Quantitative Population-specific Questions (English)

National HIV Behavioral Surveillance: Brief HIV Bio-behavioral Assessment (NHBS-BHBA)

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National HIV Behavioral Surveillance System - Brief Biobehavioral HIV Assessments (NHBS-BHBA)

Attachment #3d (English)

Quantitative Population-Specific Questions (English)

















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/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30329; Attn: OMB-PRA (0920-XXXX)




  1. HET POPULATION-SPECIFIC QUESTIONS


Last partner


Intro: Now, I would like to ask some more questions about the last time you had oral, vaginal, or anal sex with a man. I need to ask you all the questions even if some may sound similar to questions I’ve asked before. Remember, your answers will be kept private. [variable: intro_hetlp]


If SEX12=yes and SEX12_M=1 or more


Question: That last time you had sex with a man, did you or your partner use a condom?


Variable: LPCONDOM_M


Response: Condom use with last male partner


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If SEX12=yes and SEX12_M=1 or more


Question: As far as you know, during the time you were having a sexual relationship with that man, did he have sex with other people? Would you say he: [Give respondent Flashcard PopA]


Variable: LPOTH_M


Response: Last male partner had other partners


Definitely did not…0


Probably did not…1


Probably did…2


Definitely did…3


Don’t Know…(.D)


Refuse to Answer…(.R)




If SEX12=yes and SEX12_M=1 or more


Question: During the time you were having a sexual relationship with that man, did you have sex with other people?


Variable: LPROTH_M


Response: R had other partners


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPHIVSTS_M=HIV-positive


Question: Earlier you said your last male partner was HIV-positive. Did he tell you whether he was taking antiretroviral medicines or ART to treat HIV infection?


Variable: LPARTDS_M


Response: Whether last male partner disclosed ART use


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPARTDS_M=Yes


Question: Did he say he WAS taking antiretroviral medicines or was NOT taking antiretroviral medicines?


Variable: LPARTUSE_M


Response: HIV+ male partner on ART


No, partner was NOT taking ART…0


Yes, partner WAS taking ART…1


Don’t Know…(.D)


Refuse to Answer…(.R)



Intro: Now, I would like to ask some more questions about the last time you had oral, vaginal, or anal sex with a woman. (ASK ONLY MALE RESPONDENTS) [variable: intro_oma]


If SEX12=yes and SEX12_F=1 or more


Question: That last time you had sex with a woman, did you or your partner use a condom?


Variable: LPCONDOM_F


Response: Condom use with last female partner


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If SEX12=yes and SEX12_F=1 or more


Question: As far as you know, during the time you were having a sexual relationship with that woman, did she have sex with other people? Would you say she: [Give respondent Flashcard PopA]


Variable: LPOTH_F


Response: Last female partner had other partners


Definitely did not…0


Probably did not…1


Probably did…2


Definitely did…3


Don’t Know…(.D)


Refuse to Answer…(.R)




If SEX12=yes and SEX12_F=1 or more


Question: During the time you were having a sexual relationship with that woman, did you have sex with other people?


Variable: LPROTH_F


Response: R had other partners


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPHIVSTS_F=HIV-positive


Question: Earlier you said your last female partner was HIV-positive. Did she tell you whether she was taking antiretroviral medicines or ART to treat HIV infection?


Variable: LPARTDS_F


Response: Whether last female partner disclosed ART use


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPARTDS_F=Yes


Question: Did she say she WAS taking antiretroviral medicines or was NOT taking antiretroviral medicines?


Variable: LPARTUSE_F


Response: HIV+ female partner on ART


No, partner was NOT taking ART…0


Yes, partner WAS taking ART…1


Don’t Know…(.D)


Refuse to Answer…(.R)


Psychosocial Factors

"Intro: Next, I'd like to ask you some questions about where you live. Please remember your answers will be kept private." [Variable: intro_psf]


If PYHOMLS=yes


Question: In the past 12 months, about how many total nights were you homeless?


Variable: HOMLS_NTS


Response: Number of days homeless during past 12 months


___


Range: 1-365


Note: If Don’t Know or Refuse to Answer, leave it blank.




Question: In the past 12 months, that is, since [fill with interview month] of last year, did you ever move in with other people even for a little while because of financial problems?


Variable: FINPROB


Response: Moved in with others due to financial problems


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



"Intro: Next, I would like to ask you about some difficult situations that may have occurred with your romantic or sexual partners." [Variable: intro_rsp]


Question: In the past 12 months, has a romantic or sexual partner slapped, punched, shoved, kicked, shaken or otherwise physically hurt you?


Variable: PVP12MO


Response: Physical violence by partner during past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, has a romantic or sexual partner forced or pressured you to have vaginal, oral or anal sex when you did not want to?


Variable: SVP12MO


Response: Sexual violence by partner during past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




  1. MSM POPULATION-SPECIFIC QUESTIONS


Last male partner

Intro: Now, I would like to ask some more questions about the last time you had sex with a man. I need to ask you all the questions even if some may sound similar to questions I’ve asked before. Remember, your answers will be kept private. You said you had sex with a man [fill in the days/weeks/months ago reported in Core Interview]. [Variable: intro_lmp]


If AS_M1=Yes OR AS_M>1


Question: When you had sex that last time, did you have receptive anal sex where he put his penis in your anus or butt?


Variable: LPLRAS_M


Response: Receptive anal sex with male partner at last sex event


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPLRAS_M=Yes


Question: During receptive anal sex that last time, did he use a condom the whole time?


Variable: LPLRASCT_M


Response: Condom use during receptive anal sex male partner at last event


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If AS_M1=Yes OR AS_M>1


Question: When you had sex that last time, did you have insertive anal sex where you put your penis in his anus or butt?


Variable: LPLIAS_M


Response: Insertive anal sex with male partner at last sex event


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If LPLIAS_M=Yes


Question: During insertive anal sex that last time, did you use a condom the whole time?


Variable: LPLIASCT_M


Response: Condom use during insertive anal sex male partner at last event


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)


Last Event Partner Viral Load

Intro: A person with HIV whose amount of virus in their body is very low may be told by a health care provider that their HIV is undetectable. A person with an undetectable viral load cannot give HIV to their sexual partners. [Variable: intro_lpvl]


LPHIVSTS_M=HIV Positive


Question: Earlier, you told me that your last male partner was HIV-positive. The last time you had sex with him, was his viral load undetectable, detectable, or you didn’t know?


Variable: L_LPUNDETECTM


Response: Whether last male partner undetectable at last event


Undetectable…0


Detectable...1


Don’t Know…(.D)


Refuse to Answer…(.R)




LPHIVSTS_F=HIV Positive


Question: Earlier, you told me that your last female partner was HIV-positive. The last time you had sex with her, was her viral load undetectable, detectable, or you didn’t know?


Variable: L_LPUNDETECTF


Response: Whether last female partner undetectable at last event


Undetectable…0


Detectable...1


Don’t Know…(.D)


Refuse to Answer…(.R)


Pre-exposure Prophylaxis (PrEP)

Intro: PRE-exposure prophylaxis, or PrEP, is an antiretroviral medicine, such as Truvada or Descovy, taken for months or years by a person who is HIV-negative to reduce the risk of getting HIV.


If PRPUS12M=No


Intro: Earlier you told me you did not take PrEP in the past 12 months. [variable: intro_nopr]


Question: Sometimes people are prescribed medications but later decide not to take them. In the past 12 months, did a health care provider prescribe PrEP for you?


Variable: PRPPRSB


Response: PrEP, HCP prescribed, 12m


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If PRPPRSB=Yes


Question: Did you pick-up the PrEP prescription that the health care provider gave you?


Variable: PRPFLPR


Response: PrEP, filled prescription, 12m


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If PRPUS12M=Yes


Intro: Earlier you told me you had taken PrEP in the past 12 months. [variable: intro_yepr]


Question: Now I'm going to ask you about on-demand PrEP, also known as PrEP 2-1-1, which is taking 2 pills a few hours before sex, 1 pill the next day, and 1 pill the day after that. In the past 12 months, have you taken on-demand PrEP at any time?


Variable: PRPDEMAND


Response: "On-demand” PrEP use, 12m


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If PRPUS12M=Yes


Question: When was the last time you took PrEP? That is, how many days, weeks, or months ago did you last take PrEP ?


[INTERVIEWER: If today, enter "0".]


Variable: PRLDN


Response: Time since last PrEP, number


Range: 0-365 (if today, enter "0")


Note: If Don’t Know or Refuse to Answer, leave it blank.




If PRLDN>1


Question: Was this in days or months or years?


Variable: PRLDU


Response: Time since last PrEP, unit


Days…0


Months…1


Years…2


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: Which PrEP drug did you take the last time you took PrEP?


[READ choices.]


Variable: PRPDRUG


Response: PrEP drug taken


Truvada…1


Descovy…2


Injectable Cabotegravir…3


Other…4


Don’t Know…(.D)


Refuse to Answer…(.R)




If PRPDRUG=Truvada or Descovy


Intro: A lot of people don’t take medications exactly as they are supposed to, at least some of the time. We’d like to know about your experiences with PrEP. [variable: intro_dpre]


Question: In the past 30 days, on how many days did you miss a dose of your PrEP medicine?


Variable: PRPDM30


Response: PrEP adherence, Days missed, 30 d


__ __ __


Range…0-30


Note: If Don’t Know or Refuse to Answer, leave it blank.





MPOX


Intro: The next questions are about monkeypox, also known as mpox.


Question: Has a doctor or other health care provider ever told you that you had monkeypox?


Variable: MP_DXEV


Response: MPOX diagnosis, ever


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: Have you ever had any doses of a vaccine to prevent monkeypox?


Variable: MP_VCEV


Response: MPOX vaccine, ever


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Binge Drinking

Intro: The next questions are about alcohol use. Please remember your answers will be kept private. For these questions, "a drink of alcohol" means a 12 oz beer, a 5 oz glass of wine, or a 1.5 oz shot of liquor.


[Give Respondent Flashcard PopB]


Question: During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage, or liquor?


Variable: ALC30D


Response: Had one or more drinks past 30 days


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




ALC30D=yes


Question: During the past 30 days, what is the largest number of drinks you had within about two hours?


Variable: ALCLG30D


Response: Largest number drinks on single occasion - past 30 days


__ __


Range: 0-99


Note: If Don’t Know or Refuse to Answer, leave it blank.






  1. PWID POPULATION-SPECIFIC QUESTIONS


Injection History

Intro: Now I am going to ask you about experiences you may have had with injecting drugs. This includes injecting drugs like heroin, methamphetamine, Oxycontin, or any other drug that was not prescribed for you. It also includes injecting drugs that were prescribed for you that you used in a way other than instructed by your healthcare provider. I need to ask you all the questions even if some may sound similar to questions I’ve asked before. Please remember your answers will be kept private. [Variable: intro_idu]


Question: Think back to the very first time you injected any drugs, other than those prescribed for you. How old were you when you first injected any drug?


Variable: AGEINJ


Response: Age at first injection


Range…0-75


Note: If Don’t Know or Refuse to Answer, leave it blank.




[Give Respondent Flashcard PopC]


Question: Which drug do you inject most often? [READ choices.]


Variable: USINJ


Response: Drug usually injected


Speedball, which is heroin and cocaine together…1


Heroin and methamphetamine together, such as goofball…2


Fentanyl, by itself or in combination with other drugs…3


Heroin, by itself…4


Methamphetamine, by itself, also known as meth, crystal meth, speed or crank…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…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you overdose on heroin or painkillers? By overdose, I mean if you passed out, turned blue, or stopped breathing from using drugs.


Variable: OVERDOSE


Response: Overdosed in past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you need immediate medical care because you took stimulants, like methamphetamine, cocaine, or crack?


Variable: STIMOVU


Response: Stimulant overuse, 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



Injection Behaviors

Intro: Next, I'm going to ask you about your injecting behaviors in the past 12 months, that is, since [fill with interview month] of last year. When I ask you about "needles," I'm talking about needles and syringes. [Variable: intro_inbe]


Question: In the past 12 months, when you were injecting, about how often did you inject any drug? [READ choices.]


Variable: INJFX12M


Response: Overall injection frequency, 12 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…(.D)


Refuse to Answer…(.R)




Question: On a day when you inject any drug, on average, how many times a day do you inject?


Variable: INJFXD


Response: Injection frequency per day


__ __ __


Range…0-300


Note: If Don't Know or Refuse to Answer, leave it blank.




Question: In the past 12 months, have you gotten any new sterile needles? By new sterile needle, I mean no one - not even you - had ever used it before.


Variable: STLNDL12


Response: Got new sterile needles, 12m


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If STLNDL12 = Yes


[Give Respondent Flashcard PopD]


Question: From which of the following places or people did you get new sterile needles in the past 12 months? You may choose more than one option. [READ choices. CHECK ALL that apply.]


Variable: SNDLSRC


Response: Sources of new sterile needles, 12m


Syringe exchange program…1


Pharmacy or other store…2


Doctor's office, clinic, or hospital…3


Bought off the street…4


Through the mail…5


Internet…6


Someone who got them from a syringe exchange…7


Some other place or person…8


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you try to get new sterile needles but were unable to get the amount that you needed?


Variable: STERSTRY


Response: Unmet need for sterile syringes


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you use cookers, cottons, filters, or water that someone else had already used?


Variable: SHARWORK


Response: Used needle equipment after, Y/N


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you use drugs that had been divided with a syringe that someone had already injected with, also known as backloading or splitting?


Variable: SAMESYR


Response: Used drugs divided up after, Y/N


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, how many different people did you give your needle to use after you had already injected with it? Please give your best estimate.


Variable: NUM_GIVE


Response: Number distributive sharing


Range…0-300


Note: If Don't Know or Refuse to Answer, leave it blank.




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


Question: In the past 12 months, how often did you reuse a needle you already injected with?


Variable: REUSE


Response: Used same needle


Never…0


Rarely…1


About half the time…2


Most of the time…3


Always…4


Don’t Know…(.D)


Refuse to Answer…(.R)




[Give Respondent Flashcard PopE.]


Question: In the past 12 months, after you injected, how often did you dispose of your used needle in a medical sharps or other secure container and/or took it to a syringe exchange program?


Variable: SAFEDIS


Response: Frequency of safe disposal


Never…0


Rarely…1


About half the time…2


Most of the time…3


Always…4


Don’t Know…(.D)


Refuse to Answer…(.R)




Intro: The next question is about the last person that you injected with. If you injected with more than one person the last time, please think of the one that you have injected with the most often.


Question: Was this person a sex partner, such as your spouse, boyfriend/girlfriend, or other person you have sex with?:


Variable: INJLRELSX


Response: Sex relationship- last injecting partner


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



HCV Testing

Intro: Next, I'd like to ask a question about hepatitis C. Hepatitis C is spread through infected blood. Injection drug use is one of the most common reasons people get hepatitis C. [variable: intro_hcvt]


Question: Have you ever been tested for hepatitis C infection?


Variable: EVRHCTST


Response: Ever tested for HCV


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




If EVRHCTST = Yes


Question: When was your most recent hepatitis C test? Please tell me the year.


Variable: RCHCVT


Response: Year of most recent HCV test


Range (Year)…1900-2100


If Don't Know or Refuse to Answer, leave it blank.




If EVRHCTST = Yes


[Give Respondent Flashcard PopF]


Question: Has a doctor, nurse, or other health care provider ever told you that you had hepatitis C? [READ choices].


Variable: HEPCEVER


Response: Ever told had hepatitis C by doctor or nurse


No…0


Yes, I have been told I have hepatitis C and I have it now…1


Yes, I have been told I have hepatitis C, but I do not have it now…2


Yes, I have been told I have hepatitis C, but I do not know if I have it now…3


Don’t Know…(.D)


Refuse to Answer…(.R)




If HEPCEVER = Yes


[Give Respondent Flashcard PopG]


Question: When were you told you had Hepatitis C? [READ choices.]


Variable: WHENTHC


Response: 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…(.D)


Refuse to Answer…(.R)




If HEPCEVER=Yes


Question: Have you ever taken medicine to treat your Hepatitis C infection?


Variable: HEPCMEDS


Response: Ever taken medicine to treat HCV


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



HIV Prevention

Intro: Next I'd like to ask you about prevention services you may have received in the past 12 months. [variable: intro_hpi]


If SSPU= Yes


Question: In the past 12 months, have you used services at a syringe exchange program in [BHBA location]?


Response: SSP use in NHBS-BHBA location, 12m


Variable: SSPUL


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, other than syringes, have you received social services, health services, counseling, information, or other supplies from the syringe exchange program?


Variable: SSPSER


Response: SSP services received


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



Intro: Next, I'm going to ask you about programs that you may have participated in to treat drug use. These include out-patient, in-patient, residential, detox, or 12-step programs. [variable: intro_hvp]


Question: In the past 12 months, have you felt that you needed treatment for your drug use?


Variable: DTFELT


Response: Felt needed drug tx


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, have you received treatment for your drug use?


Variable: DT12M


Response: Drug treatment 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you try to get into a program to treat drug use but were unable to?


Variable: DTXTRY


Response: Tried to get Drug TX


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



Intro: 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. [variable: intro_hpiv]


Question: In the past 12 months, have you taken medicines that were provided by a doctor or other healthcare provider to treat opioid use?


Variable: MOUD


Response: Drug tx - meds in past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, did you try to get medicines to treat opioid use but were unable to?


Variable: MOUDTRY


Response: Tried to get MOUD


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



Psychosocial Factors

Intro: Next, I would like to ask you about some difficult situations that may have happened to you. [variable: intro_pf]


Question: In the past 12 months, has anyone slapped, punched, shoved, kicked, shaken or otherwise physically hurt you?


Variable: PV12MO


Response: Physical violence past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)




Question: In the past 12 months, has anyone forced or pressured you to have vaginal, oral or anal sex when you did not want to?


Variable: SV12MO


Response: Sexual violence past 12 months


No…0


Yes…1


Don’t Know…(.D)


Refuse to Answer…(.R)



  1. FLASHCARDS


Shape1

FLASHCARD PopA 

 

  • Definitely did not 

 

  • Probably did not  

 

  • Probably did  

 

  • Definitely did  



Shape2

FLASHCARD PopB

FOR USE WITH ALCOHOL QUESTIONS







Shape3

FLASHCARD PopC


  • Speedball, which is heroin and cocaine together


  • Heroin and methamphetamine together, such as goofball


  • Fentanyl, by itself or in combination with other drugs


  • Heroin, by itself


  • Methamphetamine, as also known as meth, crystal meth, speed, or crank


  • Powder cocaine, by itself


  • Crack cocaine, by itself


  • Painkillers, such as Oxycontin, Dilaudid, or Percocet


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


  • Methadone


  • Buprenorphine, also known as Suboxone or Subutex


  • Something else





Shape4 FLASHCARD PopD


  • Syringe exchange programs


  • Pharmacy or other store


  • Doctor’s office, clinic, or hospital


  • Bought off the street


  • Through the mail


  • Internet


  • Someone who got them from a syringe exchange


  • Some other place or person




Shape5

FLASHCARD PopE


  • Never


  • Rarely


  • About half the time


  • Most of the time


  • Always





Shape6 FLASHCARD PopF


  • 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




Shape7

FLASHCARD PopG


  • Less than one year ago


  • 1 year to 5 years ago


  • 6 to 10 years ago


  • More than 10 years ago




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