Form Approved
OMB No. 0920-1100
Expiration Date: XX/XX/XXXX
Identification of behavioral and clinical predictors of early HIV infection
(Project DETECT)
Attachment 8a
Phase 2 Behavioral Survey (English)
Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1100)
Project DETECT: Part 3 Questionnaire – Final Study Visit
Behavioral Survey
Description: REDCap Survey to be completed by participants in Part 3 at their final study visit, which may occur at Day 70, at the first visit where participants have concordant results on all tests, at the participant’s last visit if they leave the study early, or after 1 year of serial follow-up. Study staff will complete the ‘Face page’ questions before the participant begins the survey. The answer option “Refuse to answer” will be listed on every question on this survey except: FP-1 through FP-11, For free-text fields, the participant will have additional instructions on how to refuse the question (“If you refuse to answer this question, please enter "R".”). Any question that states [first study visit] or [first visit] may also read as [most recent visit] or [last visit] if used at JHU.
FACE PAGE (Completed by study staff)
FP-1 Research Assistant ID: _________________________
FP-5 Visit Date: MM/DD/YYYY
FP-6 Date of [First Visit] (Part 2 Visit): MM/DD/YYYY
FP-7 Reason for Final Visit:
Day 70
Concordant tests
1 year of serial follow-up
Other: ___________________
FP-8 Input the number of partners the participant reported in their Part 2 survey in the partner-specific section (0, 1, 2, or 3).
[Depending on the number of partners entered in FP-8, the next questions ask for the research assistant to enter the nickname from the survey in Part 2.]
FP-9 Please enter a nickname or initials for Partner 1:
FP-10 Please enter a nickname or initials for Partner 2:
FP-11 Please enter a nickname or initials for Partner 3:
RESEARCH STAFF HANDS COMPUTER TO PARTICIPANT
OMB Burden Statement
Form Approved
OMB No. 0920-1100
Expiration Date: XX/XX/XXXX
Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1100)
In this survey we will be asking questions similar to the ones that were asked the day you first tested for HIV in this study on [Fill in date of Part 2 testing/Questionnaire]. In these questions we want to know about things that have happened in the time since [Fill in date of Part 2 testing/Questionnaire].
STI HISTORY
The next set of questions will be about sexually transmitted infections (STIs) other than HIV that you may have had since your [first study visit] on [Fill in date of Part 2 testing/Questionnaire].
SD-1 Since your [first study visit] on [insert date], has a health care provider told you that you had an STI other than HIV?
Yes
No
Don’t know
[If SD-1=YES:] SD-2 You said a healthcare provider told you that you had an STI since your [first study visit]. Which one(s)? Check all that apply:
Gonorrhea
Chlamydia
Syphilis
Herpes
Trichomonas (“Trich”)
Other (Write in response)
Don’t know
CO-1 If you have been vaccinated against COVID-19, what was the brand of your first dose?
I have not been vaccinated against COVID-19
Moderna
Pfizer
Johnson & Johnson
Novavax
AstraZeneca
Don’t know
Refuse to answer
[If CO-1 ≠ I have not been vaccinated against COVID-19, Don’t know, or Refuse to answer] CO-2 When did you receive your most recent (latest) dose? Please enter a month and year in MM/YYYY format. If you refuse to answer this question, please enter "R".
MM/YYYY
[If CO-1 ≠ I have not been vaccinated against COVID-19, Don’t know, or Refuse to answer] CO-3 How many doses of the COVID-19 vaccine have you received? Please enter a number. If you refuse to answer this question, please enter "R".
CO-4 Have you ever tested positive for COVID-19?
Yes
No
Don’t know
Refuse to answer
[If CO-4 = Yes] CO-5 When did you last test positive for COVID-19? Please enter a month and year in MM/YYYY format. If you refuse to answer this question, please enter "R".
MM/YYYY
SEXUAL BEHAVIOR
The next couple questions will help us set up the rest of the questions in this section.
SU-1 What gender do you consider yourself?
Male
Female
Transgender: Male to Female
Transgender: Female to Male
Non-binary or Genderqueer
Another gender not listed (Write in response)
SU-2 What was your sex assigned at birth?
Male
Female
SU-3 Since your [first study visit] on [insert date], who have you had sex with? Check all that apply. Sex includes any oral, anal or vaginal sex.
Men
Women
Transmen
Transwomen
Non-binary or Genderqueer people
People of another gender not listed (Write in response)
I have not had sex since my first study visit
We will now ask you some questions about sexual experiences you’ve had since your [first study visit]. We only want to know about partners you had oral, anal or vaginal sex with since [insert date].
Some questions will ask specifically about your sex partners' HIV status and what you did with partners who were HIV positive, HIV negative, and partners whose HIV status you did not know. We know you can't always be sure of a partner's HIV status. Please try to answer the questions based on what you knew and what your partners told you or did not tell you about their HIV status.
We know that it may be difficult to answer some of these questions if one or more of your sex partners do not identify as male or female, or if they are transgender. Except where we ask specifically about transgender partners, please include these sex partners in your responses to the questions about sex with either men or women, whichever you think is most appropriate.
We also know that how people refer to their genitals can be unique and personal. The following questions may use words that don’t perfectly fit how you or your partners refer to your bodies. Please answer the questions about specific sex acts the best that you can.
Participants will be asked the appropriate sex partner questions (Female Sex Partners of Men, Male Sex Partners of Women, Other Sex Partners of Men, Male Sex Partners of Men, or none of the sex partner questions) based on their replies to questions SU-1, SU-2, and SU-3.
Female Sex Partners of Men (male sex at birth and female sex partners)
The next questions are about women you had vaginal or anal sex with since your [first study visit] on [insert date]. Vaginal sex means you put your penis in her vagina. Anal sex means you put your penis in her butt.
FX-1. Since your [first study visit], with how many different women did you have vaginal or anal sex?
___ ___ Number of women (0 to N)
FX-2. With how many of these [FX-1] women did you have vaginal or anal sex without using a condom or not using it the whole time?
___ ___ Number of women (0 to N)
Check to make sure FX-2 ≤ FX-1. If not, then display “The number of women you had sex without using a condom or not using it the whole time cannot be more than the number of women you had vaginal or anal sex with since your [first study visit]. Please carefully re-enter your response.”
FX-3. The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [FX-2] women with whom you had vaginal or anal sex without using a condom since your [first study visit]:
Since your [first study visit], how many of these [FX-2] women with whom you had vaginal or anal sex without using a condom were….
partners whose HIV status you didn’t know? ___ Number of women (0 to FX-2)
HIV positive? ___ ___ Number of women (0 to FX-2)
HIV negative? ___ ___ Number of women (0 to FX-2)
Check to make sure that the numbers in FX-3 add up to the total N from FX-2. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [FX-2]. Please carefully re-enter your responses.”
Male Sex Partners of Women (female sex at birth and male sex partners)
The next questions are about men you had vaginal or anal sex with since your [first study visit] on [insert date]. Vaginal sex means he put his penis in your vagina. Anal sex means he put his penis in your butt.
FM-1. Since your [first study visit], with how many different men did you have vaginal or anal sex?
___ ___ Number of men (0 to N)
FM-2. With how many of these [FM-1] men did you have vaginal or anal sex without using a condom or not using it the whole time?
___ ___ Number of men (0 to N)
Check to make sure FM-2 ≤ FM-1. If not, then display “The number of men you had sex without using a condom or not using it the whole time cannot be more than the number of men you had vaginal or anal sex with since your [first study visit]. Please carefully re-enter your response.”
FM-3. The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [FM-2] men with whom you had vaginal or anal sex without using a condom since your [first study visit]:
Since your first study visit, how many of these [FM-2] men with whom you had vaginal or anal sex without using a condom were….
partners whose HIV status you didn’t know? __ _Number of men (0 to FM-2)
HIV positive? ___ ___ Number of men (0 to FM-2)
HIV negative? ___ ___ Number of men (0 to FM-2)
Check to make sure that the numbers in FM-3 add up to the total N from FM-2. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [FM-2]. Please carefully re-enter your responses.”
Other Sex Partners of Men (male sex at birth and transwomen, transmen, non-binary/genderqueer, and/or other sex partners)
The next questions are about people you had sex with since your [first study visit] on [insert date] who you didn’t identify as “Women” or “Men.” For the next few questions we are only interested in persons you had penetrative sex with, and for these questions we will refer to “Vaginal sex” for sex where you put your penis in their vagina (or “front hole”). “Anal sex" means you put your penis in their butt (or “back hole”).
OX-1. Since your [first study visit], with how many different people who you would not identify as female or male did you have vaginal or anal sex?
___ ___ Number of people (0 to N)
OX-2. With how many of these [OX-1] people did you have vaginal or anal sex without using a condom or not using it the whole time?
Number of people (0 to N)
Check to make sure OX-1 ≤ OX-2. If not, then display “The number of people you had sex without using a condom or not using it the whole time cannot be more than the number of people you had vaginal or anal sex since your [first study visit]. Please carefully re-enter your response.”
FM-3. The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [OX-2] people with whom you had sex without using a condom since your [first study visit]:
OX-3. Since your [first study visit], how many of these [OX-2] people you had vaginal or anal sex without using a condom were:
HIV positive? Number of people (0 to N)
HIV negative? ___ ___ Number of people (0 to N)
People whose HIV status you did not know? (0 to N)
Check to make sure that the numbers in OX-3 add up to the total N from OX-2. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [OX-2]. Please carefully re-enter your responses.”
Male Sex Partners of Men (male sex at birth and male sex partners)
The next questions are about men you had sex with since your [first study visit] on [insert date]. Oral sex means you put your penis in his mouth, or he put his penis in your mouth. Anal sex means you put your penis in his butt, or he put his penis in your butt.
SX-1. Since your [first study visit], with how many different men did you have oral or anal sex?
___ ___ Number of men (0 to N)
SX-2. Since your [first study visit], with how many different men did you have anal sex?
___ ___ Number of men (0 to SX-1)
SX-3. Since your [first study visit], of the (SX-2) men you had anal sex with, with how many different men did you have anal sex without a condom?
___ ___ Number of men (0 to SX-2)
SX-4. Since your [first study visit], of the (SX-2) men you had anal sex with, how many were new partners, meaning guys you had never had anal sex with before [insert baseline visit date]?
___ ___ Number of men (0- to SX-2)
[IF UW Site AND SX-1>0] The next few questions will ask about times you had sex with more than one man in the same encounter since your [first study visit] on [insert baseline visit date]. For these questions, a threesome involves sex with you and two other men. Group sex involves sex with you and at least 3 other men. When the question asks about the number of partners you had during a threesome or group sex, please write the total number of different partners you had across all encounters.
[IF UW Site AND SX-1>0] GS-1: Since your [first visit], how many times did you have sex with more than one man in the same encounter? (Threesome or group sex)
____ Number of events (times you had sex with more than one man in the same encounter)
[If UW site AND GS-1 > 0:] GS-2: Since your [first visit], how many times did you have sex with only two other men in the same encounter (a threesome)?
____ Number of events (times you had a threesome) (0 to GS-1)
[If UW site AND GS-2 > 0:] GS-3: Since your [first visit], in these [GS-2] threesomes, with how many different men did you have anal sex?
___ Total number of men with whom you had anal sex during a threesome (0 to SX-2)
[If UW site AND GS-3 > 0:] GS-4: Since your [first visit], of the [GS-3] men you had anal sex with during threesomes, with how many different men did you have anal sex without a condom?
___ Total number of men with whom you had anal sex without a condom (0 to SX-3)
[If UW site AND GS-4 > 0:] GS-5: The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [GS-3] men with whom you had anal sex without using a condom in a threesome since your [first study visit]:
How many of these [GS-4] men with whom you had anal sex without using a condom during threesomes were….
partners whose HIV status you didn’t know? ___ Number of men (0 to GS-3)
HIV positive? ___ ___ Number of men (0 to GS-3)
HIV negative? _ __ ___ Number of men (0 to GS-3)
Check to make sure that the numbers in GS-5 add up to the total N from GS-4. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [GS-4]. Please carefully re-enter your responses.”
[If UW site AND GS-1 > 0 & GS-2 < GS-1:] GS-6: Since your [first visit], how many times did you have sex with 3 or more other men in the same encounter (group sex)?
____ Number of events (times you had sex with three or more other men) (0 to GS-1)
[If UW site AND GS-6 > 0:] GS-7: Since your [first visit], in these [GS-6] times you had group sex (sex with 3 or more other men), with how many different men did you have anal sex?
___ Total number of men with whom you had anal sex during group sex (0 to SX-2)
[If UW site AND GS-7 > 0:] GS-8: Since your [first visit], of the [GS-7] men you had anal sex with during group sex, with how many different men did you have anal sex without a condom?
___ Total number of men with whom you had anal sex without a condom (0 to SX-3)
[If UW site AND GS-8 > 0:] GS-9: The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [GS-8] men with whom you had anal sex without using a condom during group sex since your [first study visit]:
How many of these [GS-8] men with whom you had anal sex without using a condom during group sex were….
partners whose HIV status you didn’t know? ___ Number of men (0 to GS-8)
HIV positive? ___ ___ Number of men (0 to GS-8)
HIV negative? _ __ ___ Number of men (0 to GS-8)
Check to make sure that the numbers in GS-9 add up to the total N from GS-8. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [GS-8]. Please carefully re-enter your responses.”
In the next section we will ask you more about the [SX-2] men you had anal sex with.
[If UW site] Ongoing Partners
In this section, we will ask you about what you have done with the [1-3] partners that you provided details about in your first study visit. You nicknamed these partners [insert initials for partners 1-3].
For Each Partner:
SX-5 Do you remember who you nicknamed [insert partner initials]?
Yes
No
If SX-5 = Yes, continue with questions for that partner. If SX-5 = No, skip partner-specific questions for this partner and start at SX-5 for next ongoing partner.
SX-6 Have you had anal sex with [insert partner initials] since your first study visit on [insert date]?
Yes
No
[If SX-6 = Yes:]
SX-7 Since your first study visit, how many times did you and [insert partner initials] have anal sex?
___ ___ Number of times (0 to N)
SX-8 Since your first study visit, how many times did you and [insert partner initials] have anal sex without using a condom or not using it the whole time?
___ ___ Number of times (0 to N)
SX-9 Since your first study visit, when you and [insert partner initials] had anal sex without a condom were you the top (your penis in his butt), bottom (his penis in your butt) or both? Check only one.
Both top and bottom
Top only
Bottom only
SX-10 Since your first study visit, during the time you were having sex with [insert partner initials], did [insert partner initials] have sex with anyone else?
Yes
No
Don't know
The next few questions will ask about times you and [partner initials] had sex with at least one other man together in the same encounter. For these questions, a threesome involves sex with you, [partner initials], and one other man (a total of 3 men). Group sex involves sex with you, [partner initials], and at least 2 other men (a total of 4 or more men). When the question asks about the number of partners you had during a threesome or group sex, please write the total number of different partners you had across all encounters.
SX-11 Since your first study visit, did you and [insert partner initials] ever have sex with other people in the same encounter? (Threesome or group sex)
Yes
No
Don't know
[If SX-11 = “Yes”:] GS-10: Since your first study visit, how many times did you and [partner initials] have sex with only one other man in the same encounter (threesome)?
___ Number of times (encounters involving sex with [partner initials] and 1 other man)
[If GS=10 > 0:] GS-11: Think of the most recent time you had a threesome with [partner initials].
Did anyone have anal sex during this threesome?
Yes
No
Don’t know
[If GS-11=Yes] GS-12 Did anyone have anal sex without a condom during this threesome?
Yes
No
Don’t know
[If GS-12 =Yes] GS-13 Who had anal sex without a condom with each other in this threesome? Mark all that apply.
I had anal sex without a condom with [partner initials]
I had anal sex without a condom with the 3rd partner
[Partner initials] had anal sex without a condom with the 3rd partner.
GS-14 What was the HIV status of the 3rd Partner?
HIV-Positive
HIV-Negative
Didn’t know his HIV status
[If SX-11 = “Yes”:] GS-15: Since your first study visit, how many times did you and [partner initials] have sex with 2 or more other men in the same encounter (group sex)?
___ Number of times (encounters involving sex with you, this partnerand 2+ other men)
[If GS-15 > 0:] GS-16: Think of the most recent time you had group sex with [partner initials] and at least two other men. How many men took part in this group sex encounter? Include [partner initials], but not yourself.
___ Total number of men your last group sex encounter with this partner
[If GS-16 > 0:] GS-17: The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [GS-16] men involved the last time you had group sex with [partner initials].
How many of these [GS-16] men involved the last time you had group sex with [partner initials were….
partners whose HIV status you didn’t know? ___ Number of men (0 to GS-16)
HIV positive? ___ ___ Number of men (0 to GS-16)
HIV negative? _ __ ___ Number of men (0 to GS-16)
[If GS-16 > 0.] GS-18: Questions asking about condom use “Did X and Y have anal sex without a condom during your most recent group sex encounter that included [partner initials]?”) will be asked using the number of group sex partner from question GS-16 and following the table below for reference of which partnerships should be asked about.
|
Partner initials |
3rd |
4th |
Up to GS-16+1 |
You |
|
|
|
|
Partner initials |
|
|
|
|
3rd |
|
|
|
|
4th |
|
|
|
|
Up to GS-16 + 1 |
|
|
|
|
[For all partners:]
SX-12 Have you told [insert partner initials] about your HIV test results?
Yes
No
SX-13 Has [insert partner initials] gotten tested for HIV since you first tested positive?
He already knew he was positive
Yes, he tested for HIV
No, he hasn’t tested for HIV
Don’t know
[If SX-13 = Yes:] SX-14 What was [insert partner initials]’ HIV test result?
Positive
Negative
Don’t know
If SX-13=No he hasn’t tested or Don’t know or SX-14=Negative or Don’t Know:] SX-15 To the best of your knowledge, is [insert partner initials] currently taking medicine to prevent himself from getting HIV? This might also be known as Pre-Exposure Prophylaxis or PrEP.
Yes
No
Don’t know
Repeat SX-5 to SX-14 for Ongoing Partners 2 and 3.
[If UW site] New Partners
If SX-4 = 1 ask Partner 1 questions
If SX-4 = 2 ask Partner 1 and Partner 2 questions
If SX-4 = 3 ask Partner 1, Partner 2 and Partner 3 questions
If SX-4 ≥ 4 ask Partner 1, Partner 2, Partner 3 and Questions for ≥ 4 partners
Now, we’d like to ask you about partners that you had anal sex with for the first time after your first study visit on [insert date]. We’ll call these your ‘new partners’.
We do not want to know the names of your partners. Please choose a nickname or initials that you will remember and that will best help you identify that person.
SX-16
Please enter a nickname or initials for new partner 1 __________
nickname or initials for new partner 2 __________
Please enter a nickname or initials for new partner 3 __________
SX-17 Did you have sex with [insert partner initials] once, or more than once since your first study visit?
Once
More than once
For Each Partner:
SX-18 Which of the following statements about [insert partner initials]’s age is most true?
He is more than 10 years younger than I am
He is 2-10 years younger than I am
He is within a year of my age
He is 2-10 years older than I am
He is more than 10 years older than I am
Don't know
SX-19 Is [insert partner initials] Hispanic or Latinx?
Yes
No
Don’t know
SX-20 What is [insert partner initials]’s race? Check all that apply.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Another group (Write in response)
Don’t know
SX-22 If you had to further describe the type of sex partner [insert partner initials] is/was, which of the following would you choose? Someone who …
is a main/primary sexual partner
you have sex with on a regular basis, but who is not a main or primary partner
you have had sexual contact with more than once, but not on a regular basis, and who you normally socialize with
you have had sexual contact with more than once, but not on a regular basis, and who you don’t socialize with
you had sexual contact with only 1 time, but could find again if necessary
you had never met before you had had sexual contact and never plan to see again
you gave sex to for money or other goods or someone who gave you sex for money or other goods
SX-23 Where did you first meet [insert partner initials]?
Through friends
School or work
Online or on an app
Circuit party or Rave
At church
Through a personal ad in a newspaper
On a telephone chat line or dating line
Bar/Club
Cruising area
On the street
Adult bookstore
Bath house
Sex club
Sex resort
Private sex party
Sports club or gym
Vacation or cruise
Social organization
Other: _____________________________________
SX-24 Did you share your HIV status with [insert partner initials] before you first had sex?
Yes
No
Don’t know
SX-25 Did [insert partner initials] share his HIV status with you before you first had sex?
Yes
No
Don’t know
[If SX-25 = Yes:] SX-26 What was [insert partner initials]’s HIV status at that time?
HIV-negative
HIV-positive
[If SX-26 ≠ HIV-positive:] SX-27 To the best of your knowledge, what is [insert partner initials]'s HIV status today?
HIV-negative
HIV-positive
Don’t know
For HIV-negative partners:
SX-28 To the best of your knowledge, is [insert partner initials] currently taking medicine to prevent himself from getting HIV? This might also be known as Pre-Exposure Prophylaxis or PrEP.
Yes
No
Don’t know
For HIV-positive partners:
SX-29 To the best of your knowledge, is [insert partner initials] currently taking medicines for HIV?
Yes
No
Don’t know
SX-30 To the best of your knowledge, does [insert partner initials] have an undetectable viral load?
Yes
No
Don’t know
For all partners:
SX-31 Since your first study visit on [insert date], how many times did you and [insert partner initials] have anal sex?
___ ___ Number of times (0 to N)
SX-32 Since your first study visit on [insert date], how many times did you and [insert partner initials] have anal sex without using a condom or not using it the whole time?
___ ___ Number of times (0 to N)
SX-33 Since your first study visit on [insert date], when you and [insert partner initials] had anal sex without a condom were you the top (your penis in his butt), bottom (his penis in your butt) or both? Check only one.
Both top and bottom
Top only
Bottom only
The next few questions will ask about times you and [partner initials] had sex with at least one other man together in the same encounter. For these questions, a threesome involves sex with you, [partner initials], and one other man (a total of 3 men). Group sex involves sex with you, [partner initials], and at least 2 other men (a total of 4 or more men). When the question asks about the number of partners you had during a threesome or group sex, please write the total number of different partners you had across all encounters.
SX-34 Since your first study visit, did you and [insert partner initials] ever have sex with other people in the same encounter? (Threesome or group sex)
Yes
No
Don't know
[If SX-34 = “Yes”:] GS-19: Since your first study visit, months how many times did you and [partner initials] have sex with only one other man in the same encounter (threesome)?
___ Number of times (encounters involving sex with [partner initials] and 1 other man)
[If GS=19 > 0:] GS-20: Think of the most recent time you had a threesome with [partner initials]. Did anyone have anal sex during this threesome?
Yes
No
Don’t know
[If GS-20=Yes] GS-21 Did anyone have anal sex without a condom during this threesome?
Yes
No
Don’t know
[If GS-21 =Yes] GS-22 Who had anal sex without a condom with each other in this threesome? Mark all that apply.
I had anal sex without a condom with this partner
I had anal sex without a condom with the 3rd partner
This partner had anal sex without a condom with the 3rd partner.
GS-23 What was the HIV status of the 3rd Partner?
HIV-Positive
HIV-Negative
Didn’t know his HIV status
[If SX-34 = Yes:] GS-24: Since your first study visit, how many times did you and [partner initials] have sex with 2 or more other men in the same encounter (group sex)?
___ Number of times (encounters involving sex with you, this partner and 2+ other men)
[If GS-24 > 0:] GS-25: Think of the most recent time you had group sex with [partner initials] and at least two other men. How many men took part in this group sex encounter? Include [partner initials], but not yourself.
___ Total number of men your last group sex encounter with this partner
[If GS-25 > 0:] GS-26: The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the [GS-25] men involved the last time you had group sex with [partner initials].
How many of these [GS-25] men involved the last time you had group sex with [partner initials were….
partners whose HIV status you didn’t know? ___ Number of men (0 to GS-25)
HIV positive? ___ ___ Number of men (0 to GS-25)
HIV negative? _ __ ___ Number of men (0 to GS-25)
[If GS-25 > 0..] GS-27: Questions asking about condom use “Did X and Y have anal sex without a condom during your most recent group sex encounter that included [partner initials]?”) will be asked using the number of group sex partner from question GS-25 and following the table below for reference of which partnerships should be asked about.
|
Partner initials |
3rd |
4th |
Up to GS-25+1 |
You |
|
|
|
|
Partner initials |
|
|
|
|
3rd |
|
|
|
|
4th |
|
|
|
|
Up to GS-25 + 1 |
|
|
|
|
Partner 1 section replicated for partners 2 and 3, but excluded here for brevity.
Thank you for telling us about [new partner1].
Thank you for telling us about [new partner2].
[If UW site] Questions for ≥ (Named Ongoing and New Partners) male sex partners
The next questions are about any other partners that you haven’t answered questions about yet. This should be the [(SX-2) – (Named ongoing partners + new partners)] men you had anal sex with since your first study visit on [insert date] other than the new partners you may have already told us about. These could be partners that you had anal sex with before your first study visit and continued having sex with after OR new partners that you first had anal sex with after your first study visit. The questions will cover all of these partners as a group.
SX-31. With how many of these [(SX-2) – (Named Ongoing partners + New partners)] men did you have anal sex without using a condom or not using it the whole time?
___ ___ Number of men (0 to N)
Check to make sure ≤ (SX-2) – (Named Ongoing + New). If not, then display “The number of other men you had anal sex without using a condom cannot be more than the total number of men you had anal sex with since your first study visit. Please carefully re-enter your response.”
SX-32. : The next three questions are going to ask you about the HIV status (unknown, HIV positive, or HIV negative) of the (SX-31) men you had anal sex without using a condom or not using it the whole time, since your first study visit on [insert date] who you haven’t answered questions about yet.
How many of these (SX-31) men that you had anal sex without a condom since your first study visit were…..
partners whose HIV status you didn’t know? ___ Number of men (0 to GS-32)
HIV positive? ___ ___ Number of men (0 to GS-32)
HIV negative? _ __ ___ Number of men (0 to GS-32)
Check to make sure that the numbers in SX-32 add up to the total N from SX-31. If not, then display “The number of HIV positive, HIV negative and HIV status unknown partners must add up to [SX-31]. Please carefully re-enter your responses.”
SUBSTANCE USE
The next set of questions is about drugs that weren’t prescribed for you by a doctor, sometimes called recreational drugs, which you may have taken since your first study visit on [insert date].
DU-1 Have you used poppers since your first study visit on [insert date]?
Yes
No
Don’t know
DU-2 Have you used cocaine since your first study visit on [insert date]?
Yes
No
Don’t know
DU-3 Have you used methamphetamine (meth or crystal) since your first study visit on [insert date]?
Yes
No
Don’t know
DU-4 Have you used Viagra, Cialis or Levitra since your first study visit on [insert date]?
Yes
No
Don’t know
DU-5 Since your first study visit on [insert date], have you injected drugs other than those prescribed by a medical provider?
Yes
No
Don’t know
[If DU-5=Yes:] DU-6 Which drugs have you injected?
Heroin
Cocaine
Methamphetamine (meth or crystal)
Other: _______________________
Don’t know
[If JHU site] PRE-EXPOSURE PROPHYLAXIS
[Ask section if FP-5 ≠ Established HIV infection – diagnosis >3 months ago.]
This next set of questions is about your experiences taking HIV medicines to prevent yourself from getting HIV. This can also be called Pre-Exposure Prophylaxis or PrEP.
PR-1 Since your last visit, have you taken HIV medicines to prevent yourself from getting HIV?
Yes
No
Don’t know
[If PR-1 = Yes AND FP-5 = HIV-negative/unknown] PR-2 Are you currently taking medicines to prevent yourself from getting HIV?
Yes
No
[If PR-1 = Yes] PR-3 When did you last start taking HIV medicines to prevent yourself from getting HIV? Please enter a month and year in MM/YYYY format. If you cannot remember the month, please just enter the year.
MM/YYYY
[If (PR-1 = Yes and PR-2 = No) OR (PR-1 = Yes and FP-5 ≠ HIV-negative/unknown)] PR-4 When did you last stop taking HIV medicines to prevent yourself from getting HIV? Please enter a month and year in MM/YYYY format. If you cannot remember the month, please just enter the year.
MM/YYYY
This is the end of the survey. Thank you very much for your time!
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Katz, David |
| File Modified | 0000-00-00 |
| File Created | 2021-12-08 |