” Heard about PrEP medications”
PREPHIV There are medications available for people who do not have HIV to
IF-5c keep them from getting HIV. Have you heard of these medicines?
Yes ............................1
No .............................5
{ ASKED FOR ALL
TALKDOCT
IF-6. Has a doctor or other medical care provider ever talked with you about HIV, the virus that causes AIDS?
Yes ............................1
No .............................5 (SECTION J)
{ ASKED FOR THOSE WITH TALKDOCT = YES
AIDSTALK
IF-7. Looking at Card 74, what topics related to HIV or AIDS were covered in the discussion you had with the doctor or other medical care provider?
ENTER all that apply
How HIV/AIDS is transmitted .....................1
Other sexually transmitted diseases like
gonorrhea, herpes, or Hepatitis C .........2
The correct use of condoms ......................3
Needle cleaning/using clean needles .............4
Dangers of needle sharing .......................5
Abstinence from sex (not having sex) ............6
Reducing your number of sexual partners..........7
Condom use to prevent HIV or STD transmission....8
“Safe sex” practices (abstinence,
condom use, etc).....................9
Getting tested and knowing your HIV status .....10
Medicines to prevent getting HIV (pre-exposure
prophylaxis, also known as PrEP.................11
Other ..........................................20
{ ASKED IF R RESPONDED “OTHER” TO AIDSTALK
SP_AIDSTALK
IF-7sp. What was the other topic covered in your discussion with the doctor or medical care provider about HIV or AIDS?
NOTE: NO VERBATIM VARIABLES ARE INCLUDED ON THE PUBLIC USE FILE.
SECTION J
Residence and Place of Birth; Religion; Military Service; Past and Current Work (R and Wife/cohab Partner); Attitudes
Residence and Place of Birth (JA)
{ ASKED FOR ALL
SAMEADD
JA-0. Now I have some questions about where you live.
Were you living at this same address on April 1, 2010?
Yes................1 (GO TO JA-7 BRNOUT)
No.................5
{ ASKED IF NOT LIVING AT THIS ADDRESS ON APRIL 1, 2010
CNTRY10
JA-1. Were you living in the United States on April 1, 2010?
[HELP AVAILABLE]
Yes................1
No.................5 (GO TO JA-7 BRNOUT)
ASTATE
JA-4. Please tell me in which state you were living on April 1, 2010.
[LINK STATE DATABASE]
State ________________________
( THIS INFORMATION WILL NOT BE PLACED ON THE FINAL DATA FILE.)
{ ASKED FOR ALL
BRNOUT
JA-7. Were you born outside of the United States?
[HELP AVAILABLE]
Yes .........1
No ..........5 (GO TO JB-1 RELRSD)
{ASKED IF R WAS BORN OUTSIDE THE U.S.
STRUS_M/STRUS_Y
JA-8. In what month and year did you come to the United States to stay?
[HELP AVAILABLE]
Religion (JB)
{ ASKED FOR ALL
RELRSD
JB-1. Now I have a few questions about religion. Please look at Card 77. In what religion were you raised, if any?
[HELP AVAILABLE]
If R says Protestant, ASK: (What is the complete name of the denomination?) If necessary, ENTER [11].
ENTER [1] if R was raised “atheist” or “agnostic”.
None......................................................1
Catholic..................................................2
Jewish....................................................3
Southern Baptist..........................................4
Baptist...................................................5
Methodist or African Methodist............................6
Lutheran..................................................7
Presbyterian..............................................8
Episcopal or Anglican.....................................9
Church of Jesus Christ of Latter Day Saints (LDS/Mormon).10
Other ...................................................11
{ ASKED IF R’S RELIGION RAISED WAS “OTHER” (JB-1 RELRSD = 11)
RELRSD1
JB-2. Please look at Card 78. In what religion were you raised?
[HELP AVAILABLE]
Assemblies of God....................................12
Church of Nazarene...................................13
The Church of God....................................14
The Church of God (Cleveland, TN)....................15
The Church of God in Christ..........................16
7th Day Adventist.....................................17
United Pentecostal Church............................18
Pentecostal Assemblies...............................19
Jehovah’s Witness....................................20
Christian, another denomination not listed ..........21
Christian, no specific denomination .................22
Unitarian-Universalist...............................23
Greek Orthodox.......................................24
Other Orthodox.......................................25
Muslim...............................................26
Buddhist.............................................27
Hindu................................................28
Other ...............................................29
{ASKED IF R IS UNDER AGE 25
ATTND14
JB-4. Please look at Card 79. When you were 14, about how often did you usually attend religious services?
[HELP AVAILABLE]
More than once a week....................1
Once a week..............................2
2-3 times per month......................3
Once a month (about 12 times a year) ....4
3-11 times a year........................5
Once or twice a year.....................6
Never....................................7
{ ASKED FOR ALL
RELNOW
JB-5. Please look at Card 77. What religion are you now, if any?
If R says Protestant, ASK: What is the complete name of the denomination? If necessary, ENTER [11].
If R identifies with more than one religion, enter the number of the first one mentioned and insert an F2 comment with the code for the 2nd religion with R’s comments.
ENTER [1] if R was raised “atheist” or “agnostic”.
None......................................................1
Catholic..................................................2
Jewish....................................................3
Southern Baptist..........................................4
Baptist...................................................5
Methodist or African Methodist............................6
Lutheran..................................................7
Presbyterian..............................................8
Episcopal or Anglican.....................................9
Church of Jesus Christ of Latter Day Saints (LDS/Mormon).10
Other ...................................................11
{ ASKED IF R’S RELIGION IS “OTHER” (JB-5 RELNOW = 11)
RELNOW1
JB-6. Please look at Card 78. What religion are you now?
Assemblies of God....................................12
Church of Nazarene...................................13
The Church of God....................................14
The Church of God (Cleveland, TN)....................15
The Church of God in Christ..........................16
7th Day Adventist.....................................17
United Pentecostal Church............................18
Pentecostal Assemblies...............................19
Jehovah’s Witness....................................20
Christian, another denomination not listed ..........21
Christian, no specific denomination .................22
Unitarian-Universalist...............................23
Greek Orthodox.......................................24
Other Orthodox.......................................25
Muslim...............................................26
Buddhist.............................................27
Hindu................................................28
Other ...............................................29
{ IF R’s RELIGION IS JEWISH, MUSLIM, BUDDHIST, HINDU, DON’T KNOW, OR REFUSED,
{ GO TO JB-9 RELDLIFE
{ ELSE IF R’S RELIGION IS NONE, GO TO JB-10 ATTNDNOW
{ ELSE ASK JB-8 FUNDAM
FUNDAM
JB-8. Please look at Card 80. Which of these do you consider yourself to be, if any?
ENTER all that apply
A born again Christian..........1
A charismatic...................2
An evangelical..................3
A fundamentalist ...............4
None of the above...............5
[Response category 5 cannot be entered in combination with any other response.]
{ ASKED IF R REPORTED A RELIGION
RELDLIFE
JB-9. Currently, how important is religion in your daily life? Would you say it is very important, somewhat important, or not important?
[HELP AVAILABLE]
Very important...................1
Somewhat important...............2
Not important....................3
{ ASKED FOR ALL
ATTNDNOW
JB-10. Please look at Card 79. About how often do you attend religious services?
[HELP AVAILABLE]
More than once a week....................1
Once a week..............................2
2-3 times per month......................3
Once a month (about 12 times a year) ....4
3-11 times a year........................5
Once or twice a year.....................6
Never....................................7
{ JC SERIES ASKED ONLY IF R WAS 18 OR OLDER AT TIME OF HH SCREENER
Military Service (JC)
MILSVC
JC-1. Have you ever been on active duty in the Armed Forces for a period of 6 months or more?
Yes.............1
No..............5 (JD-4 WRK12MOS)
BEGMIL_M/BEGMIL_Y
JC-2. In what month and year did that period of active duty begin?
ENDMIL_M/ENDMIL_Y
JC-3. What was the month and year of your last separation from active duty?
If R is still on active duty, enter 96 for month.
Work (JD)
{ ASKED FOR ALL
WRK12MOS
JD-4. Now I’d like to ask about your work experience in the last 12 months. By work, I mean any job for pay that was regularly scheduled, that you were expected to perform. Please include full-time, part-time, and temporary or summer jobs.
[HELP AVAILABLE]
In the last 12 months, that is since [INTERVIEW MONTH, INTERVIEW YEAR - 1], for how many months did you have any job for pay?
w Active duty military is considered full-time employment/work
Number of months (IF ZERO, DK, RF, GO TO JE-1 DOLASTWK)
{ ASKED IF R WORKED 1-12 MONTHS
FPT12MOS
JD-5. In the last 12 months, did you work all full-time, all part-time or some of each?
[HELP AVAILABLE]
Full-time............1
Part time............2
Some of each.........3
Current/Last Job Series (JE)
{ ASKED FOR ALL
DOLASTWK
JE-1. Please look at Card 82. Last week, what were you doing? Were you working, keeping house, going to school, or something else?
[HELP AVAILABLE]
ENTER all that apply
Working....................................... 1
Not working at job due to temporary illness,
vacation, strike, etc....................... 2
On paternity or family leave from job......... 3
Unemployed, laid off, or looking for work..... 4
Keeping house................................. 5
Taking care of family .........................6
Going to school............................... 7
On permanent disability....................... 8
Something else ............................... 9
{ IF R IS CURRENTLY EMPLOYED OR WORKED IN THE LAST 12 MONTHS, GO TO JE-3 RNUMJOB.
{ ASKED IF R DIDN’T WORK IN THE LAST 12 MONTHS
{ AND WASN’T WORKING LAST WEEK
RPAYJOB
JE-2. Did you ever work at a job or business for pay on a regular basis?
Yes.....................1
No......................5 (GO TO JF SERIES)
(IF DON’T KNOW OR REFUSED, GO TO JF SERIES)
{ ASKED IF R IS CURRENTLY EMPLOYED, OR WORKED IN THE LAST 12 MONTHS, OR EVER WORKED (RPAYJOB=1)
RNUMJOB
JE-3. How many jobs did you work (last week/during the last week you worked)?
Number of jobs __________
RFTPTX
JE-4. (Please think about the last week you worked on your (primary) job. Did/At your primary job, do/Do) you work part-time or full-time, or some of each? By full-time I mean 35 or more hours a week.
Full time...............1
Part time...............2
Some of each............3
Spouse/Partner’s Current/Last Job Series (JF)
{ IF R IS NOT CURRENTLY MARRIED OR COHABITING, GO TO JG SERIES
SPLSTWK
JF-1. Please look at Card 81. Last week, what was (WIFE/PARTNER) doing? Was she working, keeping house, going to school, or something else?
[HELP AVAILABLE]
ENTER all that apply
Working....................................... 1
Not working at job due to temporary illness,
vacation, strike, etc....................... 2
On maternity or family leave from job......... 3
Unemployed, laid off, or looking for work..... 4
Keeping house................................. 5
Taking care of family .........................6
Going to school............................... 7
On permanent disability....................... 8
Something else ................................9
{ IF WIFE/PARTNER EMPLOYED/WORKING LAST WEEK (JF-1 SPLSTWK = 1, 2, 0R 3), GO
{ TO JF-3 SPNUMJOB
{ ASKED IF WIFE/PARTNER NOT EMPLOYED/WORKING LAST WEEK
SPPAYJOB
JF-2. Did she ever work at a job or business for pay on a regular basis?
Yes.....................1
No......................5 (GO TO JG SERIES)
{ ASKED IF R’S WIFE/PARTNER WAS WORKING LAST WEEK OR SHE EVER WORKED FOR PAY
SPNUMJOB
JF-3. How many jobs did she work (last week/during the last week she worked)?
Number of jobs __________
SPFTPTX
JF-3. (Please think about the last week she worked on her (primary) job. Did/At her primary job, does/Does) she work part time or full time, or some of each? By full time I mean 35 or more hours a week.
Full-time...............1
Part time...............2
Some of each............3
Attitudes Towards Sex, Contraception, Marriage, Gender and Parenthood (JG-JH)
{ JG series asked of all, unless otherwise indicated
JGINTRO1
JG-0. Next, I would like to get your opinion on some matters concerning family life. Please look at Card 84 to see the response options. I will read you some statements, and I would like you to tell me if you strongly agree, agree, disagree, or strongly disagree. The first statement is:
SAMESEX
JG-1. Sexual relations between two adults of the same sex are all right.
Strongly agree...................................1
Agree ...........................................2
Disagree ........................................3
Strongly disagree................................4
IF R INSISTS: Neither agree nor disagree ........5
CHSUPPOR
JG-2. It is okay for a young, unmarried woman to have and raise a child.
Strongly agree...................................1
Agree ...........................................2
Disagree ........................................3
Strongly disagree................................4
IF R INSISTS: Neither agree nor disagree ........5
{ ASKED IF NEITHER R NOR HIS WIFE/PARTNER, IF ANY, ARE STERILE AND HIS
{ WIFE/PARTNER IS NOT CURRENTLY PREGNANT
REACTSLF
JG-3. If you got (your wife/your partner/a female) pregnant now how would you feel? Would you be very upset, a little upset, a little pleased, or very pleased?
Very upset ......................1
A little upset ..................2
A little pleased ................3
Very pleased ....................4
IF R INSISTS: he wouldn’t care...5
{ ASKED OF ALL
CHBOTHER
JG-4. If it turns out that you do not have any (additional) children, would that bother you a great deal, some, a little, or not at all?
[HELP AVAILABLE]
A great deal ....................................1
Some ............................................2
A little ........................................3
Not at all ...... ...............................4
SEXNEEDS
JG-5. Again, please tell me if you strongly agree, agree, disagree, or strongly disagree with the following statements.
Men have greater sexual needs than women.
Strongly agree .................................1
Agree ..........................................2
Disagree .......................................3
Strongly disagree...............................4
If R insists: Neither agree nor disagree .......5
WHENSICK
JG-6. Men only need to see a doctor when they are hurt or sick.
Strongly agree .................................1
Agree ..........................................2
Disagree .......................................3
Strongly disagree...............................4
If R insists: Neither agree nor disagree .......5
SHOWPAIN
JG-7. When a man is feeling pain he should not let it show.
Strongly agree .................................1
Agree ..........................................2
Disagree .......................................3
Strongly disagree...............................4
If R insists: Neither agree nor disagree .......5
{ ASKED IF R IS NOT CURRENTLY MARRIED OR COHABITING
COHCHANCE
JG-8. Please look at Card 58. Do you think that you will ever (again) live together with a woman to whom you are not married?
If R insists he does not know, enter [Ctrl] + [D]
Definitely yes .................1
Probably yes ...................2
Probably no ...................3
Definitely no .................4
{ ASKED IF R IS NOT CURRENTLY MARRIED
MARRCHANCE
JG-9. (Please look at Card 58.) You may have already told me this, but do you think that you will get married (again) someday?
If R insists he does not know, enter [Ctrl] + [D]
Definitely yes .................1
Probably yes ...................2
Probably no ...................3
Definitely no .................4 (GO TO JH SERIES)
{ ASKED IF R SAYS THAT HE MAY (RE)MARRY SOMEDAY
PMARCOH
JG-10. Again, you may have already told me this, but do you think that you will live together with your future wife before getting married?
If R insists he does not know, enter [Ctrl] + [D]
Definitely yes .................1
Probably yes ...................2
Probably no ...................3
Definitely no .................4
{ Question only intended for interviewer.
ACASILANG
JG-11. Interviewer: Should ACASI be conducted in English or Spanish?
English............................1
Spanish............................2
SECTION K
Audio CASI
{ READ BY INTERVIEWER FROM THE SCREEN
INTRO_K1
INTRO-K1. For this last part of the interview, I’ll turn the computer over to you so that you can enter your answers by yourself. We have these headphones so that you can listen to the questions in privacy, and you can also read the questions on the computer screen. I will not be able to hear the questions or see the answers you type into the computer. After I explain a few of the keys that you’ll be using, I’ll help you with the first few practice questions, just to get you started. Then I’ll leave you on your own to answer the rest of the questions in privacy.
When you are done with this section, a screen will come up that will tell you how to lock away your responses so that no one can see how you answered the questions. Then you can return the computer to me.
INTRO_K1b
INTRO-K1b. INTERVIEWER: Explain the following things to R:
Connect the headphones to the laptop.
Give the computer to the Respondent.
Show Respondent where to find number keys, Enter, Backspace, F11,
F12, and Hyphen keys.
Show Respondent the Aid Card.
Explain that on the back of this page is a list they will be referring to toward the end of this section.
Explain how to adjust the volume.
Explain that you will be doing an unrelated task while the Respondent completes Audio CASI, but Respondent should feel free to interrupt with questions.
The next screen is for the Respondent.
A-CASI PRACTICE QUESTIONS (KA)
{ MACHINE AUDIO BEGINS HERE
INTRO_K2
INTRO-K2. These questions are for you to practice with. The interviewer is going to help you do this.
You may press the [BACKSPACE] key to clear an entry when you want to change an answer, or when the computer asks you to correct an answer.
Please press the large [Enter] key on the right side of the keyboard to see the first question.
PRACYEAR
KA-1. In what year were you born?
Please enter the 4-digit year you were born and press the [Enter] key.
Year ________
PRACMNTH
KA-2. In what month in [PRACYEAR] were you born?
Please enter the number for the month.
January ........01
February .......02
March ..........03
April ..........04
May ............05
June ...........06
July ...........07
August .........08
September ......09
October ........10
November .......11
December .......12
PRACCNFM
KA-3. The computer has recorded that you were born in [PRACMNTH, PRACYEAR]. Is this correct?
YES .......1 (KA-0 INTROK3a)
NO ........5 (RETURN TO KA-1 PRACYEAR TO RE-ENTER CORRECT INFO)
INTROK3a
KA-3a. Thank you. Now we will go over a few keystrokes which will help you complete the survey.
Please press [Enter] to continue
INTROK3ab
KA-3ab. If you want to replay the audio, press the [F11] key. It is located rear the top right side of the keyboard.
Please press [Enter] to continue
INTROK3b
KA-3b. If you want to hide the question, press the [F12] key. To make the question reappear, simply press [F12]again. The [F12] key is located near the [F11] key on the top right side of the keyboard.
Please press [Enter] to continue
INTROK3c
KA-3c. If you do not know the answer to a question, press the [CTRL] and [D] keys at the same time.
The [CTRL] key is at the bottom left of the keyboard. It is labeled “Ctrl”.
Please press [Enter] to continue
INTROK3d
KA-3d. If you do not wish to answer a particular question, press the [CTRL] and [R] keys at the same time.
Please press [Enter] to continue
INTROK3e
KA-3e. If you have any questions about how to use the computer, please ask your interviewer now. Otherwise, please press the [Enter] key to continue on your own.
INTRO_K4
INTRO-K4. These first questions are about your general health.
Please press [Enter] to continue
GENHEALT
KA-4. In general, how is your health? Would you say it is...
Excellent .....................1
Very good .....................2
Good ..........................3
Fair ..........................4
Poor ..........................5
RHEIGHT_FT
KA-5. How tall are you?
First, please select the number of feet, then press [Enter].
3 feet ......... 3
4 feet ..........4
5 feet ..........5
6 feet ..........6
7 feet ..........7
(DK OR RF: GO TO KB SERIES)
RHEIGHT_IN
KA-5. Now please select the number of inches and then press [Enter].
0 inches .......00
1 inch .........01
2 inches .......02
3 inches .......03
4 inches .......04
5 inches .......05
6 inches .......06
7 inches .......07
8 inches .......08
9 inches ......09
10 inches ......10
11 inches ......11
RWEIGHT
KA-6. How much do you weigh?
Please answer in pounds and then press [Enter].
Pounds ________
{ Asked for all Rs
DRWEIGH
KA-6a. The next couple of questions are about your weight. In the past 12 months, that is, since (CMLSTYR_FILL), did a doctor or other medical care provider weigh you?
Yes.......................1
No........................5
{ Asked if DRWEIGH=yes
TELLWGHT
KA-6b. During your visit in the past 12 months, did a doctor or other medical care provider tell you that you were underweight, normal weight, overweight, obese, or were you not told?
Underweight......................................1
Normal weight....................................2
Overweight.......................................3
Obese............................................4
Not told.........................................5
{ Asked if R was told he was overweight or obese (TELLWGHT=3 OR 4)
WGHTSCRN
KA-6c. During your visit in the past 12 months, did a doctor or other medical care provider refer you to diet or exercise counseling?
Yes.......................1
No........................5
{ Asked for all Rs
ENGSPEAK
KA-7. The next question is about your ability to speak English. How well do
you speak English?
Very well ..........1
Well ...............2
Not well ...........3
Not at all .........4
Significant Events (KB)
INTRO_K5
INTRO-K5. The next few questions are about some things that you may have experienced recently in your life. We know that some of these questions are about things that you may not think about or talk about often. These things may be difficult to remember and some are personal.
Because this information is very important, please take as much time as you need to read the questions and put your answers into the computer in complete privacy. Your interviewer will never know how you answer and will not ask you any questions about your answers.
Please press [Enter] to continue
{ Asked for all Rs
NOBEDYR
KB-0a. In the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), was there ever a time when you did not have a permanent place to stay and had to stay at least overnight in a location
such as a shelter, a car or someplace outdoors?
Yes ............1
No .............5
{ Asked for all Rs
STAYREL
KB-0b
In the last 12 months, was there ever a time when you did not have a permanent place to stay and had to stay at least overnight with a friend or relative?
Yes ............1
No .............5
JAILED
KB-2. In the last 12 months, have you spent any time in a jail, prison or a juvenile detention facility?
Yes ............1 (GO TO KB-4 FRQJAIL)
No .............5
JAILED2
KB-3. Have you ever spent time in a jail, prison or juvenile detention center?
Yes ............1
No .............5
{ Asked if ever been in jail (JAILED=1 or JAILED2=1)
FRQJAIL
KB-4. Have you been in jail, prison, or a juvenile detention facility only one time or more than one time?
Only one time?...................1
Or more than one time?...........2
FRQJAIL2
KB-5. If KB-4 FRQJAIL = 1, ask:
How long were you in jail, prison, or juvenile detention?
Else if KB-4 FRQJAIL = 2, DK, OR RF, ask:
The last time you were in jail, prison, or juvenile detention, how long were you in?
One month or less 1
More than one month but less than one year 2
One year 3
More than one year 4
{ Asked only if R is 15-24 years old
EVSUSPEN
KB-6. Have you ever been suspended or expelled from school?
Yes ............1
No .............5 (GO TO Substance Use (KC))
{ Asked only if R is 15-24 years old
GRADSUSP
KB-7. What grade were you in when you were suspended or expelled from school? If you were suspended or expelled more than once, please enter the grade you were in the most recent time.
Grade _________
Substance Use (KC)
INTRO_K6
INTRO-K6. These next questions are about your use of cigarettes, alcohol, and other substances.
Please press [Enter] to continue.
SMK100
KC-0a1. In your entire life, have you smoked at least 100 cigarettes?
100 cigarettes is about 5 packs.
Yes.......................1
No........................5
{ ASKED IF SMOKED AT LEAST 100 CIGARETTES IN LIFETIME
AGESMK
KC-0a2. How old were you when you first started smoking fairly regularly?
Please enter your age in years.
If you never smoked regularly, enter 0.
Age in years ______
{ ASKED IF SMOKED AT LEAST 100 CIGARETTES IN LIFETIME
SMOKE12
KC-0a3. During the last 12 months, that is, since (INTERVIEW MONTH,
INTERVIEW YEAR - 1), how many cigarettes did you smoke a day, on
average?
None..................................1
About one cigarette a day or less.....2
Just a few cigarettes a day (2-4).....3
About half a pack a day (5-14)........4
About a pack a day (15-24)............5
More than a pack a day (25 or more)...6
{ Asked if R reported any amount of smoking in the last 12 months
SMKSTOP
KC-0a4. During the last 12 months, has a doctor or other medical care provider provided you with counseling or support for you to stop smoking or using other kinds of tobacco?
Yes.......................1
No........................5
DRINK12
KC-1. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), how often have you had beer, wine, liquor, or other alcoholic beverages?
Never ................................1 (GO TO KC-3 POT12)
Once or twice during the year ........2
Several times during the year ........3
About once a month ...................4
About once a week ....................5
About once a day .....................6
{ Asked if R reported any drinking in the past 12 months
UNIT30D
KC-1a_U. This next question asks about your drinking over the past 30 days. Would you prefer to answer in terms of days per week or days per month?
Days per week .........1
Days per month ........5
{ Asked if R answered UNIT30D with 1, 5, or DK
DRINK30D
KC-1a_N. IF UNIT30D = 1, ASK:
During the past 30 days, that is, since (mo/day/yr), on how many days per week did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
ELSE IF UNIT30D = 5 OR DK, ASK:
During the past 30 days, that is, since (mo/day/yr), on how many days did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
___ Number of days [IF 0, GO TO POT12]
{ Asked if R reported any drinking in the past 30 days.
DRINKDAY
KC-1b. One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
NOTE: A 40 ounce beer would count as 3 drinks, or a cocktail drink with 2 shots would count as 2 drinks.
____ Number of drinks
{ Asked if R reported any drinking in the past 30 days.
BINGE30
KC-1c. Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion?
____ Number of times
{ Asked if R reported any drinking in the past 30 days.
DRNKMOST
KC-1d. During the past 30 days, what is the largest number of drinks you had on any occasion?
____ Number of drinks
{ ASKED IF R REPORTED ANY ALCOHOL CONSUMPTION IN LAST 12 MONTHS
BINGE12
KC-2. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1) how often did you have 5 or more drinks within a couple of hours?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month ...................4
About once a week ....................5
About once a day .....................6
POT12
KC-3. During the last 12 months, how often have you smoked marijuana?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month ...................4
About once a week ....................5
About once a day or more .............6
COC12
KC-4. During the last 12 months, how often have you used cocaine?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month or more ...........4
CRACK12
KC-5. During the last 12 months, how often have you used crack?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month or more ...........4
CRYSTMTH
KC-5a. During the last 12 months, how often have you used Crystal or meth, also known as tina, crank, or ice?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month or more ...........4
INJECT12
KC-6. During the last 12 months, how often have you shot up or injected drugs other than those prescribed to you? By shooting up we mean anytime you might have used drugs with a needle, by mainlining, skin-popping, or muscling.
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month or more ...........4
Pregnancy/Abortion (KD)
INTRO_K7
INTRO-K7. Here are a few questions asking about pregnancies you have fathered. Sometimes men who take part in the study are reluctant to tell an interviewer about their experience with pregnancies, especially if the pregnancies ended in abortion or with children they no longer live with.
Please press [Enter] to continue.
{ IF R HAS NOT REPORTED FATHERING ANY PREGNANCIES IN SECTIONS C-F OF THE
{ QUESTIONNAIRE, ASK KD-1 MADEPREG;
{ ELSE IF ANY PREGNANCIES PREVIOUSLY REPORTED, GO TO KD-2b PREGTOT2.
{ ASKED IF R HAS NOT REPORTED FATHERING ANY PREGNANCIES IN SECTIONS C-F OF THE QUESTIONNAIRE
MADEPREG
KD-1. To the best of your knowledge, have you ever made someone pregnant?
Yes ............1
No .............5 (TOLDPREG KD-5)
{ ASKED IF R PREVIOUSLY REPORTED ANY PREGNANCIES IN SECTIONS C-F OF THE QUESTIONNAIRE
PREGTOT2
KD-2.To the best of your knowledge, how many times have you ever made someone pregnant? Please include any pregnancies you may have already told the interviewer about.
Number ______
NUMABORT
KD-3. To the best of your knowledge, how many of these pregnancies ended in abortion?
Number ______
NUMLIVEB
KD-4. ASK ONLY IF NUMBER OF ABORTIONS < NUMBER OF TOTAL PREGNANCIES:
To the best of your knowledge, how many of these pregnancies resulted in a baby being born?
(Twins or triplets from a pregnancy count as one pregnancy.)
Number ______
{ IF R’s AGE >= 25, GO TO INTRO_K8.
{ ASKED ONLY FOR R’s UNDER AGE 25.
TOLDPREG
KD-5. Have you ever been told by someone that you may have made her pregnant?
Yes ............1
No .............5 (GO TO KE SERIES)
WHATHAPP
KD-6. The last time you were told by someone that you may have made her pregnant, ...
Did it turn out that she was pregnant and you were the father, ....1
Or was she pregnant but you were not the father, ..................2
Or did it turn out that she was not pregnant? .....................3
Sex with Females (KE)
INTRO_K8
KE-0. The next questions are about sexual experiences that you may have had with a female.
Please press [Enter] to continue.
{ READ IF R IS UNDER AGE 20 AND HE HAS NEVER BEEN MARRIED AND NEVER COHABITED.
INTRO_K9a
KE-0a. Here are some things you may have done with a female. If you have ever done this at least one time with a female, answer yes. If you have never done this, answer no.
Please press [Enter] to continue.
{ ASKED IF R IS UNDER AGE 20 AND HE HAS NEVER BEEN MARRIED.
FEMTOUCH
KE-1. Has a female ever touched your penis until you ejaculated, or "came"?
Yes ............1
No .............5
{ READ IF R IS 20 OR OLDER OR IF R HAS EVER BEEN MARRIED.
INTRO_K9b
KE-0b. Here are some things you may have done with a female. If you have ever done this at least one time with a female, answer yes. If you have never done this, answer no.
{ ASKED IF R HAS NEVER MARRIED, NEVER COHABITED, NEVER FATHERED A PREGNANCY (BASED ON CAPI OR ACASI)
VAGSEX
KE-2. Have you ever put your penis in a female's vagina (also known as vaginal intercourse)?
Yes ............1
No .............5 (KE-5 GETORALF)
AGEVAGR
KE-2b. The first time this occurred, how old were you?
Age in years ________
CONDVAG
KE-3. Did you use a condom the last time you had vaginal intercourse with a female?
Yes ............1
No .............5 (KE-5 GETORALF)
{Asked if R used a condom at last vaginal intercourse
COND1BRK
KE-3a. That time, did it break or completely fall off during intercourse or withdrawal?
Yes ............1
No .............5
{Asked if R used a condom at last vaginal intercourse
COND1OFF
KE-3b. That time, was the condom used for only part of the time during intercourse? That is, did you put it on after you started having sex, or take it off during sex but before ejaculation?
Yes ............1
No .............5
WHYCONDL
KE-4. The last time you had vaginal intercourse with a female, did you use the condom...
To prevent pregnancy, ..................................1
To prevent diseases like gonorrhea, chlamydia, syphilis,
herpes or AIDS,.........................................2
For both reasons, ......................................3
Or for some other reason ...............................4
GETORALF
KE-5. The next few questions are about oral sex. By oral sex, we mean stimulating the genitals with the mouth. Has a female ever performed oral sex on you, that is, stimulated your penis with her mouth?
Yes ............1
No .............5 (KE-7 GIVORALF)
CONDFELL
KE-6. Did you use a condom the last time a female performed oral sex on you?
Yes ............1
No .............5
GIVORALF
KE-7. Have you ever performed oral sex on a female?
Yes ............1
No .............5
{ASKED IF R IS 15-24 AND HAS EVER HAD ORAL SEX AND VAGINAL INTERCOURSE
TIMING
KE-7b. Thinking back to when you had oral sex with a female for the first time, was it before, after, or on the same occasion as your first vaginal intercourse with a female?
Before first vaginal intercourse .......1
After first vaginal intercourse ........3
Same occasion...........................5
ANALSEX
KE-8. Have you ever put your penis in a female's anus or butt (also known as anal sex)?
Yes ............1
No .............5 (CONDSEXL KE-10)
CONDANAL
KE-9. Did you use a condom the last time you had anal sex with a female?
Yes ............1
No .............5
{ ASKED IF R REPORTED MORE THAN 1 TYPE OF MALE-GENITAL-INVOLVING SEX WITH A
{ FEMALE PARTNER.
CONDSEXL
KE-10. The very last time you had any type of sex -- that is, vaginal intercourse or anal sex or oral sex -- with a female partner, did you use a condom?
Yes ............1
No .............5
{ IF R’s AGE >= 18, CONTINUE WITH KF SERIES.
{ ELSE IF R’s AGE< 18, GO TO KG SERIES.
Non Voluntary Intercourse: Female - Male (KF)
{ KF SERIES ASKED ONLY IF R AGED 18 OR OLDER.
{ IF R EVER HAD VAGINAL SEX, ASK KF-1 WANTSEX1;
{ ELSE GO TO KF-2 EVRFORCD.
WANTSEX1
KF-1. Think back to the very first time you had vaginal intercourse with a female. Which would you say comes closest to describing how much you wanted that first vaginal intercourse to happen?
I really didn’t want it to happen at the time .........1
I had mixed feelings -- part of me wanted it to
happen at the time and part of me didn’t ........2
I really wanted it to happen at the time ..............3
{ IF DK OR RF, GO TO KF-1b HOWOLD
HOWOLD
KF-1b. How old were you when this first intercourse happened?
Age in years _____
EVRFORCD
KF-2. At any time in your life, have you ever been forced by a female to have vaginal intercourse against your will?
Yes...............1
No................5 (KG SERIES)
{ REMAINING ITEMS IN KF SERIES ONLY ASKED IF R REPORTED EVER BEING FORCED BY
{ A FEMALE
AGEFORC1
KF-3. How old were you the very first time you were forced by a female to have vaginal intercourse against your will?
Age in years _____
INTROK10
KF-4. The first time this occurred, were any of these kinds of force used?
Please press [Enter] to continue.
GIVNDRG2
KF-4a. Were you given alcohol or drugs?
Yes.........1
No..........5
SHEBIGOL
KF-4b. Did you do what she said because she was bigger than you or a grown-up, and you were young?
Yes.........1
No..........5
ENDRELA2
KF-4c. Were you told that the relationship would end if you didn’t have sex?
Yes.........1
No..........5
WRDPRES2
KF-4d. Were you pressured into it by her words or actions, but without threats of harm?
Yes.........1
No..........5
THRTPHY2
KF-4e. Were you threatened with physical hurt or injury?
Yes.........1
No..........5
PHYSHRT2
KF-4f. Were you physically hurt or injured?
Yes.........1
No..........5
HELDDWN2
KF-4g. Were you physically held down?
Yes.........1
No..........5
STD/HIV Risk Behaviors: Females (KG)
{ IF R NEVER HAD ORAL, ANAL, VAGINAL SEX WITH FEMALE, GO TO SECTION KH
INTROK11
KG-0. This next section is about your female sex partners. Now please think about any female with whom you have had vaginal intercourse, oral sex, or anal sex -- any of these.
Please press [Enter] to continue.
PARTSLIF
KG-1. Thinking about your entire life, how many female sex partners have you had? Please count every partner even those you had sex with only once.
Number _______
PARTS12
KG-2. Thinking about the last 12 months, how many female sex partners have you had in the 12 months since (INTERVIEW MONTH, INTERVIEW YEAR - 1)? Please count every partner even those you had sex with only once in those 12 months.
Number _______
{NEWYEAR AND NEWLIFE ASKED IF R REPORTS MORE FEMALE PARTNERS IN LAST 12 MONTHS THAN IN LIFETIME
NEWYEAR
KG-2YR. Earlier you reported having more female partners in the last 12 months than you have had in your life. One or both of these numbers appear to be entered incorrectly, so those questions will be asked again. Your previous answers are displayed below:
___ female partners in last 12 months
___ female partners in lifetime
NEWLIFE
KG-2LF. How many female partners did you have in your lifetime?
Number ___________
{ Asked if R has ever had vaginal intercourse
VAGNUM12
KG-2YRa. Your number of female partners in the last 12 months is displayed below. Thinking of your female partners in the last 12 months, with how many of them did you have vaginal intercourse?
DISPLAY: ___ female partners in last 12 months
{ Asked if R has ever had oral sex with a female
ORALNUM12
KG-2YRb. (Your number of female partners in the last 12 months is displayed below.) Thinking of your female partners in the last 12 months, with how many of them did you have oral sex, either giving or receiving?
DISPLAY: ___ female partners in last 12 months
{ Asked if R has ever had anal sex with a female
ANALNUM12
KG-2YRc. (Your number of female partners in the last 12 months is displayed below.) Thinking of your female partners in the last 12 months, with how many of them did you have anal sex?
DISPLAY: ___ female partners in last 12 months
{ IF R’s AGE < 18 AND R HAS A CURRENT SEXUAL PARTNER, READ INTROK12.
{ ELSE IF R’s AGE < 18 AND R HAS NO CURRENT SEXUAL PARTNERS OR
{ R’s AGE >= 18, GO TO KG-4 NONMONOG
INTROK12
KG-3. You indicated in the interview that you have (NUMBER) current sexual partner. Here are a couple of questions about (her/those partners).
{ SET UP LOOP TO ASK AGE (CURRPAGE THROUGH HOWMUCH) OF EACH OF 1, 2, OR 3 CURRENT PARTNERS
CURRPAGE
KG-3a. Earlier you reported that you last had sexual intercourse with the [(first/second/third)] person shown on the screen in (Mo/Yr of last sex with this partner). How old was she at that time?
Age in years _________
{
ASK IF CURRPAGE=DK
RELAGE
KG-3b. Is she older than you, younger than you or about the same age?
Older ................1
Younger ..............2
About the same age ...3 (NONMONOG KG-4)
HOWMUCH
KG-3c. By how many years?
1-2 years ..............1
3-5 years ..............2
6-10 years .............3
More than 10 years .....4
{ IF R HAD NO FEMALE SEXUAL PARTNERS IN LAST 12 MONTHS, GO TO SECTION KH
{ ASKED IF R HAD AT LEAST 1 FEMALE SEXUAL PARTNER IN LAST 12 MONTHS
NONMONOG
KG-4. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR-1), did you have sex with any females who were also having sex with other people at around the same time?
Yes ..........1
No ...........5
{ASKED IF R HAD SEX WITH FEMALE(S) WHO HAD SEX WITH OTHER PEOPLE DURING THE PAST 12 MONTHS (NONMONOG=1), AND R HAD MORE THAN 1 FEMALE PARTNER IN PAST 12 MONTHS
{Rs WITH ONLY 1 FEMALE PARTNER IN PAST 12 MONTHS GO STRAIGHT TO KG-5B
NNONMONOG1
KG-5a. To the best of your knowledge, how many of your female sexual partners in the last 12 months were having sex with other people around the same time?
1 partner ....................1
2 or more partners............2
NNONMONOG2
KG-5b. (Thinking of your 1 female partner in the last 12 months), how many
other partners do you think she had around the same time as she
was having sex with you?
1 other partner besides you ................1
2 other partners besides you ...............2
3 or more other partners besides you .......3
{ASKED IF NONMONOG=1 AND R HAD AT LEAST 2 FEMALE PARTNERS WHO HAD SEX WITH OTHER PEOPLE DURING THE PAST 12 MONTHS
NNONMONOG3
KG-5c. Thinking of your most recent female partner who had other sexual partners, how many other partners do you think she had around the same time as she was having sex with you?
1 other partner besides you ................1
2 other partners besides you ...............2
3 or more other partners besides you .......3
{ ASKED IF R HAD FEMALE SEXUAL PARTNER IN LAST 12 MONTHS
FEMSHT12
KG-6. In the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR-1), have you had sex with a female who takes or shoots street drugs using a needle?
Yes ..........1
No ...........5
{ ASKED IF R HAD FEMALE SEXUAL PARTNER IN LAST 12 MONTHS
JOHNFREQ
KG-7. In the last 12 months, have you given a female money or drugs in exchange for having sex with you?
Yes ..........1
No ...........5
{ ASKED IF R HAD FEMALE SEXUAL PARTNER IN LAST 12 MONTHS
PROSTFRQ
KG-8. In the last 12 months, has a female given you money or drugs to have sex with her?
Yes ..........1
No ...........5
{ ASKED IF R HAD FEMALE SEXUAL PARTNER IN LAST 12 MONTHS
HIVFEM12
KG-9. In the last 12 months, have you had sex with a female who you knew was infected with the AIDS virus?
Yes ..........1
No ...........5
Sex with Males (KH)
{ ASKED FOR ALL
INTROK13
KH-0. The next questions ask about sexual experience you may have had with another male. Have you ever done any of the following with another male?
Please press [Enter] to continue.
GIVORALM
KH-1. Have you ever performed oral sex on another male, that is, stimulated his penis with your mouth?
Yes ............1
No .............5
GETORALM
KH-2. Has another male ever performed oral sex on you, that is, stimulated your penis with his mouth?
Yes ............1
No .............5
{ ASKED IF R EVER HAD ORAL SEX WITH A MALE PARTNER
ORALCONDM
KH-2b. Did you use a condom the last time you had oral sex with a male?
Yes ............1
No .............5
ANALSEX2
KH-3. Has another male ever put his penis in your anus or butt (receptive anal sex)?
Yes ............1
No .............5
{ Asked if R ever had receptive anal sex with a male partner (ANALSEX2=1)
ANALCONDM1
KH-3b. Did you use a condom the last time you had receptive anal sex with a male?
Yes ............1
No .............5
ANALSEX3
KH-4. Have you ever put your penis in another male’s anus or butt (insertive anal sex)?
Yes ............1
No .............5
{ Asked if R ever had insertive anal sex with a male partner (ANALSEX3=1)
ANALCONDM2
KH-4b. Did you use a condom the last time you had insertive anal sex with a male?
Yes ............1
No .............5
{ Asked for all Rs
MALESEX
KH-4c. Have you ever had any other sexual experience of any kind with another male?
Yes ...........1
No ............5
{ Asked for all who have ever had any sexual experience with a male partner
MALPRTAGE
KH-5. Thinking of your most recent or last male sex partner, that is, the man with whom you last had any sexual experience, was he older than you, younger than you, or about the same age?
Older ................1
Younger ..............2
Same age .............3
{ Asked for all who have ever had any sexual experience with a male partner
MALPRTHISP
KH-6. Thinking of this same male partner with whom you last had any sexual experience, is he Hispanic or Latino, or of Spanish origin?
Yes ............1
No .............5
{ Asked for all who have ever had any sexual experience with a male partner
MALPRTRACE
KH-7. Thinking of this same male sexual partner, which of the groups shown below describe his racial background?
Please enter all that apply.
To enter multiple answers, enter the number of the first answer, press the space bar, enter the number of the next answer, and so forth. The space bar is the long key at the bottom of the keyboard, in the middle. Press [Enter] once you're finished entering all your answers.
American Indian or Alaska Native ..........1
Asian......................................2
Native Hawaiian or Other Pacific Islander..3
Black or African American .................4
White .....................................5
Non Voluntary Intercourse: Male -> Male (KI)
{ IF R’s AGE < 18, GO TO KJ SERIES.
{ IF R’s AGE >= 18, CONTINUE WITH KI SERIES.
EVRFORC2
KI-1. At any time in your life, have you ever been forced by a male to have oral or anal sex against your will?
Yes.........1
No..........5 (KJ SERIES)
{ REMAINDER OF KI SERIES ONLY ASKED IF R REPORTED EVER BEING FORCED BY A MALE
AGEFORC2
KI-2. How old were you the very first time you were forced by a male to have sexual intercourse against your will?
Age in years _____
INTROK14
KI-3. The first time this occurred, were any of these kinds of force used?
Please press [Enter] to continue.
GIVNDRG3
KI-3a. Were you given alcohol or drugs?
Yes.........1
No..........5
HEBIGOLD
KI-3b. Did you do what he said because he was bigger than you or a grown-up, and you were young?
Yes.........1
No..........5
ENDRELA3
KI-3c. Were you told that the relationship would end if you didn’t have sex?
Yes.........1
No..........5
WRDPRES3
KI-3d. Were you pressured into it by his words or actions, but without threats of harm?
Yes.........1
No..........5
THRTPHY3
KI-3e. Were you threatened with physical hurt or injury?
Yes.........1
No..........5
PHYSHRT3
KI-3f. Were you physically hurt or injured?
Yes.........1
No..........5
HELDDWN3
KI-3g. Were you physically held down?
Yes.........1
No..........5
STD/HIV Risk Behaviors: Males (KJ)
{ IF R REPORTED NO SEXUAL EXPERIENCE WITH A MALE PARTNER, GO TO KK-4 ATTRACT.
INTROK15
INTRO-K15. This next section is about males with whom you have had sexual contact. Think about any male with whom you have had any sexual experience.
Please press [Enter] to continue.
{ Asked for all who have ever had any sexual experience with a male partner
MALEPRTS
KJ-1. Thinking about your entire life, how many male sex partners have you had?
Number ________
{ Asked for all who have ever had any sexual experience with a male partner
MALPRT12
KJ-2. Thinking about the last 12 months, how many male sexual partners have you had in the 12 months since (INTERVIEW MONTH, INTERVIEW YEAR - 1)? Please count every partner, even those you had sex with only once in those 12 months.
Number ________
{ Asked if R ever had oral sex with a male partner (GIVORALM=1 OR GETORALM=1)
SAMORAL12
KJ-2YRa. Your number of male partners in the last 12 months is displayed below. Thinking of your male partners in the last 12 months, with how many of them did you have oral sex?
DISPLAY: [SAMYEARNUM] male partners in last 12 months
{ Asked if R ever had receptive anal sex with a male partner (ANALSEX2=1)
RECEPANAL12
KJ-2YRb. (Your number of male partners in the last 12 months is displayed below.) Thinking of your male partners in the last 12 months, with how many of them did you have receptive anal sex where he put his penis in your anus (butt)?
DISPLAY: [SAMYEARNUM] male partners in last 12 months
{ Asked if R ever had insertive anal sex with a male partner (ANALSEX3=1)
INSERANAL12
KJ-2YRc. (Your number of male partners in the last 12 months is displayed below.) Thinking of your male partners in the last 12 months, with how many of them did you have insertive anal sex where you put your penis in his anus (butt)?
DISPLAY: [SAMYEARNUM] male partners in last 12 months
{ Asked for all who have ever had any sexual experience with a male partner
SAMESEX1
KJ-3. Thinking back to the first time you ever had any sexual experience with a male partner, how old were you?
Age in years _______
{ Asked for all Rs who have ever had any sexual experience with a male partner
MSAMEREL
KJ-3a. At the time you first had any sexual experience with a male partner, how would you describe your relationship with him?
Married to him ...............................................1
Engaged to him ...............................................2
Living together in a sexual relationship, but not engaged ....3
Going with him or going steady ...............................4
Going out with him once in a while ...........................5
Just friends .................................................6
Had just met him .............................................7
Something else ...............................................8
{ IF R REPORTED NO MALE SEXUAL PARTNERS IN LAST 12 MONTHS, GO TO KJ-11 CNDLSMAL.
{ Asked if R had at least 1 male sexual partner in past year
MSMNONMON
KJ-4. Your number of male partners in the last 12 months is displayed below. In the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), how many of your male partners were having sex with other people around the same time?
DISPLAY: [SAMYEARNUM] male partners in last 12 months
MALSHT12
KJ-5. In the last 12 months, that is since (INTERVIEW MONTH, INTERVIEW YEAR - 1) have you had sex with a male who takes or shoots street drugs using a needle?
Yes ..........1
No ...........5
JOHN2FRQ
KJ-6. In the last 12 months, have you given a male money or drugs in exchange for having sex with you?
Yes ..........1
No ...........5
PROS2FRQ
KJ-7. In the last 12 months, has a male given you money or drugs to have sex with him?
Yes ..........1
No ...........5
HIVMAL12
KJ-8. In the last 12 months, have you had sex with a male who you knew was infected with the AIDS virus?
Yes ..........1
No ...........5
MSMSORT12
KJ-10. Some men only have sex with other males that they know have the same HIV status as they do, and some do not. Thinking about your male sex partners in the last 12 months, do you usually limit your male partners to those of the same HIV status to prevent getting or transmitting HIV?
Would you say “yes, usually,” “yes, some of the time,” or “no”?
Yes, usually ............1
Yes, some of the time ...3
No ......................5
{ Asked for all who have ever had any sexual experience with a male partner
CNDLSMAL
KJ-11. Now think of the last time you had any sexual experience with a male partner, was a condom used?
Yes ............1
No .............5
Sexual Attraction, Orientation, & Experience with STDs (KK)
{ IF R HAD SEXUAL ACTIVITY WITH ONLY FEMALES OR WITH ONLY MALES IN HIS LIFE,
{ GO TO KK-4 ATTRACT.
{ IF R HAD SEXUAL ACTIVITY WITH BOTH FEMALES AND MALES IN HIS LIFE,
{ BUT ONLY WITH MALES OR ONLY WITH FEMALES IN LAST 12 MONTHS,
{ GO TO KK-4 ATTRACT
{ ASKED IF R HAD BOTH MALE AND FEMALE PARTNERS IN THE LAST 12 MONTHS
CONDALLS
KK-1. The very last time you had any type of sex -- that is vaginal intercourse or anal sex or oral sex -- with a male or female partner, was a condom used?
Yes ............1
No .............5 (KK-3a DATEAPP)
MFLASTP
KK-2. Was that last sexual partner male or female?
Male ........1 (KK-3a DATEAPP)
Female ......2
{ ASKED ONLY IF LAST SEXUAL PARTNER WAS A FEMALE
WHYCOND
KK-3. Was the condom used...
To prevent pregnancy ....................................1
To prevent diseases like gonorrhea, chlamydia, syphilis,
herpes or AIDS,..........................................2
For both reasons ........................................3
Or for some other reason ................................4
{ Asked for all Rs
DATEAPP
KK-3a. In the past 12 months, have you had sex with anyone you first met
using a dating or “hookup” website or mobile app? Sex includes vaginal, anal and oral sex.
Yes ...........1
No ............5
ATTRACT
KK-4. People are different in their sexual attraction to other people. Which best describes your feelings? Are you...
Only attracted to females ...........................1
Mostly attracted to females .........................2
Equally attracted to females and males ..............3
Mostly attracted to males ...........................4
Only attracted to males .............................5
Not sure ............................................6
{ ASKED FOR ALL – USED IN RANDOM HALF SAMPLE OF NSFG RESPONDENTS
ORIENT_A
KK-5a. Do you think of yourself as ...
Heterosexual or straight.........1
Homosexual or gay................2
Or bisexual .....................3
{ ASKED FOR ALL – USED IN RANDOM HALF SAMPLE OF NSFG RESPONDENTS
ORIENT_B
KK-5b.
Which of the following best represents how you think of
yourself?
Gay........................................1
Straight, that is, not gay.................2
Bisexual ..................................3
Something else ............................4
INTROK16
KK-6. These next questions are about your sexual and reproductive health.
{ Asked for all Rs aged 15-25
CONFCONC
KK-6a. Would you ever not go for sexual or reproductive health care because your parents might find out?
Yes ............1
No .............5
{ Asked for all Rs aged 15-17
TIMALON
KK-6b. The last time you had a health care visit in the past 12 months, did a doctor or other health provider spend any time alone with you without a parent, relative or guardian in the room?
Enter 6 if you did not have a health care visit in the past 12 months.
Yes ............1
No .............5
{ Asked for all Rs
RISKCHEK1
KK-6c. In the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), has a doctor or other medical care provider asked you about your sexual orientation or the sex of your sexual partners?
Yes ............1
No .............5
{ Asked for all Rs
RISKCHEK2
KK-6d. In the last 12 months, has a doctor or other medical care provider asked you about your number of sexual partners?
Yes ............1
No .............5
{ Asked for all Rs
RISKCHEK3
KK-6e. In the last 12 months, has a doctor or other medical care provider asked you about your use of condoms?
Yes ............1
No .............5
{ Asked for all Rs
RISKCHEK4
KK-6f. In the last 12 months, has a doctor or other medical care provider asked you about the types of sex you have, whether vaginal, oral, or anal?
Yes ............1
No .............5
{ Asked if R >=18 years and has had anal sex with male partner in last year
RECTDOUCH
KK-6g. Some men use a rectal douche before or after anal sex, and some do not. During the last 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1) how often, if at all, did you use a rectal douche?
Never ................................1
Once or twice during the year ........2
Several times during the year ........3
About once a month ...................4
About once a week ....................5
About once a day or more .............6
{ Asked for all Rs
STDTST12
KK-7. In the past 12 months, that is, since (INTERVIEW MONTH, INTERVIEW YEAR - 1), have you been tested by a doctor or other medical care provider for a sexually transmitted disease like gonorrhea, chlamydia, herpes, or syphilis?
Yes ............1
No .............5 (GO TO KK-8 STDTRT12)
{ Asked only for Rs who said “yes” to STDTST12
STDSITE12
KK-7b. ASK IF KK-7 STDTST12 = 1 (YES):
In the past 12 months, have you been tested by a doctor or other medical care provider for a sexually transmitted disease like gonorrhea or chlamydia in your throat or pharynx or your rectum (anus or butt)?
Yes ............1
No .............5
{ Asked for all Rs
STDTRT12
KK-8. In the past 12 months, have you been treated or received medication from a doctor or other medical care provider for a sexually transmitted disease like gonorrhea, chlamydia, herpes, or syphilis?
Yes ............1
No .............5
{ Asked for all Rs
GON
KK-9. In the last 12 months, have you been told by a doctor or other provider that you had gonorrhea?
Yes ............1
No .............5
{ Asked for all Rs
CHLAM
KK-10. In the last 12 months, have you been told by a doctor or other medical care provider that you had chlamydia?
Yes ............1
No .............5
{ Asked for all Rs
HERPES
KK-11. At any time in your life, have you ever been told by a doctor or other medical care provider that you had genital herpes?
Yes ............1
No .............5
{ Asked for all Rs
GENWARTS
KK-12. At any time in your life, have you ever been told by a doctor or other medical care provider that you had genital warts?
Yes ............1
No .............5
{ Asked for all Rs
SYPHILIS
KK-13. At any time in your life, have you ever been told by a doctor or other medical care provider that you had syphilis?
Yes ............1
No .............5
{ Asked if R reported never injecting drugs other than those prescribed in the past 12 months (INJECT12=1) or DK/RF
EVRINJECT
KK-14. At any time in your life, have you ever shot up or injected drugs other than those prescribed for you?
Yes .............1
No ..............5 (KL Series)
{ Asked if R reported ever injecting drugs other than those prescribed in past 12 months (INJECT12=2,3,4)
EVRSHARE
KK-15. At any time in your life, have you ever shot up or injected drugs with a needle that someone else had used before you?
Yes .............1
No ..............5
Individual Earnings and Family Income and Public Assistance (KL)
{ ASKED FOR ALL
INTROK17
KL-0. Income is important in analyzing the information we collect. For example, this information helps us to learn whether persons in each income group get the health services they need.
Please press [Enter] to continue.
{ ASKED IF R EVER WORKED
EARNTYPE
KL-0a. Next, please enter your total earnings before taxes (on your last job). Will it be easier for you to enter your total earnings per week, per month, or per year?
Week..............1
Month.............2
Year..............3
EARN
KL-0b. Which category represents your total (weekly/monthly/yearly) earnings before taxes (on your last job)?
(WEEKLY INCOME CATEGORIES)
UNDER $96 1
$ 96-143 2
$ 144-191 3
$ 192-239 4
$ 240-288 5
$ 289-384 6
$ 385-480 7
$ 481-576 8
$ 577-672 9
$ 673-768 10
$ 769-961 11
$ 962-1,153 12
$1,154-1,441 13
$1,442-1,922 14
$1,923 or more 15
(MONTHLY INCOME CATEGORIES)
UNDER $417 1
$ 417-624 2
$ 625-832 3
$ 833-1,041 4
$1,042-1,249 5
$1,250-1,666 6
$1,667-2,082 7
$2,083-2,499 8
$2,500-2,916 9
$2,917-3,332 10
$3,333-4,166 11
$4,167-4,999 12
$5,000-6,249 13
$6,250-8,332 14
$8,333 or more 15
(YEARLY INCOME CATEGORIES)
UNDER $5,000 1
$ 5,000- 7,499 2
$ 7,500- 9,999 3
$10,000-12,499 4
$12,500-14,999 5
$15,000-19,999 6
$20,000-24,999 7
$25,000-29,999 8
$30,000-34,999 9
$35,000-39,999 10
$40,000-49,999 11
$50,000-59,999 12
$60,000-74,999 13
$75,000-99,999 14
$100,000 or more 15
{ASKED IF R ANSWERED DK OR RF ON KL-0b EARN
EARNDK1
KL-0c. Was it $20,000 or more per year?
Yes..........1
No...........5 (GO TO KL-1 INTROK18)
{ASKED IF R ANSWERED “YES” TO KL-0c EARNDK1
EARNDK2
KL-0d. Was it $50,000 or more per year?
Yes..........1
No...........5 (GO TO KL-1 INTROK18)
{ASKED IF R ANSWERED “YES” TO KL-0d EARNDK2
EARNDK3
KL-0e. Was it $75,000 or more per year?
Yes..........1
No...........5 (GO TO KI-1 INTROK18)
{ASKED IF R ANSWERED “YES” TO KL-0e EARNDK3
EARNDK4
KL-0f. Was it $100,000 or more per year?
Yes ............1
{ READ IF HOUSEHOLD INCLUDES MORE THAN JUST R.
INTROK18
KL-1. IF R IS MARRIED AND HOUSEHOLD SIZE > 2, SAY:
The next questions are about your combined family income last year, that is, in the year (year of interview – 1). When answering these questions, please remember that “combined family income” means your income plus your wife’s income, income from any of your family members that live here, and income from any of your wife’s family members that live here, before taxes.
{THERE ARE OTHER WORDING VARIANTS, DETERMINED BY HOUSEHOLD SIZE & COMPOSITION
Please press [Enter] to continue.
SOURCES
KL-1a. IF ROSCNT = 1, ASK:
Please look at the list of possible sources of income on the back of last card in the showcard booklet. In thinking about your income, please include any income you received last year from any of those sources. When you have read through the list please press the [Enter] key to continue.
ELSE IF ROSCNT > 1, ASK:
Please look at the list of possible sources of income on the back of the last card in the showcard booklet. In thinking about your combined family income, please include any income anyone in your family received last year from any of those sources. When you have read through the list please press the [Enter] key to continue.
TOINCWMY
KL-2. Remember, this item is important and your answers will be kept confidential. Will it be easier for you to report (your/the) total income (LASTYEAR_FILL) per week, per month, or per year?
Week..............1
Month.............2
Year..............3
TOTINC
KL-3. Which category represents (your total (weekly/monthly/yearly) income/the total combined (weekly/monthly/yearly) income of your family) in the year (year of interview – 1)? Please enter the amount before taxes.
{ ONSCREEN NOTES REMIND R OF WHOSE INCOME TO INCLUDE
(WEEKLY INCOME CATEGORIES)
UNDER $96 1
$ 96-143 2
$ 144-191 3
$ 192-239 4
$ 240-288 5
$ 289-384 6
$ 385-480 7
$ 481-576 8
$ 577-672 9
$ 673-768 10
$ 769-961 11
$ 962-1,153 12
$1,154-1,441 13
$1,442-1,922 14
$1,923 or more 15
(MONTHLY INCOME CATEGORIES)
UNDER $417 1
$ 417-624 2
$ 625-832 3
$ 833-1,041 4
$1,042-1,249 5
$1,250-1,666 6
$1,667-2,082 7
$2,083-2,499 8
$2,500-2,916 9
$2,917-3,332 10
$3,333-4,166 11
$4,167-4,999 12
$5,000-6,249 13
$6,250-8,332 14
$8,333 or more 15
(YEARLY INCOME CATEGORIES)
UNDER $5,000 1
$ 5,000- 7,499 2
$ 7,500- 9,999 3
$10,000-12,499 4
$12,500-14,999 5
$15,000-19,999 6
$20,000-24,999 7
$25,000-29,999 8
$30,000-34,999 9
$35,000-39,999 10
$40,000-49,999 11
$50,000-59,999 12
$60,000-74,999 13
$75,000-99,999 14
$100,000 or more 15
{ IF KL-3 TOTINC IS REPORTED, GO TO KL-4 PUBASST.
{ ASKED IF INCOME = DK OR RF
FMINCDK1
KL-3a. Was it less than $50,000 or $50,000 or more in (year of interview – 1)?
Less than $50,000 1
$50,000 or more 5 (GO TO KL-3d FMINCDK4)
{ ASKED IF INCOME WAS LESS THAN $50,000
FMINCDK2
KL-3b. Was it less than $35,000?
Yes..........1
No...........5 (GO TO KL-4 PUBASST)
{ ASKED IF INCOME WAS LESS THAN $35,000
FMINCDK3
KL-3c. Was it less than (poverty threshold for a family the size of the respondent’s)?
Yes..........1 (GO TO KL-4 PUBASST)
No...........5 (GO TO KL-4 PUBASST)
( ASKED IF INCOME WAS MORE THAN $50,000
FMINCDK4
KL-3d. Was it $75,000 or more last year?
Yes ............1
No .............5 (GO TO KL-4 PUBASST)
( ASKED IF INCOME WAS MORE THAN $75,000
FMINCDK5
KL-3e. Was it $100,000 or more per year?
Yes ............1
No .............5
{ ASKED FOR ALL
PUBASST
KL-4. At any time during (year of interview -1), even for one month, did you or any members of your family living here receive any cash assistance from a state or county welfare program, such as (DISPLAY STATE PROGRAM NAME(S))?
Do not include Food Stamps, SSI, Energy Assistance, WIC, School Meals, or Transportation, Child Care, Rental or Education Assistance.
Yes ............1
No .............5 (GO TO KL-6 FOODSTMP)
{ ASKED IF ANY GOVT PAYMENTS WERE REPORTED
PUBASTYP
KL-5. From what type of program did you or any members of your family living here receive the cash assistance? Was it a welfare or welfare-to-work program such as (DISPLAY STATE PROGRAM NAME(S)), General Assistance, Emergency Assistance, or some other program?
Please enter all that apply.
To enter multiple answers, enter the number of the first answer, press the space bar, enter the number of the next answer, and so forth. The space bar is the long key at the bottom of the keyboard, in the middle. Press [Enter] once you're finished entering all your answers.
(STATE PROGRAM NAME(S))/welfare/AFDC........................1
General assistance..........................................2
Emergency Assistance/short-term cash assistance.............3
Some other program..........................................4
{ ASKED FOR ALL
FOODSTMP
KL-6. The next question is about SNAP, the Supplemental Nutrition Assistance Program, formerly known as the Food Stamp Program. SNAP benefits are provided on an electronic debit card called [Display State Program Name(s)] or EBT card. In the year (year of interview – 1), did you or any members of your family living here receive food stamps or SNAP benefits?
Yes ............1
No .............5
{ ASKED FOR ALL
WIC
KL-7. In the year (year of interview – 1), did you or any members of your family living here receive WIC, the Women, Infants, and Children Nutrition Program?
Yes ............1
No .............5
{ ASKED FOR ALL
HLPTRANS
KL-8a. In the year (year of interview – 1), did you or any members of your family living here receive the following type of government assistance because your income was low...
Transportation assistance, such as gas vouchers, bus passes, or help registering, repairing, or insuring a car?
Yes............1
No.............5
{ ASKED FOR ALL
HLPCHLDC
KL-8b. (In the year (year of interview – 1), did you or any members of your family living here receive the following type of government assistance because your income was low...)
Any child care services or assistance so you or they could go to work or school or training?
Yes............1
No.............5
{ ASKED FOR ALL
HLPJOB
KL-8c. (In the year (year of interview – 1), did you or any members of your family living here receive the following type of government assistance because your income was low...)
A social services or Welfare office’s help with job training, a Job Club, a job search program, or anything else to help you or anyone in the household try to find a job?
Yes............1
No.............5
{ ASKED FOR ALL
FREEFOOD
KL-9. In the last 12 months, did you receive free or reduced-cost food or meals because you couldn’t afford to buy food?
Yes............1
No.............5
HUNGRY
KL-10. In the past 12 months, were you or any member of your family ever hungry, but you just couldn’t afford more food?
Yes............1
No.............5
MED_COST
KL-11. In the past 12 months, was there anyone in your household who needed to see a doctor or go to the hospital but couldn’t go because of the cost?
Yes............1
No.............5
Lock
The responses you have given in this section will now be locked away to maintain your privacy. In order to activate the lock, please enter a number between 1 and 100 and press [Enter].
CONCLUSN
CONCLUSN. Thank you again for your participation in this study. Your responses to this special section have been successfully locked away. Please turn the computer back to the interviewer.
INTVCLOSE
INTVCLOSE. INTERVIEWER: PLEASE ENTER [1] TO END THE INTERVIEW.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | ATTACHMENT 7: |
| Author | CDC User |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |
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