Eligibility Screener (English)
Form Approved:
OMB No. 0920-0770
Expiration Date: XX/XX/XXXX
National HIV Behavioral Surveillance System: Eligibility Screener
Public reporting burden of this collection of information is estimated to average 5 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, Project Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0770). Do not send the completed form to this address
NHBS Round 7 CAPI REFERENCE QUESTIONNAIRE (CRQ)
Order in CAPI |
Abbreviation |
Domain |
Other topics included |
00 |
Overview |
Overview |
|
0 |
CalcVars |
Pre-set & calculated variables |
|
1 |
IE |
Interviewer-entered information |
|
2 |
ES |
Eligibility screener |
|
3 |
CN |
Consent |
|
4 |
CI |
OMB Statement & Core Introductory Statement |
|
5 |
NS |
Network size (RDS cycles only) |
|
6 |
DM |
Demographics |
General health care access & utilization |
7 |
SO |
Social experiences (MSM cycle only) |
|
8 |
SX |
Sexual behavior |
|
9 |
AL |
Alcohol use |
|
10 |
ID |
Injection drug use |
|
11 |
ND |
Non-injection drug use |
|
12 |
TX |
Drug overdose and drug treatment |
|
13 |
HT |
HIV testing & care |
|
14 |
HC |
Health conditions (STIs, hepatitis, mental health) |
|
15 |
PA |
Prevention activities |
|
16 |
JS |
Justice system experiences |
|
17 |
VE |
Violence |
|
CAPI |
Computer-Assisted Personal Interview |
CRQ |
CAPI Reference Questionnaire |
|
|
R |
Respondent |
P |
Partner |
|
|
DK |
Don't know |
REF |
Refused to answer |
NA |
Not applicable (question is 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 |
|
|
VS, UVS |
Vaginal sex, unprotected vaginal sex (i.e., without a condom) |
AS, UAS |
Anal sex, unprotected anal sex (i.e., without a condom) |
IAS |
Insertive anal sex |
RAS |
Receptive anal sex |
Below are conventions to be used for CAPI programming:Unless otherwise specified in the CRQ, all items that collect data require a response to be entered before advancing to the next item.
DK, REF, & NA options are codable options in CAPI as listed in the CRQ.
The CAPI program advances in the order specified in the CRQ. Interviewers may return to previous screens but cannot choose to skip or change the order of items, topics, sections, etc.
Text displayed on CAPI screens appears as it is formatted (e.g., bold, capitalization, etc.).
Calculated variables used solely for CAPI programming (e.g., to facilitate logic or fill text) ae not included in the CRQ.
Items requesting dates.
For items requesting full date (year, month, and day) the CAPI program should require all 3 fields to be completed if any are entered. If 1 component of the
For items requesting month & year, allow an unknown month, even
NHBS ROUND 7 QUESTIONNAIRE
PRE-SET AND CALCULATED VARIABLES
Variables with pre-set values |
|
ROUND |
NHBS Round |
|
ROUND = "NHBS Round 7" |
|
|
CYCLE |
NHBS Cycle |
|
CYCLE = 1 (MSM) If MSM cycle CYCLE = 2 (PWID) If PWID cycle CYCLE = 3 (HET) If HET cycle |
|
|
LANGUAGE |
Language |
|
LANGUAGE = 1 IF ENGLISH LANGUAGE = 2 IF SPANISH |
|
|
VERSION |
Questionnaire Version |
|
If CYCLE=1 & LANGUAGE=1, VERSION=‘NHBS-MSM2023 – ENGLISH, V1, [BUILD DATE]' If CYCLE=1 & LANGUAGE=2, VERSION = ‘NHBS-MSM2023 – SPANISH, V1, [BUILD DATE]' If CYCLE=2 & LANGUAGE=1, VERSION=‘NHBS-PWID2024 – ENGLISH, V1, [BUILD DATE]' If CYCLE=2 & LANGUAGE=2, VERSION = ‘NHBS-PWID2024 – SPANISH, V1, [BUILD DATE]' If CYCLE=3 & LANGUAGE=1, VERSION=‘’NHBS-HET2025 – ENGLISH, V1, [BUILD DATE]' If CYCLE=3 & LANGUAGE=2, VERSION = ‘NHBS-HET2025 – SPANISH, V1, [BUILD DATE]' |
|
|
IDATE |
Interview date |
|
IDATE = Today's date {system date on device} |
|
|
IDATEM |
Interview date: Month |
|
IDATEM = MONTH(IDATE) |
|
|
IDATEY |
Interview date: Year |
|
IDATEY = YEAR(IDATE) |
|
|
START |
Start Time |
|
START = Current time {system time on device} |
|
|
DATETIME |
Date and time identifier |
|
DATETIME= CONCAT(IDATE, START) |
|
|
DATAFILE |
Data file name |
|
DATAFILE = Data file name |
|
|
QYR |
Current Questionnaire Year |
|
QYR = if ((CYCLE=1), 2023, if ((CYCLE=2), 2024, if ((CYCLE=3), 2025, 0))) |
|
|
MSM21IMP |
MSM2021 data collection start date |
|
MSM21IMP = June 1, 2021 |
Computed date and duration variables used throughout the interview |
|
|
|
IDATE_C |
Interview date: Century Month |
|
IDATE_C= (IDATEY-1900) *12 + (IDATEM) |
|
|
AGO12M_C |
12 mos before interview: Century Month |
|
AGO12M_C= IDATE_C -12 |
|
|
AGO6M_C |
6 mos before interview: Century Month |
|
AGO6M_C= IDATE_C -6 |
|
|
NHBS ROUND 7 QUESTIONNAIRE
INTERVIEWER ENTERED INFORMATION (IE)
Variables from prior section(s) used in this section of the questionnaire |
|||
Section |
Question # |
Variable name |
Variable label |
Preloaded Variables |
-- |
CYCLE |
NHBS Cycle |
Preloaded Variables |
-- |
VERSION |
Questionnaire Version |
Preloaded Variables |
-- |
MSM21IMP |
MSM2021 data collection start date |
Preloaded Variables |
-- |
QYR |
Current Questionnaire Year |
Preloaded Variables |
-- |
IDATE |
Interview Date |
Preloaded Variables |
-- |
IDATEY |
Interview Date: Year |
Universe_IE. |
All Rs. |
INFO_DATETIME. |
DISPLAY: "The current date recorded on this device is [fill with current date, formatted as “Month date, year”] and the time is [fill with current time, formatted as “Hour: minute”]. If this is not correct, please close this interview and correct the date on the device." |
INFO_VERSION. |
DISPLAY: "This is questionnaire version [fill with value for VERSION]." |
INFO_OMB. |
DISPLAY: "Public reporting burden of this collection of information is estimated to average 5 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, Project Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0770). Do not send the completed form to this address." |
IE1. |
Interviewer ID: |
|
||
ICODE |
Interviewer ID |
|
||
|
---- ---- |
|
|
|
|
Range |
1-99 |
|
IE2. |
City: |
|
|
CITYR7 |
City |
|
|
|
Atlanta, GA |
10 |
|
|
Baltimore, MD |
20 |
|
|
Chicago, IL |
40 |
|
|
Denver, CO |
60 |
|
|
Detroit, MI |
70 |
|
|
Houston, TX |
90 |
|
|
Indianapolis, IN |
95 |
|
|
Los Angeles, CA |
100 |
|
|
Memphis, TN |
120 |
|
|
Newark, NJ |
140 |
|
|
New Orleans, LA |
150 |
|
|
New York City, NY |
160 |
|
|
Philadelphia, PA |
180 |
|
|
Portland, OR |
190 |
|
|
San Diego, CA |
210 |
|
|
San Francisco, CA |
220 |
|
|
San Juan, PR |
230 |
|
|
Seattle, WA |
240 |
|
|
Virginia Beach-Norfolk, VA |
170 |
|
|
Washington, DC |
250 |
|
IE3. |
Survey ID: |
|
|
SURID |
Survey ID |
|
|
|
---- ---- ---- ---- Must be 4 digits |
|
|
|
Range |
1-9999 |
|
HardEdit_IE3. |
If IE3 not 4 digits long, DISPLAY: "INTERVIEWER: The Survey ID must be four digits long." Then, go back to IE3. Else, go to IE3conf1. |
IE3conf1. |
INTERVIEWER: The Survey ID that you entered was [fill with value entered for IE3]. Is this correct? |
|||
C_SURID |
Survey ID confirmation |
|
||
|
|
No |
0 |
|
|
|
Yes |
1 |
|
HardEdit_IE3conf1. |
If value entered for IE3 is not correct (IE3conf1 EQ 0), DISPLAY: "INTERVIEWER: Enter the correct Survey ID number in the next screen." Then, go back to IE3. Else, go to Check_IE3b. |
Check_IE3b. |
If MSM cycle (CYCLE EQ 1) & interview year is 2021 (QYR EQ 2021), go to IE3b. If IDU cycle (CYCLE EQ 2) & interview year is 2022 (QYR EQ 2022), go to IE3c. Else, go to Check_IE5. |
IE3b. |
INTERVIEWER: Was this person recruited for RDS? |
|
|
RDSMSM |
RDS recruitment - MSM cycle |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
IE3c. |
INTERVIEWER: Is this interview being conducted remotely, that is, by either videoconference or phone? |
|
|
ITYPER6 |
Interview type (remote – y/n) |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
Check_IE3d. |
If interview is being conducted remotely, (IE3c EQ 1), go to interviewer’s location (IE3d). Else, go to Check_IE5. |
IE3d. |
INTERVIEWER: Are you conducting this interview from your home, from the project office, or from a field site? |
|
|
RIVWRLOCR6 |
Interviewer location (remote interviews) |
|
|
|
Interviewer’s home |
1 |
|
|
Project office |
2 |
|
|
Field site |
3 |
|
Check_IE5. |
If MSM cycle (CYCLE EQ 1), and R not recruited via RDS (IE3b EQ 0), go to IE5. Else, go to Check_IE9. |
Universe_VBSSeries. |
All Rs in MSM Cycle (CYCLE EQ 1). |
IE4. |
INTERVIEWER: Is this interview a Post Event Appointment? |
|
|
PEA |
Post Event Appointment |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
IE5. |
Venue Code: |
|
|
VENUE |
Venue Code |
|
|
|
__ __ __ __ |
|
|
|
Range |
1-9900 |
|
IE6. |
Event Number: |
|
|
VBS_EVNT |
Event number |
|
|
|
---- ---- ---- |
|
|
|
Range |
1-999 |
|
|
Don't Know |
9999 |
|
Check_IE7. |
Go to IE8. |
IE7. |
Enter the field site ID for the location of the interview: (If unknown, select "Don't Know".) |
||
PEASITE |
PEA Field site ID |
|
|
|
---- ---- ---- ---- |
|
{4 alphanumeric characters} |
|
Don't Know |
9 |
|
Check_HardEdit_IE7. |
If PEA field site is unknown (IE7 EQ DK), go to IE8. Else, go to HardEdit_IE7. |
HardEdit_IE7. |
If IE7 is NOT 4 digits long, DISPLAY: "INTERVIEWER: The PEA Field Site ID must be four alphanumeric characters long." Then, go back to IE7. Else, go to IE8. |
IE8. |
Recruitment date: (If unknown, select "Don't Know".) |
||
RECRDATE |
Recruitment date |
|
|
|
__ __ / __ __ / __ __ __ __ (MM/DD/YYYY) |
|
|
|
Range (Year) |
1900-2100 |
|
|
Don't know (Year) |
9999 |
|
HardEdit_IE8. |
If Recruitment date known & after interview date (IE8 NE DK & IE8 GT IDATE), DISPLAY: " INTERVIEWER: The date of recruitment cannot be after today's date. Please correct on next screen." Then return to IE8. Else, go to SoftEdit_IE8. |
SoftEdit_IE8. |
If Recruitment date known & before MSM cycle implementation date (IE8 NE DK & IE8 LT MSM21IMP), DISPLAY: "INTERVIEWER: The date of recruitment is before June 1, [fill with current questionnaire year (QYR)]. If this is incorrect, go back to the previous screen and re-enter the date of recruitment .” Else, go to Check_IE9. |
Check_IE9. |
If MSM cycle and interview is being conducted in person (CYCLE EQ 1 and IE3c EQ 2), or if U or HET cycle (CYCLE EQ 2 or CYCLE EQ 3), go to IE9. Else, go to Check_IE10. |
IE9. |
Field Site ID: |
|
|||||
FLDSTEID |
Field site ID |
|
|||||
|
|
---- ---- {Must be 2 digits} |
|
|
|||
|
|
Range |
0-99 |
|
|
HardEdit_IE9. |
If IE9 is not 2 digits long, DISPLAY: "INTERVIEWER: The Field Site ID must be two digits long. Please correct on next screen." Then return to IE9. Else, go to Check_IE10. |
Check_IE10. |
If MSM cycle and R recruited via RDS (CYCLE EQ 1 and IE3b EQ 1), or if IDU or HET cycle (CYCLE EQ 2 or CYCLE EQ 3), go to IE10. Else, go to END_IE. |
IE10. |
INTERVIEWER: Is the respondent a seed? |
||
ISEED |
Respondent is a seed |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
HardEdit_IE10. |
If Survey ID in non-seed range & R is a seed (IE3 GE 1000 & IE10 EQ 1), DISPLAY: "INTERVIEWER: You indicated that the respondent is a seed but earlier, recorded a non-seed Survey ID. One of these is incorrect." Then return to IE10. If Survey ID in seed range & R NOT a seed (IE3 LT 1000 & IE10 EQ 0), DISPLAY: "INTERVIEWER: You indicated that the respondent is NOT a seed but earlier, recorded a seed Survey ID. One of these is incorrect." Then return to IE3. Else, go to END_IE. |
END_IE. |
Go to Eligibility Screener Section (ES). |
NHBS ROUND 7 QUESTIONNAIRE
Variables from prior section(s) used in this section of the questionnaire |
|||
Section |
Question # |
Variable name |
Variable label |
Preloaded variables |
-- |
CYCLE |
NHBS Cycle |
Preloaded variables |
-- |
IDATE |
Interview date |
Preloaded variables |
-- |
QYR |
Current Questionnaire Year |
Interviewer Entered Information |
IE2 |
CITY |
City |
Interviewer Entered Information |
IE4 |
PEA |
Post Event Appointment |
Interviewer Entered Information |
IE8 |
PEARDTE |
PEA recruitment event date |
Universe_ES. |
All Rs. |
INTRO_ES. |
DISPLAY: "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. 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_BEGSCR. |
|
|
BEGSCR |
Time at beginning of screener |
BEGSCR = Current time |
Check_CALC_RDATE. |
Go to ES1. |
CALC_RDATE. |
|
|
RDATE |
Calculated Recruitment Date |
If interview is NOT a Post Event Appointment (IE4 EQ 0): RDATE=IDATE
If interview is Post Event Appointment (IE4 EQ 1): RDATE=RECRDATE |
ES1. |
What is your date of birth? |
||
DOB |
Date of birth |
|
|
|
__ __ / __ __ / __ __ __ __ (MM/DD/YYYY) |
|
|
|
Range (Year) |
1900-2100 |
|
|
Don't Know (Year) |
9999 |
|
|
Refuse to Answer (Year) |
7777 |
|
Check_CALC_AGE. |
If R did not provide date of birth (ES1 EQ DK or REF), go to ES2. Else, go to HardEdit_ES1. |
HardEdit_ES1. |
If date of birth is on or after interview date (ES1 GE IDATE), DISPLAY: "INTERVIEWER: Date of birth cannot be TODAY or later." Then, go back to ES1. Else, go to CALC_AGE. |
CALC_AGE. |
|
|
AGE |
QDS calculated age today |
Calculate age from date of birth (DOB) |
ES1a. |
So, you are [fill with calculated age (AGE)] years old. Is that correct? |
|||
C_AGE |
Confirm age |
|
||
|
|
No |
0 |
|
|
|
Yes |
1 |
|
HardEdit_ES1a. |
If calculated age NOT correct (ES1a EQ 0), DISPLAY: "INTERVIEWER: Please hit ok to re-enter the date of birth." Then, go back to ES1. Else, go to Check_ES2. |
Check_ES2. |
If R LT 18 years old (AGE LT 18), go to Check_CALC_EL. Else, go to ES2. |
ES2. |
During [fill with current questionnaire year (QYR)], did you already complete at least part of the health survey that (Insert Project Name) is conducting? It could have been here or at another location. |
||
E_PART |
Eligibility, previous participant |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Notes_Ethnicity. |
See Measure References. |
ES3. |
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 |
|
Check_ES3a. |
If R is Latino (ES3 EQ 1), go to ES3a. Else, go to ES4. |
ES3a. |
Which of the following describes your Hispanic, Latino/a, or Spanish origin? You may choose more than one option.
[READ choices. CHECK ALL that apply.] |
||
HSPTYP |
Hispanic Ancestry (number reported) |
|
|
HSPTYPA |
Mexican |
|
|
HSPTYPB |
Puerto Rican |
|
|
HSPTYPC |
Cuban |
|
|
HSPTYPD |
Dominican |
|
|
HSPTYPE |
Another Hispanic, Latino/a, or Spanish origin |
|
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES3spec. |
If R reports ‘Another' Hispanic origin (HSPTYPE EQ 1), go to ES3spec. Else, go to ES4. |
ES3spec. |
What is your Hispanic, Latino/a, or Spanish origin? |
||
SPECHSP |
Other specified Latino origin |
||
|
__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ |
||
|
{text response; max length = 100 characters} |
||
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
ES4. |
[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) |
|
|
RACEA |
American Indian or Alaska Native |
|
|
RACEB |
Asian |
|
|
RACEC |
Black or African American |
|
|
RACED |
Native Hawaiian or Other Pacific Islander |
|
|
RACEE |
White |
|
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
|
Not Applicable |
8 |
|
Check_CountyofResidence. |
If IE2 EQ 1, go to ES5_ATL. If IE2 EQ 2, go to ES5_BLT. If IE2 EQ 3, go to ES5_BOS. If IE2 EQ 4, go to ES5_CHI. If IE2 EQ 5, go to ES5_DAL. If IE2 EQ 6, go to ES5_DEN. If IE2 EQ 7, go to ES5_DET. If IE2 EQ 8, go to ES5_IND. If IE2 EQ 9, go to ES5_HOU. If IE2 EQ 10, go to ES5_LAX. If IE2 EQ 11, go to ES5_MIA. If IE2 EQ 12, go to ES5_MEM. If IE2 EQ 13, go to ES5_NAU. If IE2 EQ 14 go to ES5_NEW. If IE2 EQ 15, go to ES5_NOL. If IE2 EQ 16, go to ES5_NYC. If IE2 EQ 17, go to ES5_NOR. If IE2 EQ 18, go to ES5_PHL. If IE2 EQ 19, go to ES5_PTL. If IE2 EQ 21, go to ES5_SDG. If IE2 EQ 22, go to ES5_SFO. If IE2 EQ 23, go to ES5_SJN. If IE2 EQ 24, go to ES5_SEA. If IE2 EQ 25, go to ES5_WDC. |
ES5_ATL. |
What county do you currently live in?
[DO NOT read choices.] |
||
ATLCTYR6 |
Eligibility, Atlanta county of residence |
|
|
|
Barrow County |
1 |
|
|
Bartow County |
2 |
|
|
Butts County |
3 |
|
|
Carroll County |
4 |
|
|
Cherokee County |
5 |
|
|
Clayton County |
6 |
|
|
Cobb County |
7 |
|
|
Coweta County |
8 |
|
|
Dawson County |
9 |
|
|
DeKalb County |
10 |
|
|
Douglas County |
11 |
|
|
Fayette County |
12 |
|
|
Forsyth County |
13 |
|
|
Fulton County |
14 |
|
|
Gwinnett County |
15 |
|
|
Haralson County |
16 |
|
|
Heard County |
17 |
|
|
Henry County |
18 |
|
|
Jasper County |
19 |
|
|
Lamar County |
20 |
|
|
Meriwether County |
21 |
|
|
Morgan County |
22 |
|
|
Newton County |
23 |
|
|
Paulding County |
24 |
|
|
Pickens County |
25 |
|
|
Pike County |
26 |
|
|
Rockdale County |
27 |
|
|
Spalding County |
28 |
|
|
Walton County |
29 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
Check_ES5_BLT. |
Go to CALC_E_CITY. |
ES5_BLT. |
What county do you currently live in?
[DO NOT read choices.] |
||
BLTCTYR5 |
Eligibility, Baltimore county of residence |
|
|
|
Baltimore City |
1 |
|
|
Anne Arundel |
2 |
|
|
Baltimore |
3 |
|
|
Carroll |
4 |
|
|
Harford |
5 |
|
|
Howard |
6 |
|
|
Queen Anne's |
7 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_BLTELR5. |
|
|
BLTELR5 |
Eligible county resident: BLT |
BLTELR5 = if ((BLTCTYR5=1 OR BLTCTYR5=2 OR BLTCTYR5=3 OR BLTCTYR5=4 OR BLTCTYR5=5 OR BLTCTYR5=6 OR BLTCTYR5=7), 1,0) |
Check_ES5_CHI. |
Go to CALC_E_CITY. |
ES5_CHI. |
What county do you currently live in?
[DO NOT read choices.] |
||
CHICTYR7 |
Eligibility, Chicago county of residence |
|
|
|
Cook County |
1 |
|
|
DuPage County |
3 |
|
|
Grundy County |
4 |
|
|
McHenry County |
7 |
|
|
Will County |
8 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_CHIELR5. |
|
|
CHIELR5 |
Eligible county resident: CHI |
CHIELR5 = if ((CHICTYR5=1 OR CHICTYR5=3 OR CHICTYR5=4 OR CHICTYR5=6 OR CHICTYR5=7 OR CHICTYR5=8), 1,0) |
Check_ES5_DEN. |
Go to CALC_E_CITY. |
ES5_DEN. |
What county do you currently live in?
[DO NOT read choices.] |
||
DENCTYR5 |
Eligibility, Denver county of residence |
|
|
|
Adams County |
1 |
|
|
Arapahoe County |
2 |
|
|
Broomfield County |
3 |
|
|
Clear Creek County |
4 |
|
|
Denver County |
5 |
|
|
Douglas County |
6 |
|
|
Elbert County |
7 |
|
|
Gilpin County |
8 |
|
|
Jefferson County |
9 |
|
|
Park County |
10 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_DENELR5. |
|
|
DENELR5 |
Eligible county resident: DEN |
DENELR5 = if ((DENCTYR5=1 OR DENCTYR5=2 OR DENCTYR5=3 OR DENCTYR5=4 OR DENCTYR5=5 OR DENCTYR5=6 OR DENCTYR5 =7 OR DENCTYR5=8 OR DENCTYR5=9 OR DENCTYR5=10), 1,0) |
Check_ES5_DET. |
Go to CALC_E_CITY. |
ES5_DET. |
What county do you currently live in?
[DO NOT read choices.] |
||
DETCTYR5 |
Eligibility, Detroit county of residence |
|
|
|
Macomb County |
0 |
|
|
Oakland County |
1 |
|
|
Wayne County |
2 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_DETELR5. |
|
|
DETELR5 |
Eligible county resident: DET |
DETELR5 = if ((DETCTYR5=0 OR DETCTYR5=1 OR DETCTYR5=2), 1,0) |
Check_ES5_HOU. |
Go to CALC_E_CITY. |
ES5_HOU. |
What county do you currently live in?
[DO NOT read choices.] |
||
HOUCTYR5 |
Eligibility, Houston county of residence |
|
|
|
Austin County |
1 |
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Brazoria County |
2 |
|
|
Chambers County |
3 |
|
|
Fort Bend County |
4 |
|
|
Galveston County |
5 |
|
|
Harris County |
6 |
|
|
Liberty County |
7 |
|
|
Montgomery County |
8 |
|
|
Waller County |
10 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_HOUELR5. |
|
|
HOUELR5 |
Eligible county resident: HOU |
HOUELR5= if ((HOUCTYR5=1 OR HOUCTYR5=2 OR HOUCTYR5=3 OR HOUCTYR5=4 OR HOUCTYR5=5 OR HOUCTYR5=6 OR HOUCTYR5=7 OR HOUCTYR5=8 OR HOUCTYR5=10), 1,0) |
Check_ES5_IND. |
Go to CALC_E_CITY. |
ES5_IND. |
What county do you currently live in?
[DO NOT read choices.] |
||
INDCTYR6 |
Eligibility, Indianapolis county of residence |
|
|
|
Boone County |
1 |
|
|
Brown County |
2 |
|
|
Hamilton County |
3 |
|
|
Hancock County |
4 |
|
|
Hendricks County |
5 |
|
|
Johnson County |
6 |
|
|
Madison County |
7 |
|
|
Marion County |
8 |
|
|
Morgan County |
9 |
|
|
Putnam County |
10 |
|
|
Shelby County |
11 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_INDELR6. |
|
|
INDELR6 |
Eligible county resident: IND |
INDELR6= if ((INDCTYR6=1 OR INDCTYR6=2 OR INDCTYR6=3 OR INDCTYR6=4 OR INDCTYR6=5 OR INDCTYR6=6 OR INDCTYR6=7 OR INDCTYR6=8 OR INDCTYR6=9 INDCTYR6=10 OR INDCTYR6=11), 1,0) |
Check_ES5_LAX. |
Go to CALC_E_CITY. |
ES5_LAX. |
What county do you currently live in?
[DO NOT read choices.] |
||
LAXCTYR5 |
Eligibility, Los Angeles county of residence |
|
|
|
Los Angeles County |
1 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_LAXELR5. |
|
|
LAXELR5 |
Eligible county resident: LAX |
LAXELR5 = if ((LAXCTYR5=1), 1,0) |
Check_ES5_MEM. |
Go to CALC_E_CITY. |
ES5_MEM. |
What county do you currently live in?
[DO NOT read choices.] |
||
MEMCTYR7 |
Eligibility, Memphis county of residence |
|
|
|
Fayette County, TN |
1 |
|
|
Shelby County, TN |
2 |
|
|
Tipton County, TN |
3 |
|
|
DeSoto County, MS |
5 |
|
|
Marshall County, MS |
6 |
|
|
Tate County, MS |
7 |
|
|
Tunica County, MS |
8 |
|
|
Crittendon County, AR |
9 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_MEMELR5. |
|
|
MEMELR5 |
Eligible county resident: MEM |
MEMELR5 = if ((MEMCTYR5=1 OR MEMCTYR5=2 OR MEMCTYR5=3 OR MEMCTYR5=4 OR MEMCTYR5=5 OR MEMCTYR5=6 OR MEMCTYR5=7 OR MEMCTYR5=8 OR MEMCTYR5=9 ), 1,0) |
Check_ES5_NEW. |
Go to CALC_E_CITY. |
ES5_NEW. |
What county do you currently live in?
[DO NOT read choices.] |
||
NEWCTYR5 |
Eligibility, Newark county of residence |
|
|
|
Essex County, NJ |
1 |
|
|
Hunterdon County, NJ |
2 |
|
|
Hudson County, NJ |
3 |
|
|
Morris County, NJ |
4 |
|
|
Sussex County, NJ |
6 |
|
|
Union County, NJ |
7 |
|
|
Pike County, PA |
8 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_NEWELR5. |
|
|
NEWELR5 |
Eligible county resident: NEW |
NEWELR5 = if ((NEWCTYR5=1 OR NEWCTYR5=2 OR NEWCTYR5=3 OR NEWCTYR5=4 OR NEWCTYR5=5 OR NEWCTYR5=6 OR NEWCTYR5=7 OR NEWCTYR5=8), 1,0) |
Check_ES5_NOL. |
Go to CALC_E_CITY. |
ES5_NOL. |
What parish do you currently live in?
[DO NOT read choices.] |
||
NOLCTYR5 |
Eligibility, New Orleans parish of residence |
||
|
Jefferson Parish |
1 |
|
|
Orleans Parish |
2 |
|
|
Plaquemines Parish |
3 |
|
|
St. Bernard Parish |
4 |
|
|
St. Charles Parish |
5 |
|
|
St. James Parish |
6 |
|
|
St. John the Baptist Parish |
7 |
|
|
St. Tammany Parish |
8 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_NOLEL. |
|
|
NOLELR5 |
Eligible parish resident: NOL |
NOLELR5 = if ((NOLCTYR5=1 OR NOLCTYR5=2 OR NOLCTYR5=3 OR NOLCTYR5=4 OR NOLCTYR5=5 OR NOLCTYR5=6 OR NOLCTYR5=7 OR NOLCTYR5=8), 1,0) |
Check_ES5_NYC. |
Go to CALC_E_CITY. |
ES5_NYC. |
What county do you currently live in?
[DO NOT read choices.] |
||
NYCCTYR7 |
Eligibility, New York City county of residence |
||
|
Bronx County, NY |
1 |
|
|
Kings County, NY |
2 |
|
|
New York County, NY |
3 |
|
|
Putnam County, NY |
4 |
|
|
Queens County, NY |
5 |
|
|
Richmond County, NY |
6 |
|
|
Rockland County, NY |
7 |
|
|
Westchester County, NY |
8 |
|
|
Bergen County, NJ |
9 |
|
|
Passaic County, NJ |
14 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_NYCELR5. |
|
|
NYCELR5 |
Eligible county resident: NYC |
NYCELR5 = if ((NYCCTYR5=1 OR NYCCTYR5=2 OR NYCCTYR5=3 OR NYCCTYR5=4 OR NYCCTYR5=5 OR NYCCTYR5=6 OR NYCCTYR5=7 OR NYCCTYR5=8 OR NYCCTYR5=9 OR NYCCTYR5=11 OR NYCCTYR5=12 OR NYCCTYR5=13 OR NYCCTYR5=14), 1,0) |
Check_ES5_NOR. |
Go to CALC_E_CITY. |
ES5_NOR. |
What county do you currently live in?
[DO NOT read choices.] |
||
NORCTYR7 |
Eligibility, Norfolk county of residence |
|
|
|
Chesapeake city, VA |
0 |
|
|
Franklin city, VA |
1 |
|
|
Gloucester County, VA |
2 |
|
|
Hampton city, VA |
3 |
|
|
Isle of Wight County, VA |
4 |
|
|
James city County, VA |
5 |
|
|
Mathews County, VA |
6 |
|
|
Newport News city, VA |
7 |
|
|
Norfolk city, VA |
8 |
|
|
Poquoson city, VA |
9 |
|
|
Portsmouth city, VA |
10 |
|
|
Southampton County, VA |
11 |
|
|
Suffolk city, VA |
12 |
|
|
Virginia Beach city, VA |
13 |
|
|
Williamsburg city, VA |
14 |
|
|
York County, VA |
15 |
|
|
Camden County, NC |
16 |
|
|
Currituck County, NC |
17 |
|
|
Gates County, NC |
20 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_NORELR5. |
|
|
NORELR5 |
Eligible county resident: NOR |
NORELR5 = if ((NORCTYR7=0 or NORCTYR7=1 OR NORCTYR7=2 OR NORCTYR7=3 OR NORCTYR7=4 OR NORCTYR7=5 OR NORCTYR7=6 OR NORCTYR7=7 OR NORCTYR7=8 OR NORCTYR7=9 OR NORCTYR7=10 OR NORCTYR7=11 OR NORCTYR7 = 12 or NORCTYR7=13 OR NORCTYR7=14 OR NORCTYR7=15 OR NORCTYR7=16 OR NORCTYR7 = 17 or NORCTYR7=20), 1,0) |
Check_ES5_PHL. |
Go to CALC_E_CITY. |
ES5_PHL. |
What county do you currently live in?
[DO NOT read choices.] |
||
PHLCTYR5 |
Eligibility, Philadelphia county of residence |
||
|
Delaware County |
3 |
|
|
Philadelphia County |
5 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_PHLELR5. |
|
|
PHLELR5 |
Eligible county resident: PHL |
PHLELR5 = if ((PHLCTYR5=3 OR PHLCTYR5=5), 1,0) |
Check_ES5_PTL. |
Go to CALC_E_CITY. |
ES5_PTL. |
What county do you currently live in?
[DO NOT read choices.] |
||
PTLCTYR5 |
Eligibility, Portland county of residence |
|
|
|
Clackamas County, OR |
1 |
|
|
Columbia County, OR |
2 |
|
|
Multnomah County, OR |
3 |
|
|
Washington County, OR |
4 |
|
|
Yamhill County, OR |
5 |
|
|
Clark County, WA |
6 |
|
|
Skamania County, WA |
7 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_PTLELR5. |
|
|
PTLELR5 |
Eligible county resident: PTL |
PTLELR5 = if ((PTLCTYR5=1 OR PTLCTYR5=2 OR PTLCTYR5=3 OR PTLCTYR5=4 OR PTLCTYR5=5 OR PTLCTYR5=6 OR PTLCTYR5=7), 1,0) |
Check_ES5_SDG. |
Go to CALC_E_CITY. |
ES5_SDG. |
What county do you currently live in?
[DO NOT read choices.] |
||
SDGCTYR5 |
Eligibility, San Diego county of residence |
|
|
|
San Diego County |
1 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_SDGELR5. |
|
|
SDGELR5 |
Eligible county resident: SDG |
SDGELR5 = if ((SDGCTYR5=1), 1,0) |
Check_ES5_SFO. |
Go to CALC_E_CITY. |
ES5_SFO. |
What county do you currently live in?
[DO NOT read choices.] |
||
SFOCTYR5 |
Eligibility, San Francisco county of residence |
||
|
San Francisco County |
2 |
|
|
San Mateo County |
3 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_SFOELR5. |
|
|
SFOELR5 |
Eligible county resident: SFO |
SFOELR5 = if ((SFOCTYR5=2 OR SFOCTYR5=3), 1,0) |
Check_ES5_SJN. |
Go to CALC_E_CITY. |
ES5_SJN. |
What municipality (county) do you currently live in?
[DO NOT read choices.] |
||
SJNCTYR6 |
Eligibility, San Juan county (municipio) of residence |
||
|
Aguas Buenas |
1 |
|
|
Aibonito |
2 |
|
|
Barceloneta |
3 |
|
|
Barranquitas |
4 |
|
|
Bayamón |
5 |
|
|
Caguas |
6 |
|
|
Canóvanas |
7 |
|
|
Carolina |
8 |
|
|
Cataño |
9 |
|
|
Cayey |
10 |
|
|
Ceiba |
11 |
|
|
Ciales |
12 |
|
|
Cidra |
13 |
|
|
Comerío |
14 |
|
|
Corozal |
15 |
|
|
Dorado |
16 |
|
|
Fajardo |
17 |
|
|
Florida |
18 |
|
|
Guaynabo |
19 |
|
|
Gurabo |
20 |
|
|
Humacao |
21 |
|
|
Juncoa |
22 |
|
|
Las Piedras |
23 |
|
|
Loíza |
24 |
|
|
Luquillo |
25 |
|
|
Manatí |
26 |
|
|
Manuabo |
27 |
|
|
Morovis |
28 |
|
|
Naguabo |
29 |
|
|
Naranjito |
30 |
|
|
Orocovis |
31 |
|
|
Río Grande |
32 |
|
|
San Juan |
33 |
|
|
San Lorenzo |
34 |
|
|
Toa Alta |
35 |
|
|
Toa Baja |
36 |
|
|
Trujillo Alto |
37 |
|
|
Vega Alta |
38 |
|
|
Vega Baja |
39 |
|
|
Yabucoa |
40 |
|
|
Other |
88 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
CALC_SJNELR6. |
|
|
SJNELR6 |
Eligible municipality resident: SJN |
SJNELR6 = if ((SJNCTYR6=1 OR SJNCTYR6=2 OR SJNCTYR6=3 OR SJNCTYR6=4 OR SJNCTYR6=5 OR SJNCTYR6=6 OR SJNCTYR6=7 OR SJNCTYR6=8 OR SJNCTYR6=9 OR SJNCTYR6=10 OR SJNCTYR6=11 OR SJNCTYR6=12 OR SJNCTYR6=13 OR SJNCTYR6=14 OR SJNCTYR6=15 OR SJNCTYR6=16 OR SJNCTYR6=17 OR SJNCTYR6=18 OR SJNCTYR6=19 OR SJNCTYR6=20 OR SJNCTYR6=21 OR SJNCTYR6=22 OR SJNCTYR6=23 OR SJNCTYR6=24 OR SJNCTYR6=25 OR SJNCTYR6=26 OR SJNCTYR6=27 OR SJNCTYR6=28 OR SJNCTYR6=29 OR SJNCTYR6=30 OR SJNCTYR6=31 OR SJNCTYR6=32 OR SJNCTYR6=33 OR SJNCTYR6=34 OR SJNCTYR6=35 OR SJNCTYR6=36 OR SJNCTYR6=37 OR SJNCTYR6=38 OR SJNCTYR6=39 OR SJNCTYR6=40), 1,0) |
Check_ES5_SEA. |
Go to CALC_E_CITY. |
ES5_SEA. |
What county do you currently live in?
[DO NOT read choices.] |
|||
SEACTYR5 |
Eligibility, Seattle county of residence |
|||
|
|
King County |
1 |
|
|
|
Snohomish County |
2 |
|
|
|
Other |
88 |
|
|
|
Don't Know |
999 |
|
|
|
Refuse to Answer |
777 |
|
CALC_SEAELR5. |
|
|
SEAELR5 |
Eligible county resident: SEA |
SEAELR5 = if ((SEACTYR5=1 OR SEACTYR5=2), 1, 0) |
Check_ES5_WDC. |
Go to CALC_E_CITY. |
ES5_WDC. |
What county do you currently live in?
[DO NOT read choices.] |
|||
WDCCTYR7 |
Eligibility, Washington DC county of residence |
|
||
|
|
District of Columbia |
1 |
|
|
|
Calvert County, MD |
2 |
|
|
|
Charles County, MD |
3 |
|
|
|
Prince George's County, MD |
4 |
|
|
|
Alexandria city, VA |
5 |
|
|
|
Fairfax city, VA |
6 |
|
|
|
Falls Church city, VA |
7 |
|
|
|
Fredericksburg city, VA |
8 |
|
|
|
Manassas city, VA |
9 |
|
|
|
Manassas Park city, VA |
10 |
|
|
|
Arlington County, VA |
11 |
|
|
|
Clarke County, VA |
12 |
|
|
|
Culpeper County, VA |
13 |
|
|
|
Fairfax County, VA |
14 |
|
|
|
Fauquier County, VA |
15 |
|
|
|
Loudoun County, VA |
16 |
|
|
Madison County, VA |
17 |
|
|
|
|
Prince William County, VA |
18 |
|
|
|
Rappahannock County, VA |
19 |
|
|
|
Spotsylvania County, VA |
20 |
|
|
|
Stafford County, VA |
21 |
|
|
|
Warren County, VA |
22 |
|
|
|
Jefferson County, WV |
23 |
|
|
|
Other |
88 |
|
|
|
Don't Know |
999 |
|
|
|
Refuse to Answer |
777 |
|
CALC_WDCELR5. |
|
|
WDCELR5 |
Eligible county resident: WDC |
WDCELR5 = if ((WDCCTYR7=1 OR WDCCTYR7=2 OR WDCCTYR7=3 OR WDCCTYR7=4 OR WDCCTYR7=5 OR WDCCTYR7=6 OR WDCCTYR7=7 OR WDCCTYR7=8 OR WDCCTYR7=9 OR WDCCTYR7=10 OR WDCCTYR7=11 OR WDCCTYR7=12 OR WDCCTYR7=13 OR WDCCTYR7=14 OR WDCCTYR7=15 OR WDCCTYR7=16 OR WDCCTYR7=17 OR WDCCTYR7=18 OR WDCCTYR7=19 OR WDCCTYR7=20 OR WDCCTYR7=21 OR WDCCTYR7=22 or WDCCTYR7=23), 1,0) |
CALC_E_CITY. |
|
|
E_CITY |
Eligible city resident |
E_CITY = if ((ATLELR6=1 or BLTELR5=1 or CHIELR5=1 or DENELR5=1 or DETELR5=1 or HOUELR5=1 or INDELR6=1 or LAXELR5=1 or MEMELR5=1or NEWELR5=1 or NOLELR5=1 or NORELR5=1 or NYCELR5=1 or PHLELR5=1 or PTLELR5=1 or SDGELR5=1 or SFOELR5=1 or SJNELR6=1 or SEAELR5=1 or WDCELR5=1),1,0) |
Check_ES5spec. |
If R is resident of ‘other' county (ES5_ATL EQ 88 or ES5_BLT EQ 88 or ES5_CHI. EQ 88 or ES5_DEN. EQ 88 or ES5_DET. EQ 88 or ES5_HOU. EQ 88 or ES5_IND. EQ 88 or ES5_LAX. EQ 88 or ES5_MEM. EQ 88 or ES5_NEW. EQ 88 or ES5_NOL. EQ 88 or ES5_NOR. EQ 88 or ES5_NYC. EQ 88 or ES5_PHL. EQ 88 or ES5_PTL. EQ 88 or ES5_SDG. EQ 88 or ES5_SFO. EQ 88 or ES5_SJN. EQ 88 or ES5_SEA.EQ 88 or ES5_WDC. EQ 88), go to ES5spec. Else, go to Check_ES6. |
ES5spec. |
INTERVIEWER: Specify other county (If Boston, Specify other city or town): |
|
SPECCNTY |
Specify other county |
|
|
__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ |
|
|
{text response; max length = 100 characters} |
ES8a. |
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 |
|
Check_ES8b. |
If MSM cycle (CYCLE EQ 1), go to ES8b. Else, go to ES8c. |
ES8b. |
Which of the following best describes your gender?
[READ choices.] |
||
GNDRR7 |
Gender identity |
|
|
|
Man |
1 |
|
|
Woman |
2 |
|
|
Nonbinary |
5 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES9a. |
If MSM cycle (CYCLE EQ 1), go to ES9a. If PWID cycle (CYCLE EQ 2), go to ES10. If HET cycle (CYCLE EQ 3), go to Check_INTRO_ES17. |
ES9a. |
Have you ever had vaginal or anal sex with a woman? |
||
E_EVRMSW |
Eligibility: MSM, Ever had sex with woman |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
ES9b. |
Have you ever had oral or anal sex with a man? |
||
E_EVRMSM |
Eligibility: MSM, Ever had sex with man |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
ES9c. |
In the past 30 days, how many times have you gone to a place where gay men hang out, meet, or socialize? These could include bars, clubs, social organizations, parks, gay businesses, bookstores, sex clubs, etc. Do not include places where you are employed. |
||
ATTEND30 |
Venue attendance, 30 days |
|
|
|
__ __ __ |
|
|
|
Range |
0 - 700 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
Check_ES10. |
Go to INTRO_ES18. |
ES10. |
Have you ever in your life shot up or injected any drugs other than those prescribed for you? By shooting up, I mean any time you might have used drugs with a needle, either by mainlining, skin popping, or muscling. |
||
E_EVRINJ |
Eligibility: ever injected |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES11. |
If R ever injected (ES10 EQ 1), go to ES11. Else (ES10 NE 1), go to INTRO_ES18. |
ES11. |
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"] |
||
E_LINJN |
IDU ES: When last injected, number |
|
|
|
__ __ __ |
|
|
|
Range |
0 - 365 |
|
|
Don't Know |
999 |
|
|
Refuse to Answer |
777 |
|
Check_ES11a. |
If R last injected today or did not report the last time they injected (ES11 EQ 0, DK, or REF), go to CALC_E_INJ12. Else, go to ES11a. |
ES11a. |
[INTERVIEWER: Was this days or months or years?] |
||
E_LINJU |
IDU ES : When last injected, unit |
|
|
|
Days |
0 |
|
|
Months |
1 |
|
|
Years |
2 |
|
CALC_E_INJ12. |
|
|
E_INJ12 |
injected in last 12 months |
E_INJ12 = if (E_LINJN= .DK or E_LINJN= .REF),., if(E_LINJN=0), 1, if (E_LINJU=0 and E_LINJN<=365), 1, if ((E_LINJU=1 and E_LINJN<=12), 1, if ((E_LINJU=2 and E_LINJN <=1), 1, 0))))) |
ES12. |
[Give Respondent Flashcard B.]
Which drug do you inject most often?
[READ choices.] |
||
E_USINJ |
Eligibility, drug usually injected |
|
|
|
Speedball, which is heroin and cocaine together |
1 |
|
|
Heroin, by itself |
2 |
|
|
Powder cocaine, by itself |
3 |
|
|
Crack cocaine, by itself |
4 |
|
|
Methamphetamine, also known as meth, crystal meth, speed, or crank |
5 |
|
|
Painkillers, such as Oxycontin, Dilaudid, morphine, Percocet, or Demerol |
6 |
|
|
Something else |
7 |
|
|
Don't Know |
99 |
|
|
Refuse to Answer |
77 |
|
Check_ES12spec. |
If R most often injects ‘something else' (ES12 EQ 7), go to ES12spec. Else, go to Check_ES13. |
ES12spec. |
INTERVIEWER: Specify other injection drug |
|
||
SPECE_ID |
Specify other injection drug |
|
||
|
__ __ __ __ __ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ __ ____ __ __ __ ____ __ __ __ ____ __ __ __ |
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||
|
{text response; max characters = 100} |
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|
Check_ES13. |
Go to Check_INTRO_ES14. |
ES13. |
Where on your body do you usually inject?
[INTERVIEWER: Have respondent show ALL injection areas on body. Check for physical signs of injection.]
[DO NOT read choices. CHECK ALL that apply.] |
||
E_INJBD |
Part of body injected |
|
|
E_INJBDA |
Fresh track marks |
|
|
E_INJBDB |
Needle-sized scabs |
|
|
E_INJBDC |
Abscesses |
|
|
E_INJBDD |
Old track marks or scars |
|
|
E_INJBDE |
Injects in covered area |
|
|
E_INJBDF |
Showed injection area(s) but NO physical signs |
|
|
|
Refuse to Answer |
7 |
|
HardEdit_ES13. |
If interviewer records both physical signs & ‘no physical signs' of injection (E_INJBDA EQ 1 or E_INJBDB EQ 1 or E_INJBDC EQ 1 or E_INJBDD EQ 1) & E_INJBDF EQ 1, DISPLAY: "INTERVIEWER: You indicated that the respondent had both physical signs and no physical signs of injection. Clarify and re-enter response to current or prior item as needed." Then go back to ES13. Else, go to CALC_E_INJSIG. |
CALC_E_INJSIG. |
|
|
E_INJSIG |
Eligible: Phy Sign Recent Injection |
If R has fresh track marks, needle-sized scabs, or abcesses (E_INJBDA=1 OR E_INJBDB=1 OR E_INJBDC=1), E_INJSIG EQ 1. If R has old track marks or scars, has no physical signs of injection, or has no physical signs of injection and injects in a covered area (E_INJBDD=1 OR E_INJBDF=1 OR (E_INJBDE=1 and E_INJBDF=1)), E_INJSIG EQ 2. If R refused to answer (E_INJBD= REF) or only injected in a covered area (E_INJBDE=1 and (E_INJBDA EQ 0 and E_INJBDB EQ 0 and E_INJBDC EQ 0 and E_INJBDD EQ 0 and E_INJBDF=0)), E_INJSIG EQ 0. |
Check_ES14. |
If R has only non-recent signs of injection, no physical signs of injection, or has no physical signs of injection and injects in a covered area (E_INJSIG EQ 2), go to ES14. Else, go to CALC_E_INJCT. |
Check_INTRO_ES14. |
If R injected in past 12m (E_INJ12 EQ 1), to to INFO_ES14. Else, go to Check_HET_Behavioral_Eligibility. |
INFO_ES14. |
INTERVIEWER: Use the next questions to assess the participant’s injection knowledge. |
ES14. |
Step-by-step, tell me how you prepare your drugs.
[INTERVIEWER: Description could include: --Mix drugs with water or lemon juice/vinegar--Use cooker /Heat drugs--Use filter] |
||
E_INJPRP |
Eligibility, prepare drugs |
|
|
|
Description OK |
1 |
|
|
Description Not OK |
2 |
|
ES15. |
Step-by-step, tell me how you inject your drugs.
[INTERVIEWER: Description could include: --Tie off and find vein (IVDU)--Clean injection site--Register (IVDU)] |
||
E_HWINJ |
Eligibility, how is injection done |
|
|
|
Description OK |
1 |
|
|
Description Not OK |
2 |
|
ES16. |
What type of syringe do you usually inject with?
[INTERVIEWER: Description could include: --Syringe size (in cc's or units)--Needle size (gauge, length)--Cap (color, number)(Can also ask where they usually get syringes, what they do with them after injecting, and how they know if they are new or used.)] |
||
E_STYP |
Eligibility, type of syringe used |
|
|
|
Description OK |
1 |
|
|
Description Not OK |
2 |
|
CALC_E_INJKNW. |
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|
E_INJKNW |
Eligible: Injection knowledge |
E_INJKNW = if ((E_INJPRP=1 AND E_HWINJ=1 AND E_STYP=1),1,0) |
Check_E_INJCT. |
Go to CHECK_HET_Behavioral_Eligibility. |
CALC_E_INJCT. |
|
|
E_INJCT |
Eligible: Injection signs or knowledge |
E_INJCT = if (E_INJSIG=1 OR (E_INJSIG=2 AND E_INJKNW=1),1,0) |
Check_HET_Behavioral_Eligibility. |
Go to INTRO_ES18. |
Check_INTRO_ES17. |
If R male or female (ES9 EQ 1 or 2), go to INTRO_ES17. If R NOT male or female (ES9 EQ 3, DK, or REF), go to CALC_E_VAS12. |
INTRO_ES17.
|
DISPLAY: "READ: The next questions are about having sex. Please remember your answers will be kept private." |
ES17. |
Have you had sex with a [if R is male, fill with "woman"; if R is female, fill with "man"] in the past 12 months? |
||
E_OPPSEX |
Eligibility: opposite sex partner, past 12 mos. |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES17a.
|
If R had sex with opposite-sex partner (ES17 EQ 1), go to ES17a. Else, go to CALC_E_VAS12. |
ES17a. |
Did you have vaginal sex? By vaginal sex, I mean [if R is male, fill with "you put your penis in her vagina"; if R is female, fill with "he put his penis in your vagina"]. |
||
E_VS12 |
Eligibility: Vaginal sex past 12mos |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES17b.
|
If R had vaginal sex (ES17a EQ 1), go to CALC_E_VAS12. Else, go to ES17b. |
ES17b. |
Did you have anal sex? By anal sex, I mean [if R is male, fill with "you put your penis in her anus or butt"; if R is female, fill with "he put his penis in your anus or butt"]. |
||
E_AS12 |
Eligibility: Anal sex past 12mos |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
Check_ES17conf.
|
If R reported sex but neither vaginal nor anal sex with opposite sex partner (ES17 EQ 1 & ES17a EQ 0 & ES17b EQ 0), go to ES17conf. Else, go to CALC_E_VAS12. |
ES17conf. |
So, in the last 12 months, you only had oral sex with a [if R is male, fill with "woman"; if R is female, fill with "man"]? Is that correct? |
||
C_OS12 |
Eligibility: Oral sex confirmation only |
|
|
|
No |
0 |
|
|
Yes |
1 |
. |
Check_CALC_E_VAS12.
|
If oral sex only NOT correct (ES17conf EQ 0), go back to ES17a. Else, go to CALC_E_VAS12. |
CALC_E_VAS12. |
|
|
E_VAS12 |
Eligibility: Opposite Sex Partner, p 12mos |
If (E_VS12 =DK or REF) & (E_AS12 =DK or REF), E_VAS12=9. Else if (E_VS12 = 1 or E_AS12 = 1), E_VAS12 =1. Else, E_VAS12 = 0. |
Notes_LanguageProficiency |
See Measure References. |
INTRO_ES18. |
DISPLAY: "READ: The next questions are about languages you speak." |
ES18. |
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 |
|
ES19. |
How well do you speak Spanish?
[READ choices.] |
||
SPNPFCY |
Spanish proficiency |
|
|
|
Very well |
1 |
|
|
Well |
2 |
|
|
Not well |
3 |
|
|
Not at all |
4 |
|
|
Don't Know |
9 |
|
|
Refuse to Answer |
7 |
|
ES20a. |
INTERVIEWER: Is this person alert and capable of completing the survey in English or Spanish? |
||
E_CAP |
Eligibility: able to complete |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
Check_ES20b. |
If R is not able to complete the survey, go to ES20b. Else, go to ES20c. |
ES20b. |
INTERVIEWER: Specify reason person not able to complete the interview: [CHECK ALL THAT APPLY.] |
||
E_CAPA |
Eligibility: Reason not able to complete |
|
|
E_CAPAA |
Not able to understand or consent |
|
|
E_CAPAB |
Cannot speak and understand English or Spanish |
|
|
ES20c. |
INTERVIEWER: Did your field supervisor tell you that this person cannot complete the survey for some other reason? |
||
E_FS |
Eligibility: field supervisor reason |
|
|
|
No |
0 |
|
|
Yes |
1 |
|
Check_ES20d. |
If field supervisor stated that R is not able to complete the survey for some other reason (ES20c EQ 1) and MSM or IDU cycle (CYCLE EQ 1 OR 2), go to ES20d. If field supervisor stated that R is not able to complete the survey for some other reason (ES20c EQ 1) and HET cycle (CYCLE EQ 3), go to ES20e. Else, go to INTRO_Check_CALC_EL. |
ES20d. |
INTERVIEWER: Specify other reason person not able to complete the interview: [CHECK ALL THAT APPLY.] |
||
E_FSMI |
Eligibility: cannot complete- MSM, IDU |
|
|
E_FSMIA |
Known previous participant |
|
|
E_FSMIB |
Reported age not plausible ( <18 years old ) |
|
|
Check_ES20e. |
Go to INTRO_Check_CALC_EL. |
ES20e. |
INTERVIEWER: Specify other reason person not able to complete the interview: [CHECK ALL THAT APPLY.] |
||
E_FSHET |
Eligibility: cannot complete- HET |
|
|
E_FSHETA |
Known previous participant |
|
|
E_FSHETB |
Reported age not plausible ( <18 years old ) |
|
|
E_FSHETC |
Reported age not plausible ( >60 years old ) |
|
|
INTRO_Check_CALC_EL. |
DISPLAY: "READ: We've finished the first series of questions. Now the computer will determine whether you've been selected to participate in the survey." |
Check_CALC_EL.
|
If MSM cycle (CYCLE EQ 1), go to CALC_EL_MSM. If IDU cycle (CYCLE EQ 2), go to CALC_EL_IDU. If HET cycle (CYCLE EQ 3), go to CALC_EL_HET. |
CALC_EL_MSM. |
|
|
EL_MSM |
Eligible: MSM cycle |
EL_MSM = if((DOB^=.DK AND DOB^=.REF AND & AGE>17 & E_PART=0 & E_CITY=1 & E_CAP=1 & E_FS=0 & (BIRTHSEX=1 & (GNDRR7=1 or GENDRR7=3)) or ((BIRTHSEX=2 or BIRTHSEX=3) & GNDRR7=1) & E_EVRMSM=1),1,0) |
CALC_EL_IDU. |
|
|
EL_IDU |
Eligible: IDU cycle |
EL_IDU = if((DOB^=.DK & DOB^=.REF & AGE>17 & E_PART=0 & E_CITY=1 & E_CAP=1 & E_FS=0 & E_EVRINJ=1 & E_INJ12=1 & E_INJCT=1),1,0) |
CALC_EL_HET. |
|
|
EL_HET |
Eligible: HET cycle |
EL_HET = if((DOB^=.DK & DOB^=.REF & AGE>17 & AGE<61 & E_PART=0 & E_CITY=1 & E_CAP=1 & E_FS=0 & ((BIRTHSEX=1 & GNDRR7=1) OR (BIRTHSEX=2 & GNDRR7=2)) & (E_VAS12=1)),1,0) |
CALC_ENDSCR. |
|
|
ENDSCR |
Time eligibility screener ended |
ENDSCR = Current time |
END_ES. |
If R NOT eligible for cycle (CYCLE EQ 1 & EL_MSM EQ 0), or (CYCLE EQ 2 & EL_IDU EQ 0), or (CYCLE EQ 3 & EL_HET EQ 0), go to END Section (END). If R eligible for cycle (CYCLE EQ 1 & EL_MSM EQ 1) or (CYCLE EQ 2 & EL_IDU EQ 1) or (CYCLE EQ 3 & EL_HET EQ 1), DISPLAY: "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). |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | CDC User |
File Modified | 0000-00-00 |
File Created | 2022-08-15 |