Quarterly Assessment

Form Approved

OMB No. 0920-New

Expiration Date: XX/XX/XXXX

Understanding HIV/STD Risk and Enhancing PrEP Implementation Messaging in a Diverse Community-Based Sample of Gay, Bisexual, and Other Men Who Have Sex with Men in a Transformational Era (MIC-DROP)

Attachment 4c

Quarterly assessment English

Public reporting burden of this collection of information is estimated to average 45 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-New)

IRB Approved at the Protocol Level

Aug 17, 2023

20225896

#35745354.1

MIC-DROP Quantitative Assessment

MIC-DROP Quantitative Assessment 1

Sociodemographic Variables 3

QOL ITEMS (CDC MMP/NHAS) - Updated with shorter M3 homeless item 5

Outness [Mohr & Fassinger, 2000] 6

HIV Testing 7

STI Testing 10

PrEP - AMIS/EMORY study + M3 items 11

PrEP Module 11

Current PrEP Use 13

OTHER PREP MEDICATIONS 14

PrEP used 15

PrEP Use Discontinued 15

PrEP Interest for those currently using on-demand oral PrEP 16

Barriers to HIV prevention services 16

PrEP Interest and Preferences 17

PrEP Interest and Preferences 2 17

PrEP Interest for those currently using oral PrEP 18

PrEP interest for those currently taking on-demand oral prep (confirmed) 20

PrEP Interest for those currently using Injectable PrEP 21

PREP MEDS SHARING 22

nPEP for HIV 23

Doxy-PEP for STIs 23

Perceived PrEP Efficacy 24

3-month Intentions 25

Sexual Behavior 25

Primary Partner 25

Primary partner’s HIV status is positive 27

Primary partner’s HIV status is negative 28

Last sex with primary partner 29

PrEP use with primary partner 30

Primary partner HIV-negative 30

Primary partner HIV-positive 31

Alcohol/Drug use with primary partner 32

Other Male Partners 34

Partner count, HIV status 34

Non-primary HIV-positive partners 34

Non-primary HIV-negative partners 35

Non-primary HIV-status unknown partners 36

Last Non-Primary Male Partner 37

Last Non-Primary Male Partner – participant PrEP use 41

Last Non-Primary Male Partner – partner PrEP use 41

Last Non-Primary Male Partner – partner ART use 42

Substance Use and Dependency 44

Mental Health: GAD and CESD 47

IPV 48

PrEP Attitudes and Stigma 49

Beliefs in Effectiveness of Treatment as Prevention (U=U) 50

Healthcare Trust/Mistrust 51

Test Messages 58

Appendix ……………………………………………………………………………………………………………………………………………………….61

Sociodemographic Variables

1. In which country were you born?

1 United States

2 Canada

3 Mexico

4 Bangladesh

5 China

6 Colombia

7 Cuba

8 Dominican Republic

9 Ecuador

10 El Salvador

11 Germany

12 Guatemala

13 Guyana

14 Haiti

15 India

16 Iraq

17 Jamaica

18 Korea

19 Lebanon

20 Nigeria

21 Philippines

22 Puerto Rico

23 Trinidad and Tobago

24 Vietnam

25 Yemen

26 Other, specify: ____

77 I don’t know

99 I’d prefer not to answer

2. [If 1 = 2-26] What year did you first come to the United States?

YYYY

3. What is the highest level of education that you have completed?

1 Less than high school

2 High school graduate or obtained GED

3 Some college, Associate’s Degree, or Technical Degree

4 Bachelor’s Degree / College Degree

5 Any post-graduate studies

99 I’d prefer not to answer

4. What describes your employment status? Choose all that apply.

1 Employed full-time

2 Employed part-time

3 A full-time student

4 A part-time student

5 On active duty in US Armed Forces, Reserves, or National Guard

6 Unable to work for health reasons

7 Unemployed

8 Other, specify: ____

77 I don’t know

99 I’d prefer not to answer

5. Which of the following best represents how you think of yourself?

1 Gay

2 Straight, that is not gay

3 Bisexual

77 I use a different term [free-text]

99 I don’t know

6. What kind of health insurance or health care coverage do you currently have? Choose all that apply.

Health insurance--health plans people get through employment or purchased directly as well as government programs (like Medicare and Medicaid) that provide medical care or help pay medical bills.

[NHBS]

1 A private health plan purchased through an employer

2 A private health plan purchased through an exchange (I.e. Obamacare)

3 Medicaid or Medicare

4 Some other Medical Assistance Program

5 TRICARE (CHAMPUS)

6 Veteran Administration coverage

7 My parent’s health plan

8 Some other health care plan

9 I don’t currently have any health insurance

77 I don’t know

99 I’d prefer not to answer

7. In the past 12 months, have you been in jail or prison? (BL, 12mo, 24mo)

1 Yes

0 No

9 I’d prefer not to answer

QOL ITEMS (CDC MMP/NHAS) - Updated with shorter M3 homeless item

8. In general, is your health [READ RESPONSES. SELECT ONLY ONE.]:

1 Poor

2 Fair

3 Good

4 Very good

5 Excellent

8           Don't know

7           Refused to answer

9. During the past 12 months, how many times have you seen a mental health professional such as a psychologist, psychiatrist, psychiatric nurse, or clinical social worker about your mental health?

____Number

8  Don't Know

7  Refused to Answer

10. During the past 12 months, how many times have you seen a doctor, nurse, or other health care provider about your physical health?

____Number

11. During the past 12 months, were you ever hungry but didn't eat because there wasn't enough money for food?

0  No

1  Yes

8  Don't Know

7  Refused to Answer

12. How many times have you moved in the past 12 months? (BL, 12mo, 24mo)

1 None

2 1

3 2

4 3 or more

13. In the past 12 months, have you been homeless at any time?

By homeless, we mean living on the street, in a shelter, a Single Room Occupancy hotel (SRO), temporarily staying with friends or relatives, or living in a car.

1 Yes

0 No

9 I’d prefer not to answer

14. [If 10=1] Are you currently homeless?

1 Yes

0 No

9 I’d prefer not to answer

Outness [Mohr & Fassinger, 2000]

Family Awareness of Sexual Identity

15. How many of your immediate family members know your sexual identity? “Immediate family members” includes family members you live with or family members you interact with often. If you do not have regular contact with any family members, please select “Does not apply”.

1     None 

2     Some, but less than half 

3     About half 

4     More than half 

5     All

6     Does not apply

Decline to answer

Peer Awareness of Sexual Identity

16. How many of your peers know your sexual identity? “Peers” includes your friends, co-workers, and schoolmates.

1     None 

2     Some, but less than half 

3     About half 

4     More than half 

5     All

Decline to answer

Outness to Primary Medical Care Provider

17. Do you have a primary medical care provider that you see for health care?

Yes

No

If yes, how many times have you seen your primary medical care provider in the past year?

___Number

18. If yes, how open are you about your sexual identity to your primary medical care provider? A primary medical care provider is a health care provider that you see regularly, such as a pediatrician, a doctor, or other health care provider.

1     Primary medical provider definitely does NOT know your sexual identity

2     Primary medical provider might know about your sexual identity, but it is NEVER talked about 

3     Primary medical provider probably knows about your sexual identity, but it is NEVER talked about 

4     Primary medical provider probably knows about your sexual identity, but it is RARELY talked about 

5     Primary medical provider definitely knows about your sexual identity, but it is RARELY talked about 

6     Primary medical provider definitely knows about your sexual identity, and it is SOMETIMES talked about 

7     Primary medical provider definitely knows about your sexual identity, and it is OPENLY talked about

Decline to answer

HIV Testing

19. Are you currently involved in any other HIV prevention study?

1. Yes, specify study name:________________

2. No

20. When was your most recent HIV test?

0 Never tested for HIV

1 Less than 3 months ago

2 3 to 6 months ago

3 7 to 9 months ago

4 10 to 12 months ago

5 More than 12 months ago

21. [IF ever tested=1] When you last got tested, where did you get tested?

1 Private doctor’s office

2 Community health center/ public health clinic

3 HIV counseling and testing site

4 HIV/AIDS street outreach program/ Mobile testing unit

5 Hospital (inpatient)

6 Emergency Room

7 Sexually transmitted disease clinic

8 Drug treatment program

9 Correctional facility (jail or prison)

10 Blood bank/ plasma center

11 Military

12 At home

13 Other, specify: ____

77 I don’t know

99 I’d prefer not to answer

__________________

22. [IF ever tested=1] When you last got tested, what prompted you to get tested? Select all that apply.

1 The condom broke

2 I did not use a condom the last time I had sex

3 I was drunk or high the last time I had sex and I don’t remember exactly what happened

4 I found out a partner I had anal sex with was living with HIV

5 The HIV test was part of a research study

6 I was already at the doctor’s office

7 I was due for an HIV test

8 I wanted to know my status

9 My partner encouraged me to get tested

10 My partner got tested, so I did too

11 It’s a condition of my sexual agreement

12 My partner and I wanted to be monogamous

13 I was beginning a relationship

14 I was feeling sick

15 Someone I had sex with was feeling sick/got sick

16 I shared a needle with someone else

17 I have a lot of risky sex

18 I have a lot of sex partners

19 Other, specify: ____

77 I don’t know

99 I’d prefer not to answer

___________________

23. [If never tested or not in past 12 months)] Which of the following reasons best describes why you have not been tested for HIV in the past 12 months: (ask at follow up surveys)

1 I think I am at low risk for HIV infection

2 I am afraid of finding out I have HIV

3 I didn’t have time

4 I don’t know where to get tested

5 My doctor hasn’t brought it up

6 I’m worried about the cost

7 No particular reason

77 I don’t know

99 I’d prefer not to answer

24. How many times have you tested for HIV infection in the past 2 years?

______ Number

25. How often do you think you should be tested for HIV?

1 Less than once a year

2 Once a year

3 Every 6 months

4 Every 3 months

5 Every month

6 Other

77 I don’t know

99 I’d prefer not to answer

26. [IF how often tested=Other] Please specify how often you think you should be tested for HIV.

_________________

27. When do you plan to next get tested for HIV?

1 Within the next month

2 Within the next 1 to 3 months

3 Within the next 4 to 6 months

4 Within the next 7 to 12 months

5 More than a year from now

6 I’m not planning to get tested

77 I don’t know

99 I’d prefer not to answer

28. [IF plan to get tested is 5 or 6] Which of the following reasons best describes why you do not plan to be tested in the next 12 months:

1 You think you are at low risk for HIV infection

2 You are afraid of finding out you have HIV

3 You don’t have time

4 You I don’t know where to get tested

5 You’re worried about the cost

6 No particular reason

77 I don’t know

99 I’d prefer not to answer

29. [If plan to get tested is 1-4] Which of the following reasons describe why you plan to be tested in the next [number of months] months: (check all that apply)

1 I have been feeling sick

2 Someone I had sex with has been feeling sick/is sick

3 I found out a partner I had anal sex with was living with HIV

4 I am due for an HIV test

5 I want to know my status

6 It’s part of a sexual risk reduction agreement I have with my partner

7 My partner and I want to be monogamous

8 I am beginning a relationship

9 I often share needles

10 I have a lot of sex without condoms

11 I have a lot of sex partners

12 Other, specify

77 I don’t know

99 I’d prefer not to answer

STI Testing

30. In the past 3 months, that is since [month and year] have you been tested by a doctor, nurse or other health care provider for any sexually transmitted infections? This does not include tests for HIV.

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

31. In the past 3 months, that is since [month and year] has a doctor, nurse or other health care provider told you that you had any of the following STIs? Select all that apply.

1 Chlamydia

2 Gonorrhea

3 Syphilis

4 Herpes

5 Genital warts

6 Hepatitis A

7 Hepatitis B

8 Hepatitis C

9 Some other STI, specify: ____

32. When do you think you should be tested for an STI? Select all that apply.

When I have symptoms of an STI

When I’ve had sex without a condom

When my partner tests positive for an STI

When it is time for me to be tested for HIV

When a doctor or other healthcare provider tells me, I should be tested

Other, specify: ____

I don’t know

I’d prefer not to answer

PrEP - AMIS/EMORY study + M3 items

PrEP Module

There are medications called PrEP, or pre-exposure prophylaxis, that help prevent HIV infection for HIV-negative persons. PrEP is currently available in the form of (1) a daily pill, (2) on-demand or event-driven pill (2-1-1 pill dosing around the time of sex), and an injection administered by a provider every 2 months.

33. Before today, had you heard of PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

34. Have you ever taken PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Logic: if question 37 = yes

35. Are you currently taking PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Started adding AMIS PrEP Qs here:

Logic: question 43 = yes

36. Which PrEP prescription medication are you currently taking?

( ) Truvada (name brand or generic)

( ) Descovy

( ) Apretude

( ) I prefer not to answer

( ) Don’t know

37. What was your top reason for starting PrEP?

__ I want to worry less about getting HIV

__ I had more than one sexual partner

__ I didn’t always use condoms

__ Having sex with people whose HIV status I don’t know

__ I dislike condoms (32.4%).

__ PrEP recommended to them by a doctor or healthcare provider

__ PrEP was recommended to me by a friend

__ PrEP was recommended to me by a sex partner

Logic: question 44 = Apretude

Page entry logic for current PrEP use: question 43 = yes

Logic: if question 44 = Truvada or Descovy

38. In the last 30 days, about how many doses of PrEP did you take?

( ) Less than 15

( ) 16-29

( ) 30

Logic: show if Q 35 NE 30

39. Considering the past 7 days, how many days did you miss taking your medication?

(drop down)

0 days

1 day

2 days

3 days

4 days

5 days

6 days

7 days

Logic: if question 46 = Less than 15/16-29

40. How frequently do you intend to take PrEP?

( ) Daily

( ) Only when I have sex

( ) Some other schedule, please specify:_____

Logic: if question 44 = Truvada/Descovy/Apretude

41. How many months in a row have you been taking [question("answer from 31")]?

( ) Less than 2 months

( ) 2 to 6 months

( ) 7 to 12 months

( ) More than 12 months

( ) I prefer not to answer

( ) Don't know

Logic: if question 44 = Apretude

42. In the past 12 months, how many Apretude injections have you received?

( ) 1

( ) 2

( ) 3

( ) 4

( ) 5

( ) 6 or more

( ) I prefer not to answer

( ) Don't know

END page for current PrEP use

Page entry logic for “other PrEP meds”: show if question 35 = Less than 2 months, 2-6 months, 7-12 months

43. In the past 12 months, have you taken any other PrEP medication?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don’t know

Logic: if question 50 = yes

44. In the past 12 months, which other PrEP prescription medications did you take? Choose all that apply

[ ] Truvada (name brand or generic)

[ ] Descovy

[ ] Apretude

[ ] I prefer not to answer

[ ] Don't know

Logic: if question 51 = Apretude

45. Where do you go to get your Apretude injections?

( ) Private doctor's office

( ) STD Clinic

( ) Health Center

( ) Pharmacy

( ) At home

( ) Other, please specify: _______________________________________*

( ) I prefer not to answer

( ) Don't know

Logic: if question 50 = yes

46. Which of the following describes the reason(s) why you changed the PrEP medication you were using? Choose all that apply. 

[ ] I couldn't afford it

[ ] I just wanted to try something different

[ ] I experienced or was concerned about side effects

[ ] I found the injection to be painful or uncomfortable

[ ] I could not remember to take the pills

[ ] I found it difficult to keep my injection appointments

[ ] I was worried that people will think that I have HIV when they see me taking the pill or going to clinic for the injection

[ ] I was worried people will think I am very sexually active because I am on PrEP

[ ] I was worried about my privacy with someone that I live with

[ ] I was worried about my privacy on my parent’s or partner’s health insurance plan

[ ] Another reason, please specify: ______________________________________*

End page for other PrEP medications

Page logic for PrEP used: if ever used PrEP = yes and current PrEP use = No

47. In the past 12 months, (since [date 12 mo ago]), have you taken PrEP? 

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Logic: if question 54 = yes

48. In the past 12 months, which PrEP prescription medications did you take? (Check all that apply)

[ ] Truvada (name brand or generic)

[ ] Descovy

[ ] Apretude

[ ] I prefer not to answer

[ ] Don't know

Logic: if question 55 = Apretude

49. Where do you go to get your Apretude injections?

( ) Private doctor's office

( ) STD Clinic

( ) Health Center

( ) Pharmacy

( ) At home

( ) Other, please specify: _________________________________________________*

( ) I prefer not to answer

( ) Don't know

End PrEP used page

Logic for page entry PrEP Use Discontinued: current PrEP use = No and Ever used PrEP = yes

50. Which of the following describes the reason(s) why you stopped using PrEP the last time you were on it? Choose all that apply.

[ ] It was too expensive

[ ] I lost my job and/or insurance

[ ] experienced and/or was concerned about side-effects

[ ] I could not remember to take the pill every day

[ ] I started a monogamous relationship with an HIV-negative partner

[ ] I stopped being sexually active

[ ] I prefer to use other methods to protect myself from HIV

[ ] I was worried that people will think that I have HIV when they see me taking the pill

[ ] I was worried that people will know that I have sex with men or transgender people

[ ] I was worried people will think I am very sexually active because I am on PrEP

[ ] I was worried about my privacy with someone that I live with

[ ] I was worried about my privacy on my parent’s health insurance plan

[ ] I was unable or did not want to participate in the recommended sexually transmitted infection (gonorrhea, chlamydia, and syphilis) testing during clinic visits for PrEP care

[ ] Another reason, please specify: ___________________________________

End page.

Page entry logic for PrEP interest for those currently using on-demand oral PrEP: current PrEP use = yes and question 47 = only when I have sex/ some other schedule, please specify

51. Are you currently taking on-demand (event-drive, or 2-1-1 dosing) oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

Logic: show if Q 48 = Yes

52. In the past 30 days, how many times have you taken on-demand or 2-1-1 oral dosing?

_____

53. (If >0 on In the past 30 days how many times have you taken 2- 1-1 dosing?) In the past 30 days, how frequently did you remember to take the double dose 24 hours before your sexual encounter?

1. Never

2. Rarely

3. Sometimes

4. Often

5. Always

6. Decline to answer

54. (If >0 on In the past 30 days how many times have you taken 2- 1-1 dosing?) In the past 30 days, on average, how many hours before your sexual encounter did you take your double dose?

1. 2 or less hours before sex

2. 3-6 hours

3. 7-12 hours

4. 13-24 hours

5. More than 24 hours before sex

6. Decline to answer

55. (If >0 on In the past 30 days how many times have you taken 2- 1-1 dosing?) In the past 30 days how frequently did you remember to take your single dose 24 and 48 hours after the double dose?

1= Never

2= Rarely

3= Sometimes

End page

PrEP Delivery

56. Most often PrEP services are provided at a clinic or a provider's office. However, there may be other places where PrEP services might be provided. Have you heard about the possibility of PrEP services being provided in your community through various community locations, such as a community health center, HIV-related community health organization, mobile health van, local park or street pop-up clinic, or another place in your community?

__ yes

__ no

__unsure

 

57. Would you be interested in receiving PrEP services through any of these community locations mentioned above rather than receiving them through a clinic or your provider's office?

__ yes

__ no

__ unsure

 

58. [If answered yes to question above, display] Which community location you most prefer to receive PrEP services (choose one)?

__ community health center,

__ HIV-related community health organization,

__ mobile health van,

__ local park or street pop-up clinic,

__ Other (specify) __________________________________

 

59. [If answered no to question above, display] If you had to receive PrEP through a community location rather than a clinic or provider's office, which of the options below would you most prefer to receive PrEP services (choose one)?

__ community health center, 

__ HIV-related community health organization, 

__ mobile health van, 

__ local park or street pop-up clinic, 

__ Other (specify) __________________________________

Page entry logic for barriers to HIV prevention services: ((ever test for HIV = No/prefer not to answer/idk) OR (Result of most recent test = Negative/Never obtained results/indeterminate/prefer not to answer/don’t know and before most recent test, ever test pos ~= yes)) AND country born in ~= United states

60. In the United States, have you experienced any of the following barriers to getting HIV prevention services, such as HIV testing, PrEP, or PEP (post-exposure prophylaxis)? Check all that apply.

[ ] Health care provider doesn't speak my language

[ ] Pharmacist doesn't speak my language

[ ] I didn't have access to an interpreter

[ ] I was worried that an interpreter might disclose my HIV status or sexual orientation to others in my community

[ ] I was worried that a health care provider would share my information with law or immigration enforcement

[ ] I was worried that a health care provider would discriminate against me because of my sexual orientation or gender identity

[ ] I was worried that a health care provider would discriminate against me because of my race/ethnicity

[ ] I was worried that a healthcare provider would discriminate against me because of my country of origin

[ ] Health care provider doesn't understand my culture

[ ] I don't have insurance

[ ] None of the above

[ ] I prefer not to answer

[ ] I Don't know

61. Have you ever heard of pharmacy-led PrEP services, where PrEP consultations, HIV testing, prescriptions, and/or medications are provided to you by a pharmacist?

__ yes

__ no

__ unsure

 

62. Have you ever received pharmacy-led PrEP services, where PrEP consultations, HIV testing, prescriptions, and/or medications are provided to you by a pharmacist?

__ yes

__ no

__ unsure

 

63. Would you be interested in receiving pharmacy-led PrEP services in the future?

__ yes

__ no

__unsure

PrEP Interest and Preferences

Page entry logic: This page will show when: ((((#Question "In the past 12 months, (since [question('value'), id='9']), have you taken PrEP? " is one of the following answers ("No") or #Question "Have you ever taken PrEP?" is one of the following answers ("No")) or #Question "Which PrEP prescription medication are you currently taking?" is one of the following answers ("I prefer not to answer","Don't know")) or #Question "Are you currently taking on-demand oral PrEP?
" is one of the following answers ("No","I prefer not to answer","I don't know")) OR ((#Question "Have you ever taken PrEP?" is one of the following answers ("Yes") and #Question "Are you currently taking PrEP?" is one of the following answers ("No")))

PrEP stands for pre-exposure prophylaxis. Daily oral PrEP is a pill that a person who is HIV-negative takes every day in order to prevent getting HIV. PrEP is safe, but some people experience side effects like diarrhea, nausea, headache, fatigue, and stomach pain. These side effects usually go away over time. You have to see a doctor or other healthcare provider to start daily oral PrEP and go back for check-ups once every 3 months to stay on it. Studies have shown that daily oral PrEP provides about 99% protection against HIV infection from sex when it is taken every day.

64. Before today, have you ever heard of daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

65. If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

66. Do you have or know of a medical provider who you think would be willing to prescribe daily oral PrEP for you in the next month?

( ) Yes

( ) Unsure

( ) No

67. Do you plan to begin daily oral PrEP in the next month?

( ) Yes

( ) No

( ) Unsure

There is another way that some people take PrEP pills called on-demand oral PrEP. On-demand oral PrEP is also known as “intermittent” or “event-driven” PrEP. With on-demand oral PrEP you take a series of pills around the time when you have sex. This means taking two pills 2 to 24 hours before sex, one pill 24 hours after the first dose, and one pill 24 hours after the second dose. Some studies found that on-demand PrEP is effective at preventing HIV infection. This approach isn’t currently approved by the FDA (Food and Drug Administration).

68. Before today, have you ever heard of on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

69. If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

70. Do you have or know of a medical provider who you think would be willing to prescribe on-demand oral PrEP for you in the next month?

( ) Yes

( ) Unsure

( ) No

71. Do you plan to begin on-demand oral PrEP in the next month?

( ) Yes

( ) No

( ) Unsure

Page entry logic: This page will show when: ((((#Question "In the past 12 months, (since [question('value'), id='9']), have you taken PrEP? " is one of the following answers ("No") or #Question "Have you ever taken PrEP?" is one of the following answers ("No")) or #Question "Which PrEP prescription medication are you currently taking?" is one of the following answers ("I prefer not to answer","Don't know")) or #Question "Are you currently taking on-demand oral PrEP?
" is one of the following answers ("No","I prefer not to answer","I don't know")) OR ((#Question "Have you ever taken PrEP?" is one of the following answers ("Yes") and #Question "Are you currently taking PrEP?" is one of the following answers ("No")))

A long-acting form of PrEP that is given as an injection in your buttocks once every 2 months has been found to be effective in preventing HIV infection. You would have to see a doctor or healthcare provider to start injectable PrEP and go back for check-ups once every 2 months to stay on it. The possible side effects of injectable PrEP are mild-to-moderate pain at the injection site that lasts 2 to 7 days, mild rash at the injection site that clears up on its own, or a headache that lasts a couple of days after injection. Studies have found that injectable PrEP is effective at preventing HIV infection.

71. Before today, have you ever heard of injectable PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

72. If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

73. Do you have or know of a medical provider who you think would be willing to prescribe injectable PrEP for you in the next month?

( ) Yes

( ) Unsure

( ) No

74. Do you plan to begin injectable PrEP in the next month?

( ) Yes

( ) No

( ) Unsure

Logic: Hidden unless: #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes")

75. You said you'd be willing to take injectable PrEP. Once a doctor prescribes injectable PrEP for you, it may be possible to get your injection at another place. Where would you prefer to get the injection?

( ) Private doctor's office

( ) STD Clinic

( ) Health Center

( ) Pharmacy

( ) At home

( ) Other, please specify: _________________________________________________*

( ) I prefer not to answer

( ) Don't know

Logic: Hidden unless: ((#Question "If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?" is one of the following answers ("Yes") and #Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes")) and #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes"))

76. You said you’d be willing to start all 3 ways of taking PrEP. If the same doctor offered all 3 PrEP options to you, rank them in order of which you would be most likely to choose to start. 1 is the one you would be most likely to choose, and 3 is the least likely to choose.
    

________Daily oral PrEP

________On-Demand oral PrEP

________Injectable PrEP

Logic: Hidden unless: ((#Question "If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?" is one of the following answers ("Yes") AND #Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes")) AND #Question"If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("No","I prefer not to answer","Don't know"))

77. You said you’d be willing to take oral PrEP daily or on-demand. If the same doctor offered both options to you, which would you choose to start?

( ) Daily oral PrEP

( ) On-Demand oral PrEP

Logic: Hidden unless: ((#Question "If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?" is one of the following answers ("Yes") AND #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes")) AND #Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("No","I prefer not to answer","Don't know"))

78. You said you’d be willing to take daily oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose to start?

( ) Daily oral PrEP

( ) Injectable PrEP

Logic: Hidden unless: ((#Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes") AND #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes")) AND #Question "If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?" is one of the following answers ("No","I prefer not to answer","Don't know"))

79. You said you’d be willing to take on-demand oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose to start?

( ) On-demand oral PrEP

( ) Injectable PrEP

Page entry logic for PrEP interest for those currently using oral PrEP: This page will show when: (#Question "Are you currently taking PrEP?" is one of the following answers ("Yes") AND #Question "How frequently do you intend to take PrEP?" is one of the following answers ("Daily"))

There is another way that some people take PrEP pills called on-demand oral PrEP. On-demand oral PrEP is also known as “intermittent” or “event-driven” PrEP. With on-demand oral PrEP you take a series of pills around the time when you have sex. This means taking two pills 2 to 24 hours before sex, one pill 24 hours after the first dose, and one pill 24 hours after the second dose. Some studies found that on-demand PrEP is effective at preventing HIV infection. This approach isn’t currently approved by the FDA (Food and Drug Administration).

80. Before today, have you ever heard of on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

Logic: Hidden unless: #Question "Before today, have you ever heard of on-demand oral PrEP?
" is one of the following answers ("Yes")

81. Have you ever used on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

82. If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?

( ) No, I would keep using daily oral PrEP

( ) Yes, I would ask my doctor about switching to on-demand oral PrEP

( ) I prefer not to answer

( ) Don't know

A long-acting form of PrEP that is given as an injection in your buttocks once every 2 months has been found to be effective in preventing HIV infection. You would have to see a doctor or healthcare provider to start injectable PrEP and go back for check-ups once every 2 months to stay on it. The possible side effects of injectable PrEP are mild-to-moderate pain at the injection site that lasts 2 to 7 days, mild rash at the injection site that clears up on its own, or a headache that lasts a couple of days after injection. Studies have found that injectable PrEP is effective at preventing HIV infection.

83. Before today, have you ever heard of injectable PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

84. If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?

( ) No, I would keep using oral PrEP

( ) Yes, I would ask my doctor about switching to injectable PrEP

( ) I prefer not to answer

( ) Don't know

Logic: Hidden unless: (#Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes, I would ask my doctor about switching to on-demand oral PrEP") AND #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes, I would ask my doctor about switching to injectable PrEP"))

85. You said you’d be willing to switch to on-demand oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose?

( ) On-Demand oral PrEP

( ) Injectable PrEP

Logic: Hidden unless: (#Question "You said you’d be willing to switch to on-demand oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose?" is one of the following answers ("Injectable PrEP") OR #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes, I would ask my doctor about switching to injectable PrEP"))

86. Once a doctor prescribes injectable PrEP for you, it may be possible to get your injection at another place. Where would you prefer to get the injection?

( ) Private doctor's office

( ) STD Clinic

( ) Health Center

( ) Pharmacy

( ) At home

( ) Other, please specify: _________________________________________________*

( ) I prefer not to answer

( ) Don't know

Page entry logic for PrEP interest for those currently using on-demand oral PrEP: This page will show when: #Question "Are you currently taking on-demand oral PrEP?
" is one of the following answers ("Yes")

There is another way that people take PrEP called daily oral PrEP. Daily oral PrEP is a pill that a person who is HIV-negative takes every day in order to prevent getting HIV. Daily PrEP is safe, but some people experience side effects like diarrhea, nausea, headache, fatigue, and stomach pain. These side effects usually go away over time. You have to see a doctor or other healthcare provider to start daily oral PrEP and go back for check-ups once every 3 months to stay on it. Studies have shown that daily oral PrEP provides about 99% protection against HIV infection from sex when it is taken every day. 

87. Before today, have you ever heard of daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

Logic: Hidden unless: #151 Question "Before today, have you ever heard of daily oral PrEP?
" is one of the following answers ("Yes")

88. Have you ever used daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

89. If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?

( ) No, I would keep using on-demand oral PrEP

( ) Yes, I would ask my doctor about switching to daily oral PrEP

( ) I prefer not to answer

( ) Don't know

A long-acting form of PrEP that is given as an injection in your buttocks once every 2 months has been found to be effective in preventing HIV infection. You would have to see a doctor or healthcare provider to start injectable PrEP and go back for check-ups once every 2 months to stay on it. The possible side effects of injectable PrEP are mild-to-moderate pain at the injection site that lasts 2 to 7 days, mild rash at the injection site that clears up on its own, or a headache that lasts a couple of days after injection. Studies have found that injectable PrEP is effective at preventing HIV infection.

90. Before today, have you ever heard of injectable PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

91. If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?

( ) No, I would keep using on-demand oral PrEP

( ) Yes, I would ask my doctor about switching to injectable PrEP

( ) I prefer not to answer

( ) Don't know

Logic: Hidden unless: (#153 Question "If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes, I would ask my doctor about switching to daily oral PrEP") AND #155 Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes, I would ask my doctor about switching to injectable PrEP"))

92. You said you’d be willing to switch to daily oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose?

( ) Daily oral PrEP

( ) Injectable PrEP

Logic: Hidden unless: (#156 Question "You said you’d be willing to switch to daily oral PrEP or injectable PrEP. If the same doctor offered both options to you, which would you choose?" is one of the following answers ("Injectable PrEP") OR #155 Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes, I would ask my doctor about switching to injectable PrEP"))

93. Once a doctor prescribes injectable PrEP for you, it may be possible to get your injection at another place. Where would you prefer to get the injection?

( ) Private doctor's office

( ) STD Clinic

( ) Health Center

( ) Pharmacy

( ) At home

( ) Other, please specify:: _________________________________________________*

( ) I prefer not to answer

( ) Don't know

Page entry logic for PrEP interest for those currently using Injectable PrEP: This page will show when: (#Question "Are you currently taking PrEP?" is one of the following answers ("Yes") AND #Question "Which PrEP prescription medication are you currently taking?" is one of the following answers ("Apretude"))

There is another way that people take PrEP called daily oral PrEP. Daily oral PrEP is a pill that a person who is HIV-negative takes every day in order to prevent getting HIV. Daily PrEP is safe, but some people experience side effects like diarrhea, nausea, headache, fatigue, and stomach pain. These side effects usually go away over time. You have to see a doctor or other healthcare provider to start daily oral PrEP and go back for check-ups once every 3 months to stay on it. Studies have shown that daily oral PrEP provides about 99% protection against HIV infection from sex when it is taken every day.

94. Before today, have you ever heard of daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

Logic: Hidden unless: #Question "Before today, have you ever heard of daily oral PrEP?
" is one of the following answers ("Yes")

95. Have you ever used daily oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

96. If daily oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start daily oral PrEP?

( ) No, I would keep using injectable PrEP

( ) Yes, I would ask my doctor about switching to daily oral PrEP

( ) I prefer not to answer

( ) Don't know

Another way that some people take PrEP pills called on-demand oral PrEP. On-demand oral PrEP is also known as “intermittent” or “event-driven” PrEP. With on-demand oral PrEP you take a series of pills around the time when you have sex. This means taking two pills 2 to 24 hours before sex, one pill 24 hours after the first dose, and one pill 24 hours after the second dose. Some studies found that on-demand PrEP is effective at preventing HIV infection. This approach isn’t currently approved by the FDA (Food and Drug Administration).

97. Before today, have you ever heard of on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Logic: Hidden unless: #161 Question "Before today, have you ever heard of on-demand oral PrEP?
" is one of the following answers ("Yes")

98. Have you ever used on-demand oral PrEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

99. If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?

( ) No, I would keep using injectable PrEP

( ) Yes, I would ask my doctor about switching to on-demand oral PrEP

( ) I prefer not to answer

( ) Don't know

Logic: Hidden unless: (#Question "If on-demand oral PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start on-demand oral PrEP?" is one of the following answers ("Yes, I would ask my doctor about switching to on-demand oral PrEP") AND #Question "If injectable PrEP were available from your local doctor and you could access it for free, would you go to your doctor in the next month to start injectable PrEP?
" is one of the following answers ("Yes, I would ask my doctor about switching to injectable PrEP"))

100. You said you’d be willing to switch to daily oral PrEP or on-demand oral PrEP. If the same doctor offered both options to you, which would you choose?

( ) Daily oral PrEP

( ) On-Demand oral PrEP

PREP MEDS SHARING

[Show if currently on oral PrEP]

101. In the past 3 months, have you shared your PrEP medication with others?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

102. [IF ever shared=yes] Now think of the last person you shared PrEP medication with. Who was this person to you then? Select the best option.

1 Primary partner

2 Casual sex partner

3 Friend

4 Family member

5 Other (specify): _________

7 I don’t know

9 I’d prefer not to answer

103. At the time, did this person have a prescription for PrEP themselves?

__ Yes

__ No

__ Don’t know

__ Rather not say

104. (If yes to Q88?) Why did you share your PrEP medication with that person?

___ They forgot to take their own PrEP medication

___ They forgot to renew their PrEP prescription

___ They couldn’t afford to renew their PrEP prescription

___ Other (specify) ______________________________________________________________

105. In the past 3 months, on how many different occasions total did you share PrEP medication with this person?

____ [number]

nPEP for HIV

Now we will ask you a few questions about using PEP, or post-exposure prophylaxis, a pill taken for 28 days only after having unprotected sex, to prevention HIV infection.

106. Before today, have you ever heard of PEP, or post-exposure prophylaxis, for HIV infection?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

107. Have you ever used PEP to prevention HIV infection?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

108. Have you used PEP in the past 3 months?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

109. If PEP were available from your local doctor and you could access it for free, would you go to your doctor in the future to get PEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Doxy-PEP for STIs

Now we will ask you a few questions about using PEP to prevent some STDs, also known as Doxy-PEP because the medication is called doxycycline. Doxy-PEP is taking 2 pills of doxycycline after each time you have sex.

110. Before today, have you ever heard of Doxy-PEP to prevent some STD infections?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

IF YES to having heard of DoxyPEP

111. Have you ever used Doxy-PEP to prevent STD infections?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

IF YES to having used Doxy-PEP

112. Doxy-PEP is taking 2 pills of doxycycline after each time you have sex. Have you used Doxy-PEP in the past 3 months?

( ) No

( ) Yes

( ) I prefer not to answer

( ) I don't know

IF YES to having heard of Doxy-PEP:  How many of your friends or acquaintances have ever used Doxy-PEP?

-GET COUNT

113. If Doxy-PEP were available from your local doctor and you could access it for free, would you go to your doctor in the future to get Doxy-PEP?

( ) No

( ) Yes

( ) I prefer not to answer

( ) Don't know

Perceived PrEP Efficacy

114. On a scale of 0 to 100, where 0 equals no protection and 100 equals complete protection, how much protection do you think each of the following strategies offers you in preventing HIV infection?

Please slide the blue dot on the scale to indicate how much protection you think each strategy offers.

Daily oral PrEP	0% --------------------------------------------------------------------------------------100%
On demand oral PrEP	0% --------------------------------------------------------------------------------------100%
Injectable PrEP	0% --------------------------------------------------------------------------------------100%
PEP (post-exposure oral)	0% --------------------------------------------------------------------------------------100%
Using Condoms	0% --------------------------------------------------------------------------------------100%
A partner living with HIV taking HIV medications and is undetectable	0% --------------------------------------------------------------------------------------100%
You and your partner being tested for HIV infection	0% --------------------------------------------------------------------------------------100%

3-month Intentions

115. In the next 3 months, how likely are you to do each of the following?

	Definitely not Likely	Probably not Likely	Somewhat Likely	Probably Likely	Definitely Likely	Doesn’t apply
Use condoms every time you have anal sex	1	2	3	4	5	99
Get tested for HIV	1	2	3	4	5	99
Get tested for STDs	1	2	3	4	5	99
Take daily oral PrEP	1	2	3	4	5	99
Take on demand (2-1-1) oral PrEP	1	2	3	4	5	99
Take injectable PrEP	1	2	3	4	5	99
Take PEP (post-exposure pill for 28 days)	1	2	3	4	5	99

Sexual Behavior

In the next set of questions, we want to ask you about your sexual activity in the past 3 months. year].

116. Have you had a primary male partner in the past three months, since approximately [month and year]? By “primary” partner we mean a man you have lived with or have seen a lot, to whom you have felt a special emotional commitment for at least 3 months.

0 No

1 Yes

117. In the past 3 months, with how many men other than your most recent primary partner did you have any anal sex? We will refer to these as “casual” sex partners, and please include times when you were a top or bottom, used or didn't use a condom, and whether or not there was ejaculation.

____

118. [IF no primary partners and 0 others] You indicated you did not have any sex partners in the past 3 months, is this correct? (Choose one)

1 Yes [SKIP TO NEXT SECTION]

0 No, I want to change my answer [RETURN TO primary partner question]

119. [IF primary partner + number of other partners >0] Thanks. You indicated that in the past 3 months you had a total of [primary partner + number of other partners] male sex partners, including [1] primary partner and [#] casual partners. Is that correct?

1 Yes

0 No, I want to change my answer [RETURN to primary partner question]

Primary Partner

[if has a primary partner]

Past 3 months

120. Throughout this next group of questions, your male primary partner will be referred to by his initials. Please put his initials here. Use AZ if you do not know his name.

_ _

[Add this Q for subsequent waves following baseline] Is this the same man who was your primary partner the last time you completed this survey?

__ Yes

__ No

121. How old is [name]? If you are not sure, give it your best guess.

____

122. What is [name]’s primary race/ethnicity? If you are not sure, give it your best guess. (check all that apply)

1 White

2 African American or Black

3 Asian

4 Native Hawaiian or Other Pacific Islander

5 American Indian or Alaska Native

99 I’d prefer not to answer

123. Is [partner initials] Hispanic or Latino? If you are not sure, give it your best guess.

1 Hispanic or Latino

2 Not Hispanic or Latino

99 Prefer not to answer

124. Where did you first meet [name]? (Choose one)

1 A dating or hookup app/website for gay men, like Grindr or Jack’d

2 A social networking app or website for gay men (not for dating or hooking up)

3 A social networking app or website, like Facebook, Twitter, Instagram or Snapchat

4 Some other app or website

5 Work or school

6 Through family

7 Through a friend

8 A private party or social event

9 A public festival or community event, like Pride

10 A gay commercial venue, like a gay bar or dance club

11 A straight commercial venue, like a straight bar or dance club

12 A commercial sex venue, like a sex club or bath house

13 A public sex venue, like a park, beach, bathroom or tearoom

14 Other, specify:_____________________

99 I’d prefer not to answer

125. When was the first time you had any anal sex with [name]? That is, where you were a top or bottom, with or without a condom, and with or without ejaculation.

1 Less than a week

2 More than a week but less than a month ago

3 One to three months

4 Four to six months

5 Seven to twelve months

6 More than a year

99 I’d prefer not to answer

126. What is [name]’s HIV status?

1 Positive

2 Negative

3 You don’t know or are unsure about his HIV status

99 I’d prefer not to answer

127. Did [name] TELL you or disclose his HIV-status?

1 He told me and I have no reason to doubt

2 He told me and I have doubts

3 Online Profile

0 Friend told me

77 I assumed it

99 I’d prefer not to answer

128. Have you told [name] your current HIV status?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

Primary partner’s HIV status is positive

[show if partner’s HIV status is positive]

129. [If ever talked about ARV is yes] Has [name] told you he was currently taking medicines to treat his HIV?

1 Yes, and I have no reason to doubt him

2 Yes, but I have reason to doubt him

0 No, he has not talked to me about it

3 No, he told me that he is NOT currently taking antiretroviral medicines to treat his HIV

7 I don’t know

9 I’d prefer not to answer

130. [prior question = 1 or 2] Has [Name] told you his viral load is undetectable?

1 Yes, and I have no reason to doubt him

2 Yes, but I have some reason to doubt him

0 No

7 I don’t know

9 I’d prefer not to answer

Primary partner’s HIV status is negative

[show if partner’s HIV status is negative]

131. Have you ever talked to [Name] about whether he is taking PrEP to prevent HIV?

1 Yes, in the past 3 months

2 Yes, more than 3 months ago
0 No

7 I don’t know

9 I’d prefer not to answer

132. [IF have talked about prep] , has [Name] told you he is currently taking PrEP to prevent HIV?

1 Yes, and I have no reason to doubt him

2 Yes, but I have reason to doubt him

0 No, he has not talked to me about it

3 No, he told me that he is NOT currently taking PrEP to prevent HIV

7 I don’t know

9 I’d prefer not to answer

125. In the past 3 months, that is since [month and year], have you had ANY anal sex with [Name]?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

Logic: show if anal sex in p3mo with name = yes

126. Which of these is true of when you had anal sex with [name] in the past 3 months. Select all that apply.

[ ] A condom was always used

[ ] There was at least one time a condom was not used

[ ] I never used a condom

[ ] I was always taking PrEP as prescribed

[ ] I forgot to take my PrEP as prescribed at least once

[ ] I never took PrEP as prescribed

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Were you the top (you put your penis in his butt), the bottom (he put his penis in your butt), or both?

1 I was always the top

2 I was always the bottom

3 I was both the top and the bottom

7 I don’t know

9 I’d prefer not to answer

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Were you ever drunk or buzzed on alcohol within 2 hours before or during sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Did you ever use recreational drugs within 2 hours before or during sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

Last sex with primary partner

The following questions ask about the last time you had sex with your primary partner.

126. When was the last time you had anal sex with [Name]? That is, with or without a condom, and with or without ejaculation.

Month/Year drop-downs

126. During the most recent time you had any anal sex with [Name], where did you have sex? (Choose one)

1 Your house or apartment

2 His house or apartment

3 Someone else's house or apartment

4 Hotel

5 Sex club or bathhouse

6 Bar, night club, or dance club

7 Health club or gym

8 Porn theatre/video arcade

9 Public bathroom

10 Other public place, such as beach

11 Park, woods, street, car or van

12 Other

77 I don’t know

99 I’d prefer not to answer

126. During the most recent time you had anal sex with [Name], were you the top (you put your penis in his butt)? This would be with or without a condom and with or without ejaculation.

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to top] Was a condom used from start to finish when you were the top?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. During the most recent time you had anal sex with [Name], were you the bottom (he put his penis in your butt}? This would be with or without a condom and whether or not you ejaculated.

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to bottom] Was a condom used from start to finish when you were the bottom?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

PrEP use with primary partner

[show if participant is not HIV positive and if ppt indicates they have a primary partner?]

126. During the most recent time you had anal sex with [Name], were you taking PrEP?

- Yes, I was taking PrEP daily

- Yes, I was taking PrEP just before and after we had sex (sometimes called on-demand or 2-1-1 PrEP)

- Yes, I was on injectable PrEP

- Yes, but I was not taking PrEP regularly at that time, so I may not have been protected

- No, I was not taking PrEP

Primary partner HIV-negative

[show if partner is HIV negative]

126. During the most recent time you had anal sex with [Name], was he taking PrEP?

1 Yes, I am sure he was taking PrEP

0 Yes, I think he was taking PrEP, but I'm not totally sure.

77 No, he was not taking PrEP

Primary partner HIV-positive

[show if partner is HIV positive]

126. During the most recent time you had anal sex with [Name], was he taking antiretroviral medicines to treat his HIV infection?

1 yes

0 no

77 not sure

[If yes], During the most recent time you had anal sex, was [Name]'s HIV status undetectable (that is, he had so little HIV in his body, that he could not transmit HIV through sex)?

1 yes

0 no

77 not sure

Alcohol/Drug use with primary partner

126. During the most recent time you had anal sex with [Name], were you drunk or buzzed on alcohol within two hours before or during sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [if yes to drunk or buzzed] How many drinks did you have? By a drink, I mean a 12 oz. can or glass of beer, a 4 oz. glass of wine, a 1-1/2 oz. shot of liquor, or a mixed drink with that amount of liquor.

____ (number of drinks)

126. Was [Name] drunk or buzzed on alcohol within two hours before or during the most recent time you had anal sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. Did you use any drug within two hours before or during the most recent time you had anal sex with [name]?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. Which drugs? (Check all that apply)

Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice)

Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice)

Downers (Valium, Ativa, Xanax)

Pain killers (Oxycontin, Percocet)

Hallucinogens (LSD, mushrooms, Peyote, Mescaline)

Ecstacy (E, X, MDMA)

Club drugs (GHB, ketamine, special K)

Marijuana (pot, weed)

Poppers (amyl nitrate)

PCP (angel dust, wet, wicky sticks)

Synthetic marijuana (herbal incense, spice, K2)

Crack, injected

Crack, smoked or snorted

Cocaine, injected

Cocaine, smoked or snorted

Heroin, injected

Heroin, smoked or snorted

Heroin and cocaine injected together (speedballs)

Other, specify:_____________

I don’t know

I’d prefer not to answer

126. Did [Name] use any drug within two hours before or during the most recent time you had anal sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. Which drugs? (Check all that apply)

Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice)

Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice)

Downers (Valium, Ativa, Xanax)

Pain killers (Oxycontin, Percocet)

Hallucinogens (LSD, mushrooms, Peyote, Mescaline)

Ecstacy (E, X, MDMA)

Club drugs (GHB, ketamine, special K)

Marijuana (pot, weed)

Poppers (amyl nitrate)

PCP (angel dust, wet, wicky sticks)

Synthetic marijuana (herbal incense, spice, K2)

Crack, injected

Crack, smoked or snorted

Cocaine, injected

Cocaine, smoked or snorted

Heroin, injected

Heroin, smoked or snorted

Heroin and cocaine injected together (speedballs)

Other

I don’t know

I’d prefer not to answer

126. [If partner used other drug] Please specify which other drugs [Name] used.

_________________

Other Male Partners

Past 3 months

Partner count, HIV status

[show if number of partners equals or is greater than 1]

The following questions ask you about the [# of non-primary male partners] casual sex partners (that is, partners who were not your primary partner) you have had in the past 3months. If you are unsure about the HIV status of any of your casual partners in the past 3 months, please do not include them in either group.

126. Of these [# of non-primary male partners] men, how many did you believe were living with HIV?

____

126. Of these [# of non-primary male partners] men, how many did you believe were HIV-negative?

____

[TOT_UNK = [# of non-primary male partners – [# HIV-positive] – [# HIV-negative]; if TOT_UNK = 0, then skip next question]

126. So, you had [TOT_UNK] partners whose HIV status you did not know or were unsure of? (Choose one)

0 No, I want to change my answer

1 Yes

99. I’d prefer not to answer

126. [IF [# HIV-positive ≥ 1] Of the [[# HIV-positive] men living with HIV, how many actually TOLD you they were HIV positive and you have no reason to doubt them?

_ _ _

99 I’d prefer not to answer

126. [# HIV-negative ≥ 1] Of the [# HIV-negative] HIV negative men, how many actually TOLD you they were HIV negative?

_ _ _

99 I’d prefer not to answer

Non-primary HIV-positive partners

[show if # HIV-positive ≥ 1]

The following questions ask about your [# HIV-positive >1] casual sex partners living with HIV. These questions ask about the past 3 months, that is since [month and year].

126. In the past 3 months, with how many of your [# HIV-positive] casual partners living with HIV were you the top (you put your penis in his butt)?

____

126. In the past 3 months, with how many of your [# HIV-positive] casual partners living with HIV were you the bottom (he put his penis in your butt)?

____

126. In the past 3 months, with how many of your [# HIV-positive] casual partners living with HIV did you have ANY anal sex in which a condom was not used from start to finish?

____ [IF 0, SKIP to SXC8]

126. [If >0 partners with anal sex no condom] Of those [# HIV-positive no condom] men you had anal sex with and did not use a condom from start to finish, with how many were you drunk or buzzed on alcohol within 2 hours before or during sex?

____

126. [If >0 partners with anal sex no condom] Of those [# HIV-positive no condom] men you had anal sex with and did not use a condom from start to finish, with how many were you using non-prescribed drugs within 2 hours before or during sex?

____

126. In the past 3 months, have you talked to any of your male partners living with HIV about whether they were using antiretroviral medicines to treat their HIV?

1 Yes

0 No

7 I don’t know

9 Refused

126. [IF talked to partner about ARV] Of your [# HIV-positive] casual sex partners living with HIV, how many told you they were currently taking antiretroviral medicines to treat their HIV and you had no reason to doubt it?

____

126. [IF prior question ≥ 1] Of your [[# HIV-positive] HIV-positive casual sex partners, how many told you they were undetectable or virally suppressed and you had no reason to doubt it?

____

Non-primary HIV-negative partners

[show if # HIV-negative ≥ 1]

The following questions ask about your HIV-NEGATIVe partners who were NOT your primary partner. These questions ask about the past 3 months, that is since [month and year].

126. In the past 3 months, with how many of your [# HIV-negative] HIV-negative partners were you the top (you put your penis in his butt)?

____

126. In the past 3 months, with how many of your [# HIV-negative] HIV-negative partners were you the bottom (he put his penis in your butt)?

____

126. In the past 3 months, with how many of your [# HIV-negative] HIV-negative partners did you have ANY anal sex in which a condom was not used from start to finish?

____ [IF 0 SKIP TO SXC18]

126. [IF # HIV-negative no condom ≥ 1] Of those [# HIV-negative no condom] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom while you were drunk or buzzed on alcohol within 2 hours before or during sex?

____

126. [IF # HIV-negative no condom ≥ 1] Of those [# HIV-negative no condom] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom after using non-prescribed drugs within 2 hours before or during sex?

____

126. In the past 3 months, have you talked to any of your HIV-negative partners about whether they are currently taking PrEP to prevent HIV?

1 Yes

0 No

7 I don’t know

9 Refused

126. [If prior question=1] Of your [# HIV-negative] HIV-negative partners, how many told you they were currently taking PrEP to prevent HIV and you had no reason to doubt it?

____

Non-primary HIV-status unknown partners

[show if # HIV-unknown ≥ 1]

The following questions ask about your partners who were not your primary partner and whose HIV status you did not know. These questions ask about the past 3 months, that is since [month and year].

126. In the past 3 months, with how many of your [TOT_UNK] partners whose HIV status you did not know were you the top (you put your penis in his butt)?

____

126. In the past 3 months, with how many of your [TOT_UNK] partners whose HIV status you did not know were you the bottom (he put his penis in your butt)?

____

126. In the past 3 months, with how many of your [TOT_UNK] partners whose HIV status you did not know did you have ANY anal sex in which a condom was not used from start to finish?

____ [IF 0 SKIP TO next page]

126. [IF #anal sex without condom ≥ 1] Of those [#anal sex without condom] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom while you were drunk or buzzed on alcohol within 2 hours before or during sex?

____

126. [IF #anal sex without condom ≥ 1] Of those [#anal sex without condom] men you had anal sex with and did not use a condom from start to finish, with how many did you have sex without a condom after using non-prescribed drugs within 2 hours before or during sex?

____

Last Non-Primary Male Partner

[show if # of other partners > 0]

You will now be asked more detailed questions about the last man you had any anal sex with in the last THREE months who was not your male primary partner.

That is, not someone you have lived with or have seen a lot, and to whom you have not felt a special emotional commitment. Think about the very last man you had any anal sex with in the last THREE months who was not your primary partner.

126. Throughout this next group of questions, this man will be referred to by his initials. Please put his initials here. Use AZ if you do not know his name.

_ _

126. How old is [partner initials]? If you are not sure, give it your best guess.

____

126. What is [partner initials]’s race? If you are not sure, give it your best guess. (check all that apply)

1 White

2 African American or Black

3 Asian

4 Native Hawaiian or Other Pacific Islander

5 American Indian or Alaska Native

99 I’d prefer not to answer

126. Is [partner initials]’s Hispanic or Latino? If you are not sure, give it your best guess.

1 Hispanic or Latino

2 Not Hispanic or Latino

99 Prefer not to answer

126. Where did you first meet [partner initials]?

1 A dating or hookup app/website for gay men, like Grindr or Jack’d

2 A social networking app or website for gay men (not for dating or hooking up)

3 A social networking app or website, like Facebook, Twitter, Instagram or Snapchat

4 Some other app or website

5 Work or school

6 Through family

7 Through a friend

8 A private party or social event

9 A public festival or community event, like Pride

10 A gay commercial venue, like a gay bar or dance club

11 A straight commercial venue, like a straight bar or dance club

12 A commercial sex venue, like a sex club or bath house

13 A public sex venue, like a park, beach, bathroom or tearoom

14 Other, specify: ________________

99 I’d prefer not to answer

126. When was the first time you had any anal sex with [partner initials]? That is, where you were a top or bottom, with or without a condom, and with or without ejaculation.

1 Less than a week ago

2 More than a week but less than one month ago

3 One to three months ago

4 Four to six months ago

5 Seven to twelve months ago

6 More than a year ago

99 I’d prefer not to answer

126. What is [partner initials]'s HIV status?

1 Positive

2 Negative

3 I don’t know or am unsure about his HIV status

99 I’d prefer not to answer

126. Did [partner initials] TELL you or disclose his HIV status?

1 He told me and I have no reason to doubt

2 He told me and I have doubts

3 Online Profile

0 Friend told me

77 I assumed it

99 I’d prefer not to answer

126. Have you told [name] your current HIV status?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

Non-primary partner’s HIV status is positive

[show if partner’s HIV status is positive]

126. [If ever talked about ARV is yes] Has [name] told you he was currently taking antiretroviral medicines to treat his HIV?

1 Yes, and I have no reason to doubt him

2 Yes, but I have reason to doubt him

0 No, he has not talked to me about it

3 No, he told me that he is NOT currently taking antiretroviral medicines to treat his HIV

7 I don’t know

9 I’d prefer not to answer

126. [prior question = 1 or 2] Has [Name] told you his viral load is undetectable?

1 Yes, and I have no reason to doubt him

2 Yes, but I have some reason to doubt him

0 No

7 I don’t know

9 I’d prefer not to answer

Non-primary partner’s HIV status is negative

[show if partner’s HIV status is negative]

126. Have you ever talked to [Name] about whether he is taking PrEP to prevent HIV?

1 Yes, in the past 3 months

2 Yes, more than 3 months ago
0 No

7 I don’t know

9 I’d prefer not to answer

126. [IF have talked about prep] Has [Name] told you he is currently taking PrEP to prevent HIV?

1 Yes, and I have no reason to doubt him

2 Yes, but I have reason to doubt him

0 No, he has not talked to me about it

3 No, he told me that he is NOT currently taking PrEP to prevent HIV

7 I don’t know

9 I’d prefer not to answer

126. In the past 3 months, that is since [month and year], have you had ANY anal sex with [Name]?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

Logic: show if anal sex in p3mo with name = yes

126. Which of these is true of when you had anal sex with [name] in the past 3 months. Select all that apply.

[ ] A condom was always used

[ ] There was at least one time a condom was not used

[ ] I never used a condom

[ ] I was always taking PrEP as prescribed

[ ] I forgot to take my PrEP as prescribed at least once

[ ] I never took PrEP as prescribed

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Were you the top (you put your penis in his butt), the bottom (he put his penis in your butt), or both?

1 I was always the top

2 I was always the bottom

3 I was both the top and the bottom

7 I don’t know

9 I’d prefer not to answer

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Were you ever drunk or buzzed on alcohol within 2 hours before or during sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to any anal sex without condom] Think of the times in the past 3 months that you had anal sex with [Name] and did not use a condom from start to finish. Did you ever use recreational drugs within 2 hours before or during sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

Last sex with non-primary partner

The following questions ask about the last time you had sex with your casual partner [Initials from earlier]

126. When was the last time you had anal sex with [Name]? That is, with or without a condom, and with or without ejaculation.

Month/Year drop-downs

126. During the most recent time you had any anal sex with [Name], where did you have sex? (Choose one)

1 Your house or apartment

2 His house or apartment

3 Someone else's house or apartment

4 Hotel

5 Sex club or bathhouse

6 Bar, night club, or dance club

7 Health club or gym

8 Porn theatre/video arcade

9 Public bathroom

10 Other public place, such as beach

11 Park, woods, street, car or van

12 Other

77 I don’t know

99 I’d prefer not to answer

126. During the most recent time you had anal sex with [Name], were you the top (you put your penis in his butt)? This would be with or without a condom and with or without ejaculation.

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to top] Was a condom used from start to finish when you were the top?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. During the most recent time you had anal sex with [Name], were you the bottom (he put his penis in your butt}? This would be with or without a condom and whether or not you ejaculated.

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [If yes to bottom] Was a condom used from start to finish when you were the bottom?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

PrEP use with non-primary partner

[show if participant is not HIV positive and if ppt indicates they have a primary partner?]

126. During the most recent time you had anal sex with [Name], were you taking PrEP?

- Yes, I was taking PrEP daily

- Yes, I was taking PrEP just before and after we had sex (sometimes called on-demand or 2-1-1 PrEP)

- Yes, I was on injectable PrEP

- Yes, but I was not taking PrEP regularly at that time, so I may not have been protected

- No, I was not taking PrEP

Non-primary partner HIV-negative

[show if partner is HIV negative]

126. During the most recent time you had anal sex with [Name], was he taking PrEP?

Yes, I am sure he was taking PrEP

Yes, I think he was taking PrEP, but I'm not totally sure.

No, he was not taking PrEP

Non-primary partner HIV-positive

[show if partner is HIV positive]

126. During the most recent time you had anal sex with [Name], was he taking antiretroviral medicines to treat his HIV infection?

1 Yes

0 No

99 Not sure

126. [If yes], During the most recent time you had anal sex, was [Name]'s HIV status undetectable (that is, he had so little HIV in his body, that he could not transmit HIV through sex)?

1 Yes

0 No

99 Not sure

Alcohol/Drug use with non-primary partner

126. Were you drunk or buzzed on alcohol within two hours before or during the most recent time you had anal sex with [Name]?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. [if yes to drunk or buzzed] How many drinks did you have? By a drink, I mean a 12 oz. can or glass of beer, a 4 oz. glass of wine, a 1-1/2 oz. shot of liquor, or a mixed drink with that amount of liquor.

____ (number of drinks)

126. Was [Name] drunk or buzzed on alcohol within two hours before or during the most recent time you had anal sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. Did you use any drug within two hours before or during the most recent time you had anal sex with [name]?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer Which drugs? (Check all that apply)

Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice)

Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice)

Downers (Valium, Ativa, Xanax)

Pain killers (Oxycontin, Percocet)

Hallucinogens (LSD, mushrooms, Peyote, Mescaline)

Ecstacy (E, X, MDMA)

Club drugs (GHB, ketamine, special K)

Marijuana (pot, weed)

Poppers (amyl nitrate)

PCP (angel dust, wet, wicky sticks)

Synthetic marijuana (herbal incense, spice, K2)

Crack, injected

Crack, smoked or snorted

Cocaine, injected

Cocaine, smoked or snorted

Heroin, injected

Heroin, smoked or snorted

Heroin and cocaine injected together (speedballs)

Other, specify:_____________

I don’t know

I’d prefer not to answer

126. Did [Name] use any drug within two hours before or during the most recent time you had anal sex?

1 Yes

0 No

77 I don’t know

99 I’d prefer not to answer

126. Which drugs? (Check all that apply)

Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice)

Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice)

Downers (Valium, Ativa, Xanax)

Pain killers (Oxycontin, Percocet)

Hallucinogens (LSD, mushrooms, Peyote, Mescaline)

Ecstacy (E, X, MDMA)

Club drugs (GHB, ketamine, special K)

Marijuana (pot, weed)

Poppers (amyl nitrate)

PCP (angel dust, wet, wicky sticks)

Synthetic marijuana (herbal incense, spice, K2)

Crack, injected

Crack, smoked or snorted

Cocaine, injected

Cocaine, smoked or snorted

Heroin, injected

Heroin, smoked or snorted

Heroin and cocaine injected together (speedballs)

Other

I don’t know

I’d prefer not to answer

126. [If partner used other drug] Please specify which other drugs [Name] used.

_________________

PNP/Chemsex Section

Party-N-Play (PNP or sometimes called chemsex) is a term to describe the use of some drugs (for example methamphetamine) to enhance and prolong the sexual experience with sexual partners.

126. Have you ever identified as being part of the Party-N-Play (PNP) sex community?

• Yes

• No

• Unsure

126. Were you ever concerned about Party-N-Play sex being a problem for you?

• Yes

• No

• Unsure

126. Have you ever sought counseling or treatment for problems related to Party-N-Play sex?

1. Yes

0. No

77. Unsure

126. Did you participate in Party-N-Play sex in the past 3 months?

1. Yes

0. No (skip remaining items in section)

77. Unsure

126. In the past 3 months, what drugs did you use before or during Party-N-Play sex?

(select all that apply)

• Methamphetamine/Crystal/Ice

• MDMA/Ecstasy/X

• Cocaine/Crack

• Ketamine/K

• GHB/GBL/G

• Poppers/amyl nitrates

• Viagra/Cialis

• Alcohol

• Marijuana

• Other (specify) __________________________________

126. In the past 3 months, did you have sex without a condom during Party-N-Play sex?

Yes, as a bottom only

Yes, as a top only

Yes, sometimes as a top and sometimes as a bottom

No

Unsure

[If yes to question above] When you had sex without a condom during Party-N-Pay sex in the past 3 months, how often were you using PrEP?

• All the time

• Some of the time

• Rarely

• None of the time

Substance Use and Abuse

126. The following questions ask about your use of alcohol. Please select the response that best describes your use of alcohol.

[AUDIT]

	0	1	2	3	4
How often do you have a drink containing alcohol?	Never	Monthly or less	2-4 times per month	2-3 times per week	4 or more times per week
How many drinks containing alcohol do you have on a typical day when you are drinking?	1 or 2	3 or 4	5 or 6	7 to 9	10 or more
How often do you have six or more drinks on one occasion?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often during the last year have you failed to do what was normally expected of you because of drinking?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often during the last year have you need a first drink in the morning to get yourself going after a heavy drinking session?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often in the last year have you had a feeling of guilt or remorse after drinking?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often in the last year have you been unable to remember what happened the night before because of your drinking?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
Have you or someone else been injured because of your drinking	No		Yes, but not in the last year		Yes, during the last year
Has a relative, friend, doctor or other health care worker been concerned about your drinking or suggested you cut down?	No		Yes, but not in the last year		Yes, during the last year

126. In the past 3 months, have you use any drugs, including any medications not prescribed to you?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

126. [If use drugs=1] Which of the following drugs have you used in the past 3 months? Select all that apply.

Injected Methamphetamine or other amphetamine, injected (meth, speed, crystal, crank, ice)

Methamphetamine or other amphetamine, not injected (meth, speed, crystal, crank, ice)

Downers (Valium, Ativa, Xanax)

Pain killers (Oxycontin, Percocet)

Hallucinogens (LSD, mushrooms, Peyote, Mescaline)

Ecstacy (E, X, MDMA)

Club drugs (GHB, ketamine, special K)

Marijuana (pot, weed)

Poppers (amyl nitrate)

PCP (angel dust, wet, wicky sticks)

Synthetic marijuana (herbal incense, spice, K2)

Crack, injected

Crack, smoked or snorted

Cocaine, injected

Cocaine, smoked or snorted

Heroin, injected

Heroin, smoked or snorted

Heroin and cocaine injected together (speedballs)

Other

I don’t know

I’d prefer not to answer

126. [IF other drugs selected] Please specify which other drugs.

__________________

126. The following questions are about your use of drugs in the past year. Please select the response that best describes your use of drugs.

[DUDIT]

	0	1	2	3	4
How often do you use drugs other than alcohol?	Never	Monthly or less	2-4 times per month	2-3 times per week	4 or more times per week
Do you use more than one type of drug on the same occasion?	Never	Monthly or less	2-4 times per month	2-3 times per week	4 or more times per week
How many times do you take drugs on a typical day when you do drugs?	0	1 to 2	3 to 4	5 to 6	7 or more
How often are you influenced heavily by drugs?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
Over the past year, have you felt that your longing for drugs was so strong that you could not resist it?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
Has it happened, over the past year, that you have not been able to stop taking drugs once you started?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often over the past year have you taken drugs and then neglected to do something you should have done?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often over the past year have you needed to take a drug the morning	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
How often over the past year have you had guilty feelings or a bad conscience because you used drugs?	Never	Less than monthly	Monthly	Weekly	Daily or almost daily
Have you or anyone else been hurt (mentally or physically) because you used drugs?	No		Yes, but not in the last year		Yes, during the last year
Has a relative or friend, doctor or nurse, or anyone else been worried about your drug use or said that you should stop using drugs?	No		Yes, but not in the last year		Yes, during the last year

Mental Health: Anxiety and Depression

126. Over the last 2 weeks, how often have you been bothered by the following problems?

[GAD-7]

	Not at all	Several days	More than half the days	Nearly every day
Feeling nervous, anxious, or on edge	0	1	2	3
Not being able to stop or control worrying	0	1	2	3
Worrying too much about different things	0	1	2	3
Trouble relaxing	0	1	2	3
Being so restless that it’s hard to sit still	0	1	2	3
Becoming easily annoyed or irritable	0	1	2	3
Feeling afraid as if something awful might happen	0	1	2	3

126. Please choose the answer that best fits how you felt during the past week.

[CESD-10]

	Rarely or none of the time (<1 day)	Some or little of the time (1-2 days)	Occasionally or a moderate amount of time (3-4 days)	Most or all of the time (5-7 days)
I was bothered by things that usually don’t bother me	0	1	2	3
I had trouble keeping my mind on what I was doing	0	1	2	3
I felt depressed	0	1	2	3
I felt everything was an effort	0	1	2	3
I felt hopeful about the future	0	1	2	3
I felt fearful	0	1	2	3
My sleep was restless	0	1	2	3
I was happy	0	1	2	3
I felt lonely	0	1	2	3
I could not get “going”	0	1	2	3

IPV

126. In the past 3 months, has your partner pressured or forced you to do something sexual that you didn’t want to do? Examples may include any of the following: oral or anal sex, having sex with others, having sexual partners outside the relationship, or any other sexual activity that made you feel uncomfortable.

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

126. In the past 3 months, have arguments in your relationship escalated into any of the following: destruction of property, grabbing, restraining, pushing, kicking, slapping, punching, threats of violence or other acts of physical intimidation?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

126. In the past 3 months, has your partner insulted, criticized, threatened or yelled at you in any way? Examples may include the following: using slurs, calling you names, calling you fat, criticizing your sexual performance, criticizing your clothing, asking you to act more masculine or threatening to out you.

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

126. In the past 3 months, has your partner prevented you from communicating with or seeing your friends, family, or coworkers? Monitored or demanded access to your cell phone, email, social networking sites, finances or spending?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

126. In the past 3 months, have you ever felt afraid, threatened, isolated, trapped or like you are walking on eggshells as a result of your relationship? Have your friends or family raised concerns about your safety within your relationship?

1 Yes

0 No

7 I don’t know

9 I’d prefer not to answer

PrEP Attitudes and Stigma

[Mustanski B, AIDS Behav 2018] [PA=prep attitudes; PS=prep stigma]

126. Please indicate your level of agreement with each of the following statements

Please indicate your level of agreement with each of the following statements. I think people should take PrEP (PA)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP sleep around (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP are irresponsible (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
Having sex with someone on PrEP is risky (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP are making a smart decision to protect their health (PA)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
I would not trust someone who told me they were on PrEP (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP can’t control their sex drive (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP use it as an excuse to have sex without a condom (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
Many people on PrEP lie about whether or not they take it every day (PS)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer
People who are on PrEP are responsible (PA)	1 = Strongly disagree 2 = Disagree 3 = Neither agree nor disagree 4 = Agree 5 = Strongly agree 6 = Decline to answer

Beliefs in Effectiveness of Treatment as Prevention (U=U)

[Bavinton BR, PLoS One 2016]

126. Please indicate you level of agreement with each of the following statements.

How familiar are you with the Undetectable = Untransmittable (U = U) campaign?	1 = Not at all [skip to next section] 2 = A little 3 = Somewhat 4 = Very 5 = Decline to answer
With regard to men living with HIV transmitting HIV through sexual contact, how accurate do you believe the slogan Undetectable = Untransmittable is?	1 = Completely inaccurate 2 = Somewhat inaccurate 3 = Somewhat accurate 4 = Completely accurate 5 = I don’t know what “undetectable” means 6 = Decline to answer
I would be willing to get fucked (bottom) by a man living with HIV while not using a condom if he has an undetectable viral load.	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
I would be willing to fuck (top) a man living with HIV while not using a condom if he has an undetectable viral load.	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
Men living with HIV who are on treatments are unlikely to pass on HIV if they fuck without a condom	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
An undetectable viral load makes it unlikely to pass on HIV	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
I fuck without condoms more often because of HIV treatments	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
HIV treatments take the worry out of sex	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
Some things I will do now that I previously felt were too risky	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
I prefer that my HIV-positive sex partners take anti-HIV medications, so we don’t have to bother with condoms	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
I prefer to use condoms even if my HIV-positive sex partner is taking anti-HIV medications	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer
I worry that anti-HIV medications do not completely eliminate the risk of getting HIV	1 = Strongly disagree 2 = Disagree 3 = Agree 4 = Strongly agree 5 = Decline to answer

Healthcare Trust/Mistrust

126. Please indicate how much you agree with the following statements.

[Thompson GBMMS]

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Doctors and healthcare workers sometimes hide information from patients who belong to my primary racial or ethnic group	1	2	3	4	5
Doctors have the best interests of people of my primary racial or ethnic group in mind	1	2	3	4	5
People of my primary racial or ethnic group should not confide in doctors and healthcare workers because it will be used against them	1	2	3	4	5
People of my primary racial or ethnic group should be suspicious of information from doctors and healthcare workers	1	2	3	4	5
People of my primary racial or ethnic group cannot trust doctors and healthcare workers	1	2	3	4	5
People of my primary racial or ethnic group should be suspicious of modern medicine	1	2	3	4	5
Doctors and healthcare workers treat people of my primary racial or ethnic group as “guinea pigs”	1	2	3	4	5
People of my primary racial or ethnic group receive the same medical care from doctors and healthcare workers as people from other groups	1	2	3	4	5
Doctors and healthcare workers do not take the medical complaints of people of my primary racial or ethnic group seriously	1	2	3	4	5
People of my primary racial or ethnic group are treated the same as people of other groups by doctors and healthcare workers	1	2	3	4	5
In most hospitals, people of different racial or ethnic groups receive the same kind of care	1	2	3	4	5
I have personally been treated poorly or unfairly by doctors or healthcare workers because of my primary racial or ethnic group	1	2	3	4	5

Test Messages

Now we will ask you to review some prevention messages and tell us what you think of each of them.

Using PrEP consistently can offer you and your partners peace of mind about HIV. Talk to a health care provider about PrEP.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

PrEP use is becoming more and more common in our community. Talk to a healthcare provider about PrEP.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

There are more ways than ever to protect yourself and your partners. Talk to a healthcare provider about PrEP.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Don’t let cost stop you from getting PrEP. Insurance plans and medication assistance programs can cover most of the cost.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Many men find it difficult to talk about HIV with their partners. But being open with your partner about HIV testing can help make sex safer and more fun.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Did you know that if you had an STD your body may not show symptoms? Talk to a provider about getting tested for STDs at your next appointment.

126. Is the information in this message new to you?

a. Yes

b. No

c. Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

If you think you have an STD, it’s important to see a healthcare provider. Some STDs can be cured with antibiotics. Others can be managed to reduce symptoms.

126. Is the information in this message new to you?

1 Yes

0 No

77 Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Not sure about how to have a conversation about STDs with your partner? You can start with letting them know that you care and then ask if you could talk about the last time you each were tested.

126. Is the information in this message new to you?

1 Yes

0 No

77 Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Wondering when your partner last had an STD check-up? They might be wondering the same thing about you. Talk to you partners about getting tested for STDs.

126. Is the information in this message new to you?

1 Yes

0 No

77 Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Now I am going to show you a new message. Forget the last message, and just focus on the new message.

Many men find it difficult to talk about STDs with their partners. But being open with your partner about STD testing can help make sex safer and more fun.

126. Is the information in this message new to you?

127. 1 Yes

128. 0 No

129. 77 Unsure

126. Does this information make you more or less likely to want to use PrEP in the future?

a. Definitely more likely

b. Somewhat more likely

c. Not more likely and not less likely

d. Somewhat less likely

e. Definitely less likely

126. How much do you believe the information in this message?

a. I fully believe it

b. I partly believe it

c. Unsure if I believe it

d. I partly don’t believe it

e. I fully don’t believe it

Thank you for your input on this important survey

IRB Approved at the Protocol Level

Jul 27, 2023

20225896

#37978871.1

Appendix – Prevention Message Bank

During the study period, Programmers will select key messages from the list below to add to the Quantitative and Qualitative Surveys for testing at different time points.

Prevention Message Bank

1. M3 Messages

1. Primary written messages to all MSM

1. HIV Testing

1. Not sure which HIV test is right for you? Rapid test can give you results within a minute, and there are more ways than ever to know your status. Find out what test is right for you.

2. Did you know that there are more places to get tested for HIV than ever? You can do it at a clinic or a community center. You can even do it by yourself at home, or with a friend or partner.

3. Not only can this app show you the nearest place to get an HIV test, but it can also help you choose the test that’s right for you.

4. Many men talk about HIV with their partners. Make getting tested for HIV part of your routine, and talk to your partners about getting tested.

5. You can help protect yourself and your partners from getting or passing HIV by using a condom. Find the condom choice that’s right for you!

2. STI Testing

   1. Many men find it difficult to talk about STDs with partners. But, being open with your partners about STD testing frequency and status can help make sex safer and more fun.

   2. Did you know having an STD increases your chances of getting HIV? One way to take charge of your health is to get tested.

   3. Did you know that if you have an STD your body may not show symptoms?

   4. Sexually active men who have sex with men are at increased risk for STDs. Is getting tested part of your regular routine?

   5. Got a hot date? Don’t go unprepared. Get some free condoms and lube today!

   6. There is a new treatment that can cure Hepatitis C. Take the first step and get tested.

   7. Take care of all of you! Ask to be tested for other STD’s at your next appointment.

   8. Many testing locations offer STD testing for free or use sliding fee scales to keep costs down. See where you can get tested here.

3. Condom Use

   1. Want to reduce your risk of having a condom break or slip off? Water- or silicone-based lubricants are safe to use with condoms and make sex more enjoyable.

   2. For many men, an active and healthy sex life includes consistent condom use. Latex condoms remain one of the most successful ways to prevent HIV and other STDs.

   3. Condoms significantly reduce the risk of getting HIV and other STDs when used correctly and consistently.

4. Prep Use

   1. There are more ways than ever to protect yourself and your partners. Ask a health care provider about PrEP today!

   2. Don’t let cost stop you from getting PrEP! Many insurance plans and medication assistance programs cover some or all of the cost.

   3. PrEP use is becoming more and more common in our community. Find a health care provider near you!

   4. Condoms and PrEP offer a lot of protection. Using them together increases success in preventing HIV and STD infections.

   5. Using PrEP consistently can offer you and your partners peace of mind about HIV. Ask a health care provider if it’s right for you.

5. Engagement in Healthcare

   1. Talking about sex with a health care provider may be uncomfortable, but it doesn’t have to be. Find the right provider who listens to your concerns.

   2. Staying on top of your health doesn’t have to be expensive. Many locations provide services free or on a sliding scale. Find out here how to get insurance so you can see a health care provider regularly.

   3. Whether you are living with HIV or not, it’s important to see a healthcare provider and take medications as prescribed.”

   4. Seeing a health care provider regularly is an important investment toward a healthy future. Schedule an appointment today.

   5. Some STDs are treatable with antibiotics. Others may not be curable, but their symptoms can be managed. Get the information you need from your health care provider.

   6. Invest in your health by knowing your HIV/STD status.

   7. Your healthcare provider is your ally! Ask questions, get answers, and take control of your health.

   8. Many things can get in the way of your next health care appointment. Using your calendar can help you manage your health!

   9. Scheduling your next healthcare appointment at the end of each visit can help keep you on a consistent schedule.

2. Secondary written messages to target group (9 messages each)

1. HIV- higher risk/recent sexual risk

   1. Wondering how you can prevent HIV? PrEP might be right for you! Ask a health care provider at your next appointment.

   2. You can significantly reduce the risk of getting HIV by sticking to your daily PrEP routine. Setting a reminder can help!

   3. Many insurance plans and assistance programs cover the cost of PrEP. Find out what you can do to make PrEP more affordable. [https://start.truvada.com/paying-for-truvada].

   4. Wondering when your partners last had an STD check-up? They might be wondering the same thing about you. Talk to your partners about getting tested, and get your own test every 6 months.

   5. Many men make HIV/STD testing an important part of their healthcare routine. Did you know this app can help you do the same?”

   6. Many testing locations offer STD testing for free or use sliding fee scales to keep costs down. See where you can get tested here.

   7. Have 20 minutes? Rapid HIV testing has never been easier. Test at home, with a partner, or at local clinic.

   8. Going out? Make sure you have everything you need: phone, keys, wallet, gum, condoms and lube.

   9. Haven’t been tested in the last 3 months? Find the test that fits in your schedule and get tested today.

2. HIV- lower risk/no recent sexual risk

   1. Don’t let cost stop you! You can order condoms for free here!

   2. Condoms are not one size fits all. They cone in many sizes, materials, textures and flavors. Which condom is right for you?

   3. Did you know oil-based lubricants like baby oil and Vaseline make condoms weak and increase the chance that a condom will break?

   4. If you’re unsure if you have an STD, it’s important to see a doctor. Some STDs, like syphilis, can be cured with antibiotics. Others, like herpes, can be managed to reduce the symptoms.

   5. Not sure how to have a conversation about STDs with your partner? You could start with letting them know that you care, and then say “so let’s talk about the last time we got tested”.

   6. Not sure which STD tests are right for you? Check out this guide.

   7. Not sure how to have a conversation about HIV with your partner? You could start with letting them know that you care, and then say “so let’s talk about the last time we got tested”.

   8. HIV testing for you and your partner let you know where you stand. Find the test that’s right for you here.

   9. Looking for a place to get an HIV test for yourself and your partner? Use our free test locator or order a free test here.

2. PCB/CSMT Messages

1. None User

1. You have options for prevention. Ask your doctor if PrEP is right for you.

2. Take care of your mind, body and sexual health.

3. HIV prevention = self-care

4. PrEP = peace of mind

5. Prevent HIV your way. See if PrEP is right for you.

6. Trust your provider? See what s/he says about PrEP.

7. Talk with your health care provider to find out if PrEP is right for you.

8. Taking PrEP daily can give you peace of mind. You are protecting yourself against HIV.

9. Finding the right job is tough. Getting on PrEP shouldn’t be.

10. Love without limits.

11. HIV Prevention can be as easy as one pill a day.

12. Our community remains vulnerable to HIV – but PrEP can help change that.

13. PrEP is freedom.

14. PrEP puts you in control of your health.

15. PrEP, a daily pill to prevent HIV, can help you live your best life.

16. PrEP is for anyone who is concerned about their risk of HIV.

17. One daily pill to prevent HIV so you can focus on what really matters.

18. Talk openly about PrEP with your partners. By talking about PrEP, we help to break the stigma around it.

19. HIV doesn’t have to be a barrier to loving who you love. PrEP is a daily pill to prevent HIV.

20. Communication is sexy and so is HIV prevention. It shows you care about your health and his. Talk to your partner and your provider about prevention options to prevent HIV your way.

21. What are PrEP shots? PrEP shots can help prevent HIV – just one shot every two months.

22. PrEP is a medicine to prevent HIV. With PrEP, you are in control of your sexual health.

23. You can take control of your sexual health. Find out if PrEP is right for you today.

24. Studies have shown that PrEP is highly effective at preventing HIV from sex if taken consistently.

25. PrEP is just one daily pill taken to prevent HIV so that you can keep doing what you do best: being yourself.

26. Is PrEP safe? Yes, PrEP is safe. Some people may experience mild to moderate side effects like diarrhea, nausea, headache, fatigue, or stomach pains. These effects usually go away over time. Your health care provider should check for possible interactions with other medications you are taking.

27. PrEP is a safe HIV prevention option that can bring you added peace of mind.

28. How can I pay for PrEP? Most insurance and state Medicaid programs cover PrEP. That means you can’t be charged for your PrEP medication, clinic visits, or lab tests to maintain your prescription. There are also programs that provide free PrEP.

29. What are other HIV prevention options? There are more options than ever before to stay healthy. The first step is to get tested for HIV and know your status. Use condoms and talk to a heath care provider as soon as possible about PEP (post-exposure prophylaxis) if you think you’ve been exposed to HIV.

30. PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Although there is less information about how effective PrEP pills are among people who inject drugs, we know that PrEP pills reduce the risk of getting HIV by at least 74% when taken as prescribed.

31. PrEP is covered by most insurance programs. You can also contact your local health department and HIV/AIDS service organizations for more information.

32. When taken as prescribed, PrEP is highly effective for preventing HIV. PrEP can be pills or shots. One pill daily or one shot every two months.

33. Sexual health starts with knowing your HIV, STI, and mpox prevention options.

34. If you do not have insurance, your health care provider can direct you to medication assistance programs that may help pay for PrEP.

35. There are more HIV prevention options than ever before. Find out if PrEP is right for you.

2. Current User

1. Take care of your mind, body and sexual health. Stay on PrEP for your peace of mind.

2. HIV prevention = self-care

3. PrEP = peace of mind

4. Love without limits.

5. Our community remains vulnerable to HIV – but PrEP can help change that.

6. PrEP is freedom.

7. PrEP puts you in control of your health.

8. Taking PrEP daily can give you peace of mind. You are protecting yourself against HIV.

9. Talk openly about PrEP with your partners. By talking about PrEP, we help to break the stigma around it.

10. PrEP protects you against HIV but not against other STDs. Consider using condoms as an extra layer of protection.

11. One daily pill to prevent HIV so you can focus on what really matters.

12. People who use PrEP should take it as prescribed and return to their health care provider as advised for follow-ups or prescription refills.

13. Studies have shown that PrEP is highly effective at preventing HIV from sex if taken consistently.

14. If you decide to switch from PrEP pills to shots, you’ll need to visit your health care provider regularly to receive your shot. You’ll also need to be tested for HIV prior to each PrEP shot.

15. Although there is less information about how effective PrEP pills are among people who inject drugs, we know that PrEP pills reduce the risk of getting HIV by at least 74% when taken as prescribed. Currently, PrEP shots are not recommended for people who inject drugs.”

16. PrEP is a safe HIV prevention option that can bring you added peace of mind.

3. Inconsistent User

1. Trust your provider? See what s/he says about PrEP.

2. HIV prevention can be as easy as one pill a day.

3. Love without limits.

4. PrEP is freedom.

5. PrEP, a daily pill to prevent HIV, can help you live your best life.

6. One daily pill to prevent HIV, so you can focus on what really matters.

7. Studies have shown that PrEP is highly effective at preventing HIV from sex if taken consistently.

8. Communication is sexy and so is HIV prevention. It shows you care about your health and his. Talk to your partner and your provider about prevention options to prevent HIV your way.

9. What are PrEP shots? PrEP shots can help prevent HIV – just one shot every two months.

10. HIV prevention can be as easy as one pill a day.

11. Our community remains vulnerable to HIV – but PrEP can help change that.

12. PrEP is a medicine to prevent HIV. With PrEP you are in control of your sexual health.

13. Taking PrEP daily can give you peace of mind. You are protecting yourself against HIV.

14. PrEP puts you in control of your health.

15. PrEP is for anyone who is concerned about their risk of HIV.

16. Talk openly about PrEP with your partners. By talking about PrEP, we help to break the stigma around it.

17. HIV doesn’t have to be a barrier to loving who you love. PrEP is a daily pill to prevent HIV.

18. PrEP protects you against HIV but not against other STDs. Consider using condoms as an extra layer of protection.

19. People who use PrEP should take it as prescribed and return to their health care provider as advised for follow-ups or prescription refills.

20. Follow your health care provider’s advice about how to take your pill. This will give it the best chance to prevent HIV.”

21. Tell your health care provider if you have trouble remembering to take your pill or want to stop PrEP.

22. PrEP is much less effective when it is not taken as prescribed.

23. PrEP is covered by most insurance programs. You can also contact your local health department and HIV/AIDS service organizations for more information.

24. If you decide to switch from PrEP pills to shots, you’ll need to visit your health care provider regularly to receive your shot. You’ll also need to be tested for HIV prior to each PrEP shot.

25. Tell your health care provider about any side effects that are severe or do not go away.

26. Although there is less information about how effective PrEP pills are among people who inject drugs, we know that PrEP pills reduce the risk of getting HIV by at least 74% when taken as prescribed. Currently, PrEP shots are not recommended for people who inject drugs.”

27. PrEP is a safe HIV prevention option that can bring you added peace of mind.

3. Original Messages

28. Take the stress out of sex, use PrEP and take control of your love life.

29. PrEP usage = Sexual freedom.

30. Peace of mind is having sex without fear of HIV.

31. Sexual liberation is choosing to love without fear, let PrEP give you the peace of mind you deserve.

32. The most common side effects while using oral PrEP are headache, abdominal pain, weight loss, and diarrhea. These usually resolve during the first month of use. 

33. The most common side effect while using injectable PrEP is an injection site reaction of pain, swelling, and redness that subsides within a few days. 

4. Positive Preventative Messages

34. There is no universal agreement on who is desirable or attractive. Everyone has different qualities that make their bodies beautiful and attractive.

35. There is a myth that most gay men are more attracted to younger thinner men. In reality, most people have a spectrum of ages, weights, and sizes they desire.

36. Many categorize relationships as, “Boyfriends on this side, friends on that side, potential husbands over there." In truth loving connections are vast.

37. Loneliness is a direct result of perceiving separation from others. It has little to do with physical proximity, more to do with how one judges connection.

38. Sex can be a wonderful healthy way to connect with others. But when it's used to judge one's value and self-worth it can become addictive and compulsive.

39. Having sex does not make you a good person. Sharing sexual connection can be a way to express that you are a good person. There is all the difference.

40. The abundance of choices on dating apps can lead some people to feel overwhelmed and not respond to you appropriately. Don't assume you are the "problem."

41. When someone doesn't want to have sex with you, try not to take it personally. Your true power and worth has nothing to do with validation from strangers.

42. We all receive rejection at times. Being able to receive "no" graciously shows others that you are a person worthy of talking with in the future.

43. Pain and hurt feelings are inevitable parts of connecting. But you can avoid suffering by knowing someone's rejection doesn't "mean" anything about you.

44. People sometimes use drugs and alcohol to avoid painful feelings. Instead of medicating pain, what happens if you feel them a few minutes longer?

45. "Man's rejection is God's protection." Sometimes when someone doesn't want to be with you, you are being spared from drama and chaos.

46. There is nothing about relationships that inherently buffers people from feeling alone. There is nothing about singlehood that inevitably leads to loneliness.

47. "Normal is nothing more than a cycle on a washing machine" -Whoopi Goldberg. Strive to be the healthiest and fullest version of yourself you can be.

48. When you shine you give others permission to do the same. What happens when you show up confident and grounded in your true power and beauty?

49. Loving yourself is literally an attractive quality. True self love is like a magnet that draws other people into your world and increases value of connections.

50. Using another person's attention to determine your own beauty and value can make you feel like a leaf blowing around in the middle of a hurricane.

51. Cum does not give you confidence. You can feel sexy, proud, valuable, and strong even when you are not the center of one's attention.

52. Aging is an opportunity to embrace our true power, purpose, and pleasure. There has never been a better time to get older with connection and play!

53. Your body is beautiful at all ages, races, sizes, amounts of hair. But there are many advertising dollars invested in convincing you otherwise.

54. When we put aside the "shoulds" that tell us how to think, feel, have sex, perceive out bodies, and connect with others, then true liberation begins.

55. Try being intentional before going on apps. This could mean saying to yourself, "No matter what happens I'm a good person with lots to offer" before you log on.

56. When someone is rude or cruel it means they are not in a state of happiness or joy. Healthy people do not feel compelled to attack others.

57. Be the change you want to see in the world. If you want people to be kind and respectful, act kind and respectful. This helps others learn as well.

58. Unquestioned envy will only make you miserable. If you can learn something from the person you're envious of, then you can turn it into growth.

59. Don't judge your insides by other people's outsides. Lots of people whose lives look perfect are struggling behind closed doors. Focus on being the best you.

60. The only relationship you can be certain will last in your lifetime is the one you have with yourself. Why not make that connection loving, safe, and joyful.

61. "This isn't a dress rehearsal." - Cher. It's important to pace, but not procrastinate, your dreams. Don't be afraid to ask for help or advice from others.

62. There is nothing wrong with making mistakes. They can become problematic if you don't learn from them, or change from them. Saying "I'm sorry" can help.

63. The ability to laugh at ourselves leads to greater joy and self-acceptance. There can be relief and beauty in seeing the ridiculous in ourselves and others.

64. Relationships serve to enhance and increase the abundance of beauty, power, and magnificence that you already possess. They do not "give" them to you.

65. Forgiveness does not mean what happened to you was okay. It does restore you as the author of your emotional experience, and the ability to move forward.

66. Forgiving others is a decision rather than an action. It is a confirmation that all humans, including you, can harm others when they react to fear.

67. Sexual pleasure is enhanced when partners connect from a place of curiosity and discovery - versus routine and regimen. Most long-term couples forget this.

68. Most people get sexually aroused by one or more of the five senses: Taste, touch, smell, sight, sound. Learn which one(s) you enjoy, ask for what you want.

69. There is no need for anal sex to hurt. It is important to understand your own body's pleasure in order to communicate to partners how you like to be fucked.

70. Porn is great for entertainment, not for education. Good sex in real life involves communication, negotiation, consent, and sometimes very awkward moments!

71. There is no single rule for how to prepare for anal sex. Some douche, others don't. Most people learn about their bodies through trial and error.

72. There is no single rule for grooming. Some men love more body hair, some men prefer less. Ultimately do what makes you feel empowered and sexy.

73. Feel no shame in your desires or sexual preferences. These are the joys that make life more fun and meaningful. No one has the right to yuck your yums.

5. CDC/PCB/CSMT Messages for MIC-DROP

Motivating Statements and Calls to Action - Who Can Take PrEP 

All HIV-Negative Participants: 

74. Everyone can benefit from safe sex practices. See how PrEP, an affordable daily pill, can keep you and your partner protected against HIV. 

75. PrEP is for EVERYONE regardless of gender identity or sexual preference. 

76. PrEP can be used by folks of all gender and sexual identities. The only prerequisite for taking PrEP is testing negative for HIV. 

77. Even if you’re not sure about your chances of getting HIV, PrEP can still help you lead a healthier sex life. 

78. If you are sexually active, make sure you’re PrEPed and ready.

Motivating Statements and Calls to Action - PrEP as an empowering tool 

All HIV-Negative Participants: 

79. PrEP is an empowering sexual health tool, and it has the potential to change the course of HIV infection. Learn more about PrEP today. 

80. There’s no shame in self-care. Be proud of yourself for being proactive in taking care of your sexual health by asking your health care provider if PrEP is right for you. 

81. Take your sexual health into your own hands by carrying condoms and taking PrEP.  

82. PrEP is a way to help prevent HIV that you can control without other people knowing that you are using it. You can be on PrEP for as long or as short a time as you want. 

 

MSM: 

83. Adding PrEP to your sexual health toolbox can give you the power to live your best life 

  

Young Adults: 

84. Adding PrEP to your sexual health toolbox, can give you the power to live your best life⁠. 

85. You're never too young to take care of your sexual health. Take charge of your sexual health by asking your healthcare provider about PrEP 

All HIV-Negative Participants: 

86. If you don’t have a regular healthcare provider, or if your provider is reluctant to prescribe PrEP, there are organizations that can help you get on PrEP. 

87. Some people are concerned about how to pay for PrEP. There are organizations that can help you afford PrEP and take charge of your sexual health. 

88. Taking medicine can be difficult. But remind yourself that you are taking the medicine to protect your health! You have done other tough things in your life, and you can do this too. 

Motivating Statements and Calls to Action - Barriers to Using PrEP 

All HIV-Negative Participants: 

89. If you don’t have a regular healthcare provider, or if your provider is reluctant to prescribe PrEP, there are organizations that can help you get on PrEP. 

90. Some people are concerned about how to pay for PrEP. There are organizations that can help you afford PrEP and take charge of your sexual health. 

91. Taking medicine can be difficult. But remind yourself that you are taking the medicine to protect your health! You have done other tough things in your life, and you can do this too.