Eligibility screening form

Injection Drug Use Surveillance Project

Approved_IDU_survey_wscreener_track changes_OMB 0920-1325_clean

OMB: 0920-1325

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IDU SURVEILLANCE PROJECT QUESTIONNAIRE

QUESTIONNAIRE SECTIONS


Contents

Abbreviations 2

Key Terms 2

INTERVIEWER ENTERED INFORMATION (IE)/ELIGIBILITY SCREENER (ES) 3

Recruitment 5

Demographic Information 5

Behavioral Eligibility – Injection Drug Use 8

Behavioral Eligibility –Drug Use 10

Interviewer Assessment 12

PROGRAM PERMISSION FORM (CN) 12

NETWORK SECTION (NS) 14

Recruiter Relationship 14

Network Size 14

DEMOGRAPHICS (DM) 14

Residence 14

Health Care Access & Utilization 15

Health Care Stigma/Discrimination 16

Socioeconomic Status 16

Disability 17

ACASI TUTORIAL (AC) 18

SEXUAL BEHAVIOR (SX) 19

INJECTION DRUG USE (ID) 21

Injection History, Lifetime 21

Injection Frequency, 6m 21

Fentanyl Injection, 6m 24

Other Injection Behaviors, 6m 25

Injection Initiation, 6m 25

Syringe Use, 6m 26

Injection Equipment Sharing, 6m 26

Last Injecting Event 28

Last Injecting Partner 30

NON-INJECTION DRUG USE (ND) 30

Non-injection Drug Use Frequency, 6m 30

Fentanyl, Non-injection 33

Injection Drug Use Prevention 34

DRUG OVERDOSE (DO) 34

Drug Overdose 34

Narcan Access and Use 35

Consequences of Stimulant Overuse 36

JUSTICE SYSTEM AND LAW ENFORCEMENT EXPERIENCES (JT) 36

Incarceration Experience 36

Law Enforcement Experience 37

END OF ACASI 38

DRUG TREATMENT (TX) 38

Drug Treatment, History 38

Medication-assisted Treatment, 6m 38

HIV TESTING EXPERIENCES (HT) 40

HIV Testing, Ever 40

Recent HIV Testing 40

Barriers to HIV Testing 42

Linkage to Care 43

HIV Medications 43

PrEP 43

HEALTH CONDITIONS (HC) 44

Hepatitis C (HCV) 44

Other Health Conditions 47

PREVENTION ACTIVITIES (PA) 47

Access to Syringe Services Program 47

END OF SURVEY (END) 52

Interviewer Assessment – Post-Interview 52

Interviewer Comments 52

FLASHCARDS 54



OVERVIEW

Abbreviations

R

Respondent

DK

Don't know

REF

Refused to answer

NA

Not applicable (question asked of R but this is a codable response option



EQ

Equal to

GT

Greater than

GE

Greater than or equal to

LE

Less than or equal to

LT

Less than

NE

Not equal to


Key Terms

Term

Prefix / format

Definition

Calculated variable

CALC_


Item identifier (not prefix for variable name) for variables calculated by the CAPI program that appear in the CRQ.

Message

INTERVIEWER:


Message displayed to the interviewer that is not to be read to R. May be triggered by an edit check. Distinct from Interviewer Instruction. ‘FIELD NOTE’ indicates instructions that will be added as a field note rather than directly included in the question.

Filter question



A question that determines whether the respondent should receive subsequent question or set of questions, typically on a related topic.

Logic Check

Check_


Logic that must be checked (by the CAPI program) in order to determine proper routing to the next item in the CAPI programmed questionnaire.

Interviewer instruction



Instruction to interviewer regarding survey administration. Standard instructions are ‘Give Respondent Flashcard {letter}', ‘READ choices', ‘DO NOT READ choices', & ‘CHECK ALL that apply'.

Introductory statement

INTRO_


Transitional statement read to R at the beginning of a new topic (e.g., Section, set of questions, etc.). Prefix is followed by section abbreviation, series, or first item in set to which it applies.

Range



Range of valid response values for items collecting or computing numeric data. E.g., the valid range of responses to number of sex partners in past 12 months is 0 to 7000.

Section



Section of the Questionnaire. Each section has a unique two letter abbreviation.

Soft Edit Check

SoftEdit_


A check to determine whether the response entered is implausible. If yes, CAPI program displays message to interviewer; program may advance after closing the error message dialog box.





IDU SURVEILLANCE PROJECT QUESTIONNAIRE

INTERVIEWER ENTERED INFORMATION (IE)/ELIGIBILITY SCREENER (ES)





INTRO_OMB.

Public reporting burden of this collection of information is estimated to average 30 minutes per survey, including the time for reviewing instructions, administering questions and entering responses. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New).”




IE1a.

INTERVIEWER: Please enter today’s date. Start by entering the month.

IDATE_M

IDATE month




January

1




February

2




March

3




April

4




May

5




June

6




July

7




August

8




September

9




October

10




November

11




December

12




IE1b.

INTERVIEWER: Enter the day.


IDATE_D

IDATE day




---- ----





Range

1-31




IE1c.

INTERVIEWER: Enter the year.

Field note: Please enter four digits.


IDATE_Y

IDATE year




---- ---- ---- -----





Range

2020-2030




SoftEdit_IE1c.

The date you entered is not possible. Please correct the manually-entered date.



CALC_AUTODATE


Automatic, hidden variable: Today’s date

AUTODATE

Automatic start date


_ _ / _ _ / _ _ _ _





SoftEdit_AUTODATE.

INTERVIEWER: “Please confirm that the date you manually entered (IDATE_M-IDATE_D-IDATE-Y) matches today’s date ([calc_autodate]).”




IE2.


INTERVIEWER: Please enter the current time (hh:mm) using a 24-hour clock. Example: 1:30pm should be entered as 13:30.

Field note: You may click “Now.”


START


Start time



__ : __






IE3.

INTERVIEWER: Please choose the unique program ID for this SSP

PROGID

Program ID




Ellensburg, Washington

1001


Wilmington, North Carolina

1002


New Haven, Connecticut

1003


Madison, Wisconsin

1004



IE4.

INTERVIEWER: Interviewer ID:


ICODE

Interviewer ID

Field note: Cannot exceed two digits.




---- ----





Range

1-99



IE5.

INTERVIEWER: City (SSP main location):


SSPCITY

City



Ellensburg, Washington

5321240



Wilmington, North Carolina

3774440



Indianapolis, Indiana

1836003



New Haven, Connecticut………………………………………………..

0952000



Madison, Wisconsin……………………………………………………….

5548000



IE6.

INTERVIEWER: Participant ID:


PID

Participant ID




---- ---- ---- ---- Must be 4 digits





Range

1000-9999



IE7.

INTERVIEWER: Please copy the following unique Survey ID in the text box:

[SSPCITY] [PID]

Field note: Do not include any spaces.

SURID

Survey ID




---- ---- ---- ---- ---- ---- ---- ----



IE8.

INTERVIEWER: Is [fill with SURID] correct?

C_SURID

Correct concatenated SURID




No

0




Yes

1



SoftEdit_IE6.

If SURID NOT correct (C_SURID EQ 0), DISPLAY: "INTERVIEWER: Please go back to IE7 to re-enter the survey ID."

Then go to IE8.


Recruitment


IE9.

INTERVIEWER: Field Site ID:

Field note: Cannot exceed two digits


FLDSTEID

Field site ID




---- ----





Range

0-99




IE10.

INTERVIEWER: How did the respondent get recruited for this study?

ISEP

Respondent selected from SEP




Directed by syringe services program

1




Referred by someone, with a referral card

2




Referred by someone, without a referral card

3




Word of mouth

4



INTRO_DOB.

READ: “I’d like to thank you again for your interest in this health survey. Remember that all information you give me will be kept private and I will not ask for your name. Most people have never been in an interview like this one. Some questions may sound awkward, but I need to read them as worded so everyone in the study is asked the same questions. First, I will ask you a few questions about yourself and then the computer will determine if you have been selected to participate in the health survey.”




CALC_S_TIME1


Start time of eligibility screener Automatic hidden variable.


S_TIME1

Respondent start time



__ : __




Demographic Information


ES1.

How old are you?

[INTERVIEWER: DO NOT READ RESPONSES AND SELECT APPROPRIATE CATEGORY]

AGECAT

Age category




Under 18 years

1




18-24 years

2




25-29 years

3




30-34 years

4




35-39 years

5




40-44 years

6




45-49 years

7




50-54 years

8




55-59 years

9




60-64 years

10




65 years or older

11




Don't Know

99




Refuse to Answer

77













Check_ES2.

If R LT 18 years old (AGECAT EQ 1), go to INTRO_CALC_EL.

Else, go to ES2 [HISPANIC].


ES2.

Do you consider yourself to be of Hispanic, Latino/a, or Spanish origin?

[INTERVIEWER: If necessary, say "Just tell me Yes or No."]

HISPANIC

Latino ethnicity




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




ES3.

[Give Respondent Flashcard A.]

Which racial group or groups do you consider yourself to be in? You may choose more than one option.


[READ choices. CHECK ALL that apply.]

RACE

Racial group (number reported)




American Indian or Alaska Native





Asian





Black or African American





Native Hawaiian or Other Pacific Islander





White





Don't Know

9




Refuse to Answer

7




Not Applicable

8




[Give Respondent Flashcard B.]


What best describes your gender? You may choose more than one option.

ES4.

[READ choices. CHECK ALL that apply.]

GENDER

Gender




Man





Woman





Genderqueer/non-binary





Trans man





Trans woman





Other gender not listed





Don't Know

9




Refuse to Answer

7



Check_ES4spec.

If R reports ‘other gender not listed' (ES4(6) [GENDER] EQ 1), go to ES4spec [GENDER_S].

Else, go to ES5 [BIRTHSEX].


ES4spec.

INTERVIEWER: What best describes your gender?


GENDER_S

Specify other gender



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}





ES5.

What was your sex at birth?

[DO NOT READ choices.]

BIRTHSEX

Sex at birth




Male

1




Female

2




Intersex/ambiguous

3




Don't Know

9




Refuse to Answer

7



ES6.

How well do you speak English?

[READ choices.]

ENGPFCY

English proficiency




Very well

1




Well

2




Not well

3




Not at all

4




Don't Know

9




Refuse to Answer

7



Behavioral Eligibility – Injection Drug Use

INTRO_EVRINJ.

READ: "Now I am going to ask you about experiences you may have had with injecting drugs. This means injecting drugs yourself or having someone who is not a healthcare provider inject you with a needle, either in your vein, under the skin, or in the muscle.


Please only think about drugs you may have gotten without a prescription from your doctor or other healthcare provider, like heroin, methamphetamine, and drugs like Oxycontin. Please also think about drugs that were prescribed to you, but you used them in ways other than instructed by your doctor or healthcare provider.”


ES7.

Have you ever in your life injected any drugs?

EVRINJ

Eligibility: ever injected




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ES8a.

If R ever injected (ES7 [EVRINJ] EQ 1), go to ES8a [LINJN].

Else, go to INTRO_EVRDRG.


ES8a.

When was the last time you injected any drug? That is, how many days or months or years ago did you last inject?

[INTERVIEWER: If today, enter "0"]

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

LINJN

IDU ES: When last injected, number




__ __ __





Range

0 - 365



Check_ES8b.

If R last injected today (ES8a [LINJN] EQ 0) go to CALC_E_INJ6, if R did not report the last time they injected (ES8a [LINJN] EQ MISSING), go to INTRO_EVRDRG. Else, go to ES8b [LINJU].


ES8b.

[INTERVIEWER: Was this days or months or years?]

LINJU

IDU ES : When last injected, unit




Days

0




Months

1




Years

2



CALC_E_INJ6

injected in last 6 months

E_INJ6 = if([ldrgn]=0, 1, if(([ldrgu]=0 and [ldrgn]<=183), 1, if(([ldrgu]=1 and [ldrgn]<=6), 1,if([ldrgn]="",0,0))))


Check_ES9.

If R injected in the last 6 months (E_INJ6 EQ 1), go to ES9 [INJDRUG]. Else, go to INTRO_EVRDRG.



ES9.

In the past 6 months, which drugs have you injected? Please say “yes” or “no” to each drug I mention.

INJDRUG

Eligibility, drug usually injected



INJDRUGA

Speedball, which is heroin and cocaine together




INJDRUGB

Goofball, which is heroin and methamphetamine together




INJDRUGC

Fentanyl, by itself or in combination with other drugs




INJDRUGD

Heroin, by itself




INJDRUGE

Methamphetamine, by itself, also known as meth or speed




INJDRUGF

Powder cocaine, by itself




INJDRUGG

Crack cocaine, by itself




INJDRUGH

Painkillers, such as Oxycontin, Dilaudid, or Percocet




INJDRUGI

Benzodiazepines or other downers, such as Valium, Xanax, or Klonopin





Don't Know

9




Refuse to Answer

7



ES10.

In the past 6 months, have you injected methadone?

INJELM

Eligibility: injection, methadone




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




ES11.

In the past 6 months, have you injected buprenorphine, also known as Suboxone or Subutex?

INJELB

Eligibility: injection, buprenorphine




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




ES12.

Are there any other drugs you have injected in the past 6 months?

INJOTH

Eligibility: injection, other




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ES12spec.

If R reports injecting other drugs (ES12 [INJOTH] EQ 1), go to ES12spec [INJOTH_S].

Else, go to USINJ.


ES12spec.

INTERVIEWER: Specify other injection drugs.


INJOTH_S

Specify other injection drug



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}





ES13.

Which drug do you inject most often?

[DO NOT READ choices.]

USINJ

Eligibility, drug usually injected




Speedball, which is heroin and cocaine together

1




Goofball, which is heroin and methamphetamine together

2




Fentanyl, by itself or in combination with other drugs

3




Heroin, by itself

4




Methamphetamine, by itself, also known as meth or speed

5




Powder cocaine, by itself

6




Crack cocaine, by itself

7




Painkillers, such as Oxycontin, Dilaudid, or Percocet

8




Benzodiazepines or other downers, such as Valium, Xanax, or Klonopin

9




Methadone

10




Buprenorphine, also known as Suboxone or Subutex

11




Something else

12




Don't Know

99




Refuse to Answer

77




Check_ES13spec.

If R most often injects ‘something else' (ES13 [USINJ] EQ 12), go to ES13spec [USINJ_S].

Else, go to INTRO_EVRDRG.


SoftEdit_ES13.

If R says the drug they use the most often is not one of the drugs they have used in the past 6 months, DISPLAY: "INTERVIEWER: The drug the respondent injects the most often should be a drug they reported using in the past 6 months. Please confirm answers with respondent and correct data."




ES13spec.

INTERVIEWER: Specify other injection drug.


USINJ_S

Specify other injection drug



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}




Behavioral Eligibility –Drug Use

INTRO_EVRDRG.

READ: “Now I am going to ask you about experiences you may have had with drugs that you did not inject. This includes times that you may have smoked, snorted, inhaled, or ingested drugs.


Please only think about drugs you may have gotten without a prescription from your doctor or other medical provider, like heroin, methamphetamine, and drugs like Oxycontin. Please also think about drugs that were prescribed to you but you used them in ways other than instructed by your doctor or healthcare provider.”



ES14.

Have you ever in your life used any drugs that you did not inject?

EVRDRG

Eligibility: ever used non-injection drugs




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ES15a.

If R ever used (ES14 [EVRDRG] EQ 1), go to ES15a [LDRGN].

Else, go to ES20 [CAPABLE].


ES15a.

When was the last time you used any drug that you did not inject? That is, how many days or months or years ago did you last use drugs?

[INTERVIEWER: If today, enter "0"]

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

LDRGN

IDU ES: When last used non-injection drugs, number




__ __ __





Range

0 - 365



Check_ES15b.

If R last injected today (ES13a [LDRGN] EQ 0), go to ES16 [USDRG]. If ES15a [LDRGN] EQ MISSING, go to ES20 [CAPABLE]. Else, go to ES15b [LDRGU].


ES15b.

[INTERVIEWER: Was this days or months or years?]

LDRGU

IDU ES : When last used drugs, unit




Days

0




Months

1




Years

2



CALC_E_DRG6.



E_DRG6

used drug in last 6 months

E_DRG6 = if([ldrgn]=0, 1, if(([ldrgu]=0 and [ldrgn]<=183), 1, if(([ldrgu]=1 and [ldrgn]<=6), 1,if([ldrgn]="",0,0))))


Check_ES16.

If R injected in the last 6 months (E_DRG6 EQ 1), go to ES16 [USDRG]. Else, go to ES20 [CAPABLE].


ES16.

In the past 6 months, which drugs did you use that you did NOT inject? Please say “yes” or “no” to each drug I mention.

USDRG

Eligibility, drug used not injected



USDRGA

Marijuana




USDRGB

Methamphetamine, also known as meth or speed




USDRGC

Crack cocaine




USDRGD

Powder cocaine




USDRGE

Benzodiazepines or other downers such as Valium, Xanax, or Klonopin




USDRGF

Painkillers, such as Oxycontin, Dilaudid, or Percocet




USDRGG

X or ecstasy (MDMA)




USDRGH

Heroin




USDRGI

Fentanyl, by itself or in combination with other drugs




USDRGJ

Adderall, Ritalin, or other commonly prescribed stimulants





Don't Know

9




Refuse to Answer

7




ES17.

In the past 6 months, have you used methadone that was not prescribed or not taken as prescribed?

USELM

Eligibility: use, methadone




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




ES18.

In the past 6 months, have you used buprenorphine, also known as Suboxone or Subutex, that was not prescribed or not taken as prescribed?

USELB

Eligibility: use, buprenorphine




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




ES19.

Are there any other drugs you have used and did not inject in the past 6 months?

USOTH

Eligibility: use, other




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ES19spec.

If R reports injecting other drugs (ES19 [USOTH] EQ 1), go to ES19spec [USOTH_S].

Else, go to ES20 [CAPABLE].


ES19spec.

INTERVIEWER: Specify other drug that R did not inject.


USOTH_S

Specify other non-injection drug



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}





CALC_E_DRGEL

Non-injection drugs

E_DRGEL= if(([usdrgb]=1 or [usdrgc]=1 or [usdrgd]=1 or [usdrge]=1 or [usdrgf]=1 or [usdrgg]=1 or [usdrgh]=1 or [usdrgi]=1 or [usdrgj]=1 or [uselm]=1 or [uselb]=1), 1, 0)


Interviewer Assessment


ES20.

INTERVIEWER: Is this person alert and capable of completing the survey in English?

CAPABLE

Eligibility: able to complete



No

0



Yes

1



Check_ES21.

If R is able to complete the survey (ES20 [CAPABLE] EQ 1, go to ES22 [E_PART].

Else, go to ES21.


ES21.

INTERVIEWER: Specify reason person not able to complete the interview: [CHECK ALL that apply.]

CAPREAS

Eligibility: Reason not able to complete



Not able to understand or consent




Cannot speak and understand English




ES22.

INTERVIEWER: Has this person participated in this study before?

E_PART

Eligibility: Previous participant



No

0



Yes

1






ES23.

INTERVIEWER: Did your field supervisor tell you that this person cannot complete the survey for some other reason?

SUPERV

Eligibility: field supervisor reason



No

0



Yes

1




INTRO_CALC_EL_IDU.

READ: “We've finished the first series of questions. Now the computer will determine whether you've been selected to participate in the survey."


CALC_EL_IDU.

EL_IDU = IF((AGECAT NE 1 & CAPABLE=1 & E_PART=0 & SUPERV=0 & (E_INJ6=1 OR (E_DRG6=1 AND E_DRGEL=1))),1,0)


Check_ES21.

If R is not eligible (EL_IDU EQ 0) go to END_ESIN. Else, go to END_ESEL.


END_ESIN.

If R NOT eligible for cycle READ: “Unfortunately, the computer has not selected you to participate in the health survey. Thank you for your time.” Go to END1 (C_CMPLT).


END_ESEL.

If R eligible for cycle READ: “Congratulations! The computer has selected you to participate in the health survey. Let me tell you about it.” [INTERVIEWER: Proceed with the consent process.] Then go to Consent Section (CN).




PROGRAM PERMISSION FORM (CN)

INTRO_CONSENTA.

READ: "1. This project is conducted by SSP enrollment site, University of Washington, and the Centers for Disease Control and Prevention (CDC) to collect information on HIV and hepatitis C in your community. We will use this information to plan better HIV and hepatitis C virus (HCV) prevention and treatment programs for people in your community.

2. Taking part in this project is your decision. Your choice will not affect your right to health care or other services. We will send information from this project to the CDC, but we will not send any information that could identify you.

3. If you agree to participate, you will do an interview with me. I’ll ask you questions about your sex practices, drug use, and other health topics. You can refuse to answer any questions. You can stop the interview at any time without penalty. The interview will take about 30 minutes.

4. As part of this project, you will be offered a free rapid HIV antibody test at your enrollment site. This will involve enrollment site staff sticking your finger with a small lancet to draw a small amount of blood. Your results will be ready within 60 seconds. If this test is reactive (positive), site staff will offer you a referral for additional testing to confirm your results.

5. We will also offer you a free testing for HCV infection and antibodies. HCV testing will be conducted using small amounts of blood taken at the same time as performing the finger prick for your rapid HIV test. The small amounts of your blood from the finger prick will be placed on filter paper and sent to a CDC laboratory for testing. The results of your HCV tests will be available in 2 weeks. You will be provided a secure, private number to call to check your HCV test results.

6. If you agree, we’d also like to store any specimen left over from these tests for future projects.

7. Finally, I may give you the option to invite people to participate in the project.

8. There are minimal risks from being in this project. You may experience temporary discomfort in your finger from the needle stick. Some interview questions may make you feel uncomfortable and knowing your HIV or HCV test result may be upsetting, but I and site staff are here to discuss any concerns you have.

9. You may benefit from this project by learning about HIV, HCV, and other infections and how to prevent them. You will also learn your HIV and HCV status and we will refer you for any specialized treatment you may need.

10. If you complete the interview, we’ll pay you $20. If you complete the HIV and HCV testing, we’ll pay you an additional $20. After the survey, I may ask you to invite people you know to participate in this project. If you agree, you may receive $10 each for up to 4 people you refer.

11. If you decide not to participate, there will be no penalty to you. If you want information about HIV testing the field site staff can refer you to other places to get tested.

12. If you have any questions about this project, you can contact these people (Site PI).

13. Everything you tell us will be kept private—it will only be available to people working on this project. I will not ask your name. To receive your HCV results and referral payments, we will create a code based on information that only you can give us. This is to make sure the right person receives the correct HCV results and referral payments..

14. There is a very small chance that the data could legally be forced to be released. To keep the data anonymous and not able to be linked to you, I will not ask for your name or any other identifying information.



CN1.

Do you agree to take part in the survey?

CONSENTA

Consent to survey



No

0



Yes

1



Check_CN2.

If R does not consent (CN1 [CONSENTA] NE 1), this survey will STOP immediately.

Else, go to CN2 [CONSENTB].


CN2.

Do you agree to HIV counseling and testing?

CONSENTB

Consent to HIV testing



No

0



Yes

1



CN3.

Do you agree to hepatitis C testing?

CONSENTC

Consent to HCV testing



No

0



Yes

1



Not offered

2



Check_CN4.

If R consents to HIV or hepatitis testing (CN2 [CONSENTB] EQ 1 OR CN3 [CONSENTC] EQ 1), go to CN4 [CONSENTD].

Else, go to E_TIME1.


CN4.

Do you agree to let us store some of your blood for future testing?

CONSENTD

Consent to specimen storage



No

0



Yes

1



Not offered

2




CALC_E_TIME1


End time of eligibility screener Automatic hidden variable.


E_TIME1

Respondent end time



__ : __





NETWORK SECTION (NS)

Recruiter Relationship

Check_INTRO_NSREL.

If R has been recruited by someone (IE10 [ISEP] EQ 2 OR 3), go to INTRO_NSREL.

Else, go to INTRO_NSIDU.


INTRO_NSREL.

READ: “Thank you for answering the questions. I'm going to start by asking you about the person who told you about this survey. Please remember that your answers will be kept private."


CALC_S_TIME2


Start time of core questionnaire. Automatic hidden variable.


S_TIME2

Respondent start time



__ : __




NS1.

[Give Respondent Flashcard C.]

Which of the following describes how you know the person who told you about this survey? You can choose more than one answer.

[READ choices. CHECK ALL that apply.]

NSREL

Relationship to recruiter




A relative or family member





A person you have sex with





A person you use drugs with or buy drugs from





A friend





An acquaintance, that is, a person you know but do not consider a friend





A stranger, you don't know the person or just met them





Refuse to Answer

77



Network Size


INTRO_NSIDU.

READ: “Now, I'm going to ask you about people you know. Specifically, I'm going to ask you how many people you know who inject or use drugs and whom you have seen in the past 30 days. I will not ask you questions about any specific person."


NS2.

Please tell me how many people you know who inject and whom you have seen in the past 30 days.

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

NSIDU

# IDUs known: net size




Range

0 - 7500



NS3.

Please tell me how many people you know who use drugs but do not inject and whom you have seen in the past 30 days.

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

NSDU

# DUs known: net size




Range

0 - 7500





DEMOGRAPHICS (DM)

Residence


INTRO_HMLSC.

READ: “Next, I'd like to ask you some questions about where you live. Please remember your answers will be kept private."


DM1.

In the past 6 months, have you been homeless? By homeless, I mean you were living on the street, in a shelter, or in a car.

HMLSC

Homeless p6m



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM2.

What zip code do you usually live or sleep in? Please tell me only the first three digits.

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

ZIP

Zip code



__ __ __




Range

005-999




Health Care Access & Utilization



INTRO_CURRHLTH.

READ: "The next questions are about health insurance. By health insurance, we mean health plans people get through employment or purchase directly, as well as government programs like Medicare and Medicaid that provide medical care or help pay medical bills."


DM3.

Do you currently have health insurance or health care coverage?

CURRHLTH

Currently insured



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Check_DM4.

If R currently insured (DM3[CURRHLTH] EQ 1), go to DM4[TYPINS].

Else, go to DM5[VSITMD6].


DM4.

[Give Respondent Flashcard D.]

What kind of health insurance or coverage do you currently have?

[READ choices. CHECK ALL that apply.]

TYPINS

Type of health insurance



A private health plan - through an employer or purchased directly




A government plan such as Medicaid or Medicare




Some other health insurance




Don't Know

9



Refuse to Answer

7



Check_DM4spec.

If R reported ‘other' insurance type (DM4(3) [TYPINS(3)] EQ 1), go to DM4spec [TYPINS_S].

Else, go to DM5 [VSITMD6].


DM4spec.

INTERVIEWER: Specify other health insurance or coverage:

TYPINS_S

Specify other health insurance


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __


{text response; max length = 100 characters}


DM5.

In the past 6 months, have you seen a doctor, nurse, or other healthcare provider?

VSITMD6

Medical care, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_DM6.

If R reported receiving care (DM5 [VSITMD6] EQ 1), go to DM6 [VSITERN].

Else, go to DM7 [HCPOORD].


DM6.

In the past 6 months, how many times have you gone to an emergency room for medical care?

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

VSITERN

ER room, 6 months



__ __



Range

0-76



Health Care Stigma/Discrimination

Check_DM7.

If R reported receiving care (DM5[VSITMD6] EQ 1), go to DM7 [HCPOORD].

Else, go to DM8 [HCAVOID].


DM7.

In the past 6 months, have you felt that healthcare staff treated you poorly because you use drugs?

HCPOORD

Treated poorly drugs, 6m



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM8.

In the past 6 months, have you avoided seeking healthcare because you were worried about being treated poorly by healthcare staff because of your drug use?

HCAVOID

Avoid healthcare, 6m



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Socioeconomic Status

DM9.

What is the highest level of education you completed?

[DO NOT READ choices.]

SCHOOL

Education



Never attended school

1



Grades 1 through 8

2



Grades 9 through 11

3



Grade 12 or GED

4



Some college, Associate's Degree, or Technical Degree

5



Bachelor's Degree

6



Any post graduate studies

7



Don't Know

99



Refuse to Answer

77



DM10.

During the last 6 months, what was the main source of income you lived on? Your main source of income could be formal or informal. Remember all information you provide will be kept private.

[DO NOT READ choices.]

MAININC

Sources of income



Full-time job/employed with a regular salary

1



Temporary work, including legal part-time and odd jobs, off-books, etc.

2



Unemployment benefits

3



Other public assistance such as welfare, disability, or, food stamps

4



Spouse, partner, friend, or relative’s income

5



Sex for money

6



Selling drugs

7



Panhandling

8



Other (specify)

9



Don't Know

99



Refuse to Answer

77



Check_DM10spec.

If R reported ‘other ’ (MAININC=9), go to DM10spec [MAININC_S].

Else, go to INTRO_DISDEAF.


DM10spec.

INTERVIEWER: Specify other main source of income

MAININC_S

Specify other main source of income


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __


{text response; max length = 100 characters}


Disability

INTRO_DISDEAF

READ: "The next questions are about your overall health."


DM11.

Are you deaf or do you have serious difficulty hearing?

DISDEAF

Disability – Hearing



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM12.

Are you blind or do you have serious difficulty seeing, even when wearing glasses?

DISBLND

Disability – Vision



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM13.

Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?

DISCOGN

Disability – Cognition



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM14.

Do you have serious difficulty walking or climbing stairs?

DISWALK

Disability – Ambulation



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



DM15.

Do you have difficulty dressing or bathing?

DISCARE

Disability - Self-care



No

0



Yes

1



Don't Know

9



Refuse to Answer

7







DM16.

Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone, such as visiting a doctor's office or shopping?

DISERND

Disability – Errands



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




CALC_E_TIME2


End time of questions before ACASI. Automatic hidden variable.


E_TIME2

Respondent end time



__ : __




AC0.

INTERVIEWER: Does the participant have the option to complete the next section on his or her own (e.g., ACASI)?

ACASI_OPTION

Is ACASI possible – y/n




No

0




Yes

1



Check_AC0.

If ACASI is not possible (ACASI_OPTION=0), go to CALC_S_TIME_3.

Else, go to INTRO_YESNO.



ACASI TUTORIAL (AC)

INTRO_YESNO.

READ: “The next few sections will have some sensitive questions about your sex life and drug use. You have the option to complete these sections on your own or with me. If you choose to do them on your own, I will still be available to answer any questions you may have. First, I will show you the different types of questions and answers.”


INTERVIEWER: The participant should be observed for this section to assess capacity for ACASI. Give the tablet to the participant.


AC1.

Some questions you answer by clicking either “Yes” or “No”. Please click on “Yes”.

YESNO

ACASI – Y/N




No

0




Yes

1



AC2.

For other questions, you choose the best or correct answer. For example, what is the day after WEDNESDAY?

SELONE

ACASI – select one




Sunday

1




Monday

2




Tuesday

3




Wednesday

4




Thursday

5




Friday

6




Saturday

7



AC3.

For some questions, you can choose more than one answer. Select all the options which are examples of food. You can select more than one option.

MULTI

ACASI – select more than one




Apples





Cereal





Radio





Green beans




AC4.

Lastly, there are questions you answer by entering a number. Let’s try entering the number “18”.

NUMBER

ACASI – number




__ __





Range

0-99



INTRO_PASSCODE.

Please return the device to the interviewer.



AC5.

[INTERVIEWER: Enter code to continue.]

PASSCODE

ACASI – Passcode




__ __ __ __





Range

1122-1122



AC6.

We have finished the tutorial. Would you like to complete the next set of questions on your own or with me? [INTERVIEWER ENTER RESPONSE]

PASSED

ACASI – Passed




Participant will complete

0




Interviewer will complete

1




CALC_S_TIME3


Start time of ACASI questions. Automatic hidden variable.


S_TIME3

Respondent start time



__ : __




Check_S_TIME3

If ACASI is not possible (ACASI_OPTION=1), go to INTRO1_SXEVER.

Else, go to INTRO_SXEVER.


INTRO1_SXEVER.

READ: “The next few sections will have some sensitive questions about your sex life and drug use.”



SEXUAL BEHAVIOR (SX)


INTRO_SXEVER.

The next questions are about having sex. "Having sex" means vaginal or anal sex. Vaginal sex means penis in the vagina; and anal sex means penis in the anus or butt.


SX1.

Have you ever had vaginal sex or anal sex?

SXEVER

Ever sex y/n




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_SX2.

If R reported ever sex (SX1[SXEVER] EQ 1), go to SX2[SXNUM].

Else, go to INTRO_INJAGE.


SX2.

In the past 6 months, with how many different people have you had vaginal or anal sex? Please give your best estimate. If you do not know, you may leave the response blank.

SXNUM

Number of partners in last 6 months



__ __ __ __





Range

0-7000



Check_SX3.

If R reported at least 1 person (SXNUM GE 1), go to SX3 [SXGENDER].

Else, go to INTRO_INJAGE.



SX3.

In the past 6 months, with whom have you had vaginal or anal sex? You can select more than one.

SXGENDER

Gender of sex partners



Men




Women




People with other gender identities




Don't Know

99



Refuse to Answer

77




SX4.

In the past 6 months, did you receive money, drugs, or any other type of payment for having vaginal or anal sex?

SXREXCH

Exchange sex receive, 6 months




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



SX5.

In the past 6 months, did you give money, drugs, or any other type of payment for having vaginal or anal sex?

SXGEXCH

Exchange sex give, 6 months




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



SX6.

In the past 6 months, did you have vaginal or anal sex without using a condom?

SXUVAS

UVAS – 6 months




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_SX7.

If R reported condomless sex (SX6 [SXUVAS] EQ 1), go to SX7 [SXUVASP].

Else, go to INTRO_INJAGE.


SX7.

In the past 6 months, with whom did you have sex without using a condom? You can select more than one option.

SXUVASP

UVAS – partner type



Main sex partner, such as your spouse, boy/girlfriend



Casual sex partner




Someone you got drugs or money for sex




Someone else




Don't Know




Refuse to Answer




SoftEdit_SX7.

If UVAS-partner type is exchange sex (SX7 [SXUVASP(3)] EQ 1) and SX4 [SXREXCH] NE 1 and SX5 [SXGEXCH] NE 1 , DISPLAY: "INTERVIEWER: Earlier the respondent said they had not given or received sex in exchange for money or drugs. Please check with respondent and correct answers."

Then go to intro_INJAGE.


INJECTION DRUG USE (ID)


Check_INTRO_INJAGE.

If R ever injected (ES7 [EVRINJ] EQ 1), go to ID1.

Else, go to INTRO_NDMETH.



INTRO_INJAGE.

The next questions are about injection drug use. Please remember your answers will be kept private.

Injection History, Lifetime

ID1.

Think back to the very first time you injected any drugs. How old were you when you first injected any drug? Please give your best estimate. If you do not know, you may leave the response blank.

INJAGE

INJ Age at first injection




__ __




[Give Respondent Flashcard AA]

ID2.

Which drug did you inject that very first time?

INJFIRST

Drug first injected




Speedball

1




Goofball

2




Fentanyl, by itself or mixed with other drugs

3




Heroin, by itself

4




Methamphetamine, by itself

5




Powder cocaine, by itself

6




Crack cocaine, by itself

7




Painkillers, such as Oxycontin, Dilaudid, or Percocet

8




Benzodiazepines or other downers

9




Methadone

10




Buprenorphine, also known as Suboxone or Subutex

11




Something else

12




Don't Know

99




Refuse to Answer

77



Injection Frequency, 6m


Check_INTRO_INJFX6.

If R injected in the past 6 months (E_INJ6 EQ 1), go to ID3 [INJFX6].

Else, go to INTRO_NDMETH.



INTRO_INJFX6.

The next questions are about drugs you injected in the past 6 months.


[Give Respondent Flashcard BB]

ID3.

In the past 6 months, when you were injecting, about how often did you inject any drug?

INJFX6

Overall injection frequency,6m




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



ID4.

On a day when you inject any drug, on average, how many times a day do you inject? Please give your best estimate. If you do not know, you may leave the response blank.

Number injection, average day


INJTIM

__ __




Range

1-75




INTRO_INJSB.

The next questions are about the types of drugs you mentioned you had injected in the past 6 months.


Check_ID5

If R injected speedball (ES9(1) [INJDRUGA] EQ 1), go to ID5[INJSB].

Else, go to ID6[INJGB]


[Give Respondent Flashcard BB. Read for the first question in the series.]

ID5.

In the past 6 months, how often did you inject speedball?

INJSB

Speedball frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ID6

If R injected goofball (ES9(2) [INJDRUGB] EQ 1), go to ID6[INJGB].

Else, go to ID7[INJHERO]


ID6.

In the past 6 months, how often did you inject goofball?

INJGB

Goofball frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ID7

If R injected heroin (ES9(4) [INJDRUGD] EQ 1), go to ID7[INJHERO].

Else, go to ID8[INJMETH]


ID7.

In the past 6 months, how often did you inject heroin, by itself?

INJHERO

Heroin, by itself frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ID8

If R injected meth (ES9(5) [INJDRUGE] EQ 1), go to ID8[INJMETH].

Else, go to ID9[INJCOKE]


ID8.

In the past 6 months, how often did you inject methamphetamine, by itself?

INJMETH

Methamphetamine frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Never

5




Don't Know

9




Refuse to Answer

7



Check_ID9

If R injected powder cocaine (ES9(6) [INJDRUGF] EQ 1), go to ID9[INJCOKE].

Else, go to ID10[INJCRAC]


ID9.

In the past 6 months, how often did you inject powder cocaine, by itself?

INJCOKE

Powder cocaine, by itself frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ID10

If R injected crack cocaine (ES9(7) [INJDRUGG)] EQ 1), go to ID10[INJCRAC].

Else, go to ID11[INJPAIN]


ID10.

In the past 6 months, how often did you inject crack cocaine, by itself?

INJCRAC

Crack cocaine, by itself frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7




Check_ID11

If R injected painkillers (ES9(8) [INJDRUGH] EQ 1), go to ID11[INJPAIN].

Else, go to ID12[INJDOWN]


ID11.

In the past 6 months, how often did you inject painkillers, such as Oxycontin, Dilaudid, or Percocet?

INJPAIN

Painkillers frequency - 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7




Check_ID12

If R injected benzos (ES9(9) [INJDRUGI] EQ 1), go to ID12[INJDOWN].

Else, go to ID13[INJFENT]


ID12.

In the past 6 months, how often did you inject benzodiazepines or other downers?

INJDOWN

Benzos frequency - 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7




Check_ID13

If R injected methadone ([INJELM] EQ 1), go to ID13[INJMET].

Else, go to ID14[INJBUP]


ID13.

In the past 6 months, how often did you inject methadone?

INJMET

Methadone frequency – 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ID14

If R injected buprenorphine ([INJELB EQ 1), go to ID14[INJBUP].

Else, go to ID15[INJFENT]


ID14.

In the past 6 months, how often did you inject buprenorphine, also known as Suboxone or Subutex?

INJBUP

Methadone frequency – 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Fentanyl Injection, 6m


Check_ID15

If R injected fentanyl (ES9(3) [INJDRUGC] EQ 1), go to ID15[INJFENT].

Else, go to ID18 [INJLOC]


ID15.

In the past 6 months, how often did you inject fentanyl by itself or mixed with other drugs?

INJFENT

Fentanyl, injection, 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



ID16.

When you injected fentanyl in the past 6 months, was it mixed with any other drug?

INJFENTC

Fentanyl, injection, combined




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ID15.

If R reported injecting fentanyl mixed (ID16 [INJFENTC EQ 1), go to ID17[INJFENTD].

Else, go to ID18 [INJLOC].


[Give Respondent Flashcard CC]

ID17.

What other drugs was fentanyl mixed with? You can select more than one option.

INJFENTD

Fentanyl, injection, drugs combined



Speedball




Goofball




Heroin




Methamphetamine




Powder cocaine




Crack cocaine




Painkillers, such as Oxycontin, Dilaudid, or Percocet




Benzodiazepines or other downers




Methadone




Buprenorphine, also known as Suboxone or Subutex




Something else




Don't Know

99



Refuse to Answer

77




Other Injection Behaviors, 6m


[Give Respondent Flashcard DD. Read for the first question in the series.]

ID18.

In the past 6 months, how often did you inject in a public place, like an alley, public bathroom, library, or outside?

INJLOC

Location injected, 6m




Never

0




Rarely

1




About half the time

2




Most of the time

3




Always

4




Don't Know

9




Refuse to Answer

7



ID19.

In the past 6 months, how often were you alone when you injected?

INJALO

Frequency, injected alone- 6 months



Never

0



Rarely

1



About half the time

2



Most of the time

3



Always

4



Don't Know

9



Refuse to Answer

7



Injection Initiation, 6m



INTRO_INJSOM.

The next questions are about assisting someone who has never injected drugs with their first injection of any drug. This means you gave them their first injection or you showed them how to inject and then they injected themselves.



ID20.

In the past 6 months, have you injected drugs in front of someone who had never injected drugs?

INJSOM

Inject non-injector




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



ID21.

In the past 6 months, have you assisted anyone with their first time injecting any drug?

INJGIVE

Give injection




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Syringe Use, 6m


INTRO_STERILE.

Next, the questions will be about the needles you used in the past 6 months.


[Give Respondent Flashcard DD. Read for the first question in the series.]

ID22.

In the past 6 months when you injected, how often did you use a new, sterile needle? By a new, sterile needle, I mean a needle never used before by anyone, even you.

STERILE

INJ Frequency used sterile needle - 12 months




Never

0




Rarely

1




About half the time

2




Most of the time

3




Always

4




Don't Know

9




Refuse to Answer

7



ID23.

In the past 6 months, after you injected, how often did you put a used needle in a medical sharps or other secure container and/or took it to a syringe exchange program?

NDLEDSP

INJ Frequency used sterile needle - 12 months




Never

0




Rarely

1




About half the time

2




Most of the time

3




Always

4




Don't Know

9




Refuse to Answer

7




ID24.

In the past 6 months, how often did you reuse a needle you already injected with?

REUSE

Used same needle




Never

0




Rarely

1




About half the time

2




Most of the time

3




Always

4




Don't Know

9




Refuse to Answer

7




Injection Equipment Sharing, 6m


Check_ SHARNDLE.

If R always injected alone ([INJALO] NE 4, go to INTRO_SHARNDLE.

Else, go to INTRO_INJLLOC.


INTRO_SHARNDLE.

The next questions are about your injecting behaviors in the past 6 months.


Check_ INTRO_SHARNDLE.

If R always used a sterile needle in the past 6 months (ID22 [STERILE] EQ 4, go to ID27 [GIVENDLE].

Else, go to INTRO_SHARNDLE.


ID25.

In the past 6 months, did you use needles that someone else had already injected with?

SHARNDLE

Used needle after, Y/N




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ID26

If R used needle (ID25 [SHARNDLE] EQ 1), go to ID26 [NUM_NA].

Else, go to ID27 [GIVENDLE].


ID26.

In the past 6 months, with how many different people did you use a needle after they injected with it? Please give your best estimate. If you do not know, you may leave the response blank.

NUM_NA

Used needle after-number of people




__ __ __





Range

0-300



ID27.

In the past 6 months, did you give your needle to someone else to use after you had already injected with it?

GIVENDLE

Gave needle after injected, Y/N




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ID28

If R used needle (ID27 [GIVENDLE] EQ 1), go to ID28 [NUM_GIVE].

Else, go to ID29 [SHARWORK].


ID28.

In the past 6 months, how many different people did you give your needle to use after you had already injected with it? Please give your best estimate. If you do not know, you may leave the response blank.

NUM_GIVE

Gave needle after injected with it - number of people




__ __ __





Range

0-300



ID29.

In the past 6 months, did you use cookers, cottons, filters, or water that someone else had already used?

SHARWORK

Used cooker, cotton, water after, Y/N




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ID30

If R used inj equip (ID29 [SHARWORK] EQ 1), go to ID30 [NUM_CCW].

Else, go to ID31 [SAMESYR].


ID30.

In the past 6 months, with how many different people did you use the same cooker, cotton, or water that they had already used? Please give your best estimate. If you do not know, you may leave the response blank.

NUM_CCW

Used cooker, cotton, water after - number of people




__ __ __





Range

0-300



ID31.

In the past 6 months, did you use drugs that had been divided with a syringe that someone had already injected with, also known as backloading or splitting?

SAMESYR

Used drugs divided up after, Y/N




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ID32

If R divided syringe (ID31 [SAMESYR] EQ 1), go to ID32 [NUM_DDA].

Else, go to INTRO_INJLLOC.



ID32.

In the past 6 months, with how many different people did you use drugs that had been divided with a syringe that they had already used? Please give your best estimate. If you do not know, you may leave the response blank.

NUM_DDA

Used drugs divided up after - number of people




__ __ __





Range

0-300



Last Injecting Event


INTRO_INJLLOC.

Now, think about the last time you injected in the past 6 months.


Check_ID33

If R ever injected in a public place p6m (ID18 [INJLOC])=1,2,3,or 4, go to ID33 [INJLLOC].

Else, go to ID34 [INJLDIS].


ID33.

The last time you injected any drug, did you inject in a public place, like an alley, public bathroom, library, or outside?

INJLLOC

Location injected, last time




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ID34

If R ever disposed a needle in a medical sharps container p6m (ID23 [NDLESDP]=1,2,3, or 4, go to ID34 [INJLLOC].

Else, go to ID35 [INJLSTE].



ID34.

The last time after you injected, did you put the used needle in a medical sharps or other secure container and/or took it to a syringe exchange program?

INJLDIS

Needle disposal, last time




No

0




Yes

1




Don't Know

9




Refuse to Answer

7




Check_ID35.

If R used sterile needles only (ID22 [STERILE] EQ 4), go to ID36 [INJLPN].

Else, go to ID35 (INJLSTE).


ID35.

The last time you injected any drug, did you use a new, sterile needle?

INJLSTE

Sterile needle, last time




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ID35.

If R always injected alone (ID19 [INJAO] NE 4), go to ID36 [INJLPN].

Else, go to IDU37 [INJLUN].



ID36.

The last time you injected, how many other people did you inject with? Please give your best estimate. If you do not know, you may leave the response blank.

Field note: If you did not share with anybody, enter 0

INJLPN

Number of people inject, last time




__ __ __





Range

0-300




Check_ID37

If R injected with at least 1 person and used needle after (ID36 [INJLPN] GE 1 AND ID25 [SHARNDLE] EQ 1), go to ID37 [INJLUN]. If R injected with at least 1 person and did not use needle (ID36 [INJPN] GE 1 AND ID25 [SHARNDLE] NE 1) to go ID38 [INJLGIV]. Else, go to INTRO_NDMETH.



ID37.

The last time you injected, did you use a needle after anyone else had already injected with it?

INJLUN

Used needle after someone - last time



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Check_ID38

If R last gave needle to someone (ID27 [GIVENDLE EQ 1), go to ID38 [INJLGIV].

Else, go to ID39 [INJLUCW].



ID38.

The last time you injected, did you give your needle to someone else to use after you had already injected with it?

INJLGIV

Gave used needle to someone else - last time



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Check_ID39

If R last shared equipment (ID29 [SHARWORK] EQ 1), go to ID39 [INJLUCW].

Else, go to ID40 [INJLUS].


ID39.

The last time you injected, did you use a cooker, cotton, or water that anyone else had already used?

INJLUCW

Used same cooker, cotton, water - last time



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_ID40

If R last divided syringe (ID31 [SAMESYR] EQ 1), go to ID40 [INJLUS].

Else, go to INTRO_INJLGEN.


ID40.

The last time you injected, did you use drugs that had been divided with a syringe that anyone else had already injected with?

INJLUS

Used drugs divided with same syringe - last time



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Last Injecting Partner


INTRO_INJLGEN.

The next questions are about the last person that you injected with. If you injected with more than one person, please think of the one that you have injected with the most often. The next questions are about that person.



ID41.

What is this person’s gender?

INJLGEN

Gender of last injecting partner



Man

1



Woman

2



Gender not listed

6



Don't Know

9



Refuse to Answer

7



ID42.

How old is this person? Please estimate to the best of your ability. If you do not know, you may leave the response blank.

INJLAGE

Last injecting partner age



__ __




Range

1-99



[Give Respondent Flashcard EE]

ID43.

Which of the following best describes your relationship to this person? Would you say this person was a:

INJLREL

Type of relationship - Last injecting partner



Sex partner, such as your spouse, boyfriend/girlfriend, or other person you have sex with

1



Relative

2



Friend or acquaintance

3



Needle or drug dealer

4



Stranger or someone you did not know well

5



Someone else

6



Don't Know

9



Refuse to Answer

7




NON-INJECTION DRUG USE (ND)

Non-injection Drug Use Frequency, 6m


Check_INTRO_NDMETH

If E_DRG6=1 go to INTRO_NDMETH. Else go to INTRO_OVERDOSE.


INTRO_NDMETH.

The next questions are about times when you may have used drugs but did NOT inject them. This includes times that you may have smoked, snorted, inhaled, or ingested drugs such as methamphetamine, cocaine, or crack. The next questions are about the types of drugs you mentioned you had used but did not inject in the past 6 months.


Check_ND1

If R used meth (ES16(2) [USDRGB] EQ 1), go to ND1 [NDMETH].

Else, go to ND2 [NDCRACK].


[Give Respondent Flashcard BB]

ND1.

In the past 6 months, how often did you use methamphetamine that you did not inject?

NDMETH

How often used methamphetamine past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND2

If R used crack (ES16(3) [USDRGC] EQ 1), go to ND2 [NDCRACK].

Else, go to ND2 [NDCRACK].


ND2.

In the past 6 months, how often did you use crack cocaine that you did not inject?

NDCRACK

How often used crack cocaine past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND3

If R used cocaine (ES16(4) [USDRGD] EQ 1), go to ND3 [NDCOKE].

Else, go to ND4 [NDDOWN].


ND3.

In the past 6 months, how often did you use powder cocaine that you did not inject?

NDCOKE

How often used powder cocaine that is smoked or snorted past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND4

If R used downers (ES16(5) [USDRGE] EQ 1), go to ND4 [NDDOWN].

Else, go to ND5 [NDPAIN].


ND4.

In the past 6 months, how often did you use benzodiazepines or other downers that you did not inject?

NDDOWN

How often used downers (benzos) such as Valium past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND5

If R used painkillers (ES16(6) [USDRGF] EQ 1), go to ND5 [NDPAIN].

Else, go to ND6 [NDX].


ND5.

In the past 6 months, how often did you use painkillers, such as Oxycontin, Dilaudid, or Percocet, that you did not inject?

NDPAIN

How often used pain killers such as Oxycontin, past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND6

If R used X (ES16(7) [USDRGG] EQ 1), go to ND6 [NDX].

Else, go to ND7 [NDHER].


ND6.

In the past 6 months, how often did you use X or ecstasy (MDMA) that you did not inject?

NDX

How often used X or ecstasy past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND7

If R used heroin (ES16(8) [USDRGH] EQ 1), go to ND7 [NDHER].

Else, go to ND8 [NDSTIM].


ND7.

In the past 6 months, how often did you use heroin that you did not inject?

NDHER

How often used heroin that is smoked or snorted past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND8

If R used stimulants (ES16(10) [USDRGJ] EQ 1), go to ND8 [NDSTIM].

Else, go to ND9 [NDFENT].


ND8.

In the past 6 months, how often did you use Adderall, Ritalin, or other commonly prescribed stimulants that you did not inject?

NDSTIM

How often used stimulants past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



Check_ND9

If R used methadone ([USELM] EQ 1), go to ND9 [NDMET].

Else, go to ND10 [NDBUP].



ND9.

In the past 6 months, how often did you use methadone that was not prescribed or not taken as prescribed that you did not inject?

NDMET

How often used methadone past 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Check_ND10

If R used buprenorphine ([USELB] EQ 1), go to ND10 [NDMET].

Else, go to ND11 [NDFENT].



ND10.

In the past 6 months, how often did you use buprenorphine, also known as Suboxone or Subutex, that was not prescribed or not taken as prescribed that you did not inject?

NDBUP

How often used buprenorphine past 6 months




More than once a day

1




Once a day

2




More than once a week

3




Once a week or less

4




Don't Know

9




Refuse to Answer

7



Fentanyl, Non-injection


Check_ND11

If R used fentanyl (ES16(9) [USDRGI] EQ 1), go to ND11 [NDFENT].

Else, go to ND14 [INJFRNT].


ND11.

In the past 6 months, how often did you use fentanyl that you did not inject, by itself or mixed with other drugs?

NDFENT

How often used fentanyl past 6 months



More than once a day

1



Once a day

2



More than once a week

3



Once a week or less

4



Don't Know

9



Refuse to Answer

7



ND12.

When you used fentanyl, that you did not inject, in the past 6 months, was it mixed with any other drug?

NDFENTC

Fentanyl, used, combined




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Check_ND13

If R used mixed fentanyl (ND12 [NDFENTC] EQ 1), go to ND13 [NDFENTD].

Else, go to ND14 [INJFRNT].


[Give Respondent Flashcard FF]


ND13.

What other drugs was fentanyl mixed with? You can select more than one option.

NDFENTD

Fentanyl, used, drugs combined




Marijuana





Methamphetamine





Crack cocaine





Powder cocaine





Benzodiazepines or other downers





Painkillers, such as Oxycontin, Dilaudid, or Percocet





X or ecstasy (MDMA)





Heroin





Adderall, Ritalin, or other commonly prescribed stimulants





Methadone





Buprenorphine, also known as Suboxone or Subutex





Something else





Don't Know

99




Refuse to Answer

77



Injection Drug Use Prevention


Check_ND14.

If R has ever injected (EVRINJ EQ 1), go to INTRO_OVERDOSE.

Else, go to ND14.


ND14.

In the past 6 months, has anyone injected drugs in front of you?

INJFRNT

Inject in front



No

0



Yes

1



ND15.

If you want to start injecting drugs, do you know someone who would show you how?

INJSHOW

Know PWID



No

0



Yes

1




DRUG OVERDOSE (DO)


INTRO_OVERDOSE.

The next questions are about overdose from injection or use of opioids such as heroin, fentanyl, or painkillers such as Oxycontin. By overdose, I mean if someone passed out, turned blue, or stopped breathing from using drugs.


Drug Overdose


CALC_USE_OPIOIDS

Respondent used any opioids in the past 6 months (yes/no). Hidden, automatic calculation.

CALC_USE_OPIOIDS

If R used opioids ((ES9[INJDRUGA] EQ 1 OR ES9[INJDRUGB] EQ 1 OR ES9[INJDRUGC] EQ 1 OR ES9[INJDRUGD] EQ 1 OR ES9[INJDRUGH)] EQ 1 OR ES16[USDRGF] EQ 1 OR ES16[USDRGH] EQ 1 OR ES16[USDRGI] EQ 1), 1, 0))


Check_INTRO_OVERDN

If R used opioids (ES9 [INJDRUGA] EQ 1 OR ES9 [INJDRUGB] EQ 1 OR ES9 [INJDRUGC] EQ 1 OR ES9 [INJDRUGD] EQ 1 OR ES9 [INDRGH] EQ 1 OR ES16 [USDRGF] EQ 1 OR ES16 [USDRGH] EQ 1 OR ES16 [USDRGI] EQ 1), go to OVERDN.

Else, go to ODELSEN.


DO1.

In the past 6 months, how many times have you overdosed on opioids? Please give your best estimate. If you do not know, you may leave the response blank.

Field note: If you did not overdose, enter 0


OVERDN

Number, overdosed




__ __



Range

0-76











DO2.

In the past 6 months, how many other people have you seen overdose on opioids? Please give your best estimate. If you do not know, you may leave the response blank.

Field note: If you did not see anybody overdose, enter 0


ODELSEN

Number, others overdosed




__ __



Range

0-76



Check_DO3.

If R saw someone else overdose (DO2 [ODELSEN] GE 1), go to DO3 [ODMED].

Else, go to DO4 [NALX].


DO3.

The last time you saw someone overdose, did you or someone around you try to get medical treatment by calling 911 or taking them to the hospital?

ODMED

Overdose, medical treatment



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Narcan Access and Use

DO4.

Have you ever heard of naloxone, also called Narcan, a drug that can be used to reverse an overdose due to use of opioids?

NALX

Naloxone, heard



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_DO5.

If R ever heard of Narcan (DO4 [NALX] EQ 1), go to DO5 [NALX6M].

Else, go to INTRO_OUMETH.


DO5.

In the past 6 months, have you bought or otherwise gotten take-home naloxone or Narcan?

NALX6M

Have naloxone, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Check_DO6.

If R got Narcan and saw someone overdose (DO5 [NALX6M] EQ 1 AND ODELSEN GE1), go to DO6 [ODNHELP].

Else, go to DO7 [NALXAV].


DO6.

In the past 6 months, have you used naloxone or Narcan to help someone who was overdosing?

ODNHELP

Helped with naloxone, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




DO7.

In the past 6 months, have you been in a situation when naloxone or Narcan was needed and it was not available?

NALXAV

Availability naloxone, 6m



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Consequences of Stimulant Overuse


Check_INTRO_OUMETH

If R used a stimulant (ES9 [INJDRUGE] EQ 1 OR ES [INJDRUGF] EQ 1 OR ES9 [INJDRUGG] EQ 1 OR ES16 [USDRGB] EQ 1 OR ES16 [USDRGC] EQ 1 OR ES16 [USDRGD] EQ 1), go to INTRO_OUMETH.

Else, go to INTRO_HELD6M.



INTRO_OUMETH.

Now I will ask you questions about consequences due to stimulant injection or use.


Check_DO8.

If R used or injected meth (ES9[INJDRUGE] EQ 1 OR ES16 [USDRGB] EQ 1), go to DO8 (OUMETH).

Else, go to DO9 [OUCOKE].



DO8.

In the past 6 months, did you need immediate care or call 911 because you took too much methamphetamine or were having a bad reaction to methamphetamine?

OUMETH

Needed care, meth, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_INTRO_OUMETH

If R used or injected cocaine or crack (ES9 [INJDRUGF] EQ 1 OR ES9 [INDRUGG] EQ 1 OR ES16 [USDRGC] EQ 1 OR ES16 [USDRGD] EQ 1), go to DO9 (OUCOKE). Else, go to INTRO_HELD6M.



DO9.

In the past 6 months, did you need immediate care or call 911 because you took too much cocaine or crack or were having a bad reaction to cocaine or crack?

OUCOKE

Needed care, cocaine/crack, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




JUSTICE SYSTEM AND LAW ENFORCEMENT EXPERIENCES (JT)

Incarceration Experience

INTRO_HELD6M.

The next questions are about experiences you may have had with the criminal justice system or law enforcement.



JT1.

During the past 6 months, have you been held in a detention center, jail, or prison for more than 24 hours?

HELD6M

Held or arrested past 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7


Check_JT2.

If R was arrested (JT1 [HELD6M] EQ 1), go to JT2 [TXGET].

Else, go to JT4 [ARRDRG].


JT2.

The last time you were in detention, jail, or prison, did you get treatment for drug use?

TXGET

Received treatment, jail



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



JT3.

The last time you were released from detention, jail or prison, were you told where to get treatment for drug use?

TXTOLD

Referral treatment, jail



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



JT4.

In the past 6 months, have you been arrested on drug possession charges?

ARRDRG

Arrested past 6 months, drugs



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Law Enforcement Experience


Check_JT5.

If R injected in the last 6 months (E_INJ6 EQ 1) go to JT5 [ARRSYR].

Else, go to JT7 [POLNAR].


JT5.

ARRSYR

In the past 6 months, have you been arrested or cited for possession of needles or other injection equipment?


Arrested injection equipment



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



JT6.

POLSYR

In the past 6 months, have the police taken, confiscated, or destroyed your needles or other injection equipment without arresting or citing you?


Confiscated injection equipment



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_JT5.

If R got Narcan (DO5 [NALX6M EQ 1) go to JT7 [POLNAR].

Else, go to END_ACASI.


JT7.

POLNAR

In the past 6 months, have the police taken, confiscated, or destroyed your naloxone or Narcan without arresting or citing you?


Confiscated Narcan



No

0



Yes

1



Don't Know

9



Refuse to Answer

7







END OF ACASI

END_ACASI.

Thank you for answering these questions. You have completed the questions that you answer yourself. Please let the interviewer know when you are ready to continue with the interview.


CALC_E_TIME3


End time where respondent for ACASI questions. Automatic hidden variable.


E_TIME3

Respondent end time



__ : __






DRUG TREATMENT (TX)


CALC_S_TIME4


Start time for post-ACASI questions. Automatic hidden variable.


S_TIME4

Respondent start time



__ : __




Drug Treatment, History


INTRO_INTERV.

INTERVIEWER: The participant has answered difficult questions. Please check with the participant to make sure they feel comfortable moving forward with the questionnaire and if they need any assistance. Mention there will be referrals at the end of the questionnaire, if needed.


INTRO_DT6M.

READ: “Next, I'm going to ask you about your experiences in receiving treatment for drug use. By treatment, I mean you participated in a program or took medicine to treat your drug use. This includes outpatient, inpatient, residential, detox, or 12-step program. This does not include treatment for alcohol use.”


TX1.

In the past 6 months, have you felt that you needed treatment for your drug use?

DTFELT

Drug treatment – 6 months




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



TX2.

In the past 6 months, have you received treatment for your drug use?

DT6M

Drug treatment – 6 months




No

0




Yes

1




Don't Know

9




Refuse to Answer

7



Medication-assisted Treatment, 6m


Check_INTRO_MAT

If R used opioids ([CALC_USE_OPIOIDS]]=1 AND received treatment for drug use (TX2 [DT6M] EQ 1, go to INTRO_MAT. Else, go to TX6 [MATTRY].



INTRO_MAT.

READ: “Now, I am going to ask you about your experiences with taking medicines to treat drug use due to use of opioids such as heroin, fentanyl, or painkillers such as Oxycontin. Medicines to treat drug use would include methadone or buprenorphine. Please only think about these medicines given to you by a doctor or other healthcare provider.”


TX3.

In the past 6 months, have you taken medicines that were provided by a doctor or other healthcare provider to treat opioid use?

MAT

Drug tx - meds in past 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_TX4.

If R was on MAT (TX3 [MAT] EQ 1), go to TX4 [MATTYP].

Else, go to TX6 [MATTRY].


TX4.

In the past 6 months, which medicines that were provided by a doctor or other healthcare provider did you take to treat opioid use?

[READ choices. CHECK ALL that apply.]

MATTYP

Drug tx – type meds



Methadone




Buprenorphine, also known as Suboxone or Subutex




Naltrexone, also known as Vivitrol




Other medicine




Don't Know

9



Refuse to Answer

7




Check_TX4spec.

If R was prescribed ‘other medicine’ (TX4(4) [MATTYP(4)] EQ 1), go to TX4spec [MATTYP_S].

Else, go to TX5 [MATDOS].


TX4spec.

INTERVIEWER: Specify other medication.


MATTYP_S

Specify other medication



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}






Check_TX5.

If R was prescribed buprenorphine or methadone (TX4 [MATTYP(1 or 2) EQ 1), go to TX5[MATDOS].

Else, go to TX6 [MATTRY].



TX5.

In the past 6 months, when you took buprenorphine (e.g., Suboxone) or methadone, did you feel it relieved your symptoms?

MATDOS

Drug tx – right dose



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



TX6.

In the past 6 months, did you try to get medicines to treat opioid use but were unable to?

MATTRY

Drug tx – tried to get meds



No

0



Yes

1



Don't Know

9



Refuse to Answer

7





Check_TX7.

If R tried but did not get medicine (TX6 [MATTRY] EQ 1), go to TX7 [MATTRYD].

Else, go to INTRO_EVERTEST.


TX7.

In the past 6 months, which medicines did you try to get to treat opioid use but were unable to?

MATTRYD

[READ choices. CHECK ALL that apply.]

Drug tx – types tried



Methadone




Buprenorphine, also known as Suboxone or Subutex




Naltrexone, also known as Vivitrol




Other medicine




Don't Know

9



Refuse to Answer

7





Check_TX7spec.

If R was prescribed ‘other medicine’ (TX7 [MATTRYD(4)] EQ 1), go to TX7spec [MATTRYD_S].

Else, go to INTRO_EVERTEST.


TX7spec.

INTERVIEWER: Specify other medicine.


MATTRYD_S

Specify other medicine



__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max characters = 100}






HIV TESTING EXPERIENCES (HT)


INTRO_EVERTEST.

READ: “Now I'm going to ask you a few questions about getting tested for HIV."


HIV Testing, Ever


HT1.

Have you ever had an HIV test?

EVERTEST

Ever tested for HIV



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_HT2.

If R ever tested for HIV (HT1 [EVERTEST EQ 1]), go to HT2a [RCNTST_M]. If R has never tested for HIV (HT [EVERTEST] EQ 0), go to HT5 [REAS12M].

Else go to INTRO_PRPAWR.


Recent HIV Testing


HT2a.

When did you have your most recent HIV test? Please tell me the month and year.

[INTERVIEWER: FIRST ENTER MONTH OF HIV TEST]

RCNTST_M

Month of most recent HIV test




January

1




February

2




March

3




April

4




May

5




June

6




July

7




August

8




September

9




October

10




November

11




December

12




Don't Know

99




Refuse to Answer

77








HT2b.

[INTERVIEWER: ENTER YEAR OF MOST RECENT HIV TEST]

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

RCNTST_Y

Year of most recent HIV test



_ _ _ _




Range (Year)

1900-2100






CALC_HIVTST_Y


HIDDEN CALCULATION: Interim calculation – number of years between IDATE_Y and RCNTST_Y

HIVTST_Y



[IDATE_Y] – [RCNTST_Y]




CALC_HIVTST_M


HIDDEN CALCULATION: Interim calculation – number of months between IDATE_M and RCNTST_M

HIVTST_M



[IDATE_M] – [RCNTST_M]




CALC_HIVTST_T


HIDDEN CALCULATION: Interim calculation – estimated number of months between IDATE and HIV test date factoring in years and months

HIVTST_T



([HIVTST_Y]*12)+[HIVTST_M]




CALC_TST12M


R was tested for HIV in the last 12 months.

If [HIVTST_T]<=12, 1, 0

TST12M


CALC_TST6M


R was tested for HIV in the last 6 months.

If [HIVTST_T]<=6, 1, 0

TST6M



Check_HT2c.

If R did know either month or year of last test (HT2a [RCNTST_M] EQ 77 OR 99 & HT2b [RCNTST_Y] EQ MISSING]), or if year of last test is year before interview year & month of last test not reported (RCNTST_Y EQ IDATE_Y-1), go to HT2c [C_RCNTST]. Else go to HT3.


HT2c.

Was your most recent test in the past 12 months?

C_RCNTST

HIV test in 12 months – y/n



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




HT3.

The last time you were tested for HIV, where did you get tested?

[DO NOT READ choices.]

LOCHIV

Location of recent HIV test



HIV/AIDS street outreach program or mobile unit

1



Drug treatment program

2



Syringe exchange program

3



Correctional facility (jail or prison)

4



Family planning or obstetrics clinic

5



Public health clinic or community health center

6



Private doctor's office (including HMO)

7



Emergency room

8



Hospital (inpatient)

9



At home

10



Other

11



Don't Know

99



Refuse to Answer

77








HT4.

What was the result of your most recent HIV test?

[READ choices.]

RCNTRST

Result most recent HIV test



Negative, you do NOT have HIV

1



Positive, you DO have HIV

2



Did not get result

3



Don't Know

9



Refuse to Answer

7







Check_ HT5.

If recent test result was positive (HT4 [RCNTRST] EQ 2), go to HT7 [POSMD].


If recent test is negative and R did not test in past 12 months (HT4 [RCNTRST] EQ 1,3,9,7 AND TST12M EQ 0), go to HT5 [REAS12M].


If recent test was not in the past 12 months (HT2c [C_RCNTST] NE 1), go to HT5 [REAS12M].


Else, go to INTRO_PRPAWR.


CALC_POS6M


Hidden calculation: R tested positive for HIV in the past 6 months.

If [RCNTST]=2 and [TEST6M]=1, 1, 0

POS6M


Barriers to HIV Testing

HT5.

I'm going to read you a list of reasons why some people have not been tested for HIV. Which of these best describes the most important reason you have not been tested for HIV in the past 12 months?

[READ choices.]

REAS12M

Reason not tested past 12 mos



You think you are at low risk for HIV

1



Your last test was HIV-negative

2



You were afraid of finding out that you might have HIV

3



You didn't have time

4



No one offered you an HIV test

5



No HIV testing was available

6



You did not know where to get HIV testing

7



Some other reason

8



Don't Know

99



Refuse to Answer

77






SoftEdit_HT5.

If R has never tested for HIV EQ 0 (HT1 [EVERTEST] EQ 0) and said their last test was HIV-negative (HT5 [REAS12M[ EQ 2), DISPLAY: "INTERVIEWER: Earlier, the respondent said they had never been tested for HIV. Please check with respondent and correct answers."

Then go to IE8.



Check_HT5spec.

If most important reason not tested was ‘other' (HT5 [REAS12M] EQ 8), go to HT5spec [REAS12M_S].

Else, go to INTRO_PRPAWR.


HT5spec.

INTERVIEWER: Specify other reason not been tested for HIV in the past 12 months

REAS12M_S

Most important reason not tested past 12 months


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __


{text response; max length = 100 characters}




Linkage to Care

HT6.

Have you ever been seen by a doctor, nurse, or other healthcare provider for a medical evaluation or care related to your HIV infection?

POSMD

Seen health care provider for HIV infection



No

0



Yes

1



Don't Know

9



Refuse to Answer

7







Check_HT7.

If R has ever seen a provider to treat HIV (HT6 [POSMD] EQ 1), go to HT7 [LASTMD].

Else, go to HT8.


HT7.

Was your last visit for HIV care in the past 6 months?

LASTMD

Last HIV care in the past 6 months - n/y



No

0



Yes

1



Don't Know

9



Refuse to Answer

7






HIV Medications


Filter: If [EL_IDU] EQ 1 and [CONSENTA] EQ 1 and [EVERTEST EQ 1] and [RCNTRST] EQ 2

HT8.

Are you currently taking antiretroviral medicines to treat your HIV infection?

CURRARV

Currently taking antiretrovirals



No

0



Yes

1



Don't Know

9



Refuse to Answer

7


PrEP




INTRO_PRPAWR.


READ: “The next questions are about the use of pre-exposure prophylaxis, or PrEP, such as Truvada, a medicine taken for months or years by a person who is HIV-negative to reduce the risk of getting HIV.”


HT9.

Before today, have you ever heard of PrEP?

PRPAWR

PrEP, awareness



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_HT12.

If R has not heard of PrEP before today (HT9 [PRPAWR] EQ 1) or not tested HIV-positive [RCNTRST] <>2), go to HT10 [PRPUS6].

Else, go to INTRO_EVRHCTST.


HT10.

In the past 6 months, did you take PrEP?

PRPUS6

PrEP use, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7







HT11.

In the past 6 months, did you try to get PrEP but were unable to?

PRPTRY6

PrEP try, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7






HEALTH CONDITIONS (HC)

Hepatitis C (HCV)


INTRO_EVRHCTST.

READ: “Next, I'd like to ask you some questions about your health, in general. The first questions are about hepatitis C. Hepatitis C is spread through infected blood. Injection drug use is one of the most common reasons people get hepatitis C."


HC1.

Have you ever been tested for hepatitis C infection?

EVRHCTST

Ever tested for HCV



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_HC2a.

If R ever tested for hepatitis C (HC1 [EVRHCTST] EQ 1), go to HC2a [RCHCTST_M].

Else, go to INTRO_ENDOCAR.


HC2a.

When did you have your most recent hepatitis C test? Please tell me the month and year.

[INTERVIEWER: FIRST ENTER MONTH OF MOST RECENT HCV TEST]

RCHCTST_M

Month of most recent HCV test




January

1




February

2




March

3




April

4




May

5




June

6




July

7




August

8




September

9




October

10




November

11




December

12




Don't Know

99




Refuse to Answer

77



HC2b.

[INTERVIEWER: ENTER YEAR OF MOST RECENT HCV TEST]

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

RCHCTST_Y

Year of most recent HCV test



_ _ _ _




Range (Year)

1900-2100







HC3.

The last time you were tested for hepatitis C, where did you get tested?

[DO NOT READ choices.]

HCVTLOC

Location of recent HCV test



HIV/AIDS street outreach program or mobile unit

1



Drug treatment program

2



Syringe exchange program

3



Correctional facility (jail or prison)

4



Family planning or obstetrics clinic

5



Public health clinic or community health center

6



Private doctor's office (including HMO)

7



Emergency room

8



Hospital (inpatient)

9



At home

10



Other

11



Don't Know

99



Refuse to Answer

77







Check_HC3spec.

If R reported ‘Some other place' (HC3 [HCVTLOC] EQ 11), go to HC3spec [HCVTLOC_S].

Else, go to HC4 [HCVEVER].


HC3spec.

INTERVIEWER: Type in other location where respondent got the last hepatitis C test.

HCVTLOC_S

Other location where R got hepatitis C test


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __



{text response; max length = 100 characters}


[Give Respondent Flashcard E.]

HC4.

Has a doctor, nurse, or other healthcare provider ever told you that you had hepatitis C?

[READ choices].

HCVEVER

Ever told had hepatitis C by doctor or nurse



No

1



Yes, I have been told I have hepatitis C and I have it now

2



Yes, I have been told I have hepatitis C, but I do not have it now

3



Yes, I have been told I have hepatitis C, but I do not know if I have it now

4



Don't Know

9



Refuse to Answer

7




Check_HC5.

If R told they had hepatitis C (HC4 [HCVEVER] EQ 2,3,4), go to HC5 [WHENHCV]. Else, go to INTRO_ENDOCAR.


[Give Respondent Flashcard F.]

HC5.

Approximately when were you last told you had hepatitis C?

[READ choices.]


WHENHCV

When told had HCV



Less than 1 year ago

1



1 year to 5 years ago

2



6 years to 10 years ago

3



More than 10 years ago

4



Don't Know

9



Refuse to Answer

7



HC6.

Have you ever taken medicine to treat your hepatitis C infection?

HCVMED

Ever taken medicine to treat HCV



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




Check_HC7.

If R took medicine hepatitis C (HC6 [HCVMED] EQ 1), go to HC7 (HCVMEDL). Else, go to HC9 [HCVTRY].


[Give Respondent Flashcard F.]

HC7.

Approximately when did you last take medicine to treat your hepatitis C infection?

[READ choices.]

HCVMEDL

When treatment HCV



Less than 1 year ago

1



1 year to 5 years ago

2



6 to 10 years ago

3



More than 10 years ago

4



Don't Know

9



Refuse to Answer

7



[Give Respondent Flashcard G.]

HC8.

What was the outcome of your most recent hepatitis C treatment?

[READ choices.]

HCVOUT

Treatment outcome HCV



The medication worked, you are cured

1



You are still on medication

2



You stopped taking medication, the medication did not work

3



You stopped taking medication, waiting on results

4



You stopped taking medication for other reasons

5



Don't Know

9



Refuse to Answer

7


HC9.

Have you ever tried to get medicines to treat your hepatitis C infection but were unable to?

HCVTRY

Tried to get HCV meds



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Other Health Conditions



Check_HC10.

If R ever injected any drug (ES7 [EVRINJ]), go to HC10 (ENDOCAR). Else, go to Intro_STLN6.



INTRO_ENDOCAR.

READ: “Now I will ask you about other health conditions."


HC10.

Has a doctor, nurse, or other healthcare provider ever told you that you had an infection of the heart valve, also known as endocarditis?

ENDOCAR

Ever told had endocarditis by doctor or nurse



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



HC11.

Has a doctor, nurse, or other healthcare provider ever told you that you had a bone infection, also known as osteomyelitis?

OSEOM

Ever told had osteomyelitis by doctor or nurse



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



HC12.

In the past 6 months, have you had an abscess?

ABSCESS

Abscess, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7



Check_HC13.

If R had an abscess (HC12 [ABSCESS] EQ 1) and saw a doctor in the past 6 months (DM5[VSITMD6] EQ 1, go to HC13 [ABSTX]. Else, go to INTRO_STLN6.


HC13.

In the past 6 months, did a doctor or other healthcare provider help take care of an abscess?

ABSTX

Abscess HC provider, 6 months



No

0



Yes

1



Don't Know

9



Refuse to Answer

7




PREVENTION ACTIVITIES (PA)

Access to Syringe Services Program

INTRO_STLN6.

READ: “Next I'd like to ask you about prevention services you may have received in the past 6 months. We will be asking you questions about getting needles, whether you may have used them yourself or not."

PA1.

In the past 6 months, have you gotten any new sterile needles? By new sterile needle, I mean no one - not even you - had ever used it before. The needle could have been for you or someone else.

STLN6

Got new sterile needles, 6 m




No

0




Yes

1




Don’t Know

9




Refuse to Answer

7


Check_PA2.

If R got new sterile needles (PA1 [STLN6] EQ 1), go to PA2 [SNDLSRC]. Else, go to PA7 [SSPSER].



PA2.

From which of the following places or people did you get sterile needles in the past 6 months? You may choose more than one option.

[READ choices. CHECK ALL that apply.]

SNDLSRC

Sources of new sterile needles, 12m



Syringe exchange program




Pharmacy or drug store





Doctor’s office, clinic, or hospital





Bought off the street





Internet





Someone who got them from a syringe exchange





Some other place or person





Don’t Know

9




Refuse to Answer

7



Check_PA2spec.

If R reported ‘Some other place or person' (PA2 [SNDLSRC(7)] EQ 1), go to PA2spec [SNDLSRC_S].

Else, go to PA3 [SSPREAS].



PA2spec.

INTERVIEWER: Type in other sources for sterile needles.

SNDLSRC_S

Other source


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __


{text response; max length = 100 characters}


Check_PA3.

If R did not use SSP for needles (PA2(1) [SNDLSRC(1)] EQ 0), go to PA3[SSPREAS]. Else, go to PA4[SNDL30].


PA3.

What are the reasons you did not get sterile needles from a syringe exchange program?

[DO NOT READ choices. CHECK ALL that apply]

SSPREAS

No SSP reasons



Did not know about the syringe exchange




Got needles from other sources




Tried and did not want to use it again




Location was inconvenient




Location was too far away




Hours were not convenient




Did not trust that information would be kept private




Did not want to be identified as someone who injects drugs




Afraid of arrest or harassment by police




Something else




Don't Know

99



Refuse to Answer

77



Check_PA3spec

If R reports something else (PA3(10) [SSPREAS(10)] EQ 1), go to PA3spec.

Else, go to PA4[SNDL30].


PA3spec.

INTERVIEWER: Type in other reasons.

SSPREAS_S

Other reasons


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __


{text response; max length = 100 characters}



Check_PA4.

If R injected drugs in the past 6 months (E_INJ6 EQ 1), go to PA4 [SNDL30]. Else, go to PA6 [EXCHN].


PA4.

In the past 30 days, how many new sterile needles did you have for your personal use?

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

SNDL30

Number of needles, 30 days




__ __ __





Range

0-1000




Check_PA5.

If R got new sterile needles from SSP (PA2(1) [SNDLSRC(1)] EQ 1 AND SNDL30 GE 1), go to PA5 [SNDL30X]. Else, go to PA7 [SSPSER].


PA5.

In the past 30 days, how many of the [INSERT SNDL30] sterile needles did you get from the syringe exchange program?

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]

SNDL30X

Number of needles from SEP, 30 days




__ __ __





Range

1-1000



SoftEdit_PA5.

If number of total needles obtained from an SEP in the past 30 days (PA5 [SNDL30X] GT number of total needles in past 30 days (PA4 [SNDL30], read: “INTERVIEWER: Number of needles obtained at a syringe exchange program cannot be greater than the total number of needles. Please check these numbers with the respondent and correct those data.”


PA6.

In the past 6 months, not including yourself, for how many different people did you get needles at the syringe exchange program?

EXCHN

Number of people, secondary exchange

[FIELD NOTE: IF DON’T KNOW OR REFUSED, LEAVE BLANK]




__ __ __





Range

0-776



PA7.

In the past 6 months, other than syringes, have you received services, counseling, information, or other products from the syringe exchange program?

SSPSER

SSP received, 6m




No

0




Yes

1




Don’t Know

9




Refuse to Answer

7



Check_PA8.

If R got services or products from SSP (PA7 [SSPSER] EQ 1), go to PA8 [SSPREC]. Else, go to E_TIME4.


PA8.

In the past 6 months, other than syringes, what services, counseling, information, or other products have you received from the syringe exchange program?


[DO NOT READ choices. CHECK ALL that apply]


SSPREC

SSP received, types 6m



Naloxone/Narcan and/or overdose prevention education




Injecting equipment such as cookers, cotton, water, etc.




Sharps container




Food, showers, or medication locker




Information on or referrals to mental health services




Information or counseling about sexual risk behaviors




Information or counseling about injection risk behaviors




Recovery coaches




Peer support




Referrals to treatment for drug use




Medication-assisted treatment for drug use (e.g., buprenorphine)




Treatment for HIV or HCV




Testing for and/or information on HIV or HCV




Wound care




Reproductive healthcare, pregnancy test, or condoms




Vaccinations




Something else




Don’t Know

9



Refuse to Answer

7



Check_PA8spec.

If R reports ‘Something else' (PA8(17) [SSPREC(17)] EQ 1), go to PA8spec [SSPREC_S].

Else, go to PA9 [SSPIMP].


PA8spec.

INTERVIEWER: Specify other services, counseling, information, or products received at syringe exchange program.

SSPREC_S

Other received from SSP


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __


{text response; max length = 100 characters}


PA9.

Now I’d like to ask about what you think could make the syringe exchange program better for you. Please list up to three ways:

[DO NOT READ CHOICES. SELECT NO MORE THAN THREE.]

SSPIMP

SSP improvement




Open more days or hours





More convenient location or more locations





Available or accessible staff





Offered more needles/had no limit on the number of needles





Delivered to homes




Naloxone/Narcan and/or overdose prevention education




Injecting equipment such as cookers, cotton, water, etc.




Sharps container




Food, showers, or medication locker




Information on or referrals to mental health services




Information or counseling about sexual risk behaviors




Information or counseling about injection risk behaviors




Recovery coaches




Peer support




Referrals to treatment for drug use




Medication-assisted treatment for drug use (e.g., buprenorphine)




Treatment for HIV or HCV




Testing for and/or information on HIV or HCV




Wound care




Reproductive healthcare, pregnancy test, or condoms




Vaccinations




Something else




No changes needed





Don’t Know

99




Refuse to Answer

77



Check_PA9spec.

If R reports ‘Something else' (PA9(22) [SSPIMP(22)] EQ 1), go to PA9spec[SSPIMP_S].

Else, go to E_TIME4.


PA9spec.

INTERVIEWER: Type in other services to improve at syringe exchange program.

SSPIMP_S

Other services for improvement


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __


{text response; max length = 100 characters}


Filter:

If R reports ‘Something else' (PA9(22) [SSPIMP(22)] EQ 1)




CALC_E_TIME4


End time of questionnaire. Automatic hidden variable.


E_TIME4

Respondent end time



__ : __









END OF SURVEY (END)


INTRO_END.

READ: “Thank you answering these questions and for your participation so far."


END1.

INTERVIEWER: Please confirm. Did the person complete the survey?

C_CMPLT

Confirm Complete



Did NOT complete the survey

0



DID complete the survey

1





END2.

INTERVIEWER: Please enter the date this interview was completed. (mm/dd/yyyy):


EDATE

End date




_ _ /__/____






END3.

INTERVIEWER: Please enter the time the interview ended (hh:mm) using a 24-hour clock. Example: 1:30pm should be entered as 13:30.


END

End time




__ : __




Interviewer Assessment – Post-Interview


END4.

INTERVIEWER: How confident are you of the validity of the respondent's answers?

VALIDITY

Confidence in validity of answers



Confident

1



Some doubts

2



Not confident at all

3



Check_END4spec.

If Interviewer doubts validity of responses (END4 [VALIDITY] EQ 2 or 3), Go to END4spec [VALIDITY_S].

Else, go to END5.


END4spec.

INTERVIEWER: Please explain why you are not confident in the respondent's answers:

VALIDITY_S

Specify why not confident in answers




__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __




{text response; max length = 1000 characters}




Interviewer Comments


END5.

INTERVIEWER: Do you have any comments to add?

INTCOMM

Interviewer Comments



No

0



Yes

1






Check_END6

If Interviewer has comments (END5, [INTCOMM] EQ 1), go to END6 [INTTXT]. Else, end survey.

END6.

INTERVIEWER: Enter interviewer comments

INTTXT

Interviewer comments text


__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __

__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __

__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __


{text response; max length = 1000 characters}





FLASHCARDS




FLASHCARD A



  • American Indian or Alaska Native


  • Asian


  • Black or African American


  • Native Hawaiian or Other Pacific Islander


  • White










FLASHCARD B


  • Man


  • Woman


  • Genderqueer/non-binary


  • Trans man


  • Trans woman


  • Other gender not listed












FLASHCARD C


  • A relative or family member


  • A person you have sex with


  • A person you use drugs with ­or buy drugs from


  • A friend


  • An acquaintance, that is, a person you know but do not consider a friend


  • A stranger, you don't know the person or just met them









FLASHCARD D


  • A private plan – through an employer or purchased directly


  • A government plan such as Medicaid or Medicare


  • Some other health insurance














FLASHCARD E


  • No


  • Yes, I have been told I have hepatitis C and I have it now


  • Yes, I have been told I have hepatitis C, but I do not have it now


  • Yes, I have been told I have hepatitis C, but I do not know if I have it now












FLASHCARD F



  • Less than 1 year ago


  • 1 year to 5 years ago


  • 6 to 10 years ago


  • More than 10 years ago











FLASHCARD G



  • The medication worked, you are cured


  • You are still on medication


  • You stopped taking medication, the medication did not work


  • You stopped taking medication, waiting on results


  • You stopped taking medication for other reasons











File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBurnett, Janet (CDC/DDID/NCHHSTP/DHPSE)
File Modified0000-00-00
File Created2021-09-13

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