Immediate & 3-Month Follow-Up Survey
Assent to Participate
You are being asked to take a survey. This survey will ask you questions about yourself, your family, and your behavior. Some questions are about sexual health. These questions will be about romantic relationships, pregnancy, and sexually transmitted infections. The survey takes 30-40 minutes to finish. Your parent or guardian signed a form saying it is okay with them for you to take this survey. But it is your choice. You will not get in trouble if you do not take this survey. Even if you say yes now, you can quit at any time. You can also skip any questions you do not want to answer.
Benefits to You
This survey will help us learn what people your age think, feel, and do. There is no personal benefit to you. Taking this survey may not make your life better.
Risks of Taking this Survey
This survey asks questions that may make you feel uncomfortable. You may also feel embarrassed or upset. We can help you find a trusted adult to talk to about how you feel. You can also call or text any adults you know and trust. At the bottom of this page, we show some names of people and their phone numbers. You can talk to them about any of the questions or how we will use your answers.
How We Will Protect Your Information
We will protect your information. We will keep all information we get about you and from you private. Only study team members will see this information. Your information will be stored in a safe data system that only the study team can see. We will not share your information with your parents or guardians or with anybody else outside of the study team. The only time this rule will change is if you tell us that you or someone else is in danger. Then we have to tell someone whose job it is to keep you and others safe. The survey questions will not ask for your name or address. We will use a special number instead of your name. Nobody will be able to know your answers to the survey questions. When the study is over, the study team will erase your name from our records. When we use or share your data, it will be combined with other youth data. This is called “aggregate data.” This helps to make sure that no one will be able to know your answers to the survey questions. We may report aggregate data in articles or papers we publish. We will also share aggregate data with the U.S. Department of Health and Human Services.
Who to Contact If You Have Questions
If you have questions about the survey or your participation, please talk to <<insert name>> at <<insert phone number>>. You can also call the MITRE Institutional Review Board at <<insert phone number>> if you have questions about your rights as a study participant.
Do you agree to participate?
Yes
No
What is your date of birth?
Year
2003
2004
2005
2006
2007
2008
Month
January
February
March
April
May
June
July
August
September
October
November
December
Are you a…?
Male
Female
The next questions are about relationships, abstinence, birth control, and sexually transmitted diseases.
Since you took
the last survey, have you received information or learned about any
of the following?
Relationships, dating, marriage, or family
life
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
Abstinence from sex
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
Methods of birth control
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
Where to get birth control
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
Sexually transmitted diseases, also known as
STDs
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
How to talk to your partner about whether to
have sex or whether to use birth control
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
How to say no to sex
Yes
No
Since you took
the last survey, have you received information or learned about any
of the following?
How babies are made
Yes
No
Since you took the last survey, has your living situation changed? For instance, do you now live in a different place or live with different people?
Yes
No
What has
changed about your living situation since you took the last
survey?
(Check all that apply)
You live with different people
You live in a different place
Are any of the following statements true?
You are now homeless
You now live in a residential facility, detention center, or another type of facility
You were homeless when you took the last survey but now you are not
You were living in a residential facility, detention center, or another type of facility when you took the last survey but now you do not
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
Using condoms
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
Using other forms of birth control,
like birth control pills
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
Sexually transmitted diseases (STDs)
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
HIV/AIDS
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
Getting pregnant/getting someone
else pregnant
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your parent(s) or guardian(s)
about the following topics?
Waiting to have sex until you’re
older or sexual abstinence
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
Using condoms
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
Using other forms of birth control, like birth
control pills
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
Sexually transmitted diseases (STDs)
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
HIV/AIDS
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
Getting pregnant/getting someone else pregnant
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your best friend about the
following topics?
Waiting to have sex until you’re older
or sexual abstinence
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last survey, have you had a boyfriend/girlfriend or someone you liked “more than friends” who you have talked to or hung out with?
Yes (We will call this person a dating partner for the next question)
No
Since the last
survey, how much have you talked to your dating partner about the
following topics?
Using condoms
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your dating partner about the
following topics?
Using other forms of birth control, like birth
control pills
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your dating partner about the
following topics?
Sexually transmitted diseases (STDs)
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your dating partner about the
following topics?
HIV/AIDS
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your dating partner about the
following topics?
Getting pregnant/getting someone else pregnant
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
Since the last
survey, how much have you talked to your dating partner about the
following topics?
Waiting to have sex until you’re older
or sexual abstinence
Never talked about this
Talked about this 1 time
Talked about this 2 or 3 times
Talked about this 4 to 6 times
Talked about this 7+ times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Said things to hurt your feelings on
purpose
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Insulted you in front of others
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Would not let you do things with other
people
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Threatened to start dating someone else
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Did something just to make you jealous
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Blamed you for bad things they did
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Threatened to hurt you
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Made you describe where you were every
minute of the day
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Put down your looks
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Pushed, grabbed, shoved, or kicked you
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Called you names, put you down, or said
really mean things to you on Snapchat, Instagram, Facebook or other
social media and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Called your cellphone or sent you messages
when you didn’t want them to, just to make you mad
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Sent you messages that asked you to engage
in sexual acts when you didn’t want to
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Spread rumors about you on Snapchat,
Instagram, Facebook or other social media and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Used your posts or messages on Snapchat,
Instagram, Facebook or other social media and messaging apps to
harass you or put you down
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Shared private or embarrassing pictures or
videos of you on Snapchat, Instagram, Facebook or other social media
and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey has a boyfriend or girlfriend done
these things to you?
Used Snapchat, Instagram, Facebook or other
social media and messaging apps to threaten to hurt you physically
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Said things to hurt their feelings on
purpose
Never
1-3 times
4-9 times
10 or more times
How many
times since you took the last survey have you done these things to a
boyfriend or girlfriend?
Insulted you in front of others
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Would not let them do things with other
people
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Threatened to start dating someone else
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Did something just to make them jealous
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Blamed them for bad things you did
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Threatened to hurt them
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Made them describe where they were
every minute of the day
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Put down their looks
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Pushed, grabbed, shoved, or kicked them
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Called them names, put them down, or
said really mean things to them on Snapchat, Instagram, Facebook or
other social media and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Called their cellphone or sent them
messages when they didn’t want you to, just to make them mad
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Sent them messages that asked them to
engage in sexual acts when they didn’t want to
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Spread rumors about them on Snapchat,
Instagram, Facebook or other social media and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Used their posts or messages on
Snapchat, Instagram, Facebook or other social media and messaging
apps to harass them or put them down
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Shared private or embarrassing pictures
or videos of them on Snapchat, Instagram, Facebook or other social
media and messaging apps
Never
1-3 times
4-9 times
10 or more times
How many times
since you took the last survey have you done these things to a
boyfriend or girlfriend?
Used Snapchat, Instagram, Facebook or
other social media and messaging apps to threaten to hurt them
physically
Never
1-3 times
4-9 times
10 or more times
The next
question asks about cigarette smoking.
Since you took
the last survey, have you smoked cigarettes, even once?
Yes
No
The next
question asks about electronic vapor products, such as JUUL, Vuse,
MarkTen, blu, KandyPens, PaxEraPro, and APX Vape. Electronic vapor
products include e-cigarettes, e-cigars, e-hookahs, marijuana vape
pens, hookah pens, and mods.
Since you took the last
survey, have you used an electronic vapor product, even once?
Yes
No
The next
question asks about drinking alcohol. This includes drinking beer,
wine, wine coolers, and liquor such as rum, gin, vodka, or whiskey.
For this question, drinking alcohol does not include drinking a few
sips of wine for religious purposes.
Since you took the
last survey, have you drank alcohol, even once?
Yes
No
The next
question asks about marijuana use. Marijuana also is called pot,
weed, or cannabis.
Since you took the last survey, have
you ever used marijuana?
Yes
No
The next
question asks about synthetic marijuana use. Synthetic marijuana also
is called Spice, fake weed, K2, King Kong, Yucatan Fire, or Skunk.
Since you took the last survey, have you ever used synthetic
marijuana?
Yes
No
The next
question asks about the use of prescription pain medicine without a
doctor’s prescription or differently than how a doctor told you
to use it. For this question, count drugs such as codeine, Vicodin,
OxyContin, Hydrocodone, and Percocet.
Since you took the
last survey, have you ever you taken prescription pain medicine
without a doctor’s prescription or differently than how a
doctor told you to use it?
Yes
No
The next question asks about other drugs. Since you took the last survey, have you ever you used cocaine, heroin, methamphetamines, ecstasy, or hallucinogenic drugs like LSD, acid, or mushrooms?
Yes
No
The next set
of questions are about your sexual history. By sex, we mean vaginal,
oral, or anal sex. Please remember that your answers are strictly
confidential.
Since you took the last survey, have you had any
kind of sex?
Yes
No
Since you took the last survey, have you ever had vaginal sex, also called sexual intercourse? This is when a man puts his penis into a woman’s vagina.
Yes
No
Since you took the last survey, did you have sexual intercourse without using a condom?
Yes
No
The next question is about your use of the following methods of birth control: Birth control pills The shot (like, Depo Provera) The patch The ring (like, NuvaRing) IUD (like, Mirena or Paragard) Implants (like, Implanaon) Since you took the last survey, did you have sexual intercourse without using any of these methods of birth control?
Yes
No
Oral sex is
when someone puts his or her mouth on another person’s penis or
vagina, or lets someone else put his or her mouth on their penis or
vagina.
Since you took the last survey, have you had oral
sex?
Yes
No
Since you took the last survey, did you have you oral sex without using a condom or dental dam?
Yes
No
Anal sex is when a male puts his penis in someone else’s anus, or their butt, or someone lets a male put his penis in their anus or butt. Since you took the last survey, did you have anal sex?
Yes
No
Since you took the last survey, did you have you anal sex without using a condom?
Yes
No
Since you took the last survey, have you been pregnant?
Yes
No
Since you took the last survey, have you ever gotten someone pregnant?
Yes
No
Since you took the last survey, have you been tested by a doctor or nurse for a sexually transmitted disease, or STD, like gonorrhea, Chlamydia, syphilis, or HIV?
Yes
No
Since you took the last survey, have you been told by a doctor or other health professional that you had a sexually transmitted disease, or STD?
Yes
No
Don't know
Do you intend to have oral sex in the next year?
Yes, definitely
Yes, probably
No, probably not
No, definitely not
Do you intend to have sexual intercourse in the next year?
Yes, definitely
Yes, probably
No, probably not
No, definitely not
If you have sexual intercourse in the next year, do you intend to use a condom?
Yes, definitely
Yes, probably
No, probably not
No, definitely not
The next question is about your intention to use other methods of birth control, NOT including condoms: Birth control pills The shot (like, Depo Provera) The patch The ring (like, NuvaRing) IUD (like, Mirena or Paragard) Implants (like, Implanaon) If you have sexual intercourse in the next year, do you intend to use any of these other methods of birth control?
Yes, definitely
Yes, probably
No, probably not
No, definitely not
How likely is
it that you will do each of the following things?
Graduate
from high school?
Not at all likely
A little likely
Somewhat likely
Very likely
How likely is
it that you will do each of the following things?
Go
to a technical or vocational school after high school?
Not at all likely
A little likely
Somewhat likely
Very likely
How likely is
it that you will do each of the following things?
Go
to college?
Not at all likely
A little likely
Somewhat likely
Very likely
How likely is
it that you will do each of the following things?
Graduate
from a 2-year or community college program?
Not at all likely
A little likely
Somewhat likely
Very likely
How likely is
it that you will do each of the following things?
Graduate
from a 4-year college program?
Not at all likely
A little likely
Somewhat likely
Very likely
The next
series of questions is about condoms, birth control pills, pregnancy
and sexually transmitted diseases, also called STDs.
If a condom is used correctly, how much can it decrease the risk of pregnancy?
Not at all
A little
A lot
How confident are you that your answer is correct?
Not at all confident
A little confident
Somewhat confident
Very confident
If a condom is used correctly, how much can it decrease the risk of getting HIV, the virus that causes AIDS?
Not at all
A little
A lot
Don’t know
If a condom is used correctly, how much can it decrease the risk of getting Chlamydia and gonorrhea?
Not at all
A little
A lot
Don’t know
A condom can be used more than once.
True
False
A sexually active girl can become pregnant if she forgets to take her birth control pills for several days in a row.
True
False
A person who has Genital Herpes must have open sores to give the infection to his or her sexual partner.
True
False
If a person had Gonorrhea in the past he or she is immune (protected) from getting it again.
True
False
Showering, or washing one’s genitals/private parts, after sex keeps a person from getting HIV.
True
False
A person can get HIV from oral sex.
True
False
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Get pregnant or
get someone pregnant
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Enjoy it
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Get a sexually
transmitted disease
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel guilty
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Be more popular
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Have fun
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Nothing about my
life would change
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Get into trouble
with your parents
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Get a bad
reputation
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel more loved
and wanted
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Lose your
self-respect
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel more
attractive
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Keep your
boyfriend or girlfriend from breaking up with you
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel pleasure
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel closer to
your partner
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Disappoint
people who are important to you
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel satisfied
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Get HIV/AIDS
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel excited
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
In your
opinion, how likely or unlikely is it that each of the following
things would happen to you personally if you were to have sexual
intercourse? (If you’ve never had sexual intercourse, please
try to imagine and make your best guess.)
Feel more grown
up
Very unlikely
Somewhat unlikely
Somewhat likely
Very likely
Please select
the answer for each question that best describes how you feel.
I
believe people my age should wait until they are older before they
have sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe it’s OK for people my age to have sex with a steady
boyfriend or girlfriend.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe condoms (rubbers) should always be used if a person my age
has sexual intercourse.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe condoms (rubbers) should always be used if a person my age
has sexual intercourse, even if the girl uses hormonal birth control.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe condoms (rubbers) should always be used if a person my age
has sexual intercourse, even if the two people know each other very
well.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe condoms (rubbers) should always be used if a person my age
has anal sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
Please select
the answer for each question that best describes how you feel.
I
believe condoms (rubbers) or dental dams should always be used if a
person my age has oral sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe people my age
should wait until they are older before they have sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe it’s OK
for people my age to have sex with a steady boyfriend or girlfriend.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe condoms
(rubbers) should always be used if a person my age has sexual
intercourse.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe condoms
(rubbers) should always be used if a person my age has sexual
intercourse, even if the girl uses hormonal birth control.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe condoms
(rubbers) should always be used if a person my age has sexual
intercourse, even if the two people know each other very well.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe condoms
(rubbers) should always be used if a person my age has anal sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
The following
questions ask you about your friends and what they think. Even if
you’re not sure, mark the answer that you think best describes
what they think.
Most of my friends believe condoms
(rubbers) or dental dams should always be used if a person my age has
oral sex.
Definitely Yes
Probably Yes
Probably No
Definitely No
What do you
think about condoms? Please tell us how much you agree or disagree
with the following statements.
It would be embarrassing to buy
condoms (rubbers) in a store.
I strongly agree
I kind of agree
I kind of disagree
I strongly disagree
What do you
think about condoms? Please tell us how much you agree or disagree
with the following statements.
I would feel uncomfortable
carrying condoms (rubbers) with me.
I strongly agree
I kind of agree
I kind of disagree
I strongly disagree
What do you
think about condoms? Please tell us how much you agree or disagree
with the following statements.
It would be wrong to carry a
condom (rubber) with me because it would mean that I’m planning
to have sex.
I strongly agree
I kind of agree
I kind of disagree
I strongly disagree
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Draft - Baseline - V2 |
| Author | Qualtrics |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |