Novel mHealth Technologies to Enhance PrEP Adherence Among Thai MSM: Collaborative Adaptation and Evaluation
Phase: NA
Conditions: Adherence, Patient, Pre-Exposure Prophylaxis, HIV/AIDS
Sponsor: Duke University

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Official Title: P3-T: Novel mHealth Technologies to Enhance PrEP Adherence among Thai YMSM, 
Collaborative Adaptation and Evaluation 
 
NCT Number: NCT04413708 
 
Document Date: March 16, 2021 
 
 
 
 

2 
 
 
 
This form effective August 28, 2017 
Part A. Study Information 
 
1.1 Project Title  
If the research is federally funded, the project title should match the grant title.  
 
Novel mHealth Technologies to Enhance PrEP Adherence among Thai MSM: Collaborative 
Adaptation and Evaluation 
 
1.2 Project Information: 
 
1. Source of Funding: 
 
Association 
Foundation 
Duke University 
     (Department, School, Institute, Program) 
None 
Other:       
NIH  
NSF  
DOD  
USDA  
Other Federal:       
Enter grant number: 1 R21 
TW010965-01 
 
 
2. Is this research part of a Bass Connections project?  
Yes 
 No 
If yes, include all the students in Part B: Researcher Information and Assurances. 
 
3. Research Site, if research is taking place abroad: Bangkok, Thailand 
 
4. Will the research take place in public elementary or secondary schools?  
Yes 
 No 
 
If yes, identify the school district(s):       
 
5. Potentially Vulnerable Subject Populations: Please check all that apply. 
 
 Children, as defined at research site (under 18 years old in NC) 
 Cognitively impaired persons, for example, people with dementia 
 Prisoners 
 Refugees 
 Stigmatized populations  
 Undocumented immigrants 
 Victims of abuse 
 Other:        
 
 

3 
 
Part B: Researcher Information and Assurances  
 
Researchers: (Faculty, Undergraduate or Graduate Student, Research Associate, Postdoctoral 
Fellow) 
All signatories certify to the following: 
 
1. I will not begin the research until written approval is secured from the IRB.  Note: Approval 
will not be provided unless certification to conduct research with human subjects is current. 
 
2. I will conduct this study as described in the approved protocol.  
 
3. If any changes are anticipated, I will submit a Request to Amend an Approved Protocol, and I 
will not implement the changes until I receive approval from the IRB.  
 
4. I will contact the IRB staff promptly if any of the following events occur: unanticipated risks of 
harm to participants, protocol deviations, and findings during the study that would affect the risks 
of participation. 
 
Name: Sara LeGrand 
Department or School: DGHI 
E-mail Address: sara.legrand@duke.edu 
Phone Number: 919-438-0448 
 Faculty 
 Undergraduate 
 Graduate student 
 Postdoc 
 Research associate 
 Other:       
 
Signature: 
 
 
 
Date: 9/16/19 
 
Name: Shashika Bandara 
Department or School: DGHI 
E-mail Address: shashika.bandara@duke.edu  
Phone Number: 919-613-5449 
 Faculty 
 Undergraduate 
 Graduate student 
 Postdoc 
 Research associate 
 Other:       
 
Signature:
 
 
Date: 9/16/19 
 
Name: Caitlin Piccone 
Department or School: Duke Global 
Health Institute 
E-mail Address & NetID: 
caitlin.piccone@gmail.com ; CMM158 
Phone Number: 941-301-9494 
 Faculty 
 Undergraduate 
 Graduate student 
 Postdoc 
 Research associate 
 Other: Volunteer 
Research Associate 
 
Signature: 
 
Date: 11/26/2019 
 
 
 
IRB USE ONLY 
This section is to be completed by IRB staff or IRB members only. 
   
 
APPROVED as 
 Exempt 
  Expedited or 
  Full 
 
 
 IRB Designee or 
 IRB Member 
Date 

4 
 
Part C: Research Protocol 
 
2. Research Question 
 
2.1 What is the research question?  
 
Can an existing pre-exposure prophylaxis (PrEP) adherence app developed for young men who 
have sex with men (YMSM) in the US be successfully adapted, implemented and show trends 
toward efficacy (i.e., improved adherence) for YMSM in Bangkok, Thailand? 
 
2.2 Provide background information about the research that will help the reviewer understand the research. Avoid 
discipline-specific jargon.  
 
In Thailand, gay, bisexual, and other men who have sex with men (MSM) account for 41% of 
new HIV infections with an increasing trend in infections over time.1,2 Young MSM (YMSM) are 
at a significantly greater risk of HIV infection than older MSM with YMSM, ages 15-21, 
experiencing a 12.1% rate of new HIV infections.1,2 There is an urgent need to implement novel 
behavioral and biomedical interventions for YMSM in Thailand that are culturally and 
developmentally appropriate, engaging for youth, and scalable.   
 
Pre-exposure prophylaxis (PrEP), a combination of tenofovir and emtricitabine, taken once daily 
is a safe, effective method of preventing HIV among YMSM.3-5 However, efficacy is highly 
correlated with adherence and evidence suggests poorer adherence among younger 
populations.3,5,6 It is imperative that we develop adherence interventions for YMSM initiating 
PrEP that take advantage of technologies that are already embedded in their lives. The 
accessibility, affordability, anonymity and acceptability of smartphones in Thailand make them 
the intervention medium of choice for engaging youth and a logical platform to deliver an 
adherence intervention targeting PrEP.7 Further, smartphone interventions address and 
overcome issues that impede engagement with in-person interventions such as inconvenience, 
transportation, and stigma.8  
 
This R21 study, titled “Novel mHealth Technologies to Enhance PrEP Adherence among Thai 
MSM: Collaborative Adaptation and Evaluation”, adapts our theory-based smartphone app 
platform, CHARGE (Comprehensive health adherence using gaming and social engagement), 
to improve PrEP adherence among YMSM in Thailand and conducting a pilot study to assess 
study feasibility, acceptability, and potential impact. We propose a partnership between Duke 
University, Chulalongkorn University, Thai Red Cross AIDS Research Centre, and the 
University of North Carolina- Chapel Hill (UNC), and a robust plan to increase mHealth capacity 
at Thai Red Cross AIDS Research Centre (TRC-ARC). 
 
CHARGE is a theory-based, comprehensive smartphone app platform for YMSM that utilizes 
social networking and game-based mechanics as well as evidenced-based features to improve 
medication adherence. CHARGE is a product born from the collaborative effort of researchers 
and health game developers working closely with members of the target population in the 
United States (US). Built on a successful, evidence-based platform designed by our 
collaborating technology partner, Ayogo, and tested by our study team, CHARGE is flexible, 
allowing for customization and adaptations for different cultural and linguistic contexts, and 
responsive to changes in technology.  
 
The social networking features of CHARGE are designed to capitalize on social involvement as 
a means through which YMSM can receive information and social support, experience social 
norms and reflective appraisals, and feel a sense of connectedness to peers.9,10 Peers have 
been recognized as a highly important source of sexual health and HIV prevention information 
and support among Thai YMSM.2 The gaming features of CHARGE are goal-oriented and 
immersive and provide a challenging and motivating environment for behavior change.11-14 As a 
result, CHARGE is ideal for engaging YMSM in behavior change, by maintaining attention, 
avoiding boredom and attrition.15  
The specific aims of this grant are to: 
 

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1. Conduct formative research to inform adaptions of the CHARGE platform for 
YMSM in Thailand. Using an iterative research design, we will work with 
members of the target population through focus groups, key informant 
interviews, a youth advisory board (YAB), and usability testing to tailor the 
platform for maximal relevance and usability for HIV-negative Thai YMSM (aged 
16-24).  
 
2. Conduct a pilot randomized control trial (RCT) study of the app built using the 
CHARGE platform with 60 YMSM newly starting PrEP in Thailand to a) assess 
study feasibility and acceptability, and b) explore the potential impact on PrEP 
adherence.  
 
We are submitting this protocol for IRB approval of Aim 2 of the study. We have 
chosen not to amend the Aim 1 protocol to be consistent with the procedures 
followed by our collaborating university in Thailand.  
 
UNC will rely on the Duke Campus IRB for their role in this study. Co-investigators from UNC 
include Drs. Lisa Hightow-Weidman and Kathryn Muessig. They will assist the mPIs (Drs. 
LeGrand and Songtaweesin) with data interpretation, manuscript preparation and dissemination 
of study findings. 
 
Please note that the app built on the CHARGE platform is called P3-T based on findings from 
Aim 1. It will henceforth be referred to as P3-T. 
 
 
 
3. Participant Population 
 
3.1 List and describe the proposed participant population(s).  Include the expected number of participants in each 
population.   
 
Aim 2, Pilot RCT: ~60 YMSM. Inclusion criteria: male sex at birth, self-identify as MSM, ages 
16-24, plan to start PrEP in next 14 days, able to speak and read Thai, and own an Android or 
iOS smartphone. Exclusion criteria: Currently participating in another experimental PrEP 
adherence intervention, plan to move out of Bangkok in the next 6 months, unable to be 
consented due to an active substance use or psychological condition.  
 
 

6 
 
4. Description of Activities 
 
4.1 Describe the study activities and how long each activity will take. If the study involves observation, describe 
the setting and events to observe.   
 
Aim 2: Conduct a pilot study of P3-T with 60 YMSM newly starting PrEP in Bangkok, 
Thailand to a) assess study feasibility and acceptability, and b) explore the potential 
impact on PrEP adherence.  
 
Study Activities:  
 
All study activities will be conducted at TRC-ARC in Bangkok, Thailand. 
Baseline Study Visit: After participants are consented, they will complete a baseline web-
based computer-assisted self-interviewing (CASI) survey that includes questions about 
sociodemographic characteristics, factors related to PrEP adherence, sexual risk, STIs 
and potential outcome mediators and moderators. Next, participants will be randomized in 
a 1:1 ratio into the P3-T arm or standard of care (SOC) study arm. P3-T arm: Study staff 
will help the participant download and install the P3-T app on the participant’s phone and 
provide a guided tour of the app. Participants will be encouraged to explore all 
components of the app and use it routinely. Study staff will also inform P3-T arm 
participants about SOC services available to them at the clinic. SOC arm: Study staff will 
inform participants of SOC services available to them at the clinic. Services include 
individualized, youth-focused PrEP adherence and sexual risk behavior counseling at the 
1-month post-prescription visit and at visits every 3 months after that. Study staff will also 
provide participants with written or online materials/resources that provide information 
about taking PrEP. The baseline study visit is expected to take approximately 2½ to 3 
hours.   
 
Follow-up Study Visits (3 and 6 months): All study participants will complete follow-up 
CASI surveys at 3 and 6 months. Individuals in the P3-T arm will answer additional survey 
questions about app usability and satisfaction at the 3-month follow-up. CASI data at all 
time points will be linked for each individual based on study ID number (SID).  All 
participants will have their blood drawn via venipuncture at 3 and 6 months for collection of 
dried blood spots (DBS). All laboratory staff are certified to collect blood via venipuncture and 
will follow all guidelines outlined in the “WHO guidelines on drawing blood: Best practices in 
phlebotomy” to minimize risks associated with venipuncture blood draws. Participants will 
have 2mL of blood drawn from their arm or the top of their hand at each follow-up visit. 
The total amount of blood drawn during the 6-month study will not exceed 4ml. The 
amount of blood being drawn at each follow-up visit along with the cumulative amount of blood 
drawn throughout the study are considered to involve no more than minimal risk to participants. 
The DBS collection protocol is detailed under Attachment A. Follow-up study visits are 
expected to take approximately 2½ hours.  
At the 3-month visit we will conduct in-depth interviews with 10 P3-T arm participants. We will 
purposefully sample 5 moderate/high app users (defined as usage of app at least 4x/week over 
the course of the trial) and 5 low/no app users (defined as usage of app <4x/week over the 
course of the trial). Interviews will be conducted by Thai study staff. We expect that the 3-
month study visit will be 30-45 minutes longer for participants selected for in-depth interviews. 
 
 
 
4.2 List here all surveys, questionnaires, structured and unstructured interview questions, focus group guides, and 
any other instruments. Provide a description of the type and range of questions for unstructured interviews. 
Compile these documents as Attachment A.  
 
• 
CASI survey: Baseline visit 

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The baseline survey will include questions about sociodemographic characteristics, 
PrEP adherence factors, sexual risk, STIs and potential outcome mediators and 
moderators.  
 
• 
CASI survey: Follow-up visits (3 and 6 months) 
Follow-up surveys will include questions about sociodemographic characteristics, PrEP 
adherence factors, sexual risk, STIs and potential outcome mediators and moderators. 
Individuals in the P3-T arm will answer additional survey questions about app usability 
and satisfaction at the 3-month follow-up. 
 
• 
In-depth interviews: 3-month follow-up visit 
in-depth interviews will be conducted with 10 P3-T arm participants. We will purposefully 
sample 5 moderate/high app users (defined as usage of app at least 4x/week over the 
course of the trial) and 5 low/no app users (defined as usage of app <4x/week over the 
course of the trial or those participants who were initially high users but usage was not 
sustained over the full 3 months). The interview will ask participants about their experience 
and impressions of the app, how they used it, and how it may have impacted their 
behaviors during the 3-month intervention period. CASI survey data collected at baseline, 3 
and 6 months will be linked with interview data for these participants.   
 
 
5. Recruitment 
 
Resource: Guide on Recruitment. 
 
5.1 Describe the procedures for recruiting potential participants.  
  
Study staff at TRC-ARC will discuss the study with YMSM who are initiating PrEP at 
their sites. Counselors will approach potential study participants to assess their interest 
in joining the study. Those interested in participating will be screened for eligibility. We 
will also use social media advertising to recruit participants.  
       
5.2 Check all the recruitment methods that apply and provide text and or scripts for each method.  
 
  Introductory letter or e-mail messages 
  Flyers/posters 
  Newspaper ads 
  Text for social networking sites or other on-line recruitment 
  Script(s) for personal contact 
  Other. Please describe:      
 
All scripts and text will be translated into Thai and back-translated into English by the Thai study 
team.   
 
 
 
 
 

8 
 
Script for personal contact 
 
 
Hello, 
My name is __________. Thank you for your interest in the P3-T research study we are conducting at 
TRC-ARC.  
 
P3-T is an app for young men who have sex with men (YMSM) who are starting PrEP for HIV prevention. 
The app helps YMSM create tailored strategies for taking your meds daily and tracks how often you take 
them, provides information about PrEP and sexual health, and you can anonymously connect with other 
YMSM on PrEP. 
 
The P3-T research study is looking for YMSM to help test it!  The purpose is to see if using an app helps 
people take their PrEP more regularly. Participation in the P3-T study is six months long and involves 3 
study visits: an enrollment visit and follow up visits at 3 and 6 months. Participants complete a survey at 
every study visit and give a blood sample at the 3- and 6-month visits. The study will also involve daily use 
of the intervention materials (about 5-10 minutes) for the first three months of the study period.  Since this 
is a randomized study, some people will get the app and some will not.  
 
All participants will earn $XX for each study visit they complete. Those who get the app may earn 
additional money. They can earn up to $XX based on their app use. And some app users will be selected 
to complete an exit interview at the 3-month visit and can earn an addition $XX for participating. Are you 
interested in participating in the P3-T study?  
 
If no, not interested in participating: 
Thank you for your time. One last thing - if you know of other YMSM who might be interested in this 
research study, please tell them to contact us. Thank you! 
 
If yes, interested in participating: 
Great! In order to find out if you are eligible, you will need to take a brief study eligibility screener. After you 
take the screener, I will let you know if you are eligible for the study and schedule you for your enrollment 
visit. Would you like me to screen you for study eligibility now?   
 
If yes, interested in screening now: 
Okay, let’s begin. [Script for consent to be screened will be read (see RCT Eligibility Screening 
Form)]. If individual consents to be screened, the screener will be administered. If they do not 
consent, they will be thanked for their time. If screened and ineligible, they will be told that they do 
not meet the study eligibility criteria and will be thanked for their time.  
 
If eligible, study staff will explain the study procedures in detail. If they are still interested in 
participating, they will be scheduled for their enrollment/baseline visit. They will also be asked to tell 
other YMSM who might be interested in this research study to contact us. 
 
If no, not interested in screening now: 
Okay, can we schedule a more convenient time for you to complete the brief screener either in 
person or over the phone? [A time to complete screener will be scheduled]. 
 
 
 
 

9 
 
Social media advertisement text 
• 
Ready to start PrEP? Think you will need support for taking your pills? We are looking for young gay 
and bi men for a study that is testing an app to support PrEP adherence. Contact us at xxxx for more 
information! 
• 
Ready to start PrEP? Worried you will forget to take your pill every day? We’ve got an app that may 
help. Take part in the P3-T Research Study and help us test the app! Contact us at xxxx for more 
information! 
• 
We’re looking for young gay and bi men between 16-24 years of age for a study that is testing a PrEP 
adherence app. Contact us at xxxx for more information! Contact us at xxxx for more information! 
• 
We are looking for young HIV negative men who have sex with men (MSM) for a study that is testing 
an app to support PrEP adherence. Contact us at xxxx for more information! 
• 
We’re looking for young people to help us test out a new PrEP adherence app. You may be eligible if 
you are between the ages of 16-24 and a gay or bisexual man. Contact us at xxxx for more information! 
 
 
 
5.3 Describe the process for screening participants prior to enrollment in the study. Include screening instruments in 
Attachment A. Explain what will happen to any information collected during screening for participants who are 
not chosen to join the study and for those who are chosen. 
 
Aim 2: Individuals will be screened for eligibility in-person. An online RCT Eligibility 
Screening Form has been developed using Qualtrics software. For individuals interested in 
the study, the RCT Eligibility Screening Form can be administered by study staff or 
completed by the individual. The RCT Eligibility Screening Form will include questions that 
determine if an individual meets the RCT inclusion criteria. Individuals assessed as ineligible 
for the study will have the reason(s) for ineligibility recorded in an online Screening Log 
developed using Qualtrics. (Note to IRB: We do not provide this info to prevent them from 
knowing the criteria, thus potentially rescreening as eligible.) Individuals who are eligible but 
decline to participate will be asked if they are willing to provide their reason for declining 
participation; responses will be logged in the Screening Log. For individuals who are ineligible 
or decline to participate in the study, no personally identifying information will be recorded in the 
Screening Log. (Note to IRB: We will retain these data –without identifiers– so that we can 
create our CONSORT diagram for publication.) For those eligible and interested in participating 
in the study, we will collect the individual’s name and contact information including phone 
number(s), email address(es), and social media contacts on the individual’s Screening Form. 
These data will not be linked to other study data. When study accrual ends, study staff will 
obliterate the name and contact information for all individuals who were eligible and interested 
in study participation, but did not consent to participate in the study.  
 
 
 
6. Risks of Harm 
 
Risks of Harm, Part 1: The Research Topic 
 
6.1 If the research questions might upset or distress participants, please discuss. 
 
It is possible that the study may precipitate emotional discomfort and/or an emotional 
response when participants answer questions about potentially sensitive topics such as 
sexual identity, sexual behavior, PrEP use and medication adherence. Further, participants 
may feel embarrassed about discussing sensitive issues. 
 
6.2 Describe strategies to mitigate the risks. 
All participants will be told during the informed consent process that their participation is 
voluntary and that they can choose to stop participating at any time without any penalty or 
loss of any benefit to which they might otherwise be entitled and that discontinuation of study 
participation is in no way related to being able to receive care or services at the study sites. 
 

10 
 
To minimize harm, participants are not required to answer any questions or provide any 
information that they do not wish to provide. They are also not required to use any 
features of the app that they do not wish to use (P3-T arm). 
 
Based on our experiences using similar data collection methods with YMSM, the likelihood 
and seriousness of the risk of emotional discomfort and/or an emotional response is minimal 
and we will strive to create a safe and comfortable environment for all study participants. 
 
To also minimize the risk of participants feeling uncomfortable about answering personal 
survey questions, we will use Computer-Assisted Self Interviewing (CASI) methods for all 
study surveys. Using CASI, participants read survey questions on a laptop, tablet or mobile 
phone and use a mouse click/keyboard/touchscreen to input the answers themselves. Study 
staff will be available to assist participants with questions or technical difficulties with the 
CASI. Participants will also be able to refuse to answer any question that makes them 
uncomfortable. 
 
While participants will be informed that they may refuse to answer any questions at any time, 
responses or reactions to certain questions may indicate distress on the part of the 
participants. If at any time during the study, a participant divulges to study staff that he is at 
risk for harm, including but not limited to being abused or experiencing violence, if harm is 
suspected or likely, or if the participant states he is suicidal/homicidal, measures will be taken 
to ensure his safety locally. Reporting will be made as appropriate to the situation and the 
legal statutes, and referrals will be provided for appropriate support, counseling, or treatment 
resources. 
 
Risks of Harm, Part 2:  Physical Harm or Discomfort 
 
6.3 If there are any risks of physical harm or discomfort, please describe. 
 
The risks of drawing blood via venipuncture include discomfort at the site of puncture, a small 
risk of bruising and fainting, and a rare risk of infection. 
 
6.4 What are the steps to mitigate the potential risks? 
 
All laboratory staff are certified to collect blood via venipuncture and will follow all guidelines 
outlined in the “WHO guidelines on drawing blood: Best practices in phlebotomy” to minimize 
risks associated with venipuncture blood draws. Participants will have 2mL of blood drawn 
from their arm or the top of their hand at each follow-up visit. The total amount of blood 
drawn during the 6-month study will not exceed 4ml. The amount of blood being drawn at 
each follow-up visit along with the cumulative amount of blood drawn throughout the study are 
considered to involve no more than minimal risk to participants. 
 
6.5 Are there people who should be excluded from the study because of the potential risks? 
 
No 
 
Risks of Harm Part 3: Risks Associated with Information that Identifies Participants 
 
This part addresses the collection of direct identifiers such as names and email addresses, and the collection of 
other information that could be used to deduce the names of research participants.  
 
Images of participants’ face are considered direct identifiers; currently audio-recordings are not. 
 
There are four sections to this part: Recruitment, Data Collection and Storage, Data Protection Plan, and 
Reporting. 
 
1. Recruitment 
 

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6.6 If individually identifiable information is needed to contact and recruit participants, for example, email 
addresses, describe the identifiers, and explain how the information will be collected and what will happen to the 
identifiers after the recruitment process is complete. 
 
We anticipate that most recruitment will occur in-person. Study staff will discuss the study with 
individuals who show up in person for services at the study sites and express interest in the 
study or may meet study eligibility criteria. Recruitment may also occur over the phone. 
Individuals who see a social media ad or hear about the study another way may call study staff; 
study staff will discuss the study with these individuals. Therefore, no identifiable information 
will be needed to contact and recruit participants.  
 
 
2. Data Collection and Storage 
 
6.7 Do you plan to collect individually identifiable information (direct or indirect) that will be associated with 
participants’ responses?  Note: If you create a key linking direct identifiers with unique identification numbers, the 
data are considered identifiable. 
 
 No 
 Yes 
 
If yes, describe the direct identifiers you will associate with participants’ responses. If relevant, describe data you 
will collect that could be used by someone with knowledge about the study population to deduce someone’s 
identity.  Explain why it is necessary to collect identifiers. 
 
All study data will be stored on a centrally provisioned Duke Box folder with the name: 
\PROJECT_CHPIR_THAI-R21. 
Aim 2: Direct identifiers will include full names (RCT Eligibility Screening Form for those eligible 
& Informed Consent for study participation); email address(es), phone number(s), and social 
media contacts (RCT Eligibility Screening Form for those eligible). Contact information for those 
eligible will be collected through the RCT Eligibility Screening Form created in Qualtrics. These 
direct identifiers are needed to ensure the study team’s ability to contact eligible individuals 
about the enrollment visit or follow-up study visits. Full names are needed as part of informed 
consent for study participation and will be collected on paper forms. Individuals enrolled in the 
study will be assigned a study ID number (SID). A linking file will be created that includes SIDs 
and full participant names. The RCT Eligibility Screening Form files will be downloaded from 
Qualtrics and stored in a secure Duke Box folder separate from the secure Duke Box folder that 
contains the linking file. Informed Consent forms for study participation will be scanned to a 
password-protected and encrypted computer and subsequently transferred to a secure Duke 
Box folder separate from the secure Duke Box folder that contains the linking file. Consent 
forms will be destroyed after a scanned copy has been uploaded to Duke Box. Access to the 
RCT Eligibility Screening Form and Informed Consent files will be limited to study staff who 
need contact participants about enrollment or study visits and/or to verify completion of 
Informed Consent. Access to the linking file will be limited to the mPIs and study Project 
Coordinators. Only SIDs will be used to identify study participant data (e.g. survey data, lab 
results indicating intracellular levels of tenofovir-diphosphate (TFV-DP) and emtricitabine 
triphosphate (FTC-TP), in-depth interview transcripts, etc.) 
 
6.8 Would the inadvertent disclosure of identifiable data place participants at risk of harm?  
 
 No 
 Yes 
 
If no, skip Section 3. Data Protection Plan, and go to Section 4. Reporting. 
 
If yes, describe the specific harms that could occur if individually identifiable data were disclosed in the box 
below. Also, complete Section 3. Data Protection Plan.  
 

12 
 
The identification of participants’ sexual behaviors or sexual minority status could have 
negative social and economic consequences.   
 
 
3. Data Protection Plan 
 
If your participants could be harmed by an inadvertent release of identifiable data, the data are classified as sensitive. 
 
Responses to the questions in this section will assist IRB reviewers, and are needed by the Duke University 
Information Security Technology Office (ITSO) to assess your data protection plan. ITSO will review the data 
protection plan to ensure appropriate measures are in place to protect data. The IRB will send the entire protocol to 
ITSO. 
 
Please review the Developing Data Protection Plans for a list of best practices and ITSO recommendations.  
 
6.9 Who is your departmental or unit IT contact? 
 
Patrick Daniels 
 
6.10 Who is responsible for data security, including upgrades? 
 
Patrick Daniels 
 
6.11 Where will you store data? If data will not be stored on an ITSO-approved storage medium, where will they be 
stored? 
 
Qualtrics (BAA), secure Duke Box folders, locked storage cabinet/locked office at study sites 
(paper copies of Informed Consent Forms only before they are scanned, uploaded to Duke Box, 
and destroyed).  
 
6.12 How will transfers of data from the data collection site to the data storage medium described above be 
handled? 
 
Informed Consent Forms for study participation: 
The Thai study team will scan paper consent forms to a password-protected & encrypted computer and transfer 
the scans to the appropriate secure Duke Box folder. Once successfully transferred to Duke Box, the scanned 
files will be deleted from the computer and paper consent forms will be destroyed. 
 
RCT eligibility screening and surveys (baseline, 3 months, 6 months): 
These will be administered using Qualtrics. The Duke study team will download these documents from Qualtrics 
on a password-protected and encrypted computer and transfer the files to their appropriate secure Duke Box 
folder. Once successfully transferred to Duke Box, the files will be deleted from the computer. 
 
Lab results: 
Results from the analysis of DBS from the Program for HIV Prevention and Treatment (PHPT) Research Unit at 
Chiang Mai University will be sent via email in a password protected document. The results will only be identified 
by SID as the samples sent the lab will only be identified by SID. One received, the Thai mPI will download the 
document on a password-protected and encrypted computer and transfer the files to their appropriate secure 
Duke Box folder. The blood samples used to create DBS will be stored at Chulalongkorn University lab and 
destroyed 3 years after study completion. DBS stored at PHPT will be destroyed 3 years after study completion. 
 
Note to IRB: Regarding HIV status- participants are tested for HIV prior to collection of blood for drug levels. The 
test performed as part of our study does not test for HIV. However, if we learn that anyone tests positive for HIV 
while participating in the study, they will be immediately offered care/treatment by TRC-ARC and will be 
discontinued from our study. 
 
Linking File:  

13 
 
The linking file will be housed in a secure Duke Box folder separate from all study data. The Thai mPI or study 
coordinator will be responsible for updating the linking file when a new participant enrolls in the study (i.e., full 
name of participant assigned to SID). The updated version of the linking file will be saved in the secure Duke Box 
folder.  
 
6.13 Do you plan to create a key linking unique identifiers participants’ responses? If yes, describe the key, where it 
will be stored, how it will be protected, and who will have access to it (list by name).  
 
The linking file will contain SIDs and full participant names. The file will be stored in a secure 
Duke Box folder separate from all study data. Access will be limited to mPIs (Sara LeGrand, 
Wipaporn Songtaweesin) and study project coordinators (Duke- Shashika Bandara, TRC-ARC- 
Nuttawut Teachatanawat). 
 
6.14 Who will have access to the identifiable data? (List by name.) 
 
Access will be limited to mPIs (Sara LeGrand, Wipaporn Songtaweesin) and study project 
coordinators (Duke- Shashika Bandara, TRC-ARC- Nuttawut Teachatanawat). 
 
6.15 How will access to the identifiable data be controlled? 
 
Only the identified individuals will have access to the secure Duke Box folder.  
 
6.16 Where will data be analyzed? Who will perform the analysis? 
 
The data will be analyzed at Duke and TRC-ARC on a password protected & encrypted 
computer. All analysis files will be saved on a secure folder in Duke Box. Analyses will be 
conducted by the Duke mPI (LeGrand), project coordinator (Bandara), statistician (TBD), and 
Thai mPI (Songtaweesin).  
 
6.17 If the data need to be de-identified, what are the plans for de-identifying data? Describe when in the process 
the data will be de-identified and identify who will do the de-identification. In some cases, a third-party broker may 
be required to de-identify the data. 
 
N/A 
 
6.18 Will you apply for a Certificate of Confidentiality to protect the data from subpoena, if for example, you have 
identifiable data about illegal drug use or unlawful behavior?  
 
Already issued by NIH 
 
6.19 Is a non-Duke entity giving you Protected Health Information? If yes, please provide the data disclosure 
agreement as an attachment to this form. 
 
 No 
 Yes 
  
6.20 If you have entered into a data use agreement that specifies a data destruction date, what is the data destruction 
date? 
 
N/A 
 
 
4. Reporting 
 
6.21 Will you use participants’ names in your research reports? 
 
 Yes 

14 
 
 No 
 
 
6.22 If no, based on your research topic, setting, and reported characteristics of your participants, could their 
identities be readily deduced?  
 
 Yes 
 No 
 
7. Benefits 
  
7.1 Describe any anticipated direct benefits of the research for individual participants. If the research provides no 
direct benefits to participants, state “None.”  
 
Individual participants may benefit through increased PrEP adherence and reduced 
risk for HIV acquisition. 
 
 
8. Compensation 
 
Guide: The Guide to Compensating Research Participants provides more information on different methods of 
compensation, including drawings and lotteries, and compensation restrictions. 
 
8.1 Will participants receive gifts, payments, or tokens of appreciation?   
 
 No 
 Yes 
 
 
If yes, please describe: 
 
All participants will earn $20 for each study visit they complete (baseline, 3 months, 6 
months).  
P3-T arm participants can earn up to $15 based on their app use. This is a component of 
the behavioral economics feature of the app. Each user’s “bank account” is seeded with 
$1.50 and they can earn an additional $13.50 for daily app use (total=$15). Users are 
awarded $0.15 for engaging with the app each day, but lose $0.05 for each day they do not 
engage with the app. Accounts balances will never go below $0. However, if they reach $0 
and begin using the app again, their balance can increase above $0 (increase $0.15 per 
each day of use, but can still lose $0.05 for each day of non-use.  
P3-T arm participants selected for an in-depth interview at the 3-month visit will earn $20 for 
participating. 
 
8.2 If participants will receive payment, under what conditions will they receive partial or no payment?  
 
They will not receive a payment for any study visits missed or if they are not invited or otherwise 
do not complete an in-depth interview. App use payments will only be made at a follow-up study 
visit, so if they do not attend one, they will not receive their app use payment.  
 
 
9. Photographs, Videos, and Audio-recordings 
 
9.1 If participants will be photographed or video-recorded, explain why the images (photos or videos) are necessary 
to answer the research question. The IRB will consider approving the collection of photographs or videos only 
if they are necessary to answering the research question. 
 
N/A 
 

15 
 
9.2 Will participants be audio-recorded either individually or in groups? Audio-recordings of groups is allowed 
only if all participants in the group have given their explicit permission to be recorded. 
 
  No 
  Yes 
 
If yes, what happen to the recordings? 
• Clarify whether they will be destroyed after they have been transcribed. 
• If they will be saved for further research and education, explain where the recordings will be stored 
and how they might be used. 
 
Audio recordings of in-depth interviews will be permanently destroyed within 6 months of study completion. 
Until then, they will be stored in a secure folder in Duke Box. They will be kept in case there is a need to 
verify transcriptions or fill in missing data from transcriptions (e.g., transcriptionist could not understand 
participant).  
 
 
Guide: For guidance about when photographic releases are needed and to see sample release language, go to 
the Guide for Releases for Images and Recordings. 
 
 
 
 

16 
 
10. Informed Consent Process 
  
The informed consent process involves two parts: 
 
1) The process of sharing information about the research study and 
2) The documentation (a signed consent form or an audio- or video-recorded statement by the research 
participant) that the process took place 
 
• 
Please see information below about request for waiver of written consent to screen participants for 
study activities and waiver of parental permission/consent for minors.  
 
There will always need to be a process for sharing information about the research study with prospective 
participants. In some circumstances it may be appropriate to request that the IRB waive the requirement to 
document consent.  
 
If one or more of the following is true, the IRB may be able to waive the requirement to document consent. 
Please check any that apply to the study. 
 
 Participants do not read and write. (If there is a risk of harm, a third-party witness will be present.) 
 Data will be collected on-line. Participants will have the option to “click” to the survey if they would like 
to take part in the study.  
 The study data will be collected through a telephone interview. If appropriate, provide a copy of the 
consent process for participant’s reference. 
 Participants will complete a mailed survey. Prepare a cover letter that includes all the elements of 
informed consent. People who wish to take part will return the survey; thereby, demonstrating their 
consent. They do not need to sign a consent form. 
 The research will take place in settings where written consent is considered disrespectful or in settings in 
which asking people to sign a document would cause distress. 
 The primary risk to participants is a breach of confidentiality and a signed consent form or audio-
recorded statement would be the only documented link between individuals and their participation in the 
study.  (Example: a study about people with HIV/AIDS.) 
 
Waiver of written consent to screen participants for study activities:  
An online consent process for eligibility screening for study activities is proposed. The introduction to the online 
screener includes all the required elements for consent (45 CFR 46.116). No identifying information on volunteers 
is recorded during the online screening until a participant is determined eligible (i.e., by marking “I do consent to 
be screened for eligibility in the online screener). Therefore, there will be no identifying link of who agreed to be 
screened or not screened for the study. In addition, the screening presents minimal risk to participants and 
involves no procedures that would require written consent outside of a research context. Under these conditions 
the IRB is authorized to modify the requirements to obtain a signed consent form for some or all subjects (45 CFR 
46.117 [c]). 
 
 
 

17 
 
Waiver of parental permission/consent for minors (ages 16-17): 
We request that the Campus IRB grant a waiver of parental consent to participate in this research study for youth 
participants who are 16 to 17 years of age.  
• 
This study involves no more than minimal risk to the subjects.  
• 
A waiver of parental permission/consent will not adversely affect the rights and welfare of the subjects. In fact, 
failure to waive parental permission/consent may have adverse effects as sexual minority youth often have not 
disclosed their sexual minority status to their parents and requiring consent would require unwanted disclosure 
that may have negative emotional, social, financial, and/or physical consequences.   
• 
The research could not practicably be carried out without the waiver. A requirement for parental 
permission/consent in this type of study could not only affect a person’s willingness to participate but could 
also potentially impact the ability of researchers to engage in this type of research with sexual minority youth. 
Without a waiver, we would be challenged by selection bias as we would only be able to recruit youth whose 
parents are both aware of and comfortable with their sexual orientation. Commonly these youth have explored 
their sexual orientation without their parents’ knowledge as the youth struggle with issues of disclosure and its 
consequences within the social, religious, and economic context of their families. Additionally, contacting a 
parent/legal guardian could constitute a breach of confidentiality for these minor subjects and could potentially 
put some youth at risk for abuse or ousting from the home if parents/legal guardians are not aware of the 
subject's sexual minority status or sexual risk behaviors. If the purpose of requiring parental 
permission/consent as stated in CFR is to protect the minor subject, then requiring parental 
permission/consent for youth in these circumstances is not a reasonable requirement. 
 
 
Waiver of written consent at 3 and 6 month study activities: 
The project is requesting a waiver to document informed consent for the follow-up visits at 3 and 6 months after 
initial consent is signed. This request is from the local Thai team and IRB.  
 
This is standard practice approved by the Thai IRB and is standard practice for all locally and internationally 
funded clinical trials at the research site. The Thai team has told the research team that Thailand is a much more 
verbal rather than written communication culture and they feel that for local settings it is probably more helpful for 
participants to be verbally reminded what they will be tested for that day (this is standard practice even outside 
research) and to confirm this has been done we can make a note that they have provided verbal consent in the 
electronic medical records and track in REDCap for research purposes.  
 
 
REFERENCES: 
1. 
van Griensven F, Thienkrua W, McNicholl J, et al. Evidence of an explosive epidemic of HIV infection in a 
cohort of men who have sex with men in Thailand. AIDS 2013;27:825-32. 
2. 
UNICEF. Situational analysis of young people at high risk of HIV exposure in Thailand2014. 
3. 
Grant RM, Anderson PL, McMahan V, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV 
incidence in men and transgender women who have sex with men: a cohort study. The Lancet infectious diseases 
2014;14:820-9. 
4. 
Grant RM, Anderson PL, McMahan V, et al. Results of the iPrEx open-label extension (iPrEx OLE) in men 
and transgender women who have sex with men: PrEP uptake, sexual practices, and HIV incidence.  Oral 
Abstract Session # TUAC0105LB presented at AIDS 2014 in Melbourne, Australia, July 20-25, 2014 Abstract 
available at: http://pagaids2014org/abstractsaspx?aid=11143  July 20-25, 2014. 
5. 
Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who 
have sex with men. The New England journal of medicine 2010;363:2587-99. 
6. 
Amico KR, Stirratt MJ. Adherence to preexposure prophylaxis: current, emerging, and anticipated bases of 
evidence. Clin Infect Dis 2014;59 Suppl 1:S55-60. 
7. 
Anand T, Nitpolprasert C, Trachunthong D, et al. A novel Online-to-Offline (O2O) model for pre-exposure 
prophylaxis and HIV testing scale up. J Int AIDS Soc 2017;20:1-11. 
8. 
mHealth: New horizons for health through mobile technologies. 2011. at 
http://www.who.int/goe/publications/goe_mhealth_web.pdf.) 
9. 
Ramirez-Valles J. The protective effects of community involvement for HIV risk behavior: a conceptual 
framework. Health education research 2002;17:389-403. 
10. 
Ramirez-Valles J, Kuhns LM, Campbell RT, Diaz RM. Social integration and health: community 
involvement, stigmatized identities, and sexual risk in Latino sexual minorities. Journal of health and social 
behavior 2010;51:30-47. 
11. 
Baranowski T, Baranowski J, Cullen K, et al. Squire's Quest! Dietary outcome evaluation of a multimedia 
game. American journal of preventive medicine 2003;24:52-61. 

18 
 
12. 
Brown SJ, Lieberman DA, Germeny BA, Fan YC, Wilson DM, Pasta DJ. Educational video game for 
juvenile diabetes: results of a controlled trial. Medical informatics = Medecine et informatique 1997;22:77-89. 
13. 
Lieberman D. Interactive video games for health promotion: Effects on knowledge, self-efficacy, social 
support, and health. In: Street R, ed. Health Promotion and interactive technology: Theoretical applications and 
future directions. Mahwah, NJ: Lawrence Erlbaum Associates; 1997:103-20. 
14. 
Kato PM, Cole SW, Bradlyn AS, Pollock BH. A video game improves behavioral outcomes in adolescents 
and young adults with cancer: a randomized trial. Pediatrics 2008;122:e305-17. 
15. 
McGonigal J. Reality is Broken: Why Games Make Us Better and How They Can Change the World. New 
York: The Penguin Press; 2012. 
 
 
 

19 
 
Attachment A  
 
All documents will be translated into Thai and back-translated into English by the Thai study team.   
 
Contents include: 
1. CASI Survey Baseline 
2. CASI Survey 3-month- P3-T arm 
3. CASI Survey 3-month- SOC arm 
4. CASI Survey 6-month 
5. DBS Collection Protocol 
6. RCT Eligibility Screening Form 
CASI Survey Baseline  
P3-T RCT Baseline  
Instructions for study staff member:  
 
• 
Tell the participant:   
o At this time, we would like you to complete the baseline survey 
o Let me know if they have any trouble understanding any of the questions. I 
will help to clarify the question(s) for you.  
o Please leave the browser open once you have completed the survey and let 
me know that you are finished.  
o Don't worry - I will not be able to access your survey answers with the 
browser left open.  
• 
After these instructions have been given, enter and re-enter the participant's study 
ID and participant code below and hand the computer to the participant to complete 
the survey.  
 
Enter the participant's Study ID (3 digits) 
 
Re-enter the participant's Study ID  (3 digits) 
 
Participant code is the first letter of the participant's first name and the two digit day of 
their birth.  
ex: first name: Jane; Birthdate: February 05 = J05 
 
Re-enter the Participant Code 
 
ID: 93 
Thank you for participating in the P3-T study! The purpose of the study is to test a PrEP 
adherence app for young gay and bi men who are starting PrEP. As part of the P3-T study, 
you will take three surveys: one today, one at your follow up appointment in 3 months, 
and one at your follow up appointment in 6 months.        
 
Try to answer every question as best you can. If you need help, please ask the study staff. 

20 
 
Your answers will be used only for research purposes. Let’s get started!   
  
 
Age 
ID: 94 
First, tell us a little about yourself. 
Shortname / Alias: age 
ID: 95 
What is your age? 
 
Location 
Shortname / Alias: postal 
ID: 100 
What is the postal code for the location where you primarily live?* 
_________________________________________________ 
 
Education 
Shortname / Alias: schoollevel 
ID: 108 
What is the highest level of school that you have completed?* 
( ) None, no formal schooling 
( ) Primary school 
( ) Lower secondary school  
( ) Upper secondary school 
( ) Higher education 
 
Employment, Income 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: employed 
ID: 109 
Are you currently employed?* 
( ) Yes 

21 
 
( ) No 
 
Logic: Hidden unless: #12 Question "Are you currently employed?" is one of the following 
answers ("Yes") 
Shortname / Alias: employedhours 
ID: 110 
Are you employed full-time or part-time? 
Part-time means that you work less than 35 hours per week during most weeks.* 
( ) Full time 
( ) Part time 
( ) Decline to answer 
 
Shortname / Alias: income_30d 
ID: 564 
How much money did you make altogether during the past 30 days?* 
__________ 
( ) Don't know 
 
Shortname / Alias: incomelevel 
ID: 111 
How would you describe your income level?* 
( ) Low income 
( ) Middle income 
( ) High income 
 
 
Food, Shelter 
 
Shortname / Alias: cutmeal 
ID: 112 
In the past 3 months, how often did you or your family have to cut meal size or skip a meal 
because there was not enough money for food?* 
( ) Almost every week 
( ) Several weeks but not every week 
( ) Only a few weeks 

22 
 
( ) Did not have to skip or cut the size of meals 
( ) Decline to answer 
 
Shortname / Alias: shelter 
ID: 113 
In the past 3 months, have you spent at least one night (check all that apply):* 
[ ] In a shelter? 
[ ] In a public place not intended for sleeping (e.g., bus station, car, abandoned building)? 
[ ] On the street or anywhere outside (e.g., park, sidewalk)? 
[ ] Temporarily doubled up with a friend or family member? 
[ ] In a temporary housing program? 
[ ] In a welfare or voucher hotel/motel? 
[ ] In jail, prison, or a halfway house? 
[ ] In drug treatment, a detox unit, or drug program housing? 
[ ] In a hospital, nursing home, or hospice? 
[ ] I have not spent a night in any of the above places. 
[ ] Decline to answer 
 
 
 
Arrest, Incarceration 
Note to IRB:  We included the arrest/incarceration questions because these situations are not uncommon 
among our target population, largely due to arrests due to substance use. Because arrests and/or 
incarceration can have impact on PrEP adherence, we think it is important to know if these events have 
occurred. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: arrested 
ID: 114 
Have you ever been arrested?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #18 Question "Have you ever been arrested?" is one of the following 
answers ("Yes") 
Shortname / Alias: arrested3mo 

23 
 
ID: 115 
Have you been arrested in the past 3 months?* 
( ) Yes 
( ) No 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: jail 
ID: 116 
Have you ever been put in jail, prison or juvenile detention?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #20 Question "Have you ever been put in jail, prison or juvenile 
detention?" is one of the following answers ("Yes") 
Shortname / Alias: jail3mo 
ID: 117 
Have you been put in jail, prison or juvenile detention in the past 3 months?* 
( ) Yes 
( ) No 
 
Sexual Identity and Awareness 
 
ID: 565 
The following questions ask about your sexual identity and relationship status.  
 
Please answer to the best of your ability. 
 
Shortname / Alias: sexualid 
ID: 102 
What is your current sexual identity?* 
( ) Gay, homosexual, same gender loving 
( ) Bisexual 
( ) Queer 
( ) Straight or heterosexual 
( ) Other, specify:: _________________________________________________* 

24 
 
 
Shortname / Alias: familyawareness 
ID: 103 
How many of your immediate family members know about 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”.* 
( ) None 
( ) Some, but less than half 
( ) About half 
( ) More than half 
( ) All 
( ) Does not apply 
 
Shortname / Alias: peerawareness 
ID: 104 
How many of your peers know about your sexual identity? 
“Peer” includes your friends, co-workers, and schoolmates. * 
( ) None 
( ) Some, but less than half 
( ) About half 
( ) More than half 
( ) All 
 
Relationships 
 
Shortname / Alias: relationship 
ID: 118 
How do you define your primary relationship status?* 
( ) Single, not currently dating 
( ) Single, casually dating 
( ) In a relationship 
( ) Married or other legal commitment 
 
 
Page entry logic: This page will show when: #25 Question "How do you define your primary relationship 
status?" is one of the following answers ("In a relationship","Married or other legal commitment") 

25 
 
Sexual Health Priorities with Partner 
 
ID: 566 
People have different sexual health priorities. For example, some people prioritize staying 
HIV-negative; others want to have as much fun as possible with their partners; others 
want to feel as close and connected to their partners as possible. 
 
For these next questions, we are interested in you and your primary romantic partner’s 
sexual health priorities.  
  
 
Shortname / Alias: shpriorities_scale 
ID: 569 
Thinking about you and your partner’s sexual health priorities, please indicate the extent to 
which you agree or disagree with the following statements.* 
 
Strongly 
Agree 
Agree 
Disagree 
Strongly 
Disagree 
I feel like my 
partner and 
I are “on the 
same page” 
in terms of 
the 
decisions 
we make 
about 
sexual 
health and 
risk  
( )  
( )  
( )  
( )  
When it 
comes to 
sexual 
decision-
making, I 
feel like my 
partner and 
I are “of the 
same mind” 
( )  
( )  
( )  
( )  
Sometimes I 
feel like my 
priorities for 
my sexual 
health are 
( )  
( )  
( )  
( )  

26 
 
incompatible 
with my 
partner’s 
goals  
I’m 
confident 
that my 
partner and 
I generally 
share the 
same 
priorities 
when it 
comes to 
sexual 
health 
( )  
( )  
( )  
( )  
Making 
sexual 
health 
decisions 
with my 
partner can 
be difficult 
because we 
have 
different 
priorities  
( )  
( )  
( )  
( )  
 
 
Cell Phone, Internet Use 
 
ID: 120 
Now, we’d like to ask you about your cell phone and internet use. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: techuse 
ID: 121 
Which of the following devices do you own? (Check all that apply)* 
[ ] Cell phone (basic mobile phone for calling or texting; does not have internet access, apps, or a touch 
screen) 
[ ] Smartphone (advanced mobile phone with internet access, apps, and a touch screen) 

27 
 
[ ] Desktop computer 
[ ] Laptop computer 
[ ] Tablet computer 
[ ] E-book reader 
[ ] Fitness tracker or smart watch 
[ ] Another device, specify: _________________________________________________ 
 
Shortname / Alias: internetaccess 
ID: 122 
How do you usually access the internet? (Check all that apply)* 
[ ] Smartphone 
[ ] Desktop computer 
[ ] Laptop computer 
[ ] Tablet computer 
[ ] E-book reader 
[ ] Another method, specify: _________________________________________________ 
 
 
 
 
Internet (cont.), Phone Plan 
 
Action: Custom Script: Script to count checkboxes and skip q if < 2 
 
Shortname / Alias: accessrank 
ID: 123 
Piping: Piped Values From Question 28. (How do you usually access the internet? (Check all that apply)) 
How do you access the internet most frequently? (Rank your answers)* 
________Smartphone 
________Desktop computer 
________Laptop computer 
________Tablet computer 
________E-book reader 
________Another method, specify 
 

28 
 
 
Page entry logic: This page will show when: #27 Question "Which of the following devices do you own? 
(Check all that apply)" is one of the following answers ("Cell phone (basic mobile phone for calling or 
texting; does not have internet access, apps, or a touch screen)","Smartphone (advanced mobile phone 
with internet access, apps, and a touch screen)") 
Cellphone/ Smartphone Plan 
 
Logic: Hidden unless: #27 Question "Which of the following devices do you own? (Check all that 
apply)" is one of the following answers ("Smartphone (advanced mobile phone with internet 
access, apps, and a touch screen)") 
Shortname / Alias: phoneplatform 
ID: 125 
What operating system/platform does your primary smartphone use?* 
( ) Apple (iOS) 
( ) Android 
( ) Don’t know 
( ) Other, specify: _________________________________________________ 
 
Logic: Hidden unless: #27 Question "Which of the following devices do you own? (Check all that 
apply)" is one of the following answers ("Cell phone (basic mobile phone for calling or texting; 
does not have internet access, apps, or a touch screen)","Smartphone (advanced mobile phone 
with internet access, apps, and a touch screen)") 
Shortname / Alias: phoneplan 
ID: 126 
What kind of cell phone or smartphone service do you have?* 
( ) I have a prepaid account 
( ) I have a monthly contract 
( ) I’m on a shared plan 
( ) Don’t know 
( ) None of the above 
 
Logic: Hidden unless: #27 Question "Which of the following devices do you own? (Check all that 
apply)" is one of the following answers ("Cell phone (basic mobile phone for calling or texting; 
does not have internet access, apps, or a touch screen)","Smartphone (advanced mobile phone 
with internet access, apps, and a touch screen)") 
Shortname / Alias: phonepay 
ID: 127 
Who usually pays for your cell phone or smartphone plan?* 
( ) I do 

29 
 
( ) Someone else does 
 
 
Page entry logic: This page will show when: #27 Question "Which of the following devices do you own? 
(Check all that apply)" is one of the following answers ("Cell phone (basic mobile phone for calling or 
texting; does not have internet access, apps, or a touch screen)","Smartphone (advanced mobile phone 
with internet access, apps, and a touch screen)") 
Phone Disconnect 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: disconnect 
ID: 128 
In the past year, did you ever not have access to your phone or phone service?* 
( ) Yes 
( ) No 
 
 
Logic: Hidden unless: #33 Question "In the past year, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnecttimes 
ID: 129 
How many times in the last year did you not have access to your phone or phone service?* 
( ) Once 
( ) Twice 
( ) 3 to 5 times 
( ) More than 5 times 
 
Logic: Hidden unless: #33 Question "In the past year, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnectlength 
ID: 130 
The last time you did not have access to your phone or phone service, for how long did you know 
have access?* 
( ) 1 day or less 
( ) 2 to 6 days 
( ) 1 to 4 weeks 
( ) More than 4 weeks 

30 
 
 
 
Internet Time, Frequency 
 
Shortname / Alias: internettime 
ID: 131 
On average, how many hours per day do you spend on the internet (online) outside of your 
school or work responsibilities?* 
( ) No hours 
( ) Less than an hour 
( ) 1 to 3 hours 
( ) 4 to 6 hours 
( ) 7 to 9 hours 
( ) 10 to 12 hours 
( ) 13 to 15 hours 
( ) 16 hours or more 
 
 
Page entry logic: This page will show when: #27 Question "Which of the following devices do you own? 
(Check all that apply)" is one of the following answers ("Smartphone (advanced mobile phone with 
internet access, apps, and a touch screen)") 
Smartphone Apps 
 
Shortname / Alias: phoneapps 
ID: 132 
How often do you use apps on your smartphone (for example: Facebook, dating apps, banking 
apps, Snapchat)?* 
( ) More than once a day 
( ) About once a day 
( ) A few times a week 
( ) About once a week 
( ) Less than once a week 
( ) I do not use apps on my phone 
 
Smartphone Sites 
 

31 
 
Shortname / Alias: phonesites 
ID: 133 
How often do you use websites or smartphone apps for the following reasons: 
 
Never 
Rarely 
Sometimes 
Often 
Make new 
friends 
( )  
( )  
( )  
( )  
Chat with 
friends 
( )  
( )  
( )  
( )  
Chat with 
family 
( )  
( )  
( )  
( )  
Find a date 
( )  
( )  
( )  
( )  
Meet 
partners for 
casual sex 
( )  
( )  
( )  
( )  
Look for work 
opportunities 
( )  
( )  
( )  
( )  
Track health 
behaviors 
(diet, 
exercise, 
medication 
management, 
etc.) 
( )  
( )  
( )  
( )  
Get 
information 
about HIV or 
other STIs 
( )  
( )  
( )  
( )  
Get other 
health or 
medical 
information 
( )  
( )  
( )  
( )  
Create event 
reminders 
(take a daily 
pill, exercise, 
etc.) 
( )  
( )  
( )  
( )  
 
 

32 
 
Internet Opinions 
 
Shortname / Alias: hi 
ID: 145 
Please indicate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I know 
what 
health 
resources 
are 
available 
on the 
Internet.  
( )  
( )  
( )  
( )  
I know 
how to find 
helpful 
health 
resources 
on the 
Internet.  
( )  
( )  
( )  
( )  
I know 
how to use 
the 
Internet to 
answer my 
questions 
about 
health. 
( )  
( )  
( )  
( )  
I know 
how to use 
the health 
information 
I find on 
the 
Internet to 
help me. 
( )  
( )  
( )  
( )  
I have the 
skills I 
need to 
evaluate 
the health 
resources I 
( )  
( )  
( )  
( )  

33 
 
find on the 
Internet.  
I can tell 
high 
quality 
health 
resources 
from low 
quality 
health 
resources 
on the 
Internet.  
( )  
( )  
( )  
( )  
I feel 
confident 
in using 
information 
from the 
Internet to 
make 
health 
decisions.  
( )  
( )  
( )  
( )  
I know 
where to 
find helpful 
health 
resources 
on the 
Internet.  
( )  
( )  
( )  
( )  
 
 
Health Providers 
 
ID: 157 
Now, we are going to ask you about your health and health care decision making. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: pcp 
ID: 158 

34 
 
Do you have a primary health care provider (for example, a pediatrician, a doctor, or other health 
care provider that you see regularly)?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #40 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcpawareness 
ID: 105 
How open are you about your sexual identity to your primary medical care provider?* 
( ) Primary medical provider definitely does NOT know your sexual identity 
( ) Primary medical provider MIGHT know about your sexual identity 
( ) Primary medical provider PROBABLY knows about your sexual identity 
( ) Primary medical provider DEFINITELY knows about your sexual identity 
 
Logic: Hidden unless: #40 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcptalksex 
ID: 160 
How comfortable are you discussing your sexual behavior with your primary health care 
provider?* 
( ) Very comfortable 
( ) Somewhat comfortable 
( ) Somewhat uncomfortable 
( ) Very uncomfortable 
 
HIV Testing 
Shortname / Alias: recenthivtest_mon 
ID: 165 
When did you have your most recent HIV test? 
 
Please enter the month and year. 
 
Month:* 
( ) January 
( ) February 
( ) March 

35 
 
( ) April 
( ) May 
( ) June 
( ) July 
( ) August 
( ) September 
( ) October 
( ) November 
( ) December 
 
Validation: Min = 1980 Must be numeric Whole numbers only Positive numbers only Max character count 
= 4 
Shortname / Alias: recenthivtest_yr 
ID: 166 
Year:* 
 
Action: Custom Script: Check HIV test date not in future 
 
 
STI Testing 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: lifetimestitest 
ID: 170 
A sexually transmitted infection (STI) is an infection transmitted through sexual activity, such as 
syphilis, gonorrhea, chlamydia, herpes, or genital warts. Have you ever been tested for an STI 
that was not HIV?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #45 Question "A sexually transmitted infection (STI) is an infection 
transmitted through sexual activity, such as syphilis, gonorrhea, chlamydia, herpes, or genital 
warts. Have you ever been tested for an STI that was not HIV?" is one of the following answers 
("Yes") 
Shortname / Alias: sti3mo 
ID: 171 

36 
 
Please indicate whether you have been diagnosed with any of the following sexually transmitted 
infections in the past 3 months. 
Please select all that apply.* 
[ ] Chlamydia 
[ ] Genital warts, anal warts, HPV 
[ ] Gonorrhea 
[ ] Hepatitis B 
[ ] Hepatitis C 
[ ] Herpes, HSV1/HSV2 
[ ] Syphilis 
[ ] Urethritis 
[ ] Other, please specify:: _________________________________________________ 
[ ] None of these 
 
 
PrEP Start 
 
Shortname / Alias: startprep_why 
ID: 943 
Why have you decided to start taking PrEP? Select all that apply.* 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking about having sex with someone whose status HIV I don’t know 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
 

37 
 
PrEP Start 
 
Action: Custom Script: Script to count checkboxes and skip q if < 2 
 
Shortname / Alias: startprep_primwhy 
ID: 945 
Piping: Piped Values From Question 47. (Why did you choose to start taking PrEP? Select all that apply.) 
What was the main reason you have decided to start taking PrEP?* 
 
PrEP Confidence 
 
ID: 907 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: keepappts 
ID: 903 
How confident are you that you will be able to... 
 
Keep your PrEP medical appointments:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: followplan 
ID: 904 
Follow a plan for taking PrEP:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: atworkschool 
ID: 905 

38 
 
Take PrEP at work/school:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekday 
ID: 906 
Take PrEP on a weekday:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
 
PrEP Confidence 2 
 
ID: 908 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekend 
ID: 909 
How confident are you that you will be able to... 
 
Take PrEP on a weekend:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: wfriends 
ID: 910 
Take PrEP when I'm out with friends:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: prepdrinking 
ID: 911 
Take PrEP when I'm drinking or using drugs:* 
1 ________________________[__]_____________________________ 10 or N/A 

39 
 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: schedulechange 
ID: 912 
Take PrEP when my schedule changes:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
PrEP Confidence 3 
 
ID: 913 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: whiletraveling 
ID: 914 
How confident are you that you will be able to... 
 
Take PrEP while traveling:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: takewsideeffects 
ID: 915 
Take PrEP when you are having medication side effects:* 
1 ________________________[__]_____________________________ 10 or N/A 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: havingcrisis 
ID: 916 
Take PrEP when you are having a crisis:* 
1 ________________________[__]_____________________________ 10 or N/A 
 

40 
 
 
 
PrEP Delivery 
 
Shortname / Alias: prep_prefmode 
ID: 597 
Right now there are no other approved options for taking PrEP. However, if there were more than 
one option and each method was equally good at protecting you from getting HIV, which method 
would you most prefer?* 
( ) Taking one pill, every day 
( ) Taking two pills before you had sex and a pill a day for the next two days 
( ) Taking one pill a day just on Tuesday, Thursday, Saturday, and Sunday 
( ) Getting an injection about every 2 to 3 months 
( ) Putting medicated lubrication (lube) in your anus (and/or your partner’s anus) both before and after 
having anal sex 
( ) Douching with a medicated solution (microbicide) before having anal sex 
 
 
Action: JavaScript: Hide General Error Message 
 
 
PrEP Beliefs 
 
Shortname / Alias: prepbeliefs 
ID: 598 
Please rate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
Men are 
less likely 
to use 
condoms 
for anal sex 
if they are 
using PrEP 
( )  
( )  
( )  
( )  

41 
 
I feel as if 
starting to 
take PrEP 
will allow 
me to have 
more sex 
partners 
( )  
( )  
( )  
( )  
I feel as if 
starting to 
take PrEP 
will allow 
me to have 
more 
condomless 
anal sex 
( )  
( )  
( )  
( )  
 
 
PrEP and People 
 
Shortname / Alias: prepppl 
ID: 193 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I worry 
people will 
assume I 
sleep around 
if they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
assume that I 
am HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think my 
partner(s) 
( )  
( )  
( )  
( )  

42 
 
are HIV-
positive if 
they know I 
take PrEP  
I worry about 
listing PrEP 
as one of my 
current 
medications 
during 
appointments 
such as at a 
dentist's or 
specialist's 
office  
( )  
( )  
( )  
( )  
I feel 
ashamed to 
tell other 
people that I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am a 
bad person if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am 
gay if they 
know I take 
PrEP  
( )  
( )  
( )  
( )  
I worry my 
friends will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
family will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
sexual 
partners will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  

43 
 
I think people 
will give me a 
hard time if I 
tell them I 
take PrEP  
( )  
( )  
( )  
( )  
I think people 
will judge me 
if they know I 
am taking 
PrEP 
( )  
( )  
( )  
( )  
 
 
 
PrEP Concerns 
 
Shortname / Alias: prepconc 
ID: 210 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
My family 
does not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
My friends 
do not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
People 
taking PrEP 
are 
portrayed 
poorly in the 
media and 
online 
( )  
( )  
( )  
( )  
People in my 
community 
talk poorly 
about people 
taking PrEP 
( )  
( )  
( )  
( )  

44 
 
I feel 
embarrassed 
about taking 
PrEP  
( )  
( )  
( )  
( )  
I think I am 
not following 
the 'rules' of 
my 
community if 
I take PrEP  
( )  
( )  
( )  
( )  
 
 
 
PrEP Difficulties 
 
Shortname / Alias: prepdifficulties 
ID: 602 
In making your decision to continue taking PrEP after you start, please rate how much the 
following items concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
Getting the 
costs of PrEP 
covered 
(including 
office visits or 
office visit co-
pays, lab 
costs, 
transportation 
costs)  
( )  
( )  
( )  
( )  
Using 
insurance to 
get coverage 
for PrEP 
costs 
(including 
office visits, 
lab costs)  
( )  
( )  
( )  
( )  
Getting 
transportation 
( )  
( )  
( )  
( )  

45 
 
to PrEP 
appointments 
and labs 
Returning for 
PrEP follow-
up 
appointments 
and labs 
( )  
( )  
( )  
( )  
Getting PrEP 
prescription 
refilled 
( )  
( )  
( )  
( )  
 
 
 
PrEP Difficulties Continued 
 
Shortname / Alias: prepdifficulties2 
ID: 649 
In making your decision to start taking PrEP, please rate how much the following items concern 
you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
The 
possibility 
that if I were 
to become 
HIV+, 
certain 
medications 
might no 
longer work 
or I might be 
resistant to 
them  
( )  
( )  
( )  
( )  
The 
possibility 
that PrEP 
might not 
provide 
complete 
( )  
( )  
( )  
( )  

46 
 
protection 
against HIV  
Having to 
talk to a 
health care 
provider 
about PrEP 
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about my 
sex life 
( )  
( )  
( )  
( )  
Experiencing 
side effects 
from PrEP 
( )  
( )  
( )  
( )  
The long-
term effects 
of PrEP on 
my health 
( )  
( )  
( )  
( )  
Having to 
remember to 
take PrEP 
every day 
( )  
( )  
( )  
( )  
Friends 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Family 
members 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Sexual 
partners 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "The possibility that PrEP might not provide complete protection 
against HIV " is one of the following answers ("Concerned","Very concerned") 
Shortname / Alias: prepworry 

47 
 
ID: 665 
Why do you worry about the possibility that PrEP might not provide complete protection against 
HIV? (Check all that apply)* 
[ ] I worry that the drug is not effective at preventing HIV 
[ ] Because I worry that I won’t take PrEP every day consistently 
[ ] Because I feel I am at very high risk for becoming infected with HIV 
[ ] Other, please specify:: _________________________________________________ 
 
 
HIV perceptions 
 
Shortname / Alias: hivthoughts 
ID: 667 
Imagine how you would feel if you became infected with HIV. Read each statement carefully and 
indicate how strongly you agree or disagree with the following statements. 
 
  
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I would 
be afraid 
people 
would 
judge me 
when 
they 
learn I 
have HIV  
( )  
( )  
( )  
( )  
If I got 
infected, 
people 
would 
not want 
to have 
sex with 
me  
( )  
( )  
( )  
( )  
I would 
feel 
guilty if I 
got HIV  
( )  
( )  
( )  
( )  

48 
 
I would 
feel 
ashamed 
if I got 
HIV  
( )  
( )  
( )  
( )  
 
 
Insurance 
 
 
Logic: Hidden unless: #107 Question "Do you currently have health insurance or health care 
coverage? is one of the following answers ("Yes") 
Shortname / Alias: ins_type 
ID: 208 
What kind of health insurance or health care coverage do you have? Select all that apply.* 
_________________________________________________ 
[ ] Social Security Insurance 
[ ] National Health Coverage 
[ ] Private company 
[ ] Private personal insurance 
[ ] Civil service health coverage 
[ ] Private personal insurance 
[ ] Other: ___________ 
[ ] I don't know 
 
 
PEP 
 
Shortname / Alias: pep 
ID: 229 
Before today, have you ever heard of people taking anti-HIV medicines AFTER a sexual or drug 
use exposure, to reduce the risk of getting HIV? This is called post-exposure prophylaxis, or 
PEP.* 
( ) Yes 
( ) No 
 

49 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: lifetimepep 
ID: 230 
Have you ever taken post-exposure prophylaxis (PEP) AFTER a sexual or drug use exposure to 
reduce the risk of getting HIV?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #113 Question "Have you ever taken post-exposure prophylaxis (PEP) 
AFTER a sexual or drug use exposure to reduce the risk of getting HIV?" is one of the following 
answers ("Yes") 
Shortname / Alias: lastyearpep 
ID: 231 
In the past 12 months, have you taken PEP (post-exposure prophylaxis) AFTER a sexual or drug 
use exposure, to reduce the risk of getting HIV?* 
( ) Yes 
( ) No 
 
 
PrEP On-demand 
 
Shortname / Alias: heardprepod 
ID: 673 
Some people choose to not take PrEP daily, but only around the time when they are planning to 
have sex. This is known as on-demand or episodic PrEP, where you take two pills before having 
sex, and one pill a day or two days after. It is not an approved method and has not been shown to 
be an effective method for preventing HIV. Before today, have you ever heard of on-demand 
PrEP?* 
( ) Yes 
( ) No 
( ) Decline to answer 
 
 
 
 
Substances 

50 
 
 
ID: 232 
Now we’d like to ask you a little bit about your experiences using alcohol, tobacco 
products, and other drugs. Please be assured that this information will be treated as 
strictly confidential.  
 
The questions will concern your experiences with using these substances across your 
lifetime and in the past three months. These substances can be smoked, swallowed, 
snorted, inhaled, injected, or taken in the form of pills. Some of the substances may be 
prescribed by a doctor (like amphetamines, sedatives, or pain medications). For this 
survey, do not report on medications that are used as prescribed by your doctor. 
However, if you have taken such medications for reasons other than prescription, or 
taken them more frequently or at higher doses than prescribed, please report on this use. 
Once again, please remember that all information provided will be treated as strictly 
confidential. 
 
Shortname / Alias: lifetimesubstanceuse 
ID: 233 
Which of the following drugs have you used in your life? 
Please check all that apply.* 
[ ] Tobacco (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.) 
[ ] Alcohol (beer, wine, spirits, etc.) 
[ ] Cannabis (marijuana, pot, weed, grass, hash, synthetic cannabis, etc.) 
[ ] Cocaine (coke, crack, etc.) 
[ ] Amphetamines (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.) 
[ ] Inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.) 
[ ] Sedatives, tranquilizers, or sleeping pills (valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) 
[ ] Hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.) 
[ ] Opioids (heroin, morphine, methadone, codeine, Oxycotin, Percocet, Vicodin, etc.) 
[ ] None of these 
 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Tobacco (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)") 
Tobacco 
 

51 
 
Shortname / Alias: tobacco3months 
ID: 234 
In the past 3 months, how often have you used tobacco products (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccodesire 
ID: 235 
During the past 3 months, how often have you had a desire to use tobacco products (cigarettes, 
chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccoproblems 
ID: 236 
During the past 3 months, how often has your use of tobacco products (cigarettes, chewing 
tobacco, cigars, e-cigarettes, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofailed 
ID: 237 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, 
etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 

52 
 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofriend 
ID: 238 
Has a friend or relative or anyone else ever expressed concern about your use of tobacco 
products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: tobaccostop 
ID: 239 
Have you ever tried and failed to control, cut down or stop using tobacco products (cigarettes, 
chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Alcohol (beer, wine, spirits, etc.)") 
Alcohol 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: alcohol3months 
ID: 240 
In the past 3 months, how often have you used alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
Logic: Hidden unless: #125 Question "In the past 3 months, how often have you used alcoholic 
beverages (beer, wine, spirits, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily","Decline to answer") 

53 
 
Shortname / Alias: alcoholdaily 
ID: 241 
How many drinks containing alcohol do you have on a typical day?* 
( ) 0 
( ) 1 or 2 
( ) 3 or 4 
( ) 5 or 6 
( ) 7 to 9 
( ) 10 or more 
 
Shortname / Alias: alcoholbinge 
ID: 242 
How often do you have 5 or more drinks on one occasion?* 
( ) Never 
( ) Less than monthly 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholdesire 
ID: 243 
During the past 3 months, how often have you had a desire to use alcoholic beverages (beer, 
wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholproblems 
ID: 244 
During the past 3 months, how often has your use of alcoholic beverages (beer, wine, spirits, 
etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 

54 
 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfailed 
ID: 245 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfriend 
ID: 246 
Has a friend or relative or anyone else ever expressed concern about your use of alcoholic 
beverages (beer, wine, spirits, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: alcoholstop 
ID: 247 
Have you ever tried and failed to control, cut down or stop using alcoholic beverages (beer, wine, 
spirits, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Cannabis (marijuana, pot, weed, grass, 
hash, synthetic cannabis, etc.)") 
Cannabis 
Shortname / Alias: cannabis3months 
ID: 251 

55 
 
In the past 3 months, how often have you used cannabis (marijuana, pot, grass, hash, etc.) or 
synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #135 Question "In the past 3 months, how often have you 
used cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Cannabis (cont.) 
 
Shortname / Alias: cannabisdesire 
ID: 252 
During the past 3 months, how often have you had a desire to use cannabis (marijuana, pot, 
grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisproblems 
ID: 253 
During the past 3 months, how often has your use of cannabis (marijuana, pot, grass, hash, etc.) 
or synthetic cannabis led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfailed 
ID: 254 

56 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfriend 
ID: 255 
Has a friend or relative or anyone else ever expressed concern about your use of cannabis 
(marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: cannabisstop 
ID: 256 
Have you ever tried and failed to control, cut down or stop using cannabis (marijuana, pot, grass, 
hash, etc.) or synthetic cannabis?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Cocaine (coke, crack, etc.)") 
Cocaine 
 
Shortname / Alias: cocaine3months 
ID: 257 
In the past 3 months, how often have you used cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 

57 
 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #141 Question "In the past 3 months, how often have you 
used cocaine (coke, crack, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily") 
Cocaine (cont.) 
 
Shortname / Alias: cocainedesire 
ID: 258 
During the past 3 months, how often have you had a desire to use cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: cocaineproblems 
ID: 259 
During the past 3 months, how often has your use of cocaine (coke, crack, etc.) led to health, 
social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocainefailed 
ID: 260 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 

58 
 
( ) Daily or almost daily 
 
Shortname / Alias: cocainefriend 
ID: 261 
Has a friend or relative or anyone else ever expressed concern about your use of cocaine (coke, 
crack, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: cocainestop 
ID: 262 
Have you ever tried and failed to control, cut down or stop using cocaine (coke, crack, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Amphetamines (speed, meth, diet pills, 
ecstasy, Ritalin, Adderall, etc.)") 
Amphetamine 
 
Shortname / Alias: amphetamine3months 
ID: 263 
In the past 3 months, how often have you used amphetamine type stimulants (speed, meth, diet 
pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 

59 
 
 
Page entry logic: This page will show when: #147 Question "In the past 3 months, how often have you 
used amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Amphetamine (cont.) 
 
Shortname / Alias: amphetaminedesire 
ID: 265 
During the past 3 months, how often have you had a desire to use amphetamine type stimulants 
(speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetamineproblems 
ID: 266 
During the past 3 months, how often has your use of amphetamine type stimulants (speed, meth, 
diet pills, ecstasy, Ritalin, Adderall, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefailed 
ID: 267 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, 
Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

60 
 
Shortname / Alias: amphetaminefriend 
ID: 268 
Has a friend or relative or anyone else ever expressed concern about your use of amphetamine 
type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: amphetaminestop 
ID: 269 
Have you ever tried and failed to control, cut down or stop using amphetamine type stimulants 
(speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.)") 
Inhalants 
 
Shortname / Alias: inhalants3months 
ID: 271 
In the past 3 months, how often have you used inhalants (poppers, nitrous, glue, petrol, paint 
thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #153 Question "In the past 3 months, how often have you 
used inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?" is one of the following answers ("Once 
or twice","Monthly","Weekly","Daily or almost daily") 

61 
 
Inhalants (cont.) 
 
Shortname / Alias: inhalantsdesire 
ID: 272 
During the past 3 months, how often have you had a desire to use inhalants (poppers, nitrous, 
glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsproblems 
ID: 273 
During the past 3 months, how often has your use of inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfailed 
ID: 274 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfriend 
ID: 275 
Has a friend or relative or anyone else ever expressed concern about your use of inhalants 
(poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No, never 

62 
 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: inhalantsstop 
ID: 276 
Have you ever tried and failed to control, cut down or stop using inhalants (poppers, nitrous, 
glue, petrol, paint thinner, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Sedatives, tranquilizers, or sleeping pills 
(valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)") 
Sedatives 
 
Shortname / Alias: sedatives3months 
ID: 277 
In the past 3 months, how often have you used sedatives, tranquilizers, or sleeping pills (Valium, 
Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #159 Question "In the past 3 months, how often have you 
used sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?" 
is one of the following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Sedatives (cont.) 
 
Shortname / Alias: sedativesdesire 
ID: 279 

63 
 
During the past 3 months, how often have you had a desire to use sedatives, tranquilizers, or 
sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesproblems 
ID: 280 
During the past 3 months, how often has your use of sedatives, tranquilizers, or sleeping pills 
(Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) led to health, social, legal or financial 
problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesfailed 
ID: 281 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, 
Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesfriend 
ID: 282 
Has a friend or relative or anyone else ever expressed concern about your use of sedatives, 
tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 

64 
 
Shortname / Alias: sedativesstop 
ID: 283 
Have you ever tried and failed to control, cut down or stop using sedatives, tranquilizers, or 
sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Hallucinogens (LSD, acid, mushrooms, 
PCP, Ketamine, etc.)") 
Hallucinogens 
 
Shortname / Alias: hallucinogens3months 
ID: 285 
In the past 3 months, how often have you used hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #165 Question "In the past 3 months, how often have you 
used hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Hallucinogens (cont.) 
 
Shortname / Alias: hallucinogensdesire 
ID: 286 
During the past 3 months, how often have you had a desire to use hallucinogens (LSD, acid, 
mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 

65 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensproblems 
ID: 287 
During the past 3 months, how often has your use of hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfailed 
ID: 288 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfriend 
ID: 289 
Has a friend or relative or anyone else ever expressed concern about your use of hallucinogens 
(LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: hallucinogensstop 
ID: 290 
Have you ever tried and failed to control, cut down or stop using hallucinogens (LSD, acid, 
mushrooms, PCP, Ketamine, etc.)?* 
( ) No, never 

66 
 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Page entry logic: This page will show when: #118 Question "Which of the following drugs have you 
used in your life? 
Please check all that apply." is one of the following answers ("Opioids (heroin, morphine, methadone, 
codeine, Oxycotin, Percocet, Vicodin, etc.)") 
Opioids 
 
Shortname / Alias: opioids3months 
ID: 291 
In the past 3 months, how often have you used opioids (heroin, morphine, methadone, codeine, 
Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #171 Question "In the past 3 months, how often have you 
used opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Opioids (cont.) 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: opioidsheroin 
ID: 299 
In the past 3 months, has your opioid use included heroin?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #172 Question "In the past 3 months, has your opioid use included 
heroin?" is one of the following answers ("Yes") 
Shortname / Alias: heroinprimary 

67 
 
ID: 300 
In the past 3 months, was heroin the most common opioid that you used?* 
( ) Yes 
( ) No 
 
Shortname / Alias: opioidssdesire 
ID: 293 
During the past 3 months, how often have you had a desire to use opioids (heroin, morphine, 
methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsproblems 
ID: 294 
During the past 3 months, how often has your use of opioids (heroin, morphine, methadone, 
codeine, Oxycontin, Percocet, Vicodin, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfailed 
ID: 295 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, 
Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfriend 

68 
 
ID: 296 
Has a friend or relative or anyone else ever expressed concern about your use of opioids (heroin, 
morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
Shortname / Alias: opioidsstop 
ID: 297 
Have you ever tried and failed to control, cut down or stop using opioids (heroin, morphine, 
methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No, never 
( ) Yes, in the past 3 months 
( ) Yes, but not in the past 3 months 
 
 
Sexual Behaviors 
 
Page exit logic: Skip / Disqualify LogicIF: #179 Question "In the past 3 months, how many people have 
you had anal sex with?" is exactly equal to "0" THEN: Jump to page 123 - Perceived HIV Risk 
 
ID: 368 
The next section of questions will ask about your sexual behaviors. We know that this can 
be a sensitive topic, so we would like to remind you that your answers will be kept 
completely confidential. Please be as honest as possible in order to ensure the success 
of the current study. 
 
The following questions refer to your sexual behavior during the past 3 months. Our 
focus will be only on anal sex. Therefore, do not include references to people with whom 
you did not engage in anal sex. 
 
For these questions, anal sex refers to sex where the other person’s penis was in your 
rectum (you were the bottom) and to sex where your penis was in the other person's 
rectum (you were the top). 
 
These questions only ask about people assigned male at birth, which includes cisgender 
men (men assigned male at birth) and transgender women (women assigned male at 

69 
 
birth). Therefore, do not include references to cisgender women (women assigned female 
at birth) or transgender men (men assigned female at birth). 
 
Validation: Min = 0 Max = 999 Must be numeric Whole numbers only Positive numbers only 
Shortname / Alias: numsexpartner 
ID: 302 
In the past 3 months, how many people have you had anal sex with?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #179 Question "In the past 3 months, how many people 
have you had anal sex with?" is greater than "0" 
HIV Status of Sexual Partners 
 
Logic: Hidden by default 
ID: 677 
The total number must equal the number of people you had anal sex with in the last 3 months 
([question('value'), id='302']). Please correct this. 
 
Validation: Must be numeric 
Shortname / Alias: partnerhivstatus 
ID: 676 
Before you had sex, what did you know of the HIV status of your sexual partner(s)? 
 
Enter numerical values. Numbers must add up to [question('value'), id='302'], the number of people 
you reported having anal sex within the last three months.* 
________This person/these people told you they were HIV negative and you had no reason to doubt it 
________You knew this person/these people were HIV positive 
________You were not completely sure of this person/these people's HIV status 
 
 
 
Action: Custom Script: Script to check the continuous sum totals 
 
 

70 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners 
 
ID: 690 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Shortname / Alias: hivneg_timesbot 
ID: 701 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timestop 
ID: 702 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #181 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the 
bottom?" is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
Logic: Hidden by default 
ID: 714 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='701']). Please correct this. 
 
Shortname / Alias: hivneg_timesbotunp 

71 
 
ID: 710 
In the past 3 months, how many of the [question('value'), id='701'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #183 Question "In the past 3 months, how many of 
the [question('value'), id='701'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the bottom were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
ID: 721 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 999 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_typ 
ID: 711 
Regarding the partners who told you they were HIV negative who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 

72 
 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1002 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_gender 
ID: 964 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Hidden Page of Script 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Hidden Page of Script 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #182 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the top?" 
is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 

73 
 
 
ID: 722 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 719 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='702']). Please correct this. 
 
Shortname / Alias: hivneg_timestopunp 
ID: 718 
In the past 3 months, how many of the [question('value'), id='702'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the top were 
without a condom? * 
_________________________________________________ 
 
 
Hidden Page of Script 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #186 Question "In the past 3 months, how many of 
the [question('value'), id='702'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the top were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 723 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 

74 
 
Logic: Hidden by default 
ID: 1004 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_typ 
ID: 725 
Regarding the partners who told you they were HIV negative who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1005 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_gender 
ID: 965 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 

75 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners - PrEP and Alcohol and Drug Use 
 
ID: 992 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 732 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Shortname / Alias: hivneg_toldyouprep 
ID: 729 
How many of your sexual partners who told you they were HIV negative told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 733 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Logic: Hidden unless: #190 Question "Regarding your sexual partners who told you they were 
HIV negative, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivneg_youtoldprepnum 

76 
 
ID: 731 
How many of your sexual partner(s) who told you they were HIV negative did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timesdrunk 
ID: 740 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV negative were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners 
 
ID: 770 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Shortname / Alias: hivpos_timesbot 
ID: 775 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivpos_timestop 

77 
 
ID: 776 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #193 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the 
bottom?" is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 782 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 783 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='775']). Please correct this. 
 
Shortname / Alias: hivpos_timesbotunp 
ID: 784 
In the past 3 months, how many of the [question('value'), id='775'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #195 Question "In the past 3 months, how many of 
the [question('value'), id='775'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the bottom were without a condom? " is greater than "0" 

78 
 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 786 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1008 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_typ 
ID: 788 
Regarding the partners who told you they were HIV positive who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1009 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_gender 
ID: 994 

79 
 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, and gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #194 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the top?" 
is greater than "0" 
HIV Pos Partners - Condomless Insertive AI 
 
ID: 792 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 793 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='776']). Please correct this. 
 
Shortname / Alias: hivpos_timestopunp 
ID: 794 

80 
 
In the past 3 months, how many of the [question('value'), id='776'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the top were 
without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #198 Question "In the past 3 months, how many of 
the [question('value'), id='776'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the top were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Insertive AI 
 
ID: 796 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1012 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_typ 
ID: 798 
Regarding the partners who told you they were HIV positive who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 

81 
 
ID: 1013 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_gender 
ID: 995 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners - HIV Trt  
 
Logic: Hidden by default 
ID: 799 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouhivmeds 
ID: 800 
How many of your sexual partners who told you they were HIV positive told you they were 
taking medication to treat HIV?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 

82 
 
 
Logic: Hidden by default 
ID: 920 
The number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouundetect 
ID: 918 
How many of your sexual partners who told you they were HIV positive told you they were 
undetectable?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 802 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_timesdrunk 
ID: 807 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV positive were you or this person under the influence of alcohol or drugs?* 
 
Action: Custom Script: Script to check med number not greater than the total number of partners 
 
Action: Custom Script: Script to check undetectable number not greater than the total number of 
partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners 

83 
 
 
ID: 810 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Shortname / Alias: hivunk_timesbot 
ID: 815 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivunk_timestop 
ID: 816 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #206 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
bottom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 822 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 823 

84 
 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='815']). Please correct this. 
 
Shortname / Alias: hivunk_timesbotunp 
ID: 824 
In the past 3 months, how many of the [question('value'), id='815'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #208 Question "In the past 3 months, how many of 
the [question('value'), id='815'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the bottom were without a condom? " is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 826 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1016 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_typ 
ID: 828 
Regarding the partners whose HIV status you were not sure of who you had condomless 
receptive anal sex with (where you were the bottom), how many were...  

85 
 
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1017 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_gender 
ID: 996 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #207 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
top?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 832 

86 
 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 833 
This number cannot be greater than the number of times you had anal sex with sexual partner(s) 
whose HIV status you were not sure of where you were the top ([question('value'), id='816']). 
Please correct this. 
 
Shortname / Alias: hivunk_timestopunp 
ID: 834 
In the past 3 months, how many of the [question('value'), id='816'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the top 
were without a condom?* 
_________________________________________________ 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #211 Question "In the past 3 months, how many of 
the [question('value'), id='816'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the top were without a condom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 836 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1020 

87 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_typ 
ID: 838 
Regarding the partners whose HIV status you were not sure of who you had condomless 
insertive anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1021 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_gender 
ID: 997 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 

88 
 
HIV Status Unknown Partners - PrEP 
 
Logic: Hidden by default 
ID: 839 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Shortname / Alias: hivunk_toldyouprep 
ID: 840 
How many of your sexual partners whose HIV status you were not sure of told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 842 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
_________________________________________________ 
 
Shortname / Alias: hivunk_timesdrunk 
ID: 847 
In the past 3 months, how many of the times you had anal sex with partners whose HIV 
status you were not sure of were you or this person under the influence of alcohol or 
drugs?* 
_________________________________________________ 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Perceived HIV Risk 

89 
 
 
Shortname / Alias: perceivedrisk1 
ID: 762 
Based on your reported sexual activities over the last 3 months, how at risk do you think you 
were for contracting HIV in the last 3 months?* 
( ) Not at all at risk for contracting HIV 
( ) Somewhat at risk for contracting HIV 
( ) High risk for contracting HIV 
 
Shortname / Alias: perceivedrisk2 
ID: 763 
What is your gut feeling about how likely you are to get infected with HIV?* 
( ) Extremely unlikely 
( ) Very unlikely 
( ) Somewhat likely 
( ) Very likely 
( ) Extremely likely 
 
Shortname / Alias: perceivedrisk3 
ID: 764 
I worry about getting infected with HIV:* 
( ) None of the time 
( ) Rarely 
( ) Some of the time 
( ) A moderate amount of time 
( ) A lot of the time 
( ) All of the time 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk4 
ID: 765 
Getting HIV is something I am...* 
( ) Not concerned about 
( ) A little concerned about 

90 
 
( ) Moderately concerned about 
( ) Concerned about a lot 
( ) Extremely concerned about 
 
Shortname / Alias: perceivedrisk5 
ID: 766 
There is a chance, no matter how small, I could get HIV:* 
( ) Strongly Disagree 
( ) Disagree 
( ) Neither agree nor disagree 
( ) Agree 
( ) Strongly Agree 
 
Shortname / Alias: perceivedrisk6 
ID: 767 
I think my chances of getting infected with HIV are:* 
( ) Zero 
( ) Almost zero 
( ) Small 
( ) Moderate 
( ) Large 
( ) Very large 
 
 
PHQ-2/GAD-2 
 
ID: 768 
Now we are going to ask you about your mental health and how you have been feeling 
recently. 
 
Shortname / Alias: mentalhealthscreener 
ID: 388 

91 
 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Little 
interest or 
pleasure in 
doing 
things 
( )  
( )  
( )  
( )  
Feeling 
down, 
depressed, 
or 
hopeless 
( )  
( )  
( )  
( )  
Feeling 
nervous, 
anxious or 
on edge 
( )  
( )  
( )  
( )  
Not being 
able to 
stop or 
control 
worrying 
( )  
( )  
( )  
( )  
 
Hidden Mental Health Screener Script 
 
Hidden Value: psychdistress1 
Value:  
 
Hidden Value: psychdistress2 
Value:  
 
Action: Custom Script: Mental Health Script 
 
 
Page entry logic: This page will show when: psychdistress1 is greater than or equal to "3" 

92 
 
PHQ-8 
 
Shortname / Alias: phq8 
ID: 397 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Trouble 
falling or 
staying 
asleep, or 
sleeping too 
much 
( )  
( )  
( )  
( )  
Feeling tired 
or having 
little energy 
( )  
( )  
( )  
( )  
Poor appetite 
or overeating 
( )  
( )  
( )  
( )  
Feeling bad 
about 
yourself - or 
that you are 
a failure or 
have let 
yourself or 
your family 
down 
( )  
( )  
( )  
( )  
Trouble 
concentrating 
on things, 
such as 
reading the 
newspaper 
or watching 
television 
( )  
( )  
( )  
( )  
Moving or 
speaking so 
slowly that 
other people 
could have 
noticed, or 
( )  
( )  
( )  
( )  

93 
 
the opposite 
- being so 
fidgety or 
restless that 
you have 
been moving 
around a lot 
more than 
usual 
 
 
 
 
Page entry logic: This page will show when: psychdistress2 is greater than or equal to "3" 
GAD-7 
 
Shortname / Alias: gad7 
ID: 404 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Worrying 
too much 
about 
different 
things 
( )  
( )  
( )  
( )  
Trouble 
relaxing 
( )  
( )  
( )  
( )  
Being so 
restless 
that it is 
hard to sit 
still 
( )  
( )  
( )  
( )  
Becoming 
easily 
annoyed 
or irritable 
( )  
( )  
( )  
( )  

94 
 
Feeling 
afraid as if 
something 
awful 
might 
happen 
( )  
( )  
( )  
( )  
 
 
Social Isolation 
 
Shortname / Alias: socialisolation 
ID: 432 
The following questions ask about your relationships with other people.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I feel 
left out. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
barely 
know 
me. 
( )  
( )  
( )  
( )  
( )  
I feel 
isolated 
from 
others. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
are 
around 
me but 
not with 
me. 
( )  
( )  
( )  
( )  
( )  
 
 
Emotional Support 
 

95 
 
Shortname / Alias: emotionalsupport 
ID: 411 
The following questions ask about your relationships with other people.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone 
who will 
listen to me 
when I need 
to talk. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
confide in or 
talk to about 
myself or 
my 
problems. 
( )  
( )  
( )  
( )  
( )  
I have 
someone 
who makes 
me feel 
appreciated. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
talk with 
when I have 
a bad day. 
( )  
( )  
( )  
( )  
( )  
 
 
Informational Support 
 
Shortname / Alias: informationalsupport 
ID: 417 
The following questions ask about your relationships with other people.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone to 
give me 
good 
( )  
( )  
( )  
( )  
( )  

96 
 
advice 
about a 
crisis if I 
need it. 
I have 
someone to 
turn to for 
suggestions 
about how 
to deal with 
a problem. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
give me 
information 
if I need it. 
( )  
( )  
( )  
( )  
( )  
I get useful 
advice 
about 
important 
things in 
life. 
( )  
( )  
( )  
( )  
( )  
 
 
 
Instrumental Support 
 
Shortname / Alias: instrumentalsupport 
ID: 422 
The following questions ask about your relationships with other people.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you 
have 
someone 
to help 
you if 
you are 
confined 
to bed? 
( )  
( )  
( )  
( )  
( )  

97 
 
Do you 
have 
someone 
to take 
you to 
the 
doctor if 
you need 
it? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to help 
with your 
daily 
chores if 
you are 
sick? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to run 
errands 
if you 
need it? 
( )  
( )  
( )  
( )  
( )  
 
 
Companionship 
 
Shortname / Alias: companionship 
ID: 427 
The following questions ask about your relationships with other people. 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you have 
someone with 
whom to have 
fun? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
whom to 
relax? 
( )  
( )  
( )  
( )  
( )  

98 
 
Do you have 
someone with 
whom you can 
do something 
enjoyable? 
( )  
( )  
( )  
( )  
( )  
Do you find 
companionship 
when you want 
it? 
( )  
( )  
( )  
( )  
( )  
 
 
Thank You! 
 
ID: 1 
Thank you for taking this survey! 
 
 
 
 
 

99 
 
CASI Survey 3-month- P3-T arm 
P3-T RCT Month-3 Follow-up (P3-T Arm) 
 
Shortname / Alias: studyarm 
ID: 1071 
Enter Study Arm for testing survey (will switch to staff login before launch): 
( ) P3-T Arm 
( ) Standard of Care Arm 
 
ID: 93 
Thank you for participating in the P3-T study! The purpose of the study is to test a PrEP 
adherence intervention for young men who have sex with men who are starting PrEP. As 
part of the P3-T study, there are three surveys: one when you enrolled, one at your follow 
up appointment today, and one at your follow up appointment in 3 months.        
 
Try to answer every question as best you can. If you need help, please ask the study staff. 
Your answers will be used only for research purposes. Let’s get started!   
  
 
 
Cell Phone 
 
ID: 120 
Now, we’d like to ask you about your cell phone and internet use. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: paychange 
ID: 1068 
In the last 3 months, has who pays for your cellphone or smart phone changed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #2 Question "In the last 3 months, has who pays for your cellphone or 
smart phone changed?" is one of the following answers ("Yes") 
Shortname / Alias: phonepay 

100 
 
ID: 127 
Who usually pays for your cell phone or smartphone plan?* 
( ) I do 
( ) Someone else does 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: disconnect 
ID: 128 
In the last 3 months, did you ever not have access to your phone or phone service?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnecttimes 
ID: 129 
How many times in the last 3 months did you not have access to your phone or phone service?* 
( ) Once 
( ) Twice 
( ) 3 to 5 times 
( ) More than 5 times 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnectlength 
ID: 130 
The last time you did not have access to your phone or phone service, for how long did you not 
have access?* 
( ) 1 day or less 
( ) 2 to 6 days 
( ) 1 to 4 weeks 
( ) More than 4 weeks 
 
 
 
Employment, Income 

101 
 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: employed 
ID: 109 
Are you currently employed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #7 Question "Are you currently employed?" is one of the following 
answers ("Yes") 
Shortname / Alias: employedhours 
ID: 110 
Are you employed full-time or part-time? 
Part-time means that you work less than 35 hours per week during most weeks.* 
( ) Full time 
( ) Part time 
 
Shortname / Alias: income_30d 
ID: 564 
How much money did you make altogether during the past 30 days?* 
___________________ 
( ) Don't know 
 
Shortname / Alias: incomelevel 
ID: 111 
How would you describe your income level?* 
( ) Low income 
( ) Middle income 
( ) High income 
( ) Decline to answer 
 
 
Food, Shelter 
 
Shortname / Alias: cutmeal 

102 
 
ID: 112 
In the past 3 months, how often did you or your family have to cut meal size or skip a meal 
because there was not enough money for food?* 
( ) Almost every week 
( ) Several weeks but not every week 
( ) Only a few weeks 
( ) Did not have to skip or cut the size of meals 
 
Shortname / Alias: shelter 
ID: 113 
In the past 3 months, have you spent at least one night (check all that apply):* 
[ ] In a shelter? 
[ ] In a public place not intended for sleeping (e.g., bus station, car, abandoned building)? 
[ ] On the street or anywhere outside (e.g., park, sidewalk)? 
[ ] Temporarily doubled up with a friend or family member? 
[ ] In a temporary housing program? 
[ ] In a welfare or voucher hotel/motel? 
[ ] In jail, prison, or a halfway house? 
[ ] In drug treatment, a detox unit, or drug program housing? 
[ ] In a hospital, nursing home, or hospice? 
[ ] I have not spent a night in any of the above places. 
 
 
 
Insurance 
Shortname / Alias: insurance 
ID: 206 
Do you currently have health insurance or health care coverage? 
( ) Yes 
( ) No 
( ) I don’t know 
 
Sexual Identity, Relationships 
 
ID: 565 

103 
 
The following questions ask about your sexual identity and relationship status.  
 
Please answer to the best of your ability. 
 
Shortname / Alias: sexualid 
ID: 102 
What is your current sexual identity?* 
( ) Gay, homosexual, same gender loving 
( ) Bisexual 
( ) Queer 
( ) Straight or heterosexual 
( ) Other, specify:: _________________________________________________* 
 
Shortname / Alias: relationship 
ID: 118 
How do you define your primary relationship status?* 
( ) Single, not currently dating 
( ) Single, casually dating 
( ) In a relationship 
( ) Married or other legal commitment 
 
 
 
Page entry logic: This page will show when: #20 Question "How do you define your primary relationship 
status?" is one of the following answers ("In a relationship","Married or other legal commitment") 
Sexual Health Priorities with Partner 
 
ID: 566 
People have different sexual health priorities. For example, some people prioritize staying 
HIV-negative; others want to have as much fun as possible with their partners; others 
want to feel as close and connected to their partners as possible. 
 
For these next questions, we are interested in you and your primary romantic partner’s 
sexual health priorities.  
  
 

104 
 
Shortname / Alias: shpriorities_scale 
ID: 569 
Thinking about you and your partner’s sexual health priorities, please indicate the extent to 
which you agree or disagree with the following statements.* 
 
Strongly 
Agree 
Agree 
Disagree 
Strongly 
Disagree 
I feel like my 
partner and 
I are “on the 
same page” 
in terms of 
the 
decisions 
we make 
about 
sexual 
health and 
risk  
( )  
( )  
( )  
( )  
When it 
comes to 
sexual 
decision-
making, I 
feel like my 
partner and 
I are “of the 
same mind” 
( )  
( )  
( )  
( )  
Sometimes I 
feel like my 
priorities for 
my sexual 
health are 
incompatible 
with my 
partner’s 
goals  
( )  
( )  
( )  
( )  
I’m 
confident 
that my 
partner and 
I generally 
share the 
same 
priorities 
when it 
comes to 
sexual 
health 
( )  
( )  
( )  
( )  

105 
 
Making 
sexual 
health 
decisions 
with my 
partner can 
be difficult 
because we 
have 
different 
priorities  
( )  
( )  
( )  
( )  
 
 
Health Providers 
 
ID: 157 
Now, we are going to ask you about your health care and health care decision making. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: pcp 
ID: 158 
Do you have a primary health care provider (for example, a pediatrician, a doctor, or other health 
care provider that you see regularly)?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcpawareness 
ID: 105 
How open are you about your sexual identity to your primary medical care provider?* 
( ) Primary medical provider definitely does NOT know your sexual identity 
( ) Primary medical provider MIGHT know about your sexual identity 
( ) Primary medical provider PROBABLY knows about your sexual identity 
( ) Primary medical provider DEFINITELY knows about your sexual identity 
 

106 
 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcptalksex 
ID: 160 
How comfortable are you discussing your sexual behavior with your primary health care 
provider?* 
( ) Very comfortable 
( ) Somewhat comfortable 
( ) Somewhat uncomfortable 
( ) Very uncomfortable 
 
 
STI Testing 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: stitest3m 
ID: 170 
A sexually transmitted infection (STI) is an infection transmitted through sexual activity, such as 
syphilis, gonorrhea, chlamydia, herpes, or genital warts. In the past 3 months, have you been 
tested for an STI that was not HIV?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #25 Question "A sexually transmitted infection (STI) is an infection 
transmitted through sexual activity, such as syphilis, gonorrhea, chlamydia, herpes, or genital 
warts. In the past 3 months, have you been tested for an STI that was not HIV?" is one of the 
following answers ("Yes") 
Shortname / Alias: sti3mo 
ID: 171 
Please indicate whether you have been diagnosed with any of the following sexually transmitted 
infections in the past 3 months. 
Please select all that apply.* 
[ ] Chlamydia 
[ ] Genital warts, anal warts, HPV 
[ ] Gonorrhea 
[ ] Hepatitis B 
[ ] Hepatitis C 
[ ] Herpes, HSV1/HSV2 

107 
 
[ ] Syphilis 
[ ] Urethritis 
[ ] Other, please specify:: _________________________________________________ 
[ ] None of these 
 
 
 
 
HIV Testing 
Shortname / Alias: recenthivtest_mon 
ID: 165 
When did you have your most recent HIV test? 
 
Please enter the month and year. 
 
Month:* 
( ) January 
( ) February 
( ) March 
( ) April 
( ) May 
( ) June 
( ) July 
( ) August 
( ) September 
( ) October 
( ) November 
( ) December 
 
Validation: Min = 1980 Must be numeric Whole numbers only Positive numbers only Max character count 
= 4 
Shortname / Alias: recenthivtest_yr 
ID: 166 
Year:* 
_________________________________________________ 
 

108 
 
 
 
Page entry logic: This page will show when: (#27 Question "When did you have your most recent HIV 
test? 
 
Please enter the month and year. 
 
Month:" AND #28 Question "Year:" ) 
 
Action: Custom Script: Check HIV test date not in future 
 
 
PrEP Use 
Shortname / Alias: prepstartafterP3-T 
ID: 1201 
Did you start taking PrEP after you started the P3-T study?* 
( ) Yes 
( ) No 
 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: nowprep 
ID: 1202 
Are you taking PrEP right now?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: Fix logic- If no to Did you start taking PrEP after you enrolled in P3-T 
Shortname / Alias: noprep_why 
ID: 1203 
Why did you decide not to start PrEP? Select all of the factors below that were related to why you 
didn’t start PrEP.* 
[ ] I couldn't afford it 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to take a pill every day 

109 
 
[ ] My parent(s) or guardian(s) found out and wouldn’t let me start 
[ ] I kept forgetting to take my pill 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I was worried about experiencing side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to take PrEP (due to kidney/renal function, bone density, or another 
medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] I was worried that the medication would taste bad and/or the pill would be too big 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #32 Question "Why did you decide not to take PrEP? 
Select all of the factors below that were related to why you didn’t take PrEP."  
PrEP Use, why didn't start 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
ID: 1204 
Piping: Piped Values From Question 32. (Why did you decide not to take PrEP? Select all of the factors 
below that were related to why you didn’t take PrEP.) 
Please rank the reasons you did not start taking PrEP in order of importance.* 
 
 
Page entry logic: Fix logic- If yes to Did you start taking PrEP after you enrolled in P3-T 
PrEP Start 
 
Shortname / Alias: startprep_why 
ID: 943 
Why did you choose to start taking PrEP? Select all that apply.* 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking about having sex with someone whose HIV status I don’t know 

110 
 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
 
PrEP Start 
 
Action: Custom Script: Script to count checkboxes and skip q if < 2 
 
Shortname / Alias: startprep_primwhy 
ID: 945 
Piping: Piped Values From Question 34. (Why did you choose to start taking PrEP? Select all that apply.) 
What was the main reason you started PrEP?* 
 
 
Page entry logic: This page will show when: (#30 Question "Did you start taking PrEP after you started 
the P3-T study?" is one of the following answers ("Yes") OR #31 Question "Are you taking PrEP right 
now?" is one of the following answers ("Yes")) 
PrEP Start and Stop 
 
Validation: %s format expected 
Logic: Hidden unless: #30 Question "Did you start taking PrEP after you started the P3-T study?" 
is one of the following answers ("Yes") 
Shortname / Alias: prep_firststart 

111 
 
ID: 947 
When did you start taking PrEP after enrolling in P3-T? 
If you do not know the exact day of the month, please give your best estimate. * 
_________________________________________________ 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: prepstoP3-Tmo 
ID: 576 
Have you stopped taking PrEP for 7 days in a row or more in the last 3 months?* 
( ) Yes 
( ) No 
 
Action: Custom Script: Check date not in future 
 
Action: Custom Script: Script to populate - 3 months date 
 
Hidden Value: Date for prompt - today minus 3 months 
Value:  
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Stop, last 3 months 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: timesprepstoP3-Tmo 
ID: 950 
How many times did you stop taking PrEP for 7 days in a row or more in the last three months 
(from [question('value'), id='1026'] to today)?* 
( ) 0 
( ) 1 
( ) 2 
( ) 3 
( ) 4 

112 
 
( ) 5 
( ) 6 
( ) 7 
( ) 8 
( ) 9 
( ) 10 
( ) 11 
( ) 12 or more 
 
Logic: Hidden by default 
ID: 1159 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1") 
Shortname / Alias: time1_dates 
ID: 1027 
Please enter the dates you were off PrEP (from [question('value'), id='1026'] to today): 
Validation: %s format expected 
ID: 1028 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1029 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1160 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefirst_dates 

113 
 
ID: 1030 
Please enter the dates you were off PrEP for the first time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1031 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1032 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1161 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesecond_dates 
ID: 1033 
Please enter the dates you were off PrEP for the second time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1034 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1035 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1162 
The date re-started is before the date stopped. Please correct this.  
 

114 
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timethird_dates 
ID: 1036 
Please enter the dates you were off PrEP for the third time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1037 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1038 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1163 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefourth_dates 
ID: 1039 
Please enter the dates you were off PrEP for the fourth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1040 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1041 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1164 

115 
 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefifth_dates 
ID: 1042 
Please enter the dates you were off PrEP for the fifth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1043 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1044 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1165 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesixth_dates 
ID: 1045 
Please enter the dates you were off PrEP the sixth time (from [question('value'), id='1026'] 
to today): 
Validation: %s format expected 
ID: 1046 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1047 
Date re-started:*: _________________________________________________ 
 

116 
 
Logic: Hidden by default 
ID: 1166 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("7","8","9","10","11","12 or more") 
Shortname / Alias: timeseventh_dates 
ID: 1048 
Please enter the dates you were off PrEP for the seventh time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1049 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1050 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1167 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("8","9","10","11","12 or more") 
Shortname / Alias: timeeighth_dates 
ID: 1051 
Please enter the dates you were off PrEP for the eighth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1052 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1053 

117 
 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1168 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("9","10","11","12 or more") 
Shortname / Alias: timeninth_dates 
ID: 1054 
Please enter the dates you were off PrEP for the ninth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1055 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1056 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1169 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("10","11","12 or more") 
Shortname / Alias: timetenth_dates 
ID: 1057 
Please enter the dates you were off PrEP for the tenth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1058 

118 
 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1059 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1170 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("11","12 or more") 
Shortname / Alias: timeeleventh_dates 
ID: 1060 
Please enter the dates you were off PrEP for the eleventh time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1061 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1062 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1171 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("12 or more") 
Shortname / Alias: timetwelfth_dates 
ID: 1063 

119 
 
Please enter the dates you were off PrEP for the twelfth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1064 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1065 
Date re-started:*: _________________________________________________ 
 
Page entry logic: This page will show when: ((#37 Question "Have you stopped taking PrEP for 7 days 
in a row or more in the last 3 months?" is one of the following answers ("Yes") OR (#29 Question "When 
you started the P3-T study, were you taking PrEP?" is one of the following answers ("Yes") AND #31 
Question "Are you taking PrEP right now?" is one of the following answers ("No"))) OR (#30 Question 
"Did you start taking PrEP after you started the P3-T study?" is one of the following answers ("Yes") AND 
#31 Question "Are you taking PrEP right now?" is one of the following answers ("No"))) 
PrEP Stop 
 
Logic: Hidden by default 
ID: 1206 
This number cannot be greater than the number of times you stopped taking PrEP for 7 days in a 
row or more in the last 3 months ([question('value'), id='950']). Please correct this. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1","2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: prepstop_drconsult 
ID: 578 
Of the [question("value"), id="950"] times you stopped taking PrEP, how many did you 
talk with your medical provider about before you stopped taking PrEP?* 
_________________________________________________ 
 
Shortname / Alias: stopprep_why 
ID: 581 
Think about the most recent time you stopped taking PrEP. Select all of the factors below that 
were related to why you stopped PrEP.* 
[ ] I couldn't afford it anymore 

120 
 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to keep taking a pill every day 
[ ] My parent(s) or guardian(s) found out and made me stop 
[ ] I kept forgetting to take my pill 
[ ] I haven't been able to make it to my follow-up appointments 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I experienced side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to continue taking PrEP (due to kidney/renal function, bone density, or 
another medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] The medication tastes bad and/or the pill is too big 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #38 Question "How many times did you stop taking PrEP 
for 7 days in a row or more in the last three months (from [question('value'), id='1026'] to today)?" is one 
of the following answers ("1","2","3","4","5","6","7","8","9","10","11") 
 
Action: Custom Script: Script to check number of times off PrEP 
 
 
Page entry logic: This page will show when: #53 Question "Think about the most recent time you 
stopped taking PrEP. Select all of the factors below that were related to why you stopped PrEP."  
PrEP Stop Continued 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: stopprep_primwhy 
ID: 582 
Piping: Piped Values From Question 53. (Think about the most recent time you stopped taking PrEP. 
Select all of the factors below that were related to why you stopped PrEP.) 

121 
 
Please rank the reasons you stopped taking PrEP in order of importance.* 
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Restart, current users 
 
Shortname / Alias: restart_why 
ID: 956 
Why did you choose to restart taking PrEP the last time? Select all that apply.* 
[ ] I was able to start seeing my PrEP provider again 
[ ] I found a new PrEP provider 
[ ] I was having issues with side effects, but I found a way to deal with them 
[ ] I was having issues taking my pill every day, but I found a way to deal with it 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking having sex with someone whose status HIV I don’t know 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #55 Question "Why did you choose to restart taking PrEP 
the last time? Select all that apply."  
Restart reason, current users 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 

122 
 
 
Shortname / Alias: restart_primwhy 
ID: 957 
Piping: Piped Values From Question 55. (Why did you choose to restart taking PrEP the last time? 
Select all that apply.) 
What was the main reason you decided to restart PrEP?* 
 
 
Healthcare Visits 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists.  
Shortname / Alias: numdrvisits3m 
ID: 584 
In the last 3 months, how many times did you go to the doctor for any reason?* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 940 
This number cannot be greater than the total number of doctor's visits entered above.  
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists. Hidden unless: #57 Question "In the last 3 months, how many 
times did you go to the doctor for any reason?" is greater than "0" 
Shortname / Alias: numprepvisits3m 
ID: 586 
Out of all these visits, how many were routine/scheduled PrEP appointments?* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 988 

123 
 
This number cannot be greater than the total number of routine PrEP appointments. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #58 Question "Out of all these visits, how many were routine/scheduled 
PrEP appointments?" is greater than "0" 
Shortname / Alias: missedprepvisits3m 
ID: 587 
In the last 3 months, how many of your scheduled PrEP appointments did you miss 
because you didn't show or forgot? 
By scheduled appointments, we mean routine PrEP appointments, not walk-in or urgent 
care appointments for acute/urgent issues. * 
_________________________________________________ 
 
Action: Custom Script: Script to check number of visits 
 
Action: Custom Script: Script to check number of days 
 
 
PrEP Adherence 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: preplastweek 
ID: 177 
How many of the last 7 days did you take your PrEP medication?* 
( ) 0 days 
( ) 1 day 
( ) 2 days 
( ) 3 days 
( ) 4 days 
( ) 5 days 
( ) 6 days 
( ) 7 days 
 
Validation: Min = 0 Max = 100 
Logic: Show/hide trigger exists.  

124 
 
Shortname / Alias: prepmonth 
ID: 178 
In the last month, what percent of the time did you take your PrEP as prescribed (once a day)? 
Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:* 
0 ________________________[__]_____________________________ 100 
 
 
PrEP Dose Barriers 
 
Shortname / Alias: dose_ 
ID: 959 
What has gotten in the way of you taking your PrEP on a daily basis? Please select all that apply.* 
[ ] I have not had any trouble taking PrEP on a daily basis 
[ ] I get tired of taking a pill every day 
[ ] I forget to take it 
[ ] I don’t always have my pills with me 
[ ] My work/school schedule 
[ ] My social life 
[ ] I’m around people I don’t want to take it in front of 
[ ] I experience side effects 
[ ] I was drinking or using drugs and I didn’t take it 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: does_rank 
ID: 960 
Piping: Piped Values From Question 62. (What has gotten in the way of you taking your PrEP on a daily 
basis? Please select all that apply.) 
Please rank the things that have gotten in the way of you taking your PrEP on a daily basis.* 
 
 
PrEP Adherence Continued 

125 
 
 
Logic: Hidden unless: #61 Question "In the last month, what percent of the time did you take your 
PrEP as prescribed (once a day)? Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:"  
Shortname / Alias: prepadher_protection 
ID: 588 
You said you took your PrEP [question("value"), id="178"] percent of the time in the last month. 
Based on this adherence level, how protected do you think you were from HIV in the last month?* 
( ) Not protected at all 
( ) Somewhat protected 
( ) Mostly protected 
( ) Fully protected 
( ) Decline to answer 
 
Shortname / Alias: prepadher_decisionbot 
ID: 589 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you bottom?* 
( ) My decision about condom use when I bottom was not influenced by whether or not I took my pill 
every day 
( ) My decision about condom use when I bottom was somewhat influenced by whether or not I took my 
pill every day 
( ) My decision about condom use when I bottom was influenced by whether or not I took my pill every 
day 
 
Shortname / Alias: prepadher_decisiontop 
ID: 590 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you top?* 
( ) My decision about condom use when I top was not influenced by whether or not I took my pill every 
day 
( ) My decision about condom use when I top was somewhat influenced by whether or not I took my pill 
every day 
( ) My decision about condom use when I top was influenced by whether or not I took my pill every day 
( ) I did not top in the last month 
 
PrEP Confidence 

126 
 
 
ID: 907 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: keepappts 
ID: 903 
How confident are you that you can... 
 
Keep your PrEP medical appointments:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: followplan 
ID: 904 
Follow a plan for taking PrEP:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: atworkschool 
ID: 905 
Take PrEP at work/school:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekday 
ID: 906 
Take PrEP on a weekday:* 
1 ________________________[__]_____________________________ 10 
 
Action: JavaScript: Hide General Error Message 
 

127 
 
 
PrEP Confidence 2 
 
ID: 908 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekend 
ID: 909 
How confident are you that you can... 
 
Take PrEP on a weekend:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: wfriends 
ID: 910 
Take PrEP when I'm out with friends:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: prepdrinking 
ID: 911 
Take PrEP when I'm drinking or using drugs:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: schedulechange 
ID: 912 
Take PrEP when my schedule changes:* 
1 ________________________[__]_____________________________ 10 
 

128 
 
 
 
PrEP Confidence 3 
 
ID: 913 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: whiletraveling 
ID: 914 
How confident are you that you can... 
 
Take PrEP while traveling:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: takewsideeffects 
ID: 915 
Take PrEP when you are having medication side effects:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: havingcrisis 
ID: 916 
Take PrEP when you are having a crisis:* 
1 ________________________[__]_____________________________ 10 
 
PrEP Delivery 
Shortname / Alias: prep_prefmode 
ID: 597 

129 
 
Right now there are no other approved options for taking PrEP. However, if there were more than 
one option and each method was equally good at protecting you from getting HIV, which method 
would you most prefer?* 
( ) Taking one pill, every day 
( ) Taking two pills before you had sex and a pill a day for the next two days 
( ) Taking one pill a day just on Tuesday, Thursday, Saturday, and Sunday 
( ) Getting an injection about every 2 to 3 months 
( ) Putting medicated lubrication (lube) in your anus (and/or your partner’s anus) before having anal sex 
( ) Douching with a medicated solution (microbicide) before having anal sex 
 
 
PrEP Beliefs 
 
Shortname / Alias: prepbeliefs 
ID: 598 
Please rate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
People are 
less likely 
to use 
condoms 
for anal sex 
if they are 
using PrEP 
( )  
( )  
( )  
( )  
I feel as if 
starting to 
take PrEP 
would allow 
me to have 
more sex 
partners 
( )  
( )  
( )  
( )  
I feel as if 
starting to 
take PrEP 
would allow 
me to have 
more 
condomless 
anal sex 
( )  
( )  
( )  
( )  
 

130 
 
 
PrEP and People 
 
Shortname / Alias: prepppl 
ID: 193 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I worry 
people will 
assume I 
sleep around 
if they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
assume that I 
am HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think my 
partner(s) 
are HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry about 
listing PrEP 
as one of my 
current 
medications 
during 
appointments 
such as at a 
dentist's or 
specialist's 
office  
( )  
( )  
( )  
( )  
I feel 
ashamed to 
tell other 
( )  
( )  
( )  
( )  

131 
 
people that I 
am taking 
PrEP  
I worry 
people will 
think I am a 
bad person if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am 
gay if they 
know I take 
PrEP  
( )  
( )  
( )  
( )  
I worry my 
friends will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
family will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
sexual 
partners will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I think people 
will give me a 
hard time if I 
tell them I 
take PrEP  
( )  
( )  
( )  
( )  
I think people 
will judge me 
if they know I 
am taking 
PrEP 
( )  
( )  
( )  
( )  
 
 
PrEP Concerns 
 

132 
 
Shortname / Alias: prepconc 
ID: 210 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
My family 
does not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
My friends 
do not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
People 
taking PrEP 
are 
portrayed 
poorly in the 
media and 
online 
( )  
( )  
( )  
( )  
People in my 
community 
talk poorly 
about people 
taking PrEP 
( )  
( )  
( )  
( )  
I feel 
embarrassed 
about taking 
PrEP  
( )  
( )  
( )  
( )  
I think I am 
not following 
the 'rules' of 
my 
community if 
I take PrEP  
( )  
( )  
( )  
( )  
I have been 
blamed by 
people in my 
community 
for spreading 
HIV through 
PrEP use  
( )  
( )  
( )  
( )  

133 
 
I have been 
blamed by 
people in my 
community 
for spreading 
sexually 
transmitted 
infections 
through not 
using 
condoms  
( )  
( )  
( )  
( )  
I have been 
rejected 
romantically 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
slut-shamed 
because I 
take PrEP 
(or told that I 
am a 
"Truvada-
slut/whore")  
( )  
( )  
( )  
( )  
I have been 
judged by a 
health care 
provider for 
taking PrEP  
( )  
( )  
( )  
( )  
I don't think 
that I need to 
take PrEP 
anymore 
( )  
( )  
( )  
( )  
I have been 
told by a 
health care 
provider that 
I don't need 
PrEP or I 
shouldn't 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
yelled at or 
scolded 
because I 
take PrEP  
( )  
( )  
( )  
( )  

134 
 
I have been 
unfairly 
discriminated 
against 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have 
experienced 
physical 
violence 
because I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "I don't think that I need to take PrEP anymore" is one of the 
following answers ("Agree","Strongly Agree") 
Shortname / Alias: whydontneed 
ID: 1067 
Why do you think that you do not need to take PrEP anymore? Select all that apply.* 
[ ] My relationship status changed -- I became single 
[ ] My relationship status changed -- I became monogamous (only having sex with one person) 
[ ] I stopped having sex with an HIV-positive person 
[ ] I am having less sex 
[ ] I am sexually inactive (I haven't been having sex for a period of time) 
[ ] I have started using condoms every time I have sex 
[ ] Other, please specify:: _________________________________________________ 
 
PrEP Difficulties 
 
Shortname / Alias: prepdifficulties 
ID: 602 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
Getting the 
costs of PrEP 
covered 
(including 
( )  
( )  
( )  
( )  

135 
 
office visits or 
office visit co-
pays, lab 
costs, 
transportation 
costs)  
Using 
insurance to 
get coverage 
for PrEP 
costs 
(including 
office visits, 
lab costs)  
( )  
( )  
( )  
( )  
Getting 
transportation 
to PrEP 
appointments 
and labs 
( )  
( )  
( )  
( )  
Returning for 
PrEP follow-
up 
appointments 
and labs 
( )  
( )  
( )  
( )  
Getting PrEP 
prescription 
refilled 
( )  
( )  
( )  
( )  
 
 
PrEP Difficulties Continued 
 
Shortname / Alias: prepdifficulties2 
ID: 649 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
The 
possibility 
that if I were 
to become 
( )  
( )  
( )  
( )  

136 
 
HIV+, 
certain 
medications 
might no 
longer work 
or I might be 
resistant to 
them  
The 
possibility 
that PrEP 
might not 
provide 
complete 
protection 
against HIV  
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about PrEP 
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about my 
sex life 
( )  
( )  
( )  
( )  
Experiencing 
side effects 
from PrEP 
( )  
( )  
( )  
( )  
The long-
term effects 
of PrEP on 
my health 
( )  
( )  
( )  
( )  
Having to 
remember to 
take PrEP 
every day 
( )  
( )  
( )  
( )  
Friends 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Family 
members 
finding out 
( )  
( )  
( )  
( )  

137 
 
that I am on 
PrEP 
Sexual 
partners 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "The possibility that PrEP might not provide complete protection 
against HIV " is one of the following answers ("Concerned","Very concerned") 
Shortname / Alias: prepworry 
ID: 665 
Why do you worry about the possibility that PrEP might not provide complete protection against 
HIV? (Check all that apply)* 
[ ] I worry that the drug is not effective at preventing HIV 
[ ] Because I don't take PrEP every day consistently 
[ ] Because I feel I am at very high risk for becoming infected with HIV 
[ ] Other, please specify:: _________________________________________________ 
 
 
HIV perceptions 
 
Shortname / Alias: hivthoughts 
ID: 667 
Imagine how you would feel if you became infected with HIV. Read each statement carefully and 
indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I would 
be afraid 
people 
would 
judge me 
when 
they 
learn I 
have HIV  
( )  
( )  
( )  
( )  

138 
 
If I got 
infected, 
people 
would 
not want 
to have 
sex with 
me  
( )  
( )  
( )  
( )  
I would 
feel 
guilty if I 
got HIV  
( )  
( )  
( )  
( )  
I would 
feel 
ashamed 
if I got 
HIV  
( )  
( )  
( )  
( )  
 
 
PEP and PrEP On-Demand 
 
Shortname / Alias: pep3m 
ID: 230 
In the past 3 months, have you taken post-exposure prophylaxis (PEP) AFTER a sexual or drug 
use exposure to reduce the risk of getting HIV?* 
( ) Yes 
( ) No 
 
Shortname / Alias: prepondemand3m 
ID: 674 
In the past 3 months, have you taken PrEP on-demand (taking two pills before you had sex and a 
pill a day for the next two days)? 
It is not an approved method and has not been shown to be an effective method for preventing 
HIV.* 
( ) Yes 
( ) No 
 
Substances 
 

139 
 
ID: 232 
Now we’d like to ask you a little bit about your experiences using alcohol, tobacco 
products, and other drugs. Please be assured that this information will be treated as 
strictly confidential. 
 
The questions will concern your experiences with using these substances in the past 
three months. These substances can be smoked, swallowed, snorted, inhaled, injected, or 
taken in the form of pills. Some of the substances may be prescribed by a doctor (like 
amphetamines, sedatives, or pain medications). For this survey, do not report on 
medications that are used as prescribed by your doctor. However, if you have taken such 
medications for reasons other than prescription, or taken them more frequently or at 
higher doses than prescribed, please report on this use. Once again, please remember 
that all information provided will be treated as strictly confidential. 
 
Shortname / Alias: substanceuse3m 
ID: 233 
Which of the following drugs have you used in the last 3 months? 
Please check all that apply.* 
[ ] Tobacco (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.) 
[ ] Alcohol (beer, wine, spirits, etc.) 
[ ] Cannabis (marijuana, pot, weed, grass, hash, synthetic cannabis, etc.) 
[ ] Cocaine (coke, crack, etc.) 
[ ] Amphetamines (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.) 
[ ] Inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.) 
[ ] Sedatives, tranquilizers, or sleeping pills (valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) 
[ ] Hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.) 
[ ] Opioids (heroin, morphine, methadone, codeine, Oxycotin, Percocet, Vicodin, etc.) 
[ ] None of these 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Tobacco (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)") 
Tobacco 
 
Shortname / Alias: tobacco3months 
ID: 234 

140 
 
In the past 3 months, how often have you used tobacco products (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: tobaccodesire 
ID: 235 
During the past 3 months, how often have you had a desire to use tobacco products (cigarettes, 
chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccoproblems 
ID: 236 
During the past 3 months, how often has your use of tobacco products (cigarettes, chewing 
tobacco, cigars, e-cigarettes, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofailed 
ID: 237 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, 
etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 

141 
 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofriend 
ID: 238 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: tobaccostop 
ID: 239 
In the last 3 months, have you tried and failed to control, cut down or stop using tobacco 
products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Alcohol (beer, wine, spirits, etc.)") 
Alcohol 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: alcohol3months 
ID: 240 
In the past 3 months, how often have you used alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Logic: Hidden unless: #97 Question "In the past 3 months, how often have you used alcoholic 
beverages (beer, wine, spirits, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily","Decline to answer") 
Shortname / Alias: alcoholdaily 

142 
 
ID: 241 
How many drinks containing alcohol do you have on a typical day?* 
( ) 0 
( ) 1 or 2 
( ) 3 or 4 
( ) 5 or 6 
( ) 7 to 9 
( ) 10 or more 
 
Shortname / Alias: alcoholbinge 
ID: 242 
How often do you have 5 or more drinks on one occasion?* 
( ) Never 
( ) Less than monthly 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholdesire 
ID: 243 
During the past 3 months, how often have you had a desire to use alcoholic beverages (beer, 
wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholproblems 
ID: 244 
During the past 3 months, how often has your use of alcoholic beverages (beer, wine, spirits, 
etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

143 
 
 
Shortname / Alias: alcoholfailed 
ID: 245 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfriend 
ID: 246 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: alcoholstop 
ID: 247 
In the last 3 months, have you tried and failed to control, cut down or stop using alcoholic 
beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cannabis (marijuana, pot, weed, grass, 
hash, synthetic cannabis, etc.)") 
Cannabis 
 
Shortname / Alias: cannabis3months 

144 
 
ID: 251 
In the past 3 months, how often have you used cannabis (marijuana, pot, grass, hash, etc.) or 
synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #107 Question "In the past 3 months, how often have you 
used cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Cannabis (cont.) 
 
Shortname / Alias: cannabisdesire 
ID: 252 
During the past 3 months, how often have you had a desire to use cannabis (marijuana, pot, 
grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisproblems 
ID: 253 
During the past 3 months, how often has your use of cannabis (marijuana, pot, grass, hash, etc.) 
or synthetic cannabis led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfailed 
ID: 254 

145 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfriend 
ID: 255 
In the past 3 months, has a friend or relative or anyone else expressed concern about your use of 
cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cannabisstop 
ID: 256 
In the last 3 months, have you tried and failed to control, cut down or stop using cannabis 
(marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cocaine (coke, crack, etc.)") 
Cocaine 
 
Shortname / Alias: cocaine3months 
ID: 257 
In the past 3 months, how often have you used cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

146 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #113 Question "In the past 3 months, how often have you 
used cocaine (coke, crack, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily") 
Cocaine (cont.) 
 
Shortname / Alias: cocainedesire 
ID: 258 
During the past 3 months, how often have you had a desire to use cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocaineproblems 
ID: 259 
During the past 3 months, how often has your use of cocaine (coke, crack, etc.) led to health, 
social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocainefailed 
ID: 260 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

147 
 
 
Shortname / Alias: cocainefriend 
ID: 261 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
cocaine (coke, crack, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cocainestop 
ID: 262 
In the last 3 months, have you tried and failed to control, cut down or stop using cocaine (coke, 
crack, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Amphetamines (speed, meth, diet pills, 
ecstasy, Ritalin, Adderall, etc.)") 
Amphetamine 
 
Shortname / Alias: amphetamine3months 
ID: 263 
In the past 3 months, how often have you used amphetamine type stimulants (speed, meth, diet 
pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 

148 
 
Page entry logic: This page will show when: #119 Question "In the past 3 months, how often have you 
used amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Amphetamine (cont.) 
 
Shortname / Alias: amphetaminedesire 
ID: 265 
During the past 3 months, how often have you had a desire to use amphetamine type stimulants 
(speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetamineproblems 
ID: 266 
During the past 3 months, how often has your use of amphetamine type stimulants (speed, meth, 
diet pills, ecstasy, Ritalin, Adderall, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefailed 
ID: 267 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, 
Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefriend 

149 
 
ID: 268 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: amphetaminestop 
ID: 269 
In the last 3 months, have you tried and failed to control, cut down or stop using amphetamine 
type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.)") 
Inhalants 
 
Shortname / Alias: inhalants3months 
ID: 271 
In the past 3 months, how often have you used inhalants (poppers, nitrous, glue, petrol, paint 
thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 

150 
 
Page entry logic: This page will show when: #125 Question "In the past 3 months, how often have you 
used inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?" is one of the following answers ("Once 
or twice","Monthly","Weekly","Daily or almost daily") 
Inhalants (cont.) 
 
Shortname / Alias: inhalantsdesire 
ID: 272 
During the past 3 months, how often have you had a desire to use inhalants (poppers, nitrous, 
glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsproblems 
ID: 273 
During the past 3 months, how often has your use of inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfailed 
ID: 274 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfriend 

151 
 
ID: 275 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
 
Shortname / Alias: inhalantsstop 
ID: 276 
In the last 3 months, have you tried and failed to control, cut down or stop using inhalants 
(poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Sedatives, tranquilizers, or sleeping pills 
(valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)") 
Sedatives 
 
Shortname / Alias: sedatives3months 
ID: 277 
In the past 3 months, how often have you used sedatives, tranquilizers, or sleeping pills (Valium, 
Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 

152 
 
Page entry logic: This page will show when: #131 Question "In the past 3 months, how often have you 
used sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?" 
is one of the following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Sedatives (cont.) 
 
Shortname / Alias: sedativesdesire 
ID: 279 
During the past 3 months, how often have you had a desire to use sedatives, tranquilizers, or 
sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesproblems 
ID: 280 
During the past 3 months, how often has your use of sedatives, tranquilizers, or sleeping pills 
(Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) led to health, social, legal or financial 
problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesfailed 
ID: 281 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, 
Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

153 
 
Shortname / Alias: sedativesfriend 
ID: 282 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, 
etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: sedativesstop 
ID: 283 
In the last 3 months, have you tried and failed to control, cut down or stop using sedatives, 
tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Hallucinogens (LSD, acid, mushrooms, 
PCP, Ketamine, etc.)") 
Hallucinogens 
 
Shortname / Alias: hallucinogens3months 
ID: 285 
In the past 3 months, how often have you used hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Action: JavaScript: Hide General Error Message 
 
 

154 
 
Page entry logic: This page will show when: #137 Question "In the past 3 months, how often have you 
used hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Hallucinogens (cont.) 
 
Shortname / Alias: hallucinogensdesire 
ID: 286 
During the past 3 months, how often have you had a desire to use hallucinogens (LSD, acid, 
mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: hallucinogensproblems 
ID: 287 
During the past 3 months, how often has your use of hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfailed 
ID: 288 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

155 
 
Shortname / Alias: hallucinogensfriend 
ID: 289 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: hallucinogensstop 
ID: 290 
In the last 3 months, have you tried and failed to control, cut down or stop using hallucinogens 
(LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Opioids (heroin, morphine, methadone, 
codeine, Oxycotin, Percocet, Vicodin, etc.)") 
Opioids 
 
Shortname / Alias: opioids3months 
ID: 291 
In the past 3 months, how often have you used opioids (heroin, morphine, methadone, codeine, 
Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 

156 
 
Page entry logic: This page will show when: #143 Question "In the past 3 months, how often have you 
used opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Opioids (cont.) 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: opioidsheroin 
ID: 299 
In the past 3 months, has your opioid use included heroin?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #144 Question "In the past 3 months, has your opioid use included 
heroin?" is one of the following answers ("Yes") 
Shortname / Alias: heroinprimary 
ID: 300 
In the past 3 months, was heroin the most common opioid that you used?* 
( ) Yes 
( ) No 
 
Shortname / Alias: opioidssdesire 
ID: 293 
During the past 3 months, how often have you had a desire to use opioids (heroin, morphine, 
methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsproblems 
ID: 294 
During the past 3 months, how often has your use of opioids (heroin, morphine, methadone, 
codeine, Oxycontin, Percocet, Vicodin, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 

157 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfailed 
ID: 295 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, 
Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfriend 
ID: 296 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 
 
Shortname / Alias: opioidsstop 
ID: 297 
In the last 3 months, have you tried and failed to control, cut down or stop using opioids (heroin, 
morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Sexual Behaviors 
 

158 
 
Page exit logic: Skip / Disqualify LogicIF: #151 Question "In the past 3 months, how many people have 
you had anal sex with?" is exactly equal to "0" THEN: Jump to page 120 - Perceived HIV Risk 
 
ID: 368 
The next section of questions will ask about your sexual behaviors. We know that this can 
be a sensitive topic, so we would like to remind you that your answers will be kept 
completely confidential. Please be as honest as possible in order to ensure the success 
of the current study. 
 
The following questions refer to your sexual behavior during the past 3 months. Our 
focus will be only on anal sex. Therefore, do not include references to people with whom 
you did not engage in anal sex. 
 
For these questions, anal sex refers to sex where the other person’s penis was in your 
rectum (you were the bottom) and to sex where your penis was in the other person's 
rectum (you were the top). 
 
These questions only ask about people assigned male at birth, which includes cisgender 
men (men assigned male at birth) and transgender women (women assigned male at 
birth). Therefore, do not include references to cisgender women (women assigned female 
at birth) or transgender men (men assigned female at birth). 
 
Validation: Min = 0 Max = 999 Must be numeric Whole numbers only Positive numbers only 
Shortname / Alias: numsexpartner 
ID: 302 
In the past 3 months, how many people have you had anal sex with?* 
_________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #151 Question "In the past 3 months, how many people 
have you had anal sex with?" is greater than "0" 
HIV Status of Sexual Partners 
 
Logic: Hidden by default 
ID: 677 

159 
 
The total number must equal the number of people you had anal sex with in the last 3 months 
([question('value'), id='302']). Please correct this. 
 
Validation: Must be numeric 
Shortname / Alias: partnerhivstatus 
ID: 676 
Before you had sex, what did you know of the HIV status of your sexual partner(s)? 
 
Enter numerical values. Numbers must add up to [question('value'), id='302'], the number of people 
you reported having anal sex within the last three months.* 
________This person/these people told you they were HIV negative and you had no reason to doubt it 
________You knew this person/these people were HIV positive 
________You were not completely sure of this person/these people's HIV status 
 
 
 
Action: Custom Script: Script to check the continuous sum totals 
 
 
 
Hidden Value: Num HIV Neg partners 
Value: [question("option value"), id="676", option="12278"] 
 
Hidden Value: Num HIV Pos partners 
Value: [question("option value"), id="676", option="12279"] 
 
Hidden Value: Num HIV Unk partners 
Value: [question("option value"), id="676", option="12280"] 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners 
 
ID: 690 

160 
 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Shortname / Alias: hivneg_timesbot 
ID: 701 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timestop 
ID: 702 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #153 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the 
bottom?" is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
Logic: Hidden by default 
ID: 714 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='701']). Please correct this. 
 
Shortname / Alias: hivneg_timesbotunp 
ID: 710 
In the past 3 months, how many of the [question('value'), id='701'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the bottom 
were without a condom? * 
_________________________________________________ 
 

161 
 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #155 Question "In the past 3 months, how many of 
the [question('value'), id='701'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the bottom were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
ID: 721 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 999 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_typ 
ID: 711 
Regarding the partners who told you they were HIV negative who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1002 

162 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_gender 
ID: 964 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #154 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the top?" 
is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 722 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 719 

163 
 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='702']). Please correct this. 
 
Shortname / Alias: hivneg_timestopunp 
ID: 718 
In the past 3 months, how many of the [question('value'), id='702'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the top were 
without a condom? * 
_________________________________________________ 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #158 Question "In the past 3 months, how many of 
the [question('value'), id='702'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the top were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 723 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 1004 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_typ 
ID: 725 
Regarding the partners who told you they were HIV negative who you had condomless insertive 
anal sex with (where you were the top), how many were...  

164 
 
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1005 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_gender 
ID: 965 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners - PrEP and Alcohol and Drug Use 
 
ID: 992 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 

165 
 
Logic: Hidden by default 
ID: 732 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Shortname / Alias: hivneg_toldyouprep 
ID: 729 
How many of your sexual partners who told you they were HIV negative told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivneg_youtoldprep 
ID: 730 
Regarding your sexual partners who told you they were HIV negative, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 733 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Logic: Hidden unless: #162 Question "Regarding your sexual partners who told you they were 
HIV negative, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivneg_youtoldprepnum 
ID: 731 
How many of your sexual partner(s) who told you they were HIV negative did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 

166 
 
 
Shortname / Alias: hivneg_timesdrunk 
ID: 740 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV negative were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners 
 
ID: 770 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Shortname / Alias: hivpos_timesbot 
ID: 775 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivpos_timestop 
ID: 776 

167 
 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #165 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the 
bottom?" is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 782 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 783 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='775']). Please correct this. 
 
Shortname / Alias: hivpos_timesbotunp 
ID: 784 
In the past 3 months, how many of the [question('value'), id='775'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #167 Question "In the past 3 months, how many of 
the [question('value'), id='775'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the bottom were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 

168 
 
 
ID: 786 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1008 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_typ 
ID: 788 
Regarding the partners who told you they were HIV positive who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1009 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_gender 
ID: 994 
How many were...  
 
Enter numerical values.* 
________Men 

169 
 
________Transwomen 
________Non-binary, genderqueer, and gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #166 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the top?" 
is greater than "0" 
HIV Pos Partners - Condomless Insertive AI 
 
ID: 792 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 793 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='776']). Please correct this. 
 
Shortname / Alias: hivpos_timestopunp 
ID: 794 
In the past 3 months, how many of the [question('value'), id='776'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the top were 
without a condom? * 
_________________________________________________ 
 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 

170 
 
 
 
Page entry logic: This page will show when: #170 Question "In the past 3 months, how many of 
the [question('value'), id='776'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the top were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Insertive AI 
 
ID: 796 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1012 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_typ 
ID: 798 
Regarding the partners who told you they were HIV positive who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1013 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 

171 
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_gender 
ID: 995 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners - HIV Trt and PrEP 
 
Logic: Hidden by default 
ID: 799 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouhivmeds 
ID: 800 
How many of your sexual partners who told you they were HIV positive told you they were 
taking medication to treat HIV?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 920 

172 
 
The number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouundetect 
ID: 918 
How many of your sexual partners who told you they were HIV positive told you they were 
undetectable?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivpos_youtoldprep 
ID: 801 
Regarding your sexual partners who told you they were HIV positive, did you tell any of them that 
you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 802 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Logic: Hidden unless: #175 Question "Regarding your sexual partners who told you they were 
HIV positive, did you tell any of them that you were taking PrEP?" is one of the following answers 
("Yes") 
Shortname / Alias: hivpos_youtoldprepnum 
ID: 803 
How many of your sexual partner(s) who told you they were HIV positive did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Shortname / Alias: hivpos_timesdrunk 

173 
 
ID: 807 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV positive were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 
 
Action: Custom Script: Script to check med number not greater than the total number of partners 
 
 
 
Action: Custom Script: Script to check undetectable number not greater than the total number of 
partners 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners 
 
ID: 810 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Shortname / Alias: hivunk_timesbot 
ID: 815 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the bottom?* 
_________________________________________________ 

174 
 
 
Shortname / Alias: hivunk_timestop 
ID: 816 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #178 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
bottom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 822 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 823 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='815']). Please correct this. 
 
Shortname / Alias: hivunk_timesbotunp 
ID: 824 
In the past 3 months, how many of the [question('value'), id='815'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 

175 
 
Page entry logic: This page will show when: #180 Question "In the past 3 months, how many of 
the [question('value'), id='815'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the bottom were without a condom? " is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 826 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1016 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_typ 
ID: 828 
Regarding the partners whose HIV status you were not sure of who you had condomless 
receptive anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1017 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 

176 
 
Shortname / Alias: hivunk_botunp_gender 
ID: 996 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #179 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
top?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 832 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 833 
This number cannot be greater than the number of times you had anal sex with sexual partner(s) 
whose HIV status you were not sure of where you were the top ([question('value'), id='816']). 
Please correct this. 
 
Shortname / Alias: hivunk_timestopunp 
ID: 834 

177 
 
In the past 3 months, how many of the [question('value'), id='816'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the top 
were without a condom?* 
_________________________________________________ 
 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #183 Question "In the past 3 months, how many of 
the [question('value'), id='816'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the top were without a condom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 836 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1020 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_typ 
ID: 838 
Regarding the partners whose HIV status you were not sure of who you had condomless 
insertive anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 

178 
 
 
Logic: Hidden by default 
ID: 1021 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_gender 
ID: 997 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners - PrEP 
 
Logic: Hidden by default 
ID: 839 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Shortname / Alias: hivunk_toldyouprep 
ID: 840 

179 
 
How many of your sexual partners whose HIV status you were not sure of told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivunk_youtoldprep 
ID: 841 
Regarding your sexual partners whose HIV status you were not sure of, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 842 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Logic: Hidden unless: #187 Question "Regarding your sexual partners whose HIV status you 
were not sure of, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivunk_youtoldprepnum 
ID: 843 
How many of your sexual partner(s) whose HIV status you were not sure of did you tell 
you were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Shortname / Alias: hivunk_timesdrunk 
ID: 847 
In the past 3 months, how many of the times you had anal sex with partners whose HIV 
status you were not sure of were you or this person under the influence of alcohol or 
drugs?* 
_________________________________________________ 
 

180 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk1 
ID: 762 
Based on your reported sexual activities over the last 3 months, how at risk do you think you 
were for contracting HIV in the last 3 months?* 
( ) Not at all at risk for contracting HIV 
( ) Somewhat at risk for contracting HIV 
( ) High risk for contracting HIV 
 
Shortname / Alias: perceivedrisk2 
ID: 763 
What is your gut feeling about how likely you are to get infected with HIV?* 
( ) Extremely unlikely 
( ) Very unlikely 
( ) Somewhat likely 
( ) Very likely 
( ) Extremely likely 
 
Shortname / Alias: perceivedrisk3 
ID: 764 
I worry about getting infected with HIV:* 
( ) None of the time 
( ) Rarely 
( ) Some of the time 
( ) A moderate amount of time 
( ) A lot of the time 
( ) All of the time 
 

181 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk4 
ID: 765 
Getting HIV is something I am...* 
( ) Not concerned about 
( ) A little concerned about 
( ) Moderately concerned about 
( ) Concerned about a lot 
( ) Extremely concerned about 
 
Shortname / Alias: perceivedrisk5 
ID: 766 
There is a chance, no matter how small, I could get HIV:* 
( ) Strongly Disagree 
( ) Disagree 
( ) Agree 
( ) Strongly Agree 
 
Shortname / Alias: perceivedrisk6 
ID: 767 
I think my chances of getting infected with HIV are:* 
( ) Zero 
( ) Almost zero 
( ) Small 
( ) Moderate 
( ) Large 
( ) Very large 
 
 
PHQ-2/GAD-2 
 
ID: 768 

182 
 
Now we are going to ask you about your mental health and how you have been feeling 
recently. 
 
Shortname / Alias: mentalhealthscreener 
ID: 388 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Little 
interest or 
pleasure in 
doing 
things 
( )  
( )  
( )  
( )  
Feeling 
down, 
depressed, 
or 
hopeless 
( )  
( )  
( )  
( )  
Feeling 
nervous, 
anxious or 
on edge 
( )  
( )  
( )  
( )  
Not being 
able to 
stop or 
control 
worrying 
( )  
( )  
( )  
( )  
 
 
 
Page entry logic: This page will show when: psychdistress1 is greater than or equal to "3" 
PHQ-8 
 
Shortname / Alias: phq8 
ID: 397 

183 
 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Trouble 
falling or 
staying 
asleep, or 
sleeping too 
much 
( )  
( )  
( )  
( )  
Feeling tired 
or having 
little energy 
( )  
( )  
( )  
( )  
Poor appetite 
or overeating 
( )  
( )  
( )  
( )  
Feeling bad 
about 
yourself - or 
that you are 
a failure or 
have let 
yourself or 
your family 
down 
( )  
( )  
( )  
( )  
Trouble 
concentrating 
on things, 
such as 
reading the 
newspaper 
or watching 
television 
( )  
( )  
( )  
( )  
Moving or 
speaking so 
slowly that 
other people 
could have 
noticed, or 
the opposite 
- being so 
fidgety or 
restless that 
you have 
been moving 
around a lot 
( )  
( )  
( )  
( )  

184 
 
more than 
usual 
 
 
Page entry logic: This page will show when: psychdistress2 is greater than or equal to "3" 
GAD-7 
 
Shortname / Alias: gad7 
ID: 404 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Worrying 
too much 
about 
different 
things 
( )  
( )  
( )  
( )  
Trouble 
relaxing 
( )  
( )  
( )  
( )  
Being so 
restless 
that it is 
hard to sit 
still 
( )  
( )  
( )  
( )  
Becoming 
easily 
annoyed 
or irritable 
( )  
( )  
( )  
( )  
Feeling 
afraid as if 
something 
awful 
might 
happen 
( )  
( )  
( )  
( )  
 

185 
 
 
Social Isolation 
 
Shortname / Alias: socialisolation 
ID: 432 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I feel 
left out. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
barely 
know 
me. 
( )  
( )  
( )  
( )  
( )  
I feel 
isolated 
from 
others. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
are 
around 
me but 
not with 
me. 
( )  
( )  
( )  
( )  
( )  
 
 
Emotional Support 
 
Shortname / Alias: emotionalsupport 
ID: 411 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 

186 
 
I have 
someone 
who will 
listen to me 
when I need 
to talk. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
confide in or 
talk to about 
myself or 
my 
problems. 
( )  
( )  
( )  
( )  
( )  
I have 
someone 
who makes 
me feel 
appreciated. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
talk with 
when I have 
a bad day. 
( )  
( )  
( )  
( )  
( )  
 
 
Informational Support 
 
Shortname / Alias: informationalsupport 
ID: 417 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone to 
give me 
good 
advice 
about a 
crisis if I 
need it. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
( )  
( )  
( )  
( )  
( )  

187 
 
turn to for 
suggestions 
about how 
to deal with 
a problem. 
I have 
someone to 
give me 
information 
if I need it. 
( )  
( )  
( )  
( )  
( )  
I get useful 
advice 
about 
important 
things in 
life. 
( )  
( )  
( )  
( )  
( )  
 
 
 
Instrumental Support 
 
Shortname / Alias: instrumentalsupport 
ID: 422 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you 
have 
someone 
to help 
you if 
you are 
confined 
to bed? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to take 
you to 
the 
doctor if 
you need 
it? 
( )  
( )  
( )  
( )  
( )  

188 
 
Do you 
have 
someone 
to help 
with your 
daily 
chores if 
you are 
sick? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to run 
errands 
if you 
need it? 
( )  
( )  
( )  
( )  
( )  
 
 
Companionship 
 
Shortname / Alias: companionship 
ID: 427 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you have 
someone with 
whom to have 
fun? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
whom to 
relax? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
whom you can 
do something 
enjoyable? 
( )  
( )  
( )  
( )  
( )  
Do you find 
companionship 
when you want 
it? 
( )  
( )  
( )  
( )  
( )  

189 
 
 
 
 
Page entry logic: This page will show when: #1 Question "Enter Study Arm for testing survey (will 
switch to staff login before launch):" is one of the following answers ("P3 Intervention","P3-T+ (WITH 
COUNSELOR) Intervention") 
P3-T App Questions, Content 
 
Shortname / Alias: P3-T_1 
ID: 1072 
The following questions ask about the content in P3-T.  Please rate how strongly you agree or 
disagree with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I trust the 
information 
in P3-T 
( )  
( )  
( )  
( )  
The 
information 
in P3-T is 
easy to 
understand  
( )  
( )  
( )  
( )  
The 
information 
in P3-T is 
accurate  
( )  
( )  
( )  
( )  
 
 
Page entry logic: Fix 
P3-T App Questions, Experience 
 
Shortname / Alias: P3-T_2 
ID: 1076 

190 
 
The following questions ask about the content in P3-T.  Please rate how strongly you agree or 
disagree with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
P3-T helps 
me to 
quickly find 
information 
and 
support for 
healthy 
living 
( )  
( )  
( )  
( )  
P3-T helps 
me make 
healthier 
choices in 
my life 
( )  
( )  
( )  
( )  
P3-T helps 
me deal 
with health 
challenges 
that might 
come up  
( )  
( )  
( )  
( )  
P3-T is 
useful to 
me  
( )  
( )  
( )  
( )  
 
 
Page entry logic: Fix 
P3-T App Questions, Satisfaction 
 
Shortname / Alias: P3-T_3 
ID: 1081 
The following questions ask about the content in P3-T.  Please rate how strongly you agree or 
disagree with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
Overall, I 
am very 
( )  
( )  
( )  
( )  

191 
 
satisfied 
with P3-T  
Using P3-T 
is very 
frustrating  
( )  
( )  
( )  
( )  
I would 
recommend 
P3-T to my 
friends  
( )  
( )  
( )  
( )  
 
 
 
Page entry logic: Fix 
P3-T App Questions, Opinions 
 
Validation: Max. answers = 2 (if answered) 
Shortname / Alias: leastP3-T 
ID: 1089 
Which two things did you like least about P3-T?* 
[ ] Medication tracker 
[ ] Quests 
[ ] Social wall 
[ ] Knowledge center 
[ ] Collections (written stories) 
[ ] Collections (video) 
[ ] Adherence counselor 
[ ] Decline to answer 
 
Validation: Max. answers = 2 (if answered) 
Shortname / Alias: bestP3-T 
ID: 1090 
Which two things did you like best about P3-T?* 
[ ] Medication tracker 
[ ] Quests 
[ ] Social wall 

192 
 
[ ] Knowledge center 
[ ] Collections (written stories) 
[ ] Collections (video) 
[ ] Adherence counselor 
[ ] Decline to answer 
 
 
Shortname / Alias: P3-Tbetter 
ID: 1093 
Are there any features that would make P3-T better?* 
____________________________________________  
____________________________________________  
____________________________________________  
____________________________________________  
 
 
Page entry logic: This page will show when: #1 Question "Enter Study Arm for testing survey (will 
switch to staff login before launch):" is one of the following answers ("P3-T Intervention","P3-T+ (WITH 
COUNSELOR) Intervention") 
P3-T Opinions 
 
Shortname / Alias: P3-T_4 
ID: 1094 
Please indicate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I think that I 
would like to 
use P3-T 
frequently 
( )  
( )  
( )  
( )  
I found P3-T 
unnecessarily 
complex 
( )  
( )  
( )  
( )  
I thought P3-
T was easy 
to use 
( )  
( )  
( )  
( )  

193 
 
I think that I 
would need 
the support of 
a technical 
person to be 
able to use 
P3-T 
( )  
( )  
( )  
( )  
I found the 
various 
functions in 
P3-T were 
well 
integrated 
( )  
( )  
( )  
( )  
I thought 
there was too 
much 
inconsistency 
in P3-T 
( )  
( )  
( )  
( )  
I imagine that 
most people 
would learn 
to use P3-T 
very quickly 
( )  
( )  
( )  
( )  
I found P3-T 
very 
cumbersome 
to use 
( )  
( )  
( )  
( )  
I felt very 
confident 
using P3-T 
( )  
( )  
( )  
( )  
I needed to 
learn a lot of 
things before 
I could get 
going with 
P3-T 
( )  
( )  
( )  
( )  
I would use 
P3-T in the 
future if it 
were 
available.  
 
 
 
 
 
If P3-T were available in the app store, how much would you be willing to pay for it?  

194 
 
____________ 
 
 
Page entry logic: Fix 
P3-T Opinions 
 
Shortname / Alias: qualityP3-T 
ID: 1107 
How would you rate the quality of the help you have received from P3-T?* 
( ) Excellent 
( ) Good 
( ) Fair 
( ) Poor 
 
Shortname / Alias: appwanted 
ID: 1108 
Did you get the kind of help and/or support you wanted from P3-T?* 
( ) No, definitely not 
( ) No, not really 
( ) Yes, generally 
( ) Yes, definitely 
 
Shortname / Alias: metneeds 
ID: 1109 
To what extent has P3-T met your needs related to improving taking your meds?* 
( ) Almost all of my needs have been met 
( ) Most of my needs have been met 
( ) Only a few of my needs have been met 
( ) None of my needs have been met 
 
Shortname / Alias: recommendP3-T 
ID: 1110 
If a friend were in need of similar help, would you recommend P3-T to them?* 
( ) No, definitely not 

195 
 
( ) No, I don't think so 
( ) Yes, I think so 
( ) Yes, definitely 
 
 
Page entry logic: Fix 
P3-T Opinions 
 
Shortname / Alias: satisfiedhelp 
ID: 1111 
How satisfied are you with the amount of help taking your meds you have received from P3-T?* 
( ) Quite dissatisfied 
( ) Indifferent or mildly dissatisfied 
( ) Mostly satisfied 
( ) Very satisfied 
 
Shortname / Alias: effectiveP3-T 
ID: 1112 
Has P3-T helped you to deal with the challenges you’ve faced taking PrEP?* 
( ) Yes, they helped a great deal 
( ) Yes, they helped 
( ) No, they really didn't help 
( ) No, they seemed to make things worse 
 
Shortname / Alias: satisfiedP3-T 
ID: 1113 
In an overall, general sense, how satisfied are you with P3-T?* 
( ) Very satisfied 
( ) Mostly satisfied 
( ) Indifferent or mildly dissatisfied 
 
Shortname / Alias: returnP3-T 
ID: 1114 

196 
 
If you were having trouble taking your meds in the future, would you use P3-T again?* 
( ) No, definitely not 
( ) No, I don't think so 
( ) Yes, I think so 
( ) Yes, definitely 
 
 
 
 
 
 
 
Please indicate your agreement with the following statements: 
 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I understand how to 
use all the features in 
P3-T. 
( )  
( )  
( )  
( )  
I could show a friend 
how to use all of the 
features in P3-T.  
( )  
( )  
( )  
( )  
I thought P3-T was 
confusing to use. 
( )  
( )  
( )  
( )  
P3-T helped me take 
my PrEP. 
( )  
( )  
( )  
( )  
I will have less 
trouble taking my 
PrEP because of P3-
T. 
( )  
( )  
( )  
( )  
I’m confident that I 
can use P3-T even if 
I’m really busy. 
( )  
( )  
( )  
( )  
I enjoy using P3-T.  
( )  
( )  
( )  
( )  

197 
 
 
Please indicate your agreement with the following statement: 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I understand how to 
use all the features in 
P3-T. 
( )  
( )  
( )  
( )  
I think P3-T would be 
a positive addition for 
young people on 
PrEP. 
 
( )  
( )  
( )  
( )  
It is easy to navigate 
within P3-T. 
( )  
( )  
( )  
( )  
I like the look of P3-
T.  
( )  
( )  
( )  
( )  
Everyone on PrEP 
should have P3-T.  
( )  
( )  
( )  
( )  
If to “everyone on PrEP should have P3-T” answers strongly agree-undecided, then ask,  
Who would P3-T be best for? Check all that apply.  
( ) People starting PrEP 
( ) People who have been on PrEP more than 6 monghts 
( ) People having trouble taking PrEP 
( ) People who are taking PrEP regularly  
 ( ) Other:_____ 
 
If to “everyone on PrEP should have P3-T” answers disagree-strongly disagree, then ask,  
Who would P3-T not be good for? Check all the apply.  
( ) People starting PrEP 
( ) People who have been on PrEP more than 6 months 

198 
 
( ) People having trouble taking PrEP 
( ) People who are taking PrEP regularly  
 ( ) Other:_____ 
 
Page entry logic: Fix 
P3-T Informational Support 
 
Shortname / Alias: P3-Tinformationalsupport 
ID: 1122 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
The P3-T 
app gives 
me good 
advice 
about a 
crisis if I 
need it 
( )  
( )  
( )  
( )  
( )  
The P3-T 
app gives 
me 
suggestions 
about how 
to deal with 
a problem 
( )  
( )  
( )  
( )  
( )  
The P3-T 
app gives 
me 
information 
if I need it 
( )  
( )  
( )  
( )  
( )  
The P3-T 
app gives 
me useful 
advice 
about 
important 
things in life 
( )  
( )  
( )  
( )  
( )  
 
Action: JavaScript: Hide General Error Message 

199 
 
 
 
Page entry logic: Fix 
P3-T Social Isolation 
 
Shortname / Alias: P3-Tisolation 
ID: 1131 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
In P3-T, I 
feel left out 
( )  
( )  
( )  
( )  
( )  
In P3-T, I 
feel that 
people 
barely know 
me 
( )  
( )  
( )  
( )  
( )  
In P3-T, I 
feel isolated 
from others 
( )  
( )  
( )  
( )  
( )  
In P3-T, I 
feel that 
people are 
around me 
but not with 
me 
( )  
( )  
( )  
( )  
( )  
 
 
Please respond to each item by marking one circle per row.*’ 
 
Strongl
y 
Disagre
e 
Disagre
e 
Agre
e 
Strongl
y Agree 
It was easy to 
schedule with the 
adherence 
counselor. 
( )  
( )  
( )  
( )  

200 
 
The adherence 
counselor helped me 
take PrEP more 
regularly. 
( )  
( )  
( )  
( )  
The adherence 
counselor helped me 
solve problems I had 
taking PrEP. 
 
 
 
 
Talking to the 
adherence counselor 
was useful.  
 
 
 
 
I trusted the 
information and 
advice from the 
adherence 
counselor.  
 
 
 
 
The adherence 
counselor was 
responsive and 
reliable. 
 
 
 
 
  
 
Page entry logic: Fix 
P3-T Virtual Community 
 
ID: 1186 
The following questions regard your experience with other users of the P3-T app. Group refers to 
the community of users on the P3-T app.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I think this 
group is a 
good 
place for 
me to be a 
member. 
( )  
( )  
( )  
( )  

201 
 
I feel at 
home in 
this group. 
( )  
( )  
( )  
( )  
It is very 
important 
to me to 
be a 
member of 
this group. 
( )  
( )  
( )  
( )  
I anticipate 
how some 
members 
will react 
to certain 
questions 
or issues 
in this 
group. 
( )  
( )  
( )  
( )  
I get a lot 
out of 
being in 
this group. 
( )  
( )  
( )  
( )  
I’ve had 
questions 
that have 
been 
answered 
by this 
group. 
( )  
( )  
( )  
( )  
I’ve gotten 
support 
from this 
group. 
( )  
( )  
( )  
( )  
Some 
members 
of this 
group 
seem to 
have 
friendships 
with each 
other. 
( )  
( )  
( )  
( )  
I have 
friends in 
this group. 
( )  
( )  
( )  
( )  

202 
 
Some 
members 
of this 
group can 
be 
counted 
on to help 
others by 
providing 
support or 
answering 
questions. 
( )  
( )  
( )  
( )  
I feel 
obligated 
to help 
others in 
this group 
by 
providing 
support or 
answering 
questions. 
( )  
( )  
( )  
( )  
I really like 
this group.  
( )  
( )  
( )  
( )  
This group 
means a 
lot to me. 
( )  
( )  
( )  
( )  
 
 
Thank You! 
 
ID: 1 
Thank you for taking this survey and for participating! We greatly appreciate your 
involvement! 

203 
 
CASI Survey 3-month- SOC arm 
P3-T RCT Month-3 Follow-up (SOC Arm) 
 
Shortname / Alias: studyarm 
ID: 1071 
Enter Study Arm for testing survey (will switch to staff login before launch): 
( ) P3-T Arm 
 ( ) Standard of Care Arm 
 
ID: 93 
Thank you for participating in the P3-T study! The purpose of the study is to test a PrEP 
adherence intervention for young men who have sex with men who are starting PrEP. As 
part of the P3-T study, there are three surveys: one when you enrolled, one at your follow 
up appointment today, and one at your follow up appointment in 3 months.        
 
Try to answer every question as best you can. If you need help, please ask the study staff. 
Your answers will be used only for research purposes. Let’s get started!   
 
  
 
Cell Phone 
 
ID: 120 
Now, we’d like to ask you about your cell phone and internet use. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: paychange 
ID: 1068 
In the last 3 months, has who pays for your cellphone or smart phone changed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #2 Question "In the last 3 months, has who pays for your cellphone or 
smart phone changed?" is one of the following answers ("Yes") 
Shortname / Alias: phonepay 
ID: 127 

204 
 
Who usually pays for your cell phone or smartphone plan?* 
( ) I do 
( ) Someone else does 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: disconnect 
ID: 128 
In the last 3 months, did you ever not have access to your phone or phone service?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnecttimes 
ID: 129 
How many times in the last 3 months did you not have access to your phone or phone service?* 
( ) Once 
( ) Twice 
( ) 3 to 5 times 
( ) More than 5 times 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnectlength 
ID: 130 
The last time you did not have access to your phone or phone service, for how long did you not 
have access?* 
( ) 1 day or less 
( ) 2 to 6 days 
( ) 1 to 4 weeks 
( ) More than 4 weeks 
 
 
 
Employment, Income 
 

205 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: employed 
ID: 109 
Are you currently employed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #7 Question "Are you currently employed?" is one of the following 
answers ("Yes") 
Shortname / Alias: employedhours 
ID: 110 
Are you employed full-time or part-time? 
Part-time means that you work less than 35 hours per week during most weeks.* 
( ) Full time 
( ) Part time 
 
Shortname / Alias: income_30d 
ID: 564 
How much money did you make altogether during the past 30 days?* 
______________________ 
( ) Don't know 
 
Shortname / Alias: incomelevel 
ID: 111 
How would you describe your income level?* 
( ) Low income 
( ) Middle income 
( ) High income 
 
 
 
Food, Shelter 
 
Shortname / Alias: cutmeal 

206 
 
ID: 112 
In the past 3 months, how often did you or your family have to cut meal size or skip a meal 
because there was not enough money for food?* 
( ) Almost every week 
( ) Several weeks but not every week 
( ) Only a few weeks 
( ) Did not have to skip or cut the size of meals 
 
Shortname / Alias: shelter 
ID: 113 
In the past 3 months, have you spent at least one night (check all that apply):* 
[ ] In a shelter? 
[ ] In a public place not intended for sleeping (e.g., bus station, car, abandoned building)? 
[ ] On the street or anywhere outside (e.g., park, sidewalk)? 
[ ] Temporarily doubled up with a friend or family member? 
[ ] In a temporary housing program? 
[ ] In a welfare or voucher hotel/motel? 
[ ] In jail, prison, or a halfway house? 
[ ] In drug treatment, a detox unit, or drug program housing? 
[ ] In a hospital, nursing home, or hospice? 
[ ] I have not spent a night in any of the above places. 
 
 
 
Insurance 
Shortname / Alias: insurance 
ID: 206 
Do you currently have health insurance or health care coverage? 
( ) Yes 
( ) No 
( ) I don’t know 
 
 
Sexual Identity, Relationships 
 

207 
 
ID: 565 
The following questions ask about your sexual identity and relationship status.  
 
Please answer to the best of your ability. 
 
Shortname / Alias: sexualid 
ID: 102 
What is your current sexual identity?* 
( ) Gay, homosexual, same gender loving 
( ) Bisexual 
( ) Queer 
( ) Straight or heterosexual 
( ) Other, specify:: _________________________________________________* 
 
Shortname / Alias: relationship 
ID: 118 
How do you define your primary relationship status?* 
( ) Single, not currently dating 
( ) Single, casually dating 
( ) In a relationship 
( ) Married or other legal commitment 
 
 
Page entry logic: This page will show when: #20 Question "How do you define your primary relationship 
status?" is one of the following answers ("In a relationship","Married or other legal commitment") 
Sexual Health Priorities with Partner 
 
ID: 566 
People have different sexual health priorities. For example, some people prioritize staying 
HIV-negative; others want to have as much fun as possible with their partners; others 
want to feel as close and connected to their partners as possible. 
 
For these next questions, we are interested in you and your primary romantic partner’s 
sexual health priorities.  
  
 

208 
 
Shortname / Alias: shpriorities_scale 
ID: 569 
Thinking about you and your partner’s sexual health priorities, please indicate the extent to 
which you agree or disagree with the following statements.* 
 
Strongly 
Agree 
Agree 
Disagree 
Strongly 
Disagree 
I feel like my 
partner and 
I are “on the 
same page” 
in terms of 
the 
decisions 
we make 
about 
sexual 
health and 
risk  
( )  
( )  
( )  
( )  
When it 
comes to 
sexual 
decision-
making, I 
feel like my 
partner and 
I are “of the 
same mind” 
( )  
( )  
( )  
( )  
Sometimes I 
feel like my 
priorities for 
my sexual 
health are 
incompatible 
with my 
partner’s 
goals  
( )  
( )  
( )  
( )  
I’m 
confident 
that my 
partner and 
I generally 
share the 
same 
priorities 
when it 
comes to 
sexual 
health 
( )  
( )  
( )  
( )  

209 
 
Making 
sexual 
health 
decisions 
with my 
partner can 
be difficult 
because we 
have 
different 
priorities  
( )  
( )  
( )  
( )  
 
 
 
Health Providers 
 
ID: 157 
Now, we are going to ask you about your health care and health care decision making. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: pcp 
ID: 158 
Do you have a primary health care provider (for example, a pediatrician, a doctor, or other health 
care provider that you see regularly)?* 
( ) Yes 
( ) No 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcpawareness 
ID: 105 
How open are you about your sexual identity to your primary medical care provider?* 
( ) Primary medical provider definitely does NOT know your sexual identity 
( ) Primary medical provider MIGHT know about your sexual identity 
( ) Primary medical provider PROBABLY knows about your sexual identity 
( ) Primary medical provider DEFINITELY knows about your sexual identity 
 

210 
 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcptalksex 
ID: 160 
How comfortable are you discussing your sexual behavior with your primary health care 
provider?* 
( ) Very comfortable 
( ) Somewhat comfortable 
( ) Somewhat uncomfortable 
( ) Very uncomfortable 
 
 
STI Testing 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: stitest3m 
ID: 170 
A sexually transmitted infection (STI) is an infection transmitted through sexual activity, such as 
syphilis, gonorrhea, chlamydia, herpes, or genital warts. In the past 3 months, have you been 
tested for an STI that was not HIV?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #25 Question "A sexually transmitted infection (STI) is an infection 
transmitted through sexual activity, such as syphilis, gonorrhea, chlamydia, herpes, or genital 
warts. In the past 3 months, have you been tested for an STI that was not HIV?" is one of the 
following answers ("Yes") 
Shortname / Alias: sti3mo 
ID: 171 
Please indicate whether you have been diagnosed with any of the following sexually transmitted 
infections in the past 3 months. 
Please select all that apply.* 
[ ] Chlamydia 
[ ] Genital warts, anal warts, HPV 
[ ] Gonorrhea 
[ ] Hepatitis B 
[ ] Hepatitis C 
[ ] Herpes, HSV1/HSV2 

211 
 
[ ] Syphilis 
[ ] Urethritis 
[ ] Other, please specify:: _________________________________________________ 
[ ] None of these 
 
 
 
HIV Testing 
 
Shortname / Alias: recenthivtest_mon 
ID: 165 
When did you have your most recent HIV test? 
 
Please enter the month and year. 
 
Month:* 
( ) January 
( ) February 
( ) March 
( ) April 
( ) May 
( ) June 
( ) July 
( ) August 
( ) September 
( ) October 
( ) November 
( ) December 
 
Validation: Min = 1980 Must be numeric Whole numbers only Positive numbers only Max character count 
= 4 
Shortname / Alias: recenthivtest_yr 
ID: 166 
Year:* 
_________________________________________________ 
 
Action: JavaScript: Hide General Error Message 

212 
 
 
 
Page entry logic: This page will show when: (#27 Question "When did you have your most recent HIV 
test? 
 
Please enter the month and year. 
 
Month:" AND #28 Question "Year:" ) 
 
Action: Custom Script: Check HIV test date not in future 
 
 
PrEP Use 
Shortname / Alias: prepstartafterP3-T 
ID: 1201 
Did you start taking PrEP after you started the P3-T study?* 
( ) Yes 
( ) No 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: nowprep 
ID: 1202 
Are you taking PrEP right now?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: Fix logic- If no to Did you start taking PrEP after you enrolled in P3-T 
Shortname / Alias: noprep_why 
ID: 1203 
Why did you decide not to start PrEP? Select all of the factors below that were related to why you 
didn’t take PrEP.* 
[ ] I couldn't afford it 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to take a pill every day 
[ ] My parent(s) or guardian(s) found out and wouldn’t let me start 

213 
 
[ ] I kept forgetting to take my pill 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I was worried about experiencing side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to take PrEP (due to kidney/renal function, bone density, or another 
medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] I was worried that the medication would taste bad and/or the pill would be too big 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #32 Question "Why did you decide not to take PrEP? 
Select all of the factors below that were related to why you didn’t take PrEP."  
PrEP Use, why didn't start 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
ID: 1204 
Piping: Piped Values From Question 32. (Why did you decide not to take PrEP? Select all of the factors 
below that were related to why you didn’t take PrEP.) 
Please rank the reasons you did not start taking PrEP in order of importance.* 
 
 
Page entry logic: Fix logic- If yes to Did you start taking PrEP after you enrolled in P3-T 
PrEP Start 
 
Shortname / Alias: startprep_why 
ID: 943 
Why did you choose to start taking PrEP? Select all that apply.* 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking about having sex with someone whose HIV status I don’t know 
[ ] I want to be in control of my sexual health 

214 
 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
[ ] Decline to answer 
 
 
PrEP Start 
 
Action: Custom Script: Script to count checkboxes and skip q if < 2 
 
Shortname / Alias: startprep_primwhy 
ID: 945 
Piping: Piped Values From Question 34. (Why did you choose to start taking PrEP? Select all that apply.) 
What was the main reason you started PrEP?* 
 
 
Page entry logic: This page will show when: (#30 Question "Did you start taking PrEP after you started 
the P3-T-T study?" is one of the following answers ("Yes") OR #31 Question "Are you taking PrEP right 
now?" is one of the following answers ("Yes")) 
PrEP Start and Stop 
 
Validation: %s format expected 
Logic: Hidden unless: #30 Question "Did you start taking PrEP after you started the P3-T-T 
study?" is one of the following answers ("Yes") 
Shortname / Alias: prep_firststart 

215 
 
ID: 947 
When did you start taking after enrolling in P3-T? 
If you do not know the exact day of the month, please give your best estimate. * 
_________________________________________________ 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: prepstoP3-T-Tmo 
ID: 576 
Have you stopped taking PrEP for 7 days in a row or more in the last 3 months?* 
( ) Yes 
( ) No 
 
Action: Custom Script: Check date not in future 
 
Action: Custom Script: Script to populate - 3 months date 
 
Hidden Value: Date for prompt - today minus 3 months 
Value:  
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Stop, last 3 months 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: timesprepstoP3-Tmo 
ID: 950 
How many times did you stop taking PrEP for 7 days in a row or more in the last three months 
(from [question('value'), id='1026'] to today)?* 
( ) 0 
( ) 1 
( ) 2 
( ) 3 
( ) 4 

216 
 
( ) 5 
( ) 6 
( ) 7 
( ) 8 
( ) 9 
( ) 10 
( ) 11 
( ) 12 or more 
 
Logic: Hidden by default 
ID: 1159 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1") 
Shortname / Alias: time1_dates 
ID: 1027 
Please enter the dates you were off PrEP (from [question('value'), id='1026'] to today): 
Validation: %s format expected 
ID: 1028 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1029 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1160 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefirst_dates 

217 
 
ID: 1030 
Please enter the dates you were off PrEP for the first time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1031 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1032 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1161 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesecond_dates 
ID: 1033 
Please enter the dates you were off PrEP for the second time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1034 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1035 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1162 
The date re-started is before the date stopped. Please correct this.  
 

218 
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timethird_dates 
ID: 1036 
Please enter the dates you were off PrEP for the third time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1037 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1038 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1163 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefourth_dates 
ID: 1039 
Please enter the dates you were off PrEP for the fourth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1040 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1041 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1164 

219 
 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefifth_dates 
ID: 1042 
Please enter the dates you were off PrEP for the fifth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1043 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1044 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1165 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesixth_dates 
ID: 1045 
Please enter the dates you were off PrEP the sixth time (from [question('value'), id='1026'] 
to today): 
Validation: %s format expected 
ID: 1046 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1047 
Date re-started:*: _________________________________________________ 
 

220 
 
Logic: Hidden by default 
ID: 1166 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("7","8","9","10","11","12 or more") 
Shortname / Alias: timeseventh_dates 
ID: 1048 
Please enter the dates you were off PrEP for the seventh time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1049 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1050 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1167 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("8","9","10","11","12 or more") 
Shortname / Alias: timeeighth_dates 
ID: 1051 
Please enter the dates you were off PrEP for the eighth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1052 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1053 

221 
 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1168 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("9","10","11","12 or more") 
Shortname / Alias: timeninth_dates 
ID: 1054 
Please enter the dates you were off PrEP for the ninth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1055 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1056 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1169 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("10","11","12 or more") 
Shortname / Alias: timetenth_dates 
ID: 1057 
Please enter the dates you were off PrEP for the tenth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1058 

222 
 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1059 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1170 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("11","12 or more") 
Shortname / Alias: timeeleventh_dates 
ID: 1060 
Please enter the dates you were off PrEP for the eleventh time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1061 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1062 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1171 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("12 or more") 
Shortname / Alias: timetwelfth_dates 
ID: 1063 

223 
 
Please enter the dates you were off PrEP for the twelfth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1064 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1065 
Date re-started:*: _________________________________________________ 
 
 
Page entry logic: This page will show when: ((#37 Question "Have you stopped taking PrEP for 7 days 
in a row or more in the last 3 months?" is one of the following answers ("Yes") OR (#29 Question "When 
you started the P3-T study, were you taking PrEP?" is one of the following answers ("Yes") AND #31 
Question "Are you taking PrEP right now?" is one of the following answers ("No"))) OR (#30 Question 
"Did you start taking PrEP after you started the P3-T study?" is one of the following answers ("Yes") AND 
#31 Question "Are you taking PrEP right now?" is one of the following answers ("No"))) 
PrEP Stop 
 
Logic: Hidden by default 
ID: 1206 
This number cannot be greater than the number of times you stopped taking PrEP for 7 days in a 
row or more in the last 3 months ([question('value'), id='950']). Please correct this. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1","2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: prepstop_drconsult 
ID: 578 
Of the [question("value"), id="950"] times you stopped taking PrEP, how many did you 
talk with your medical provider about before you stopped taking PrEP?* 
_________________________________________________ 
Shortname / Alias: stopprep_why 
ID: 581 
Think about the most recent time you stopped taking PrEP. Select all of the factors below that 
were related to why you stopped PrEP.* 
[ ] I couldn't afford it anymore 

224 
 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to keep taking a pill every day 
[ ] My parent(s) or guardian(s) found out and made me stop 
[ ] I kept forgetting to take my pill 
[ ] I haven't been able to make it to my follow-up appointments 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I experienced side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to continue taking PrEP (due to kidney/renal function, bone density, or 
another medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] The medication tastes bad and/or the pill is too big 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #38 Question "How many times did you stop taking PrEP 
for 7 days in a row or more in the last three months (from [question('value'), id='1026'] to today)?" is one 
of the following answers ("1","2","3","4","5","6","7","8","9","10","11") 
 
Action: Custom Script: Script to check number of times off PrEP 
 
 
Page entry logic: This page will show when: #53 Question "Think about the most recent time you 
stopped taking PrEP. Select all of the factors below that were related to why you stopped PrEP."  
PrEP Stop Continued 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: stopprep_primwhy 
ID: 582 
Piping: Piped Values From Question 53. (Think about the most recent time you stopped taking PrEP. 
Select all of the factors below that were related to why you stopped PrEP.) 

225 
 
Please rank the reasons you stopped taking PrEP in order of importance.* 
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Restart, current users 
 
Shortname / Alias: restart_why 
ID: 956 
Why did you choose to restart taking PrEP the last time? Select all that apply.* 
[ ] I was able to start seeing my PrEP provider again 
[ ] I found a new PrEP provider 
[ ] I was having issues with side effects, but I found a way to deal with them 
[ ] I was having issues taking my pill every day, but I found a way to deal with it 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking having sex with someone whose status HIV I don’t know 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #55 Question "Why did you choose to restart taking PrEP 
the last time? Select all that apply."  
Restart reason, current users 

226 
 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: restart_primwhy 
ID: 957 
Piping: Piped Values From Question 55. (Why did you choose to restart taking PrEP the last time? 
Select all that apply.) 
What was the main reason you decided to restart PrEP?* 
 
 
Healthcare Visits 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists.  
Shortname / Alias: numdrvisits3m 
ID: 584 
In the last 3 months, how many times did you go to the doctor for any reason?* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 940 
This number cannot be greater than the total number of doctor's visits entered above.  
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists. Hidden unless: #57 Question "In the last 3 months, how many 
times did you go to the doctor for any reason?" is greater than "0" 
Shortname / Alias: numprepvisits3m 
ID: 586 
Out of all these visits, how many were routine/scheduled PrEP appointments?* 
_________________________________________________ 
 
Logic: Hidden by default 

227 
 
ID: 988 
This number cannot be greater than the total number of routine PrEP appointments. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #58 Question "Out of all these visits, how many were routine/scheduled 
PrEP appointments?" is greater than "0" 
Shortname / Alias: missedprepvisits3m 
ID: 587 
In the last 3 months, how many of your scheduled PrEP appointments did you miss 
because you didn't show or forgot? 
By scheduled appointments, we mean routine PrEP appointments, not walk-in or urgent 
care appointments for acute/urgent issues. * 
_________________________________________________ 
 
Action: Custom Script: Script to check number of visits 
 
Action: Custom Script: Script to check number of days 
 
 
PrEP Adherence 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: preplastweek 
ID: 177 
How many of the last 7 days did you take your PrEP medication?* 
( ) 0 days 
( ) 1 day 
( ) 2 days 
( ) 3 days 
( ) 4 days 
( ) 5 days 
( ) 6 days 
( ) 7 days 
 
Validation: Min = 0 Max = 100 

228 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: prepmonth 
ID: 178 
In the last month, what percent of the time did you take your PrEP as prescribed (once a day)? 
Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:* 
0 ________________________[__]_____________________________ 100 
 
PrEP Dose Barriers 
 
Shortname / Alias: dose_ 
ID: 959 
What has gotten in the way of you taking your PrEP on a daily basis? Please select all that apply.* 
[ ] I have not had any trouble taking PrEP on a daily basis 
[ ] I get tired of taking a pill every day 
[ ] I forget to take it 
[ ] I don’t always have my pills with me 
[ ] My work/school schedule 
[ ] My social life 
[ ] I’m around people I don’t want to take it in front of 
[ ] I experience side effects 
[ ] I was drinking or using drugs and I didn’t take it 
 
 
Hidden Page of Script 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: does_rank 
ID: 960 
Piping: Piped Values From Question 62. (What has gotten in the way of you taking your PrEP on a daily 
basis? Please select all that apply.) 
Please rank the things that have gotten in the way of you taking your PrEP on a daily basis.* 
 

229 
 
 
PrEP Adherence Continued 
 
Logic: Hidden unless: #61 Question "In the last month, what percent of the time did you take your 
PrEP as prescribed (once a day)? Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:"  
Shortname / Alias: prepadher_protection 
ID: 588 
You said you took your PrEP [question("value"), id="178"] percent of the time in the last month. 
Based on this adherence level, how protected do you think you were from HIV in the last month?* 
( ) Not protected at all 
( ) Somewhat protected 
( ) Mostly protected 
( ) Fully protected 
 
Shortname / Alias: prepadher_decisionbot 
ID: 589 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you bottom?* 
( ) My decision about condom use when I bottom was not influenced by whether or not I took my pill 
every day 
( ) My decision about condom use when I bottom was somewhat influenced by whether or not I took my 
pill every day 
( ) My decision about condom use when I bottom was influenced by whether or not I took my pill every 
day 
( ) I did not bottom in the last month 
 
Shortname / Alias: prepadher_decisiontop 
ID: 590 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you top?* 
( ) My decision about condom use when I top was not influenced by whether or not I took my pill every 
day 
( ) My decision about condom use when I top was somewhat influenced by whether or not I took my pill 
every day 
( ) My decision about condom use when I top was influenced by whether or not I took my pill every day 
 ( ) Decline to answer 

230 
 
 
 
PrEP Confidence 
 
ID: 907 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: keepappts 
ID: 903 
How confident are you that you can... 
 
Keep your PrEP medical appointments:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: followplan 
ID: 904 
Follow a plan for taking PrEP:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: atworkschool 
ID: 905 
Take PrEP at work/school:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekday 
ID: 906 
Take PrEP on a weekday:* 
1 ________________________[__]_____________________________ 10 

231 
 
 
Action: JavaScript: Hide General Error Message 
 
 
PrEP Confidence 2 
 
ID: 908 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekend 
ID: 909 
How confident are you that you can... 
 
Take PrEP on a weekend:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: wfriends 
ID: 910 
Take PrEP when I'm out with friends:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: prepdrinking 
ID: 911 
Take PrEP when I'm drinking or using drugs:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: schedulechange 

232 
 
ID: 912 
Take PrEP when my schedule changes:* 
1 ________________________[__]_____________________________ 10 
 
Action: JavaScript: Hide General Error Message 
 
 
PrEP Confidence 3 
 
ID: 913 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: whiletraveling 
ID: 914 
How confident are you that you can... 
 
Take PrEP while traveling:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: takewsideeffects 
ID: 915 
Take PrEP when you are having medication side effects:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: havingcrisis 
ID: 916 
Take PrEP when you are having a crisis:* 
1 ________________________[__]_____________________________ 10 
 

233 
 
 
 
PrEP Delivery 
 
Shortname / Alias: prep_prefmode 
ID: 597 
Right now there are no other approved options for taking PrEP. However, if there were more than 
one option and each method was equally good at protecting you from getting HIV, which method 
would you most prefer?* 
( ) Taking one pill, every day 
( ) Taking two pills before you had sex and a pill a day for the next two days 
( ) Taking one pill a day just on Tuesday, Thursday, Saturday, and Sunday 
( ) Getting an injection about every 2 to 3 months 
( ) Putting medicated lubrication (lube) in your anus (and/or your partner’s anus) before having anal sex 
( ) Douching with a medicated solution (microbicide) before having anal sex 
 
 
PrEP Beliefs 
 
Shortname / Alias: prepbeliefs 
ID: 598 
Please rate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
People are 
less likely 
to use 
condoms 
for anal sex 
if they are 
using PrEP 
( )  
( )  
( )  
( )  
I feel as if 
starting to 
take PrEP 
would allow 
me to have 
more sex 
partners 
( )  
( )  
( )  
( )  

234 
 
I feel as if 
starting to 
take PrEP 
would allow 
me to have 
more 
condomless 
anal sex 
( )  
( )  
( )  
( )  
 
 
PrEP and People 
 
Shortname / Alias: prepppl 
ID: 193 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I worry 
people will 
assume I 
sleep around 
if they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
assume that I 
am HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think my 
partner(s) 
are HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry about 
listing PrEP 
as one of my 
( )  
( )  
( )  
( )  

235 
 
current 
medications 
during 
appointments 
such as at a 
dentist's or 
specialist's 
office  
I feel 
ashamed to 
tell other 
people that I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am a 
bad person if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am 
gay if they 
know I take 
PrEP  
( )  
( )  
( )  
( )  
I worry my 
friends will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
family will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
sexual 
partners will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I think people 
will give me a 
hard time if I 
tell them I 
take PrEP  
( )  
( )  
( )  
( )  

236 
 
I think people 
will judge me 
if they know I 
am taking 
PrEP 
( )  
( )  
( )  
( )  
 
 
 
 
PrEP Concerns 
 
Shortname / Alias: prepconc 
ID: 210 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
My family 
does not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
My friends 
do not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
People 
taking PrEP 
are 
portrayed 
poorly in the 
media and 
online 
( )  
( )  
( )  
( )  
People in my 
community 
talk poorly 
about people 
taking PrEP 
( )  
( )  
( )  
( )  
I feel 
embarrassed 
about taking 
PrEP  
( )  
( )  
( )  
( )  

237 
 
I think I am 
not following 
the 'rules' of 
my 
community if 
I take PrEP  
( )  
( )  
( )  
( )  
I have been 
blamed by 
people in my 
community 
for spreading 
HIV through 
PrEP use  
( )  
( )  
( )  
( )  
I have been 
blamed by 
people in my 
community 
for spreading 
sexually 
transmitted 
infections 
through not 
using 
condoms  
( )  
( )  
( )  
( )  
I have been 
rejected 
romantically 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
slut-shamed 
because I 
take PrEP 
(or told that I 
am a 
"Truvada-
slut/whore")  
( )  
( )  
( )  
( )  
I have been 
judged by a 
health care 
provider for 
taking PrEP  
( )  
( )  
( )  
( )  
I don't think 
that I need to 
take PrEP 
anymore 
( )  
( )  
( )  
( )  

238 
 
I have been 
told by a 
health care 
provider that 
I don't need 
PrEP or I 
shouldn't 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
yelled at or 
scolded 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
unfairly 
discriminated 
against 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have 
experienced 
physical 
violence 
because I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "I don't think that I need to take PrEP anymore" is one of the 
following answers ("Agree","Strongly Agree") 
Shortname / Alias: whydontneed 
ID: 1067 
Why do you think that you do not need to take PrEP anymore? Select all that apply.* 
[ ] My relationship status changed -- I became single 
[ ] My relationship status changed -- I became monogamous (only having sex with one person) 
[ ] I stopped having sex with an HIV-positive person 
[ ] I am having less sex 
[ ] I am sexually inactive (I haven't been having sex for a period of time) 
[ ] I have started using condoms every time I have sex 
[ ] Other, please specify:: _________________________________________________ 
 
 
PrEP Difficulties 

239 
 
 
Shortname / Alias: prepdifficulties 
ID: 602 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
Getting the 
costs of PrEP 
covered 
(including 
office visits or 
office visit co-
pays, lab 
costs, 
transportation 
costs)  
( )  
( )  
( )  
( )  
Using 
insurance to 
get coverage 
for PrEP 
costs 
(including 
office visits, 
lab costs)  
( )  
( )  
( )  
( )  
Getting 
transportation 
to PrEP 
appointments 
and labs 
( )  
( )  
( )  
( )  
Returning for 
PrEP follow-
up 
appointments 
and labs 
( )  
( )  
( )  
( )  
Getting PrEP 
prescription 
refilled 
( )  
( )  
( )  
( )  
 
 
 
PrEP Difficulties Continued 

240 
 
 
Shortname / Alias: prepdifficulties2 
ID: 649 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
The 
possibility 
that if I were 
to become 
HIV+, 
certain 
medications 
might no 
longer work 
or I might be 
resistant to 
them  
( )  
( )  
( )  
( )  
The 
possibility 
that PrEP 
might not 
provide 
complete 
protection 
against HIV  
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about PrEP 
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about my 
sex life 
( )  
( )  
( )  
( )  
Experiencing 
side effects 
from PrEP 
( )  
( )  
( )  
( )  
The long-
term effects 
of PrEP on 
my health 
( )  
( )  
( )  
( )  

241 
 
Having to 
remember to 
take PrEP 
every day 
( )  
( )  
( )  
( )  
Friends 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Family 
members 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Sexual 
partners 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "The possibility that PrEP might not provide complete protection 
against HIV " is one of the following answers ("Concerned","Very concerned") 
Shortname / Alias: prepworry 
ID: 665 
Why do you worry about the possibility that PrEP might not provide complete protection against 
HIV? (Check all that apply)* 
[ ] I worry that the drug is not effective at preventing HIV 
[ ] Because I don't take PrEP every day consistently 
[ ] Because I feel I am at very high risk for becoming infected with HIV 
[ ] Other, please specify:: _________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 
HIV perceptions 
 
Shortname / Alias: hivthoughts 
ID: 667 

242 
 
Imagine how you would feel if you became infected with HIV. Read each statement carefully and 
indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I would 
be afraid 
people 
would 
judge me 
when 
they 
learn I 
have HIV  
( )  
( )  
( )  
( )  
If I got 
infected, 
people 
would 
not want 
to have 
sex with 
me  
( )  
( )  
( )  
( )  
I would 
feel 
guilty if I 
got HIV  
( )  
( )  
( )  
( )  
I would 
feel 
ashamed 
if I got 
HIV  
( )  
( )  
( )  
( )  
 
 
PEP and PrEP On-Demand 
 
Shortname / Alias: peP3-Tm 
ID: 230 
In the past 3 months, have you taken post-exposure prophylaxis (PEP) AFTER a sexual or drug 
use exposure to reduce the risk of getting HIV?* 
( ) Yes 
( ) No 
( ) Decline to answer 

243 
 
 
Shortname / Alias: prepondemand3m 
ID: 674 
In the past 3 months, have you taken PrEP on-demand (taking two pills before you had sex and a 
pill a day for the next two days)? 
It is not an approved method and has not been shown to be an effective method for preventing 
HIV.* 
( ) Yes 
( ) No 
( ) Decline to answer 
 
 
Substances 
 
ID: 232 
Now we’d like to ask you a little bit about your experiences using alcohol, tobacco 
products, and other drugs. Please be assured that this information will be treated as 
strictly confidential. 
 
The questions will concern your experiences with using these substances in the past 
three months. These substances can be smoked, swallowed, snorted, inhaled, injected, or 
taken in the form of pills. Some of the substances may be prescribed by a doctor (like 
amphetamines, sedatives, or pain medications). For this survey, do not report on 
medications that are used as prescribed by your doctor. However, if you have taken such 
medications for reasons other than prescription, or taken them more frequently or at 
higher doses than prescribed, please report on this use. Once again, please remember 
that all information provided will be treated as strictly confidential. 
 
Shortname / Alias: substanceuse3m 
ID: 233 
Which of the following drugs have you used in the last 3 months? 
Please check all that apply.* 
[ ] Tobacco (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.) 
[ ] Alcohol (beer, wine, spirits, etc.) 
[ ] Cannabis (marijuana, pot, weed, grass, hash, synthetic cannabis, etc.) 
[ ] Cocaine (coke, crack, etc.) 
[ ] Amphetamines (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.) 
[ ] Inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.) 
[ ] Sedatives, tranquilizers, or sleeping pills (valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) 

244 
 
[ ] Hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.) 
[ ] Opioids (heroin, morphine, methadone, codeine, Oxycotin, Percocet, Vicodin, etc.) 
[ ] None of these 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Tobacco (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)") 
Tobacco 
 
Shortname / Alias: tobacco3months 
ID: 234 
In the past 3 months, how often have you used tobacco products (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccodesire 
ID: 235 
During the past 3 months, how often have you had a desire to use tobacco products (cigarettes, 
chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccoproblems 
ID: 236 

245 
 
During the past 3 months, how often has your use of tobacco products (cigarettes, chewing 
tobacco, cigars, e-cigarettes, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofailed 
ID: 237 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, 
etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: tobaccofriend 
ID: 238 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
 
Shortname / Alias: tobaccostop 
ID: 239 
In the last 3 months, have you tried and failed to control, cut down or stop using tobacco 
products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
 

246 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Alcohol (beer, wine, spirits, etc.)") 
Alcohol 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: alcohol3months 
ID: 240 
In the past 3 months, how often have you used alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Logic: Hidden unless: #97 Question "In the past 3 months, how often have you used alcoholic 
beverages (beer, wine, spirits, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily","Decline to answer") 
Shortname / Alias: alcoholdaily 
ID: 241 
How many drinks containing alcohol do you have on a typical day?* 
( ) 0 
( ) 1 or 2 
( ) 3 or 4 
( ) 5 or 6 
( ) 7 to 9 
( ) 10 or more 
 
 
Shortname / Alias: alcoholbinge 
ID: 242 
How often do you have 5 or more drinks on one occasion?* 
( ) Never 
( ) Less than monthly 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

247 
 
 
 
Shortname / Alias: alcoholdesire 
ID: 243 
During the past 3 months, how often have you had a desire to use alcoholic beverages (beer, 
wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholproblems 
ID: 244 
During the past 3 months, how often has your use of alcoholic beverages (beer, wine, spirits, 
etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfailed 
ID: 245 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: alcoholfriend 
ID: 246 

248 
 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: alcoholstop 
ID: 247 
In the last 3 months, have you tried and failed to control, cut down or stop using alcoholic 
beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cannabis (marijuana, pot, weed, grass, 
hash, synthetic cannabis, etc.)") 
Cannabis 
 
Shortname / Alias: cannabis3months 
ID: 251 
In the past 3 months, how often have you used cannabis (marijuana, pot, grass, hash, etc.) or 
synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #107 Question "In the past 3 months, how often have you 
used cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Cannabis (cont.) 
 
Shortname / Alias: cannabisdesire 

249 
 
ID: 252 
During the past 3 months, how often have you had a desire to use cannabis (marijuana, pot, 
grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisproblems 
ID: 253 
During the past 3 months, how often has your use of cannabis (marijuana, pot, grass, hash, etc.) 
or synthetic cannabis led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfailed 
ID: 254 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfriend 
ID: 255 
In the past 3 months, has a friend or relative or anyone else expressed concern about your use of 
cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cannabisstop 

250 
 
ID: 256 
In the last 3 months, have you tried and failed to control, cut down or stop using cannabis 
(marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cocaine (coke, crack, etc.)") 
Cocaine 
 
Shortname / Alias: cocaine3months 
ID: 257 
In the past 3 months, how often have you used cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #113 Question "In the past 3 months, how often have you 
used cocaine (coke, crack, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily") 
Cocaine (cont.) 
 
Shortname / Alias: cocainedesire 
ID: 258 
During the past 3 months, how often have you had a desire to use cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

251 
 
Shortname / Alias: cocaineproblems 
ID: 259 
During the past 3 months, how often has your use of cocaine (coke, crack, etc.) led to health, 
social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: cocainefailed 
ID: 260 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocainefriend 
ID: 261 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
cocaine (coke, crack, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cocainestop 
ID: 262 
In the last 3 months, have you tried and failed to control, cut down or stop using cocaine (coke, 
crack, etc.)?* 
( ) No 
( ) Yes 
 
 

252 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Amphetamines (speed, meth, diet pills, 
ecstasy, Ritalin, Adderall, etc.)") 
Amphetamine 
 
Shortname / Alias: amphetamine3months 
ID: 263 
In the past 3 months, how often have you used amphetamine type stimulants (speed, meth, diet 
pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #119 Question "In the past 3 months, how often have you 
used amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Amphetamine (cont.) 
 
Shortname / Alias: amphetaminedesire 
ID: 265 
During the past 3 months, how often have you had a desire to use amphetamine type stimulants 
(speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: amphetamineproblems 
ID: 266 

253 
 
During the past 3 months, how often has your use of amphetamine type stimulants (speed, meth, 
diet pills, ecstasy, Ritalin, Adderall, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefailed 
ID: 267 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, 
Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefriend 
ID: 268 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: amphetaminestop 
ID: 269 
In the last 3 months, have you tried and failed to control, cut down or stop using amphetamine 
type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 

254 
 
Please check all that apply." is one of the following answers ("Inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.)") 
Inhalants 
 
Shortname / Alias: inhalants3months 
ID: 271 
In the past 3 months, how often have you used inhalants (poppers, nitrous, glue, petrol, paint 
thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #125 Question "In the past 3 months, how often have you 
used inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?" is one of the following answers ("Once 
or twice","Monthly","Weekly","Daily or almost daily") 
Inhalants (cont.) 
 
Shortname / Alias: inhalantsdesire 
ID: 272 
During the past 3 months, how often have you had a desire to use inhalants (poppers, nitrous, 
glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsproblems 
ID: 273 
During the past 3 months, how often has your use of inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 

255 
 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: inhalantsfailed 
ID: 274 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfriend 
ID: 275 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: inhalantsstop 
ID: 276 
In the last 3 months, have you tried and failed to control, cut down or stop using inhalants 
(poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Sedatives, tranquilizers, or sleeping pills 
(valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)") 
Sedatives 
 
Shortname / Alias: sedatives3months 

256 
 
ID: 277 
In the past 3 months, how often have you used sedatives, tranquilizers, or sleeping pills (Valium, 
Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #131 Question "In the past 3 months, how often have you 
used sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?" 
is one of the following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Sedatives (cont.) 
 
Shortname / Alias: sedativesdesire 
ID: 279 
During the past 3 months, how often have you had a desire to use sedatives, tranquilizers, or 
sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: sedativesproblems 
ID: 280 
During the past 3 months, how often has your use of sedatives, tranquilizers, or sleeping pills 
(Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) led to health, social, legal or financial 
problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
Shortname / Alias: sedativesfailed 
ID: 281 

257 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, 
Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: sedativesfriend 
ID: 282 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, 
etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: sedativesstop 
ID: 283 
In the last 3 months, have you tried and failed to control, cut down or stop using sedatives, 
tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Hallucinogens (LSD, acid, mushrooms, 
PCP, Ketamine, etc.)") 
Hallucinogens 
 
Shortname / Alias: hallucinogens3months 
ID: 285 
In the past 3 months, how often have you used hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 

258 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #137 Question "In the past 3 months, how often have you 
used hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Hallucinogens (cont.) 
 
Shortname / Alias: hallucinogensdesire 
ID: 286 
During the past 3 months, how often have you had a desire to use hallucinogens (LSD, acid, 
mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: hallucinogensproblems 
ID: 287 
During the past 3 months, how often has your use of hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfailed 
ID: 288 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 

259 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfriend 
ID: 289 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: hallucinogensstop 
ID: 290 
In the last 3 months, have you tried and failed to control, cut down or stop using hallucinogens 
(LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Opioids (heroin, morphine, methadone, 
codeine, Oxycotin, Percocet, Vicodin, etc.)") 
Opioids 
 
Shortname / Alias: opioids3months 
ID: 291 
In the past 3 months, how often have you used opioids (heroin, morphine, methadone, codeine, 
Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 

260 
 
Page entry logic: This page will show when: #143 Question "In the past 3 months, how often have you 
used opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Opioids (cont.) 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: opioidsheroin 
ID: 299 
In the past 3 months, has your opioid use included heroin?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #144 Question "In the past 3 months, has your opioid use included 
heroin?" is one of the following answers ("Yes") 
Shortname / Alias: heroinprimary 
ID: 300 
In the past 3 months, was heroin the most common opioid that you used?* 
( ) Yes 
( ) No 
 
Shortname / Alias: opioidssdesire 
ID: 293 
During the past 3 months, how often have you had a desire to use opioids (heroin, morphine, 
methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsproblems 
ID: 294 
During the past 3 months, how often has your use of opioids (heroin, morphine, methadone, 
codeine, Oxycontin, Percocet, Vicodin, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 

261 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfailed 
ID: 295 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, 
Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfriend 
ID: 296 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: opioidsstop 
ID: 297 
In the last 3 months, have you tried and failed to control, cut down or stop using opioids (heroin, 
morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 
 
Sexual Behaviors 
 
Page exit logic: Skip / Disqualify LogicIF: #151 Question "In the past 3 months, how many people have 
you had anal sex with?" is exactly equal to "0" THEN: Jump to page 120 - Perceived HIV Risk 
 

262 
 
ID: 368 
The next section of questions will ask about your sexual behaviors. We know that this can 
be a sensitive topic, so we would like to remind you that your answers will be kept 
completely confidential. Please be as honest as possible in order to ensure the success 
of the current study. 
 
The following questions refer to your sexual behavior during the past 3 months. Our 
focus will be only on anal sex. Therefore, do not include references to people with whom 
you did not engage in anal sex. 
 
For these questions, anal sex refers to sex where the other person’s penis was in your 
rectum (you were the bottom) and to sex where your penis was in the other person's 
rectum (you were the top). 
 
These questions only ask about people assigned male at birth, which includes cisgender 
men (men assigned male at birth) and transgender women (women assigned male at 
birth). Therefore, do not include references to cisgender women (women assigned female 
at birth) or transgender men (men assigned female at birth). 
 
Validation: Min = 0 Max = 999 Must be numeric Whole numbers only Positive numbers only 
Shortname / Alias: numsexpartner 
ID: 302 
In the past 3 months, how many people have you had anal sex with?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #151 Question "In the past 3 months, how many people 
have you had anal sex with?" is greater than "0" 
HIV Status of Sexual Partners 
 
Logic: Hidden by default 
ID: 677 
The total number must equal the number of people you had anal sex with in the last 3 months 
([question('value'), id='302']). Please correct this. 
 
Validation: Must be numeric 
Shortname / Alias: partnerhivstatus 

263 
 
ID: 676 
Before you had sex, what did you know of the HIV status of your sexual partner(s)? 
 
Enter numerical values. Numbers must add up to [question('value'), id='302'], the number of people 
you reported having anal sex within the last three months.* 
________This person/these people told you they were HIV negative and you had no reason to doubt it 
________You knew this person/these people were HIV positive 
________You were not completely sure of this person/these people's HIV status 
 
 
 
Action: Custom Script: Script to check the continuous sum totals 
 
 
 
Hidden Value: Num HIV Neg partners 
Value: [question("option value"), id="676", option="12278"] 
 
Hidden Value: Num HIV Pos partners 
Value: [question("option value"), id="676", option="12279"] 
 
Hidden Value: Num HIV Unk partners 
Value: [question("option value"), id="676", option="12280"] 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners 
 
ID: 690 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Shortname / Alias: hivneg_timesbot 
ID: 701 

264 
 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timestop 
ID: 702 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #153 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the 
bottom?" is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
Logic: Hidden by default 
ID: 714 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='701']). Please correct this. 
 
Shortname / Alias: hivneg_timesbotunp 
ID: 710 
In the past 3 months, how many of the [question('value'), id='701'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 

265 
 
Page entry logic: This page will show when: #155 Question "In the past 3 months, how many of 
the [question('value'), id='701'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the bottom were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
ID: 721 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 999 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_typ 
ID: 711 
Regarding the partners who told you they were HIV negative who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1002 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_gender 

266 
 
ID: 964 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #154 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the top?" 
is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 722 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 719 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='702']). Please correct this. 
 
Shortname / Alias: hivneg_timestopunp 
ID: 718 
In the past 3 months, how many of the [question('value'), id='702'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the top were 
without a condom? * 
_________________________________________________ 

267 
 
 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #158 Question "In the past 3 months, how many of 
the [question('value'), id='702'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the top were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 723 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 1004 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_typ 
ID: 725 
Regarding the partners who told you they were HIV negative who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1005 

268 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_gender 
ID: 965 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners - PrEP and Alcohol and Drug Use 
 
ID: 992 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 732 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Shortname / Alias: hivneg_toldyouprep 

269 
 
ID: 729 
How many of your sexual partners who told you they were HIV negative told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivneg_youtoldprep 
ID: 730 
Regarding your sexual partners who told you they were HIV negative, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 733 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Logic: Hidden unless: #162 Question "Regarding your sexual partners who told you they were 
HIV negative, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivneg_youtoldprepnum 
ID: 731 
How many of your sexual partner(s) who told you they were HIV negative did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timesdrunk 
ID: 740 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV negative were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 

270 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners 
 
ID: 770 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Shortname / Alias: hivpos_timesbot 
ID: 775 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivpos_timestop 
ID: 776 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #165 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the 
bottom?" is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 782 

271 
 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 783 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='775']). Please correct this. 
 
Shortname / Alias: hivpos_timesbotunp 
ID: 784 
In the past 3 months, how many of the [question('value'), id='775'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #167 Question "In the past 3 months, how many of 
the [question('value'), id='775'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the bottom were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 786 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1008 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 

272 
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_typ 
ID: 788 
Regarding the partners who told you they were HIV positive who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1009 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_gender 
ID: 994 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, and gender non-conforming 
 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 

273 
 
Page entry logic: This page will show when: #166 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the top?" 
is greater than "0" 
HIV Pos Partners - Condomless Insertive AI 
 
ID: 792 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 793 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='776']). Please correct this. 
 
Shortname / Alias: hivpos_timestopunp 
ID: 794 
In the past 3 months, how many of the [question('value'), id='776'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the top were 
without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #170 Question "In the past 3 months, how many of 
the [question('value'), id='776'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the top were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Insertive AI 
 
ID: 796 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 

274 
 
Logic: Hidden by default 
ID: 1012 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_typ 
ID: 798 
Regarding the partners who told you they were HIV positive who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1013 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_gender 
ID: 995 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 

275 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners - HIV Trt and PrEP 
 
Logic: Hidden by default 
ID: 799 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouhivmeds 
ID: 800 
How many of your sexual partners who told you they were HIV positive told you they were 
taking medication to treat HIV?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 920 
The number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouundetect 
ID: 918 
How many of your sexual partners who told you they were HIV positive told you they were 
undetectable?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivpos_youtoldprep 

276 
 
ID: 801 
Regarding your sexual partners who told you they were HIV positive, did you tell any of them that 
you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 802 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Logic: Hidden unless: #175 Question "Regarding your sexual partners who told you they were 
HIV positive, did you tell any of them that you were taking PrEP?" is one of the following answers 
("Yes") 
Shortname / Alias: hivpos_youtoldprepnum 
ID: 803 
How many of your sexual partner(s) who told you they were HIV positive did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Shortname / Alias: hivpos_timesdrunk 
ID: 807 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV positive were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
 
Action: Custom Script: Script to check med number not greater than the total number of partners 
 
Action: Custom Script: Script to check undetectable number not greater than the total number of 
partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 

277 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners 
 
ID: 810 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Shortname / Alias: hivunk_timesbot 
ID: 815 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivunk_timestop 
ID: 816 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #178 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
bottom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 822 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 

278 
 
ID: 823 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='815']). Please correct this. 
 
Shortname / Alias: hivunk_timesbotunp 
ID: 824 
In the past 3 months, how many of the [question('value'), id='815'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #180 Question "In the past 3 months, how many of 
the [question('value'), id='815'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the bottom were without a condom? " is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 826 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1016 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_typ 

279 
 
ID: 828 
Regarding the partners whose HIV status you were not sure of who you had condomless 
receptive anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1017 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_gender 
ID: 996 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #179 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
top?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 

280 
 
ID: 832 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 833 
This number cannot be greater than the number of times you had anal sex with sexual partner(s) 
whose HIV status you were not sure of where you were the top ([question('value'), id='816']). 
Please correct this. 
 
Shortname / Alias: hivunk_timestopunp 
ID: 834 
In the past 3 months, how many of the [question('value'), id='816'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the top 
were without a condom?* 
_________________________________________________ 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #183 Question "In the past 3 months, how many of 
the [question('value'), id='816'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the top were without a condom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 836 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1020 

281 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_typ 
ID: 838 
Regarding the partners whose HIV status you were not sure of who you had condomless 
insertive anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1021 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_gender 
ID: 997 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 

282 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners - PrEP 
 
Logic: Hidden by default 
ID: 839 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Shortname / Alias: hivunk_toldyouprep 
ID: 840 
How many of your sexual partners whose HIV status you were not sure of told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivunk_youtoldprep 
ID: 841 
Regarding your sexual partners whose HIV status you were not sure of, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
 
Logic: Hidden by default 
ID: 842 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Logic: Hidden unless: #187 Question "Regarding your sexual partners whose HIV status you 
were not sure of, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 

283 
 
Shortname / Alias: hivunk_youtoldprepnum 
ID: 843 
How many of your sexual partner(s) whose HIV status you were not sure of did you tell 
you were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Shortname / Alias: hivunk_timesdrunk 
ID: 847 
In the past 3 months, how many of the times you had anal sex with partners whose HIV 
status you were not sure of were you or this person under the influence of alcohol or 
drugs?* 
_________________________________________________ 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk1 
ID: 762 
Based on your reported sexual activities over the last 3 months, how at risk do you think you 
were for contracting HIV in the last 3 months?* 
( ) Not at all at risk for contracting HIV 
( ) Somewhat at risk for contracting HIV 
( ) High risk for contracting HIV 
Shortname / Alias: perceivedrisk2 
ID: 763 
What is your gut feeling about how likely you are to get infected with HIV?* 
( ) Extremely unlikely 
( ) Very unlikely 
( ) Somewhat likely 
( ) Very likely 
( ) Extremely likely 

284 
 
 
Shortname / Alias: perceivedrisk3 
ID: 764 
I worry about getting infected with HIV:* 
( ) None of the time 
( ) Rarely 
( ) Some of the time 
( ) A moderate amount of time 
( ) A lot of the time 
( ) All of the time 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk4 
ID: 765 
Getting HIV is something I am...* 
( ) Not concerned about 
( ) A little concerned about 
( ) Moderately concerned about 
( ) Concerned about a lot 
( ) Extremely concerned about 
 
Shortname / Alias: perceivedrisk5 
ID: 766 
There is a chance, no matter how small, I could get HIV:* 
( ) Strongly Disagree 
( ) Disagree 
( ) Agree 
( ) Strongly Agree 
 
Shortname / Alias: perceivedrisk6 
ID: 767 
I think my chances of getting infected with HIV are:* 
( ) Zero 

285 
 
( ) Almost zero 
( ) Small 
( ) Moderate 
( ) Large 
( ) Very large 
 
 
PHQ-2/GAD-2 
 
ID: 768 
Now we are going to ask you about your mental health and how you have been feeling 
recently. 
 
Shortname / Alias: mentalhealthscreener 
ID: 388 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Little 
interest or 
pleasure in 
doing 
things 
( )  
( )  
( )  
( )  
Feeling 
down, 
depressed, 
or 
hopeless 
( )  
( )  
( )  
( )  
Feeling 
nervous, 
anxious or 
on edge 
( )  
( )  
( )  
( )  
Not being 
able to 
stop or 
( )  
( )  
( )  
( )  

286 
 
control 
worrying 
 
 
Hidden Mental Health Screener Script 
 
Hidden Value: psychdistress1 
Value:  
 
Hidden Value: psychdistress2 
Value:  
 
Action: Custom Script: Mental Health Script 
 
 
Page entry logic: This page will show when: psychdistress1 is greater than or equal to "3" 
PHQ-8 
 
Shortname / Alias: phq8 
ID: 397 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Trouble 
falling or 
staying 
asleep, or 
sleeping too 
much 
( )  
( )  
( )  
( )  
Feeling tired 
or having 
little energy 
( )  
( )  
( )  
( )  

287 
 
Poor appetite 
or overeating 
( )  
( )  
( )  
( )  
Feeling bad 
about 
yourself - or 
that you are 
a failure or 
have let 
yourself or 
your family 
down 
( )  
( )  
( )  
( )  
Trouble 
concentrating 
on things, 
such as 
reading the 
newspaper 
or watching 
television 
( )  
( )  
( )  
( )  
Moving or 
speaking so 
slowly that 
other people 
could have 
noticed, or 
the opposite 
- being so 
fidgety or 
restless that 
you have 
been moving 
around a lot 
more than 
usual 
( )  
( )  
( )  
( )  
 
 
Page entry logic: This page will show when: psychdistress2 is greater than or equal to "3" 
GAD-7 
 
Shortname / Alias: gad7 
ID: 404 

288 
 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Worrying 
too much 
about 
different 
things 
( )  
( )  
( )  
( )  
Trouble 
relaxing 
( )  
( )  
( )  
( )  
Being so 
restless 
that it is 
hard to sit 
still 
( )  
( )  
( )  
( )  
Becoming 
easily 
annoyed 
or irritable 
( )  
( )  
( )  
( )  
Feeling 
afraid as if 
something 
awful 
might 
happen 
( )  
( )  
( )  
( )  
 
 
Social Isolation 
 
Shortname / Alias: socialisolation 
ID: 432 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I feel 
left out. 
( )  
( )  
( )  
( )  
( )  

289 
 
I feel 
that 
people 
barely 
know 
me. 
( )  
( )  
( )  
( )  
( )  
I feel 
isolated 
from 
others. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
are 
around 
me but 
not with 
me. 
( )  
( )  
( )  
( )  
( )  
 
 
Emotional Support 
 
Shortname / Alias: emotionalsupport 
ID: 411 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone 
who will 
listen to me 
when I need 
to talk. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
confide in or 
talk to about 
myself or 
my 
problems. 
( )  
( )  
( )  
( )  
( )  
I have 
someone 
( )  
( )  
( )  
( )  
( )  

290 
 
who makes 
me feel 
appreciated. 
I have 
someone to 
talk with 
when I have 
a bad day. 
( )  
( )  
( )  
( )  
( )  
 
 
Informational Support 
 
Shortname / Alias: informationalsupport 
ID: 417 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone to 
give me 
good 
advice 
about a 
crisis if I 
need it. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
turn to for 
suggestions 
about how 
to deal with 
a problem. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
give me 
information 
if I need it. 
( )  
( )  
( )  
( )  
( )  
I get useful 
advice 
about 
important 
( )  
( )  
( )  
( )  
( )  

291 
 
things in 
life. 
 
 
Instrumental Support 
 
Shortname / Alias: instrumentalsupport 
ID: 422 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you 
have 
someone 
to help 
you if 
you are 
confined 
to bed? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to take 
you to 
the 
doctor if 
you need 
it? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to help 
with your 
daily 
chores if 
you are 
sick? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to run 
errands 
( )  
( )  
( )  
( )  
( )  

292 
 
if you 
need it? 
 
 
Companionship 
 
Shortname / Alias: companionship 
ID: 427 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you have 
someone with 
whom to have 
fun? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
whom to 
relax? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
whom you can 
do something 
enjoyable? 
( )  
( )  
( )  
( )  
( )  
Do you find 
companionship 
when you want 
it? 
( )  
( )  
( )  
( )  
( )  
 
Thank You! 
 
ID: 1 
Thank you for taking this survey and for participating! We greatly appreciate your 
involvement! 
 
 

293 
 
CASI Survey 6-month 
P3-T RCT Month-6 Follow-up  
 
ID: 93 
Thank you for participating in the P3-T study! The purpose of the study is to test a PrEP 
adherence intervention for young men who have sex with men who are starting PrEP. As 
part of the P3-T study, there are three surveys: one when you enrolled, one at your follow 
up appointment today, and one at your follow up appointment in 3 months.        
 
Try to answer every question as best you can. If you need help, please ask the study staff. 
Your answers will be used only for research purposes. Let’s get started!   
 
 
Cell Phone 
ID: 120 
Now, we’d like to ask you about your cell phone and internet use. 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: paychange 
ID: 1068 
In the last 3 months, has who pays for your cellphone or smart phone changed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #2 Question "In the last 3 months, has who pays for your cellphone or 
smart phone changed?" is one of the following answers ("Yes") 
Shortname / Alias: phonepay 
ID: 127 
Who usually pays for your cell phone or smartphone plan?* 
( ) I do 
( ) Someone else does 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: disconnect 
ID: 128 

294 
 
In the last 3 months, did you ever not have access to your phone or phone service?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnecttimes 
ID: 129 
How many times in the last 3 months did you not have access to your phone or phone service?* 
( ) Once 
( ) Twice 
( ) 3 to 5 times 
( ) More than 5 times 
 
Logic: Hidden unless: #4 Question "In the last 3 months, did you ever not have access to your 
phone or phone service?" is one of the following answers ("Yes") 
Shortname / Alias: disconnectlength 
ID: 130 
The last time you did not have access to your phone or phone service, for how long did you not 
have access?* 
( ) 1 day or less 
( ) 2 to 6 days 
( ) 1 to 4 weeks 
( ) More than 4 weeks 
Employment, Income 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: employed 
ID: 109 
Are you currently employed?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #7 Question "Are you currently employed?" is one of the following 
answers ("Yes") 
Shortname / Alias: employedhours 

295 
 
ID: 110 
Are you employed full-time or part-time? 
Part-time means that you work less than 35 hours per week during most weeks.* 
( ) Full time 
( ) Part time 
 
Shortname / Alias: income_30d 
ID: 564 
How much money did you make altogether during the past 30 days?* 
___________________ 
( ) Don't know 
 
Shortname / Alias: incomelevel 
ID: 111 
How would you describe your income level?* 
( ) Low income 
( ) Middle income 
( ) High income 
( ) Decline to answer 
 
Food, Shelter 
 
Shortname / Alias: cutmeal 
ID: 112 
In the past 3 months, how often did you or your family have to cut meal size or skip a meal 
because there was not enough money for food?* 
( ) Almost every week 
( ) Several weeks but not every week 
( ) Only a few weeks 
( ) Did not have to skip or cut the size of meals 
 
Shortname / Alias: shelter 
ID: 113 
In the past 3 months, have you spent at least one night (check all that apply):* 
[ ] In a shelter? 
[ ] In a public place not intended for sleeping (e.g., bus station, car, abandoned building)? 

296 
 
[ ] On the street or anywhere outside (e.g., park, sidewalk)? 
[ ] Temporarily doubled up with a friend or family member? 
[ ] In a temporary housing program? 
[ ] In a welfare or voucher hotel/motel? 
[ ] In jail, prison, or a halfway house? 
[ ] In drug treatment, a detox unit, or drug program housing? 
[ ] In a hospital, nursing home, or hospice? 
[ ] I have not spent a night in any of the above places. 
 
Insurance 
Shortname / Alias: insurance 
ID: 206 
Do you currently have health insurance or health care coverage? 
( ) Yes 
( ) No 
( ) I don’t know 
 
Sexual Identity, Relationships 
 
ID: 565 
The following questions ask about your sexual identity and relationship status.  
 
Please answer to the best of your ability. 
 
Shortname / Alias: sexualid 
ID: 102 
What is your current sexual identity?* 
( ) Gay, homosexual, same gender loving 
( ) Bisexual 
( ) Queer 
( ) Straight or heterosexual 
( ) Other, specify:: _________________________________________________* 
 
Shortname / Alias: relationship 
ID: 118 

297 
 
How do you define your primary relationship status?* 
( ) Single, not currently dating 
( ) Single, casually dating 
( ) In a relationship 
( ) Married or other legal commitment 
 
Page entry logic: This page will show when: #20 Question "How do you define your primary relationship 
status?" is one of the following answers ("In a relationship","Married or other legal commitment") 
Sexual Health Priorities with Partner 
 
ID: 566 
People have different sexual health priorities. For example, some people prioritize staying 
HIV-negative; others want to have as much fun as possible with their partners; others 
want to feel as close and connected to their partners as possible. 
 
For these next questions, we are interested in you and your primary romantic partner’s 
sexual health priorities.  
  
Shortname / Alias: shpriorities_scale 
ID: 569 
Thinking about you and your partner’s sexual health priorities, please indicate the extent to 
which you agree or disagree with the following statements.* 
 
Strongly 
Agree 
Agree 
Disagree 
Strongly 
Disagree 
I feel like my 
partner and 
I are “on the 
same page” 
in terms of 
the 
decisions 
we make 
about 
sexual 
health and 
risk  
( )  
( )  
( )  
( )  
When it 
comes to 
sexual 
decision-
making, I 
feel like my 
partner and 
( )  
( )  
( )  
( )  

298 
 
I are “of the 
same mind” 
Sometimes I 
feel like my 
priorities for 
my sexual 
health are 
incompatible 
with my 
partner’s 
goals  
( )  
( )  
( )  
( )  
I’m 
confident 
that my 
partner and 
I generally 
share the 
same 
priorities 
when it 
comes to 
sexual 
health 
( )  
( )  
( )  
( )  
Making 
sexual 
health 
decisions 
with my 
partner can 
be difficult 
because we 
have 
different 
priorities  
( )  
( )  
( )  
( )  
 
 
Health Providers 
 
ID: 157 
Now, we are going to ask you about your health care and health care decision making. 
 
Logic: Show/hide trigger exists.  

299 
 
Shortname / Alias: pcp 
ID: 158 
Do you have a primary health care provider (for example, a pediatrician, a doctor, or other health 
care provider that you see regularly)?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcpawareness 
ID: 105 
How open are you about your sexual identity to your primary medical care provider?* 
( ) Primary medical provider definitely does NOT know your sexual identity 
( ) Primary medical provider MIGHT know about your sexual identity 
( ) Primary medical provider PROBABLY knows about your sexual identity 
( ) Primary medical provider DEFINITELY knows about your sexual identity 
 
Logic: Hidden unless: #22 Question "Do you have a primary health care provider (for example, a 
pediatrician, a doctor, or other health care provider that you see regularly)?" is one of the 
following answers ("Yes") 
Shortname / Alias: pcptalksex 
ID: 160 
How comfortable are you discussing your sexual behavior with your primary health care 
provider?* 
( ) Very comfortable 
( ) Somewhat comfortable 
( ) Somewhat uncomfortable 
( ) Very uncomfortable 
 
 
STI Testing 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: stitest3m 
ID: 170 

300 
 
A sexually transmitted infection (STI) is an infection transmitted through sexual activity, such as 
syphilis, gonorrhea, chlamydia, herpes, or genital warts. In the past 3 months, have you been 
tested for an STI that was not HIV?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #25 Question "A sexually transmitted infection (STI) is an infection 
transmitted through sexual activity, such as syphilis, gonorrhea, chlamydia, herpes, or genital 
warts. In the past 3 months, have you been tested for an STI that was not HIV?" is one of the 
following answers ("Yes") 
Shortname / Alias: sti3mo 
ID: 171 
Please indicate whether you have been diagnosed with any of the following sexually transmitted 
infections in the past 3 months. 
Please select all that apply.* 
[ ] Chlamydia 
[ ] Genital warts, anal warts, HPV 
[ ] Gonorrhea 
[ ] Hepatitis B 
[ ] Hepatitis C 
[ ] Herpes, HSV1/HSV2 
[ ] Syphilis 
[ ] Urethritis 
[ ] Other, please specify:: _________________________________________________ 
[ ] None of these 
 
 
 
 
HIV Testing 
Shortname / Alias: recenthivtest_mon 
ID: 165 
When did you have your most recent HIV test? 
 
Please enter the month and year. 
 
Month:* 
( ) January 
( ) February 

301 
 
( ) March 
( ) April 
( ) May 
( ) June 
( ) July 
( ) August 
( ) September 
( ) October 
( ) November 
( ) December 
 
Validation: Min = 1980 Must be numeric Whole numbers only Positive numbers only Max character count 
= 4 
Shortname / Alias: recenthivtest_yr 
ID: 166 
Year:* 
_________________________________________________ 
 
 
 
Page entry logic: This page will show when: (#27 Question "When did you have your most recent HIV 
test? 
 
Please enter the month and year. 
 
Month:" AND #28 Question "Year:" ) 
 
PrEP Use 
Shortname / Alias: prepstartafterP3-T 
ID: 1201 
Did you start taking PrEP after you started the P3-T study?* 
( ) Yes 
( ) No 
 
 
Logic: Show/hide trigger exists.  

302 
 
Shortname / Alias: nowprep 
ID: 1202 
Are you taking PrEP right now?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: Fix logic- If no to Did you start taking PrEP after you enrolled in P3-T 
Shortname / Alias: noprep_why 
ID: 1203 
Why did you decide not to start PrEP? Select all of the factors below that were related to why you 
didn’t start PrEP.* 
[ ] I couldn't afford it 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to take a pill every day 
[ ] My parent(s) or guardian(s) found out and wouldn’t let me start 
[ ] I kept forgetting to take my pill 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I was worried about experiencing side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to take PrEP (due to kidney/renal function, bone density, or another 
medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] I was worried that the medication would taste bad and/or the pill would be too big 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #32 Question "Why did you decide not to take PrEP? 
Select all of the factors below that were related to why you didn’t take PrEP."  
PrEP Use, why didn't start 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 

303 
 
ID: 1204 
Piping: Piped Values From Question 32. (Why did you decide not to take PrEP? Select all of the factors 
below that were related to why you didn’t take PrEP.) 
Please rank the reasons you did not start taking PrEP in order of importance.* 
 
 
Page entry logic: Fix logic- If yes to Did you start taking PrEP after you enrolled in P3-T 
PrEP Start 
 
Shortname / Alias: startprep_why 
ID: 943 
Why did you choose to start taking PrEP? Select all that apply.* 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking about having sex with someone whose HIV status I don’t know 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
 
PrEP Start 
 
Action: Custom Script: Script to count checkboxes and skip q if < 2 
 
Shortname / Alias: startprep_primwhy 

304 
 
ID: 945 
Piping: Piped Values From Question 34. (Why did you choose to start taking PrEP? Select all that apply.) 
What was the main reason you started PrEP?* 
 
 
Page entry logic: This page will show when: (#30 Question "Did you start taking PrEP after you started 
the P3-T study?" is one of the following answers ("Yes") OR #31 Question "Are you taking PrEP right 
now?" is one of the following answers ("Yes")) 
PrEP Start and Stop 
 
Validation: %s format expected 
Logic: Hidden unless: #30 Question "Did you start taking PrEP after you started the P3-T study?" 
is one of the following answers ("Yes") 
Shortname / Alias: prep_firststart 
ID: 947 
When did you start taking PrEP after enrolling in P3-T? 
If you do not know the exact day of the month, please give your best estimate. * 
_________________________________________________ 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: prepstoP3-Tmo 
ID: 576 
Have you stopped taking PrEP for 7 days in a row or more in the last 3 months?* 
( ) Yes 
( ) No 
 
Action: Custom Script: Check date not in future 
 
Action: Custom Script: Script to populate - 3 months date 
 
Hidden Value: Date for prompt - today minus 3 months 
Value:  
 

305 
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Stop, last 3 months 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: timesprepstoP3-Tmo 
ID: 950 
How many times did you stop taking PrEP for 7 days in a row or more in the last three months 
(from [question('value'), id='1026'] to today)?* 
( ) 0 
( ) 1 
( ) 2 
( ) 3 
( ) 4 
( ) 5 
( ) 6 
( ) 7 
( ) 8 
( ) 9 
( ) 10 
( ) 11 
( ) 12 or more 
 
Logic: Hidden by default 
ID: 1159 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1") 
Shortname / Alias: time1_dates 
ID: 1027 
Please enter the dates you were off PrEP (from [question('value'), id='1026'] to today): 
Validation: %s format expected 
ID: 1028 

306 
 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1029 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1160 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefirst_dates 
ID: 1030 
Please enter the dates you were off PrEP for the first time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1031 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1032 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1161 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesecond_dates 
ID: 1033 

307 
 
Please enter the dates you were off PrEP for the second time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1034 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1035 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1162 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timethird_dates 
ID: 1036 
Please enter the dates you were off PrEP for the third time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1037 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1038 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1163 
The date re-started is before the date stopped. Please correct this.  
 

308 
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefourth_dates 
ID: 1039 
Please enter the dates you were off PrEP for the fourth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1040 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1041 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1164 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: timefifth_dates 
ID: 1042 
Please enter the dates you were off PrEP for the fifth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1043 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1044 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1165 

309 
 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("6","7","8","9","10","11","12 or more") 
Shortname / Alias: timesixth_dates 
ID: 1045 
Please enter the dates you were off PrEP the sixth time (from [question('value'), id='1026'] 
to today): 
Validation: %s format expected 
ID: 1046 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1047 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1166 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("7","8","9","10","11","12 or more") 
Shortname / Alias: timeseventh_dates 
ID: 1048 
Please enter the dates you were off PrEP for the seventh time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1049 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1050 
Date re-started:*: _________________________________________________ 
 

310 
 
Logic: Hidden by default 
ID: 1167 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("8","9","10","11","12 or more") 
Shortname / Alias: timeeighth_dates 
ID: 1051 
Please enter the dates you were off PrEP for the eighth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1052 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1053 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1168 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("9","10","11","12 or more") 
Shortname / Alias: timeninth_dates 
ID: 1054 
Please enter the dates you were off PrEP for the ninth time (from [question('value'), 
id='1026'] to today): 
Validation: %s format expected 
ID: 1055 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1056 

311 
 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1169 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("10","11","12 or more") 
Shortname / Alias: timetenth_dates 
ID: 1057 
Please enter the dates you were off PrEP for the tenth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1058 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1059 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1170 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("11","12 or more") 
Shortname / Alias: timeeleventh_dates 
ID: 1060 
Please enter the dates you were off PrEP for the eleventh time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1061 

312 
 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1062 
Date re-started:*: _________________________________________________ 
 
Logic: Hidden by default 
ID: 1171 
The date re-started is before the date stopped. Please correct this.  
 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("12 or more") 
Shortname / Alias: timetwelfth_dates 
ID: 1063 
Please enter the dates you were off PrEP for the twelfth time (from [question('value'), 
id='1026'] to today):* 
Validation: %s format expected 
ID: 1064 
Date stopped:*: _________________________________________________ 
Validation: %s format expected 
ID: 1065 
Date re-started:*: _________________________________________________ 
 
Page entry logic: This page will show when: ((#37 Question "Have you stopped taking PrEP for 7 days 
in a row or more in the last 3 months?" is one of the following answers ("Yes") OR (#29 Question "When 
you started the P3-T study, were you taking PrEP?" is one of the following answers ("Yes") AND #31 
Question "Are you taking PrEP right now?" is one of the following answers ("No"))) OR (#30 Question 
"Did you start taking PrEP after you started the P3-T study?" is one of the following answers ("Yes") AND 
#31 Question "Are you taking PrEP right now?" is one of the following answers ("No"))) 
PrEP Stop 
 
Logic: Hidden by default 
ID: 1206 

313 
 
This number cannot be greater than the number of times you stopped taking PrEP for 7 days in a 
row or more in the last 3 months ([question('value'), id='950']). Please correct this. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #38 Question "How many times did you stop taking PrEP for 7 days in a 
row or more in the last three months (from [question('value'), id='1026'] to today)?" is one of the 
following answers ("1","2","3","4","5","6","7","8","9","10","11","12 or more") 
Shortname / Alias: prepstop_drconsult 
ID: 578 
Of the [question("value"), id="950"] times you stopped taking PrEP, how many did you 
talk with your medical provider about before you stopped taking PrEP?* 
_________________________________________________ 
 
Shortname / Alias: stopprep_why 
ID: 581 
Think about the most recent time you stopped taking PrEP. Select all of the factors below that 
were related to why you stopped PrEP.* 
[ ] I couldn't afford it anymore 
[ ] I was not having sex 
[ ] I was no longer having sex with a person living with HIV 
[ ] I was only having sex with one person and they were undetectable or HIV negative 
[ ] I didn't want to keep taking a pill every day 
[ ] My parent(s) or guardian(s) found out and made me stop 
[ ] I kept forgetting to take my pill 
[ ] I haven't been able to make it to my follow-up appointments 
[ ] I could no longer see my PrEP provider and haven't found another PrEP provider 
[ ] I experienced side effects 
[ ] I was worried about the long term effects of PrEP on my health 
[ ] It was medically unsafe for me to continue taking PrEP (due to kidney/renal function, bone density, or 
another medical issue) 
[ ] I was worried that if I were to become HIV-positive certain medications may no longer work or I might 
be resistant to them 
[ ] I was worried that PrEP might not provide complete protection against HIV 
[ ] I started using condoms all of the time 
[ ] The medication tastes bad and/or the pill is too big 
[ ] Other, please specify:: _________________________________________________ 
 
 

314 
 
Page entry logic: This page will show when: #38 Question "How many times did you stop taking PrEP 
for 7 days in a row or more in the last three months (from [question('value'), id='1026'] to today)?" is one 
of the following answers ("1","2","3","4","5","6","7","8","9","10","11") 
 
Action: Custom Script: Script to check number of times off PrEP 
 
 
Page entry logic: This page will show when: #53 Question "Think about the most recent time you 
stopped taking PrEP. Select all of the factors below that were related to why you stopped PrEP."  
PrEP Stop Continued 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: stopprep_primwhy 
ID: 582 
Piping: Piped Values From Question 53. (Think about the most recent time you stopped taking PrEP. 
Select all of the factors below that were related to why you stopped PrEP.) 
Please rank the reasons you stopped taking PrEP in order of importance.* 
 
 
Page entry logic: This page will show when: #37 Question "Have you stopped taking PrEP for 7 days in 
a row or more in the last 3 months?" is one of the following answers ("Yes") 
PrEP Restart, current users 
 
Shortname / Alias: restart_why 
ID: 956 
Why did you choose to restart taking PrEP the last time? Select all that apply.* 
[ ] I was able to start seeing my PrEP provider again 
[ ] I found a new PrEP provider 
[ ] I was having issues with side effects, but I found a way to deal with them 
[ ] I was having issues taking my pill every day, but I found a way to deal with it 
[ ] I’m having sex with or thinking about having sex with someone who is HIV+ 
[ ] I’m having sex with or thinking having sex with someone whose status HIV I don’t know 
[ ] I want to be in control of my sexual health 
[ ] I want to reduce my anxiety around sex 

315 
 
[ ] I want to increase my sexual satisfaction and intimacy 
[ ] I want to be safe and healthy 
[ ] I want to have a better future 
[ ] I am having sex with multiple partners 
[ ] I don’t like to use condoms 
[ ] My partner won’t use condoms 
[ ] I had a previous HIV scare 
[ ] My health care provider recommended it 
[ ] I was recently diagnosed with an STI 
[ ] Many people in my community take PrEP 
[ ] Other, please specify:: _________________________________________________ 
 
 
Page entry logic: This page will show when: #55 Question "Why did you choose to restart taking PrEP 
the last time? Select all that apply."  
Restart reason, current users 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: restart_primwhy 
ID: 957 
Piping: Piped Values From Question 55. (Why did you choose to restart taking PrEP the last time? 
Select all that apply.) 
What was the main reason you decided to restart PrEP?* 
 
 
Healthcare Visits 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists.  
Shortname / Alias: numdrvisits3m 
ID: 584 
In the last 3 months, how many times did you go to the doctor for any reason?* 
_________________________________________________ 

316 
 
 
Logic: Hidden by default 
ID: 940 
This number cannot be greater than the total number of doctor's visits entered above.  
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Show/hide trigger exists. Hidden unless: #57 Question "In the last 3 months, how many 
times did you go to the doctor for any reason?" is greater than "0" 
Shortname / Alias: numprepvisits3m 
ID: 586 
Out of all these visits, how many were routine/scheduled PrEP appointments?* 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 988 
This number cannot be greater than the total number of routine PrEP appointments. 
 
Validation: Must be numeric Whole numbers only Positive numbers only 
Logic: Hidden unless: #58 Question "Out of all these visits, how many were routine/scheduled 
PrEP appointments?" is greater than "0" 
Shortname / Alias: missedprepvisits3m 
ID: 587 
In the last 3 months, how many of your scheduled PrEP appointments did you miss 
because you didn't show or forgot? 
By scheduled appointments, we mean routine PrEP appointments, not walk-in or urgent 
care appointments for acute/urgent issues. * 
_________________________________________________ 
 
Action: Custom Script: Script to check number of visits 
 
Action: Custom Script: Script to check number of days 
 
 
PrEP Adherence 

317 
 
 
Logic: Hidden unless: #31 Question "Are you taking PrEP right now?" is one of the following 
answers ("Yes") 
Shortname / Alias: preplastweek 
ID: 177 
How many of the last 7 days did you take your PrEP medication?* 
( ) 0 days 
( ) 1 day 
( ) 2 days 
( ) 3 days 
( ) 4 days 
( ) 5 days 
( ) 6 days 
( ) 7 days 
 
Validation: Min = 0 Max = 100 
Logic: Show/hide trigger exists.  
Shortname / Alias: prepmonth 
ID: 178 
In the last month, what percent of the time did you take your PrEP as prescribed (once a day)? 
Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:* 
0 ________________________[__]_____________________________ 100 
 
 
PrEP Dose Barriers 
 
Shortname / Alias: dose_ 
ID: 959 
What has gotten in the way of you taking your PrEP on a daily basis? Please select all that apply.* 
[ ] I have not had any trouble taking PrEP on a daily basis 
[ ] I get tired of taking a pill every day 
[ ] I forget to take it 
[ ] I don’t always have my pills with me 
[ ] My work/school schedule 

318 
 
[ ] My social life 
[ ] I’m around people I don’t want to take it in front of 
[ ] I experience side effects 
[ ] I was drinking or using drugs and I didn’t take it 
 
Action: Custom Script: Script to count checkboxes and skip if q <2 
 
Shortname / Alias: does_rank 
ID: 960 
Piping: Piped Values From Question 62. (What has gotten in the way of you taking your PrEP on a daily 
basis? Please select all that apply.) 
Please rank the things that have gotten in the way of you taking your PrEP on a daily basis.* 
 
 
PrEP Adherence Continued 
 
Logic: Hidden unless: #61 Question "In the last month, what percent of the time did you take your 
PrEP as prescribed (once a day)? Use the scale below. 
0% would mean ‘NONE’ of the time and 100% would mean ‘ALL’ of the time. If you are unsure, 
make a guess. 
 
% medication taken:"  
Shortname / Alias: prepadher_protection 
ID: 588 
You said you took your PrEP [question("value"), id="178"] percent of the time in the last month. 
Based on this adherence level, how protected do you think you were from HIV in the last month?* 
( ) Not protected at all 
( ) Somewhat protected 
( ) Mostly protected 
( ) Fully protected 
 
Shortname / Alias: prepadher_decisionbot 
ID: 589 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you bottom?* 
( ) My decision about condom use when I bottom was not influenced by whether or not I took my pill 
every day 

319 
 
( ) My decision about condom use when I bottom was somewhat influenced by whether or not I took my 
pill every day 
( ) My decision about condom use when I bottom was influenced by whether or not I took my pill every 
day 
( ) I did not bottom in the last month 
 
Shortname / Alias: prepadher_decisiontop 
ID: 590 
In the last month, how much did your adherence to PrEP (if you took it every day or not) affect 
how often you used a condom during anal sex when you top?* 
( ) My decision about condom use when I top was not influenced by whether or not I took my pill every 
day 
( ) My decision about condom use when I top was somewhat influenced by whether or not I took my pill 
every day 
( ) My decision about condom use when I top was influenced by whether or not I took my pill every day 
( ) I did not top in the last month 
 
PrEP Confidence 
 
ID: 907 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: keepappts 
ID: 903 
How confident are you that you can... 
 
Keep your PrEP medical appointments:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: followplan 
ID: 904 
Follow a plan for taking PrEP:* 
1 ________________________[__]_____________________________ 10 

320 
 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: atworkschool 
ID: 905 
Take PrEP at work/school:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekday 
ID: 906 
Take PrEP on a weekday:* 
1 ________________________[__]_____________________________ 10 
 
 
PrEP Confidence 2 
 
ID: 908 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: onweekend 
ID: 909 
How confident are you that you can... 
 
Take PrEP on a weekend:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: wfriends 
ID: 910 
Take PrEP when I'm out with friends:* 
1 ________________________[__]_____________________________ 10 

321 
 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: prepdrinking 
ID: 911 
Take PrEP when I'm drinking or using drugs:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: schedulechange 
ID: 912 
Take PrEP when my schedule changes:* 
1 ________________________[__]_____________________________ 10 
 
PrEP Confidence 3 
 
ID: 913 
We are interested in how you feel about the following statements. Please answer by 
indicating your confidence about each statement on a scale from 1 (not confident) to 10 
(totally confident). 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: whiletraveling 
ID: 914 
How confident are you that you can... 
 
Take PrEP while traveling:* 
1 ________________________[__]_____________________________ 10 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: takewsideeffects 
ID: 915 
Take PrEP when you are having medication side effects:* 
1 ________________________[__]_____________________________ 10 
 

322 
 
Validation: Min = 1 Max = 10 
Shortname / Alias: havingcrisis 
ID: 916 
Take PrEP when you are having a crisis:* 
1 ________________________[__]_____________________________ 10 
 
PrEP Delivery 
Shortname / Alias: prep_prefmode 
ID: 597 
Right now there are no other approved options for taking PrEP. However, if there were more than 
one option and each method was equally good at protecting you from getting HIV, which method 
would you most prefer?* 
( ) Taking one pill, every day 
( ) Taking two pills before you had sex and a pill a day for the next two days 
( ) Taking one pill a day just on Tuesday, Thursday, Saturday, and Sunday 
( ) Getting an injection about every 2 to 3 months 
( ) Putting medicated lubrication (lube) in your anus (and/or your partner’s anus) before having anal sex 
( ) Douching with a medicated solution (microbicide) before having anal sex 
 
 
PrEP Beliefs 
 
Shortname / Alias: prepbeliefs 
ID: 598 
Please rate your agreement with the following statements:* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
People are 
less likely 
to use 
condoms 
for anal sex 
if they are 
using PrEP 
( )  
( )  
( )  
( )  
I feel as if 
starting to 
take PrEP 
( )  
( )  
( )  
( )  

323 
 
would allow 
me to have 
more sex 
partners 
I feel as if 
starting to 
take PrEP 
would allow 
me to have 
more 
condomless 
anal sex 
( )  
( )  
( )  
( )  
 
 
PrEP and People 
 
Shortname / Alias: prepppl 
ID: 193 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I worry 
people will 
assume I 
sleep around 
if they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
assume that I 
am HIV-
positive if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think my 
partner(s) 
are HIV-
positive if 
( )  
( )  
( )  
( )  

324 
 
they know I 
take PrEP  
I worry about 
listing PrEP 
as one of my 
current 
medications 
during 
appointments 
such as at a 
dentist's or 
specialist's 
office  
( )  
( )  
( )  
( )  
I feel 
ashamed to 
tell other 
people that I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am a 
bad person if 
they know I 
take PrEP  
( )  
( )  
( )  
( )  
I worry 
people will 
think I am 
gay if they 
know I take 
PrEP  
( )  
( )  
( )  
( )  
I worry my 
friends will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
family will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  
I worry my 
sexual 
partners will 
find out that I 
take PrEP 
( )  
( )  
( )  
( )  

325 
 
I think people 
will give me a 
hard time if I 
tell them I 
take PrEP  
( )  
( )  
( )  
( )  
I think people 
will judge me 
if they know I 
am taking 
PrEP 
( )  
( )  
( )  
( )  
 
 
PrEP Concerns 
 
Shortname / Alias: prepconc 
ID: 210 
We are interested in how you feel about the following statements. Read each statement carefully 
and indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
My family 
does not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
My friends 
do not 
support me 
taking PrEP 
( )  
( )  
( )  
( )  
People 
taking PrEP 
are 
portrayed 
poorly in the 
media and 
online 
( )  
( )  
( )  
( )  
People in my 
community 
talk poorly 
about people 
taking PrEP 
( )  
( )  
( )  
( )  

326 
 
I feel 
embarrassed 
about taking 
PrEP  
( )  
( )  
( )  
( )  
I think I am 
not following 
the 'rules' of 
my 
community if 
I take PrEP  
( )  
( )  
( )  
( )  
I have been 
blamed by 
people in my 
community 
for spreading 
HIV through 
PrEP use  
( )  
( )  
( )  
( )  
I have been 
blamed by 
people in my 
community 
for spreading 
sexually 
transmitted 
infections 
through not 
using 
condoms  
( )  
( )  
( )  
( )  
I have been 
rejected 
romantically 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
slut-shamed 
because I 
take PrEP 
(or told that I 
am a 
"Truvada-
slut/whore")  
( )  
( )  
( )  
( )  
I have been 
judged by a 
health care 
provider for 
taking PrEP  
( )  
( )  
( )  
( )  

327 
 
I don't think 
that I need to 
take PrEP 
anymore 
( )  
( )  
( )  
( )  
I have been 
told by a 
health care 
provider that 
I don't need 
PrEP or I 
shouldn't 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
yelled at or 
scolded 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have been 
unfairly 
discriminated 
against 
because I 
take PrEP  
( )  
( )  
( )  
( )  
I have 
experienced 
physical 
violence 
because I 
am taking 
PrEP  
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "I don't think that I need to take PrEP anymore" is one of the 
following answers ("Agree","Strongly Agree") 
Shortname / Alias: whydontneed 
ID: 1067 
Why do you think that you do not need to take PrEP anymore? Select all that apply.* 
[ ] My relationship status changed -- I became single 
[ ] My relationship status changed -- I became monogamous (only having sex with one person) 
[ ] I stopped having sex with an HIV-positive person 
[ ] I am having less sex 
[ ] I am sexually inactive (I haven't been having sex for a period of time) 
[ ] I have started using condoms every time I have sex 
[ ] Other, please specify:: _________________________________________________ 

328 
 
 
PrEP Difficulties 
 
Shortname / Alias: prepdifficulties 
ID: 602 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
Getting the 
costs of PrEP 
covered 
(including 
office visits or 
office visit co-
pays, lab 
costs, 
transportation 
costs)  
( )  
( )  
( )  
( )  
Using 
insurance to 
get coverage 
for PrEP 
costs 
(including 
office visits, 
lab costs)  
( )  
( )  
( )  
( )  
Getting 
transportation 
to PrEP 
appointments 
and labs 
( )  
( )  
( )  
( )  
Returning for 
PrEP follow-
up 
appointments 
and labs 
( )  
( )  
( )  
( )  
Getting PrEP 
prescription 
refilled 
( )  
( )  
( )  
( )  
 
 

329 
 
PrEP Difficulties Continued 
 
Shortname / Alias: prepdifficulties2 
ID: 649 
In making your decision to continue taking PrEP, please rate how much the following items 
concern you.* 
 
Not at all 
concerned 
A little 
concerned 
Concerned 
Very 
concerned 
The 
possibility 
that if I were 
to become 
HIV+, 
certain 
medications 
might no 
longer work 
or I might be 
resistant to 
them  
( )  
( )  
( )  
( )  
The 
possibility 
that PrEP 
might not 
provide 
complete 
protection 
against HIV  
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about PrEP 
( )  
( )  
( )  
( )  
Having to 
talk to a 
health care 
provider 
about my 
sex life 
( )  
( )  
( )  
( )  
Experiencing 
side effects 
from PrEP 
( )  
( )  
( )  
( )  
The long-
term effects 
( )  
( )  
( )  
( )  

330 
 
of PrEP on 
my health 
Having to 
remember to 
take PrEP 
every day 
( )  
( )  
( )  
( )  
Friends 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Family 
members 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
Sexual 
partners 
finding out 
that I am on 
PrEP 
( )  
( )  
( )  
( )  
 
Logic: Hidden unless: Question "The possibility that PrEP might not provide complete protection 
against HIV " is one of the following answers ("Concerned","Very concerned") 
Shortname / Alias: prepworry 
ID: 665 
Why do you worry about the possibility that PrEP might not provide complete protection against 
HIV? (Check all that apply)* 
[ ] I worry that the drug is not effective at preventing HIV 
[ ] Because I don't take PrEP every day consistently 
[ ] Because I feel I am at very high risk for becoming infected with HIV 
[ ] Other, please specify:: _________________________________________________ 
 
 
HIV perceptions 
 
Shortname / Alias: hivthoughts 
ID: 667 

331 
 
Imagine how you would feel if you became infected with HIV. Read each statement carefully and 
indicate how strongly you agree or disagree with the following statements.* 
 
Strongly 
Disagree 
Disagree 
Agree 
Strongly 
Agree 
I would 
be afraid 
people 
would 
judge me 
when 
they 
learn I 
have HIV  
( )  
( )  
( )  
( )  
If I got 
infected, 
people 
would 
not want 
to have 
sex with 
me  
( )  
( )  
( )  
( )  
I would 
feel 
guilty if I 
got HIV  
( )  
( )  
( )  
( )  
I would 
feel 
ashamed 
if I got 
HIV  
( )  
( )  
( )  
( )  
 
 
PEP and PrEP On-Demand 
 
Shortname / Alias: pep3m 
ID: 230 
In the past 3 months, have you taken post-exposure prophylaxis (PEP) AFTER a sexual or drug 
use exposure to reduce the risk of getting HIV?* 
( ) Yes 
( ) No 
 

332 
 
Shortname / Alias: prepondemand3m 
ID: 674 
In the past 3 months, have you taken PrEP on-demand (taking two pills before you had sex and a 
pill a day for the next two days)? 
It is not an approved method and has not been shown to be an effective method for preventing 
HIV.* 
( ) Yes 
( ) No 
 
Substances 
 
ID: 232 
Now we’d like to ask you a little bit about your experiences using alcohol, tobacco 
products, and other drugs. Please be assured that this information will be treated as 
strictly confidential. 
 
The questions will concern your experiences with using these substances in the past 
three months. These substances can be smoked, swallowed, snorted, inhaled, injected, or 
taken in the form of pills. Some of the substances may be prescribed by a doctor (like 
amphetamines, sedatives, or pain medications). For this survey, do not report on 
medications that are used as prescribed by your doctor. However, if you have taken such 
medications for reasons other than prescription, or taken them more frequently or at 
higher doses than prescribed, please report on this use. Once again, please remember 
that all information provided will be treated as strictly confidential. 
 
Shortname / Alias: substanceuse3m 
ID: 233 
Which of the following drugs have you used in the last 3 months? 
Please check all that apply.* 
[ ] Tobacco (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.) 
[ ] Alcohol (beer, wine, spirits, etc.) 
[ ] Cannabis (marijuana, pot, weed, grass, hash, synthetic cannabis, etc.) 
[ ] Cocaine (coke, crack, etc.) 
[ ] Amphetamines (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.) 
[ ] Inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.) 
[ ] Sedatives, tranquilizers, or sleeping pills (valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) 
[ ] Hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.) 
[ ] Opioids (heroin, morphine, methadone, codeine, Oxycotin, Percocet, Vicodin, etc.) 
[ ] None of these 
 

333 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Tobacco (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)") 
Tobacco 
 
Shortname / Alias: tobacco3months 
ID: 234 
In the past 3 months, how often have you used tobacco products (cigarettes, chewing tobacco, 
cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: tobaccodesire 
ID: 235 
During the past 3 months, how often have you had a desire to use tobacco products (cigarettes, 
chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccoproblems 
ID: 236 
During the past 3 months, how often has your use of tobacco products (cigarettes, chewing 
tobacco, cigars, e-cigarettes, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

334 
 
 
Shortname / Alias: tobaccofailed 
ID: 237 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, 
etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: tobaccofriend 
ID: 238 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
tobacco products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: tobaccostop 
ID: 239 
In the last 3 months, have you tried and failed to control, cut down or stop using tobacco 
products (cigarettes, chewing tobacco, cigars, e-cigarettes, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Alcohol (beer, wine, spirits, etc.)") 
Alcohol 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: alcohol3months 
ID: 240 
In the past 3 months, how often have you used alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 

335 
 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Logic: Hidden unless: #97 Question "In the past 3 months, how often have you used alcoholic 
beverages (beer, wine, spirits, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily","Decline to answer") 
Shortname / Alias: alcoholdaily 
ID: 241 
How many drinks containing alcohol do you have on a typical day?* 
( ) 0 
( ) 1 or 2 
( ) 3 or 4 
( ) 5 or 6 
( ) 7 to 9 
( ) 10 or more 
 
Shortname / Alias: alcoholbinge 
ID: 242 
How often do you have 5 or more drinks on one occasion?* 
( ) Never 
( ) Less than monthly 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholdesire 
ID: 243 
During the past 3 months, how often have you had a desire to use alcoholic beverages (beer, 
wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 

336 
 
Shortname / Alias: alcoholproblems 
ID: 244 
During the past 3 months, how often has your use of alcoholic beverages (beer, wine, spirits, 
etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfailed 
ID: 245 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: alcoholfriend 
ID: 246 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
alcoholic beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: alcoholstop 
ID: 247 
In the last 3 months, have you tried and failed to control, cut down or stop using alcoholic 
beverages (beer, wine, spirits, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 

337 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cannabis (marijuana, pot, weed, grass, 
hash, synthetic cannabis, etc.)") 
Cannabis 
 
Shortname / Alias: cannabis3months 
ID: 251 
In the past 3 months, how often have you used cannabis (marijuana, pot, grass, hash, etc.) or 
synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Page entry logic: This page will show when: #107 Question "In the past 3 months, how often have you 
used cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Cannabis (cont.) 
 
Shortname / Alias: cannabisdesire 
ID: 252 
During the past 3 months, how often have you had a desire to use cannabis (marijuana, pot, 
grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisproblems 
ID: 253 

338 
 
During the past 3 months, how often has your use of cannabis (marijuana, pot, grass, hash, etc.) 
or synthetic cannabis led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfailed 
ID: 254 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cannabisfriend 
ID: 255 
In the past 3 months, has a friend or relative or anyone else expressed concern about your use of 
cannabis (marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cannabisstop 
ID: 256 
In the last 3 months, have you tried and failed to control, cut down or stop using cannabis 
(marijuana, pot, grass, hash, etc.) or synthetic cannabis?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Cocaine (coke, crack, etc.)") 
Cocaine 

339 
 
 
Shortname / Alias: cocaine3months 
ID: 257 
In the past 3 months, how often have you used cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #113 Question "In the past 3 months, how often have you 
used cocaine (coke, crack, etc.)?" is one of the following answers ("Once or 
twice","Monthly","Weekly","Daily or almost daily") 
Cocaine (cont.) 
 
Shortname / Alias: cocainedesire 
ID: 258 
During the past 3 months, how often have you had a desire to use cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocaineproblems 
ID: 259 
During the past 3 months, how often has your use of cocaine (coke, crack, etc.) led to health, 
social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

340 
 
 
Shortname / Alias: cocainefailed 
ID: 260 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of cocaine (coke, crack, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: cocainefriend 
ID: 261 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
cocaine (coke, crack, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: cocainestop 
ID: 262 
In the last 3 months, have you tried and failed to control, cut down or stop using cocaine (coke, 
crack, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Amphetamines (speed, meth, diet pills, 
ecstasy, Ritalin, Adderall, etc.)") 
Amphetamine 
 
Shortname / Alias: amphetamine3months 
ID: 263 
In the past 3 months, how often have you used amphetamine type stimulants (speed, meth, diet 
pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 

341 
 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #119 Question "In the past 3 months, how often have you 
used amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Amphetamine (cont.) 
 
Shortname / Alias: amphetaminedesire 
ID: 265 
During the past 3 months, how often have you had a desire to use amphetamine type stimulants 
(speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetamineproblems 
ID: 266 
During the past 3 months, how often has your use of amphetamine type stimulants (speed, meth, 
diet pills, ecstasy, Ritalin, Adderall, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefailed 
ID: 267 

342 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, 
Adderall, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: amphetaminefriend 
ID: 268 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
amphetamine type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: amphetaminestop 
ID: 269 
In the last 3 months, have you tried and failed to control, cut down or stop using amphetamine 
type stimulants (speed, meth, diet pills, ecstasy, Ritalin, Adderall, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.)") 
Inhalants 
 
Shortname / Alias: inhalants3months 
ID: 271 
In the past 3 months, how often have you used inhalants (poppers, nitrous, glue, petrol, paint 
thinner, etc.)?* 
( ) Never 

343 
 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #125 Question "In the past 3 months, how often have you 
used inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?" is one of the following answers ("Once 
or twice","Monthly","Weekly","Daily or almost daily") 
Inhalants (cont.) 
 
Shortname / Alias: inhalantsdesire 
ID: 272 
During the past 3 months, how often have you had a desire to use inhalants (poppers, nitrous, 
glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsproblems 
ID: 273 
During the past 3 months, how often has your use of inhalants (poppers, nitrous, glue, petrol, 
paint thinner, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfailed 
ID: 274 

344 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: inhalantsfriend 
ID: 275 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
inhalants (poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
 
Shortname / Alias: inhalantsstop 
ID: 276 
In the last 3 months, have you tried and failed to control, cut down or stop using inhalants 
(poppers, nitrous, glue, petrol, paint thinner, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Sedatives, tranquilizers, or sleeping pills 
(valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)") 
Sedatives 
 
Shortname / Alias: sedatives3months 
ID: 277 
In the past 3 months, how often have you used sedatives, tranquilizers, or sleeping pills (Valium, 
Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 

345 
 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #131 Question "In the past 3 months, how often have you 
used sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?" 
is one of the following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Sedatives (cont.) 
 
Shortname / Alias: sedativesdesire 
ID: 279 
During the past 3 months, how often have you had a desire to use sedatives, tranquilizers, or 
sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesproblems 
ID: 280 
During the past 3 months, how often has your use of sedatives, tranquilizers, or sleeping pills 
(Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.) led to health, social, legal or financial 
problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesfailed 
ID: 281 

346 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, 
Xanax, Ambien, GHB, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: sedativesfriend 
ID: 282 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
sedatives, tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, 
etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: sedativesstop 
ID: 283 
In the last 3 months, have you tried and failed to control, cut down or stop using sedatives, 
tranquilizers, or sleeping pills (Valium, Serepax, Rohypnol, Xanax, Ambien, GHB, etc.)?* 
( ) No 
( ) Yes 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Hallucinogens (LSD, acid, mushrooms, 
PCP, Ketamine, etc.)") 
Hallucinogens 
 
Shortname / Alias: hallucinogens3months 
ID: 285 
In the past 3 months, how often have you used hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 

347 
 
( ) Weekly 
( ) Daily or almost daily 
 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #137 Question "In the past 3 months, how often have you 
used hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?" is one of the following answers 
("Once or twice","Monthly","Weekly","Daily or almost daily") 
Hallucinogens (cont.) 
 
Shortname / Alias: hallucinogensdesire 
ID: 286 
During the past 3 months, how often have you had a desire to use hallucinogens (LSD, acid, 
mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
 
Shortname / Alias: hallucinogensproblems 
ID: 287 
During the past 3 months, how often has your use of hallucinogens (LSD, acid, mushrooms, PCP, 
Ketamine, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfailed 
ID: 288 

348 
 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: hallucinogensfriend 
ID: 289 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
hallucinogens (LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
Shortname / Alias: hallucinogensstop 
ID: 290 
In the last 3 months, have you tried and failed to control, cut down or stop using hallucinogens 
(LSD, acid, mushrooms, PCP, Ketamine, etc.)?* 
( ) No 
( ) Yes 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #90 Question "Which of the following drugs have you used 
in the last 3 months? 
Please check all that apply." is one of the following answers ("Opioids (heroin, morphine, methadone, 
codeine, Oxycotin, Percocet, Vicodin, etc.)") 
Opioids 
 
Shortname / Alias: opioids3months 
ID: 291 
In the past 3 months, how often have you used opioids (heroin, morphine, methadone, codeine, 
Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 

349 
 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Action: JavaScript: Hide General Error Message 
 
 
Page entry logic: This page will show when: #143 Question "In the past 3 months, how often have you 
used opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?" is one of the 
following answers ("Once or twice","Monthly","Weekly","Daily or almost daily") 
Opioids (cont.) 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: opioidsheroin 
ID: 299 
In the past 3 months, has your opioid use included heroin?* 
( ) Yes 
( ) No 
 
Logic: Hidden unless: #144 Question "In the past 3 months, has your opioid use included 
heroin?" is one of the following answers ("Yes") 
Shortname / Alias: heroinprimary 
ID: 300 
In the past 3 months, was heroin the most common opioid that you used?* 
( ) Yes 
( ) No 
 
Shortname / Alias: opioidssdesire 
ID: 293 
During the past 3 months, how often have you had a desire to use opioids (heroin, morphine, 
methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 

350 
 
 
Shortname / Alias: opioidsproblems 
ID: 294 
During the past 3 months, how often has your use of opioids (heroin, morphine, methadone, 
codeine, Oxycontin, Percocet, Vicodin, etc.) led to health, social, legal or financial problems?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfailed 
ID: 295 
During the past 3 months, how often have you failed to do what was normally expected of you 
because of your use of opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, 
Vicodin, etc.)?* 
( ) Never 
( ) Once or twice 
( ) Monthly 
( ) Weekly 
( ) Daily or almost daily 
 
Shortname / Alias: opioidsfriend 
ID: 296 
In the last 3 months, has a friend or relative or anyone else expressed concern about your use of 
opioids (heroin, morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 
 
Shortname / Alias: opioidsstop 
ID: 297 
In the last 3 months, have you tried and failed to control, cut down or stop using opioids (heroin, 
morphine, methadone, codeine, Oxycontin, Percocet, Vicodin, etc.)?* 
( ) No 
( ) Yes 
 

351 
 
Action: JavaScript: Hide General Error Message 
 
 
Sexual Behaviors 
 
Page exit logic: Skip / Disqualify LogicIF: #151 Question "In the past 3 months, how many people have 
you had anal sex with?" is exactly equal to "0" THEN: Jump to page 120 - Perceived HIV Risk 
 
ID: 368 
The next section of questions will ask about your sexual behaviors. We know that this can 
be a sensitive topic, so we would like to remind you that your answers will be kept 
completely confidential. Please be as honest as possible in order to ensure the success 
of the current study. 
 
The following questions refer to your sexual behavior during the past 3 months. Our 
focus will be only on anal sex. Therefore, do not include references to people with whom 
you did not engage in anal sex. 
 
For these questions, anal sex refers to sex where the other person’s penis was in your 
rectum (you were the bottom) and to sex where your penis was in the other person's 
rectum (you were the top). 
 
These questions only ask about people assigned male at birth, which includes cisgender 
men (men assigned male at birth) and transgender women (women assigned male at 
birth). Therefore, do not include references to cisgender women (women assigned female 
at birth) or transgender men (men assigned female at birth). 
 
Validation: Min = 0 Max = 999 Must be numeric Whole numbers only Positive numbers only 
Shortname / Alias: numsexpartner 
ID: 302 
In the past 3 months, how many people have you had anal sex with?* 
_________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 

352 
 
Page entry logic: This page will show when: #151 Question "In the past 3 months, how many people 
have you had anal sex with?" is greater than "0" 
HIV Status of Sexual Partners 
 
Logic: Hidden by default 
ID: 677 
The total number must equal the number of people you had anal sex with in the last 3 months 
([question('value'), id='302']). Please correct this. 
 
Validation: Must be numeric 
Shortname / Alias: partnerhivstatus 
ID: 676 
Before you had sex, what did you know of the HIV status of your sexual partner(s)? 
 
Enter numerical values. Numbers must add up to [question('value'), id='302'], the number of people 
you reported having anal sex within the last three months.* 
________This person/these people told you they were HIV negative and you had no reason to doubt it 
________You knew this person/these people were HIV positive 
________You were not completely sure of this person/these people's HIV status 
 
 
 
Action: Custom Script: Script to check the continuous sum totals 
 
 
 
Hidden Value: Num HIV Neg partners 
Value: [question("option value"), id="676", option="12278"] 
 
Hidden Value: Num HIV Pos partners 
Value: [question("option value"), id="676", option="12279"] 
 
Hidden Value: Num HIV Unk partners 
Value: [question("option value"), id="676", option="12280"] 
 

353 
 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners 
 
ID: 690 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Shortname / Alias: hivneg_timesbot 
ID: 701 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timestop 
ID: 702 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV negative where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #153 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the 
bottom?" is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
Logic: Hidden by default 
ID: 714 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='701']). Please correct this. 
 
Shortname / Alias: hivneg_timesbotunp 

354 
 
ID: 710 
In the past 3 months, how many of the [question('value'), id='701'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #155 Question "In the past 3 months, how many of 
the [question('value'), id='701'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the bottom were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Receptive AI 
 
ID: 721 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 999 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_typ 
ID: 711 
Regarding the partners who told you they were HIV negative who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 

355 
 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1002 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_botunp_gender 
ID: 964 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #154 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV negative where you were the top?" 
is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 722 

356 
 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 719 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='702']). Please correct this. 
 
Shortname / Alias: hivneg_timestopunp 
ID: 718 
In the past 3 months, how many of the [question('value'), id='702'] times you had anal sex 
with sexual partner(s) who told you they were HIV negative where you were the top were 
without a condom? * 
_________________________________________________ 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #158 Question "In the past 3 months, how many of 
the [question('value'), id='702'] times you had anal sex with sexual partner(s) who told you they were HIV 
negative where you were the top were without a condom? " is greater than "0" 
HIV Negative Partners - Condomless Insertive AI 
 
ID: 723 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 1004 

357 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_typ 
ID: 725 
Regarding the partners who told you they were HIV negative who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1005 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV negative ([question('option value'), id='676', 
option='12278']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivneg_topunp_gender 
ID: 965 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 

358 
 
Page entry logic: This page will show when: Num HIV Neg partners is greater than "0" 
HIV Negative Partners - PrEP and Alcohol and Drug Use 
 
ID: 992 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12278'] sexual partner(s) in the last 3 months who told you they were HIV negative. 
 
Logic: Hidden by default 
ID: 732 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 
Shortname / Alias: hivneg_toldyouprep 
ID: 729 
How many of your sexual partners who told you they were HIV negative told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivneg_youtoldprep 
ID: 730 
Regarding your sexual partners who told you they were HIV negative, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 733 
This number cannot be greater than the number of partners who told you they were HIV negative 
([question('option value'), id='676', option='12278']). Please correct this. 
 

359 
 
Logic: Hidden unless: #162 Question "Regarding your sexual partners who told you they were 
HIV negative, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivneg_youtoldprepnum 
ID: 731 
How many of your sexual partner(s) who told you they were HIV negative did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12278'].* 
_________________________________________________ 
 
Shortname / Alias: hivneg_timesdrunk 
ID: 740 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV negative were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners 
 
ID: 770 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Shortname / Alias: hivpos_timesbot 

360 
 
ID: 775 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivpos_timestop 
ID: 776 
In the past 3 months, how many times did you have anal sex with sexual partner(s) who 
told you they were HIV positive where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #165 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the 
bottom?" is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 782 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 783 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='775']). Please correct this. 
 
Shortname / Alias: hivpos_timesbotunp 
ID: 784 
In the past 3 months, how many of the [question('value'), id='775'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the bottom 
were without a condom? * 
_________________________________________________ 
 

361 
 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #167 Question "In the past 3 months, how many of 
the [question('value'), id='775'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the bottom were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Receptive AI 
 
ID: 786 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1008 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_typ 
ID: 788 
Regarding the partners who told you they were HIV positive who you had condomless receptive 
anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1009 

362 
 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
who told you they were HIV positive ([question('option value'), id='676', option='12279']). Please 
correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_botunp_gender 
ID: 994 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, and gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #166 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) who told you they were HIV positive where you were the top?" 
is greater than "0" 
HIV Pos Partners - Condomless Insertive AI 
 
ID: 792 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 793 
This number cannot be greater than the number of times you had anal sex where you were the 
top ([question('value'), id='776']). Please correct this. 
 

363 
 
Shortname / Alias: hivpos_timestopunp 
ID: 794 
In the past 3 months, how many of the [question('value'), id='776'] times you had anal sex 
with sexual partner(s) who told you they were HIV positive where you were the top were 
without a condom? * 
_________________________________________________ 
 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #170 Question "In the past 3 months, how many of 
the [question('value'), id='776'] times you had anal sex with sexual partner(s) who told you they were HIV 
positive where you were the top were without a condom? " is greater than "0" 
HIV Positive Partners - Condomless Insertive AI 
 
ID: 796 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12279'] sexual partner(s) in the last 3 months who told you they were HIV positive. 
 
Logic: Hidden by default 
ID: 1012 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_typ 
ID: 798 
Regarding the partners who told you they were HIV positive who you had condomless insertive 
anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 

364 
 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1013 
The total number cannot be greater than the number of sexual partner(s) in the last 3 
months who told you they were HIV positive ([question('option value'), id='676', 
option='12279']). Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivpos_topunp_gender 
ID: 995 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Pos partners is greater than "0" 
HIV Positive Partners - HIV Trt and PrEP 
 
Logic: Hidden by default 
ID: 799 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 

365 
 
Shortname / Alias: hivpos_toldyouhivmeds 
ID: 800 
How many of your sexual partners who told you they were HIV positive told you they were 
taking medication to treat HIV?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Hidden by default 
ID: 920 
The number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 
Shortname / Alias: hivpos_toldyouundetect 
ID: 918 
How many of your sexual partners who told you they were HIV positive told you they were 
undetectable?    
Number must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivpos_youtoldprep 
ID: 801 
Regarding your sexual partners who told you they were HIV positive, did you tell any of them that 
you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 802 
This number cannot be greater than the number of partners who told you they were HIV positive 
([question('option value'), id='676', option='12279']). Please correct this. 
 

366 
 
Logic: Hidden unless: #175 Question "Regarding your sexual partners who told you they were 
HIV positive, did you tell any of them that you were taking PrEP?" is one of the following answers 
("Yes") 
Shortname / Alias: hivpos_youtoldprepnum 
ID: 803 
How many of your sexual partner(s) who told you they were HIV positive did you tell you 
were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12279']. 
_________________________________________________ 
 
Shortname / Alias: hivpos_timesdrunk 
ID: 807 
In the past 3 months, how many of the times you had anal sex with partners who told you 
they were HIV positive were you or this person under the influence of alcohol or drugs?* 
_________________________________________________ 
 
Action: JavaScript: Hide General Error Message 
 
 
 
Action: Custom Script: Script to check med number not greater than the total number of partners 
 
 
 
Action: Custom Script: Script to check undetectable number not greater than the total number of 
partners 
 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners 
 

367 
 
ID: 810 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Shortname / Alias: hivunk_timesbot 
ID: 815 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the bottom?* 
_________________________________________________ 
 
Shortname / Alias: hivunk_timestop 
ID: 816 
In the past 3 months, how many times did you have anal sex with sexual partner(s) whose 
HIV status you were not sure of where you were the top?* 
_________________________________________________ 
 
 
Page entry logic: This page will show when: #178 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
bottom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 822 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 823 
This number cannot be greater than the number of times you had anal sex where you were the 
bottom ([question('value'), id='815']). Please correct this. 
 

368 
 
Shortname / Alias: hivunk_timesbotunp 
ID: 824 
In the past 3 months, how many of the [question('value'), id='815'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the bottom 
were without a condom? * 
_________________________________________________ 
 
Action: Custom Script: Check number condomless is not greater than total times 
 
 
Page entry logic: This page will show when: #180 Question "In the past 3 months, how many of 
the [question('value'), id='815'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the bottom were without a condom? " is greater than "0" 
HIV Status Unknown Partners - Condomless Receptive AI 
 
ID: 826 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1016 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_typ 
ID: 828 
Regarding the partners whose HIV status you were not sure of who you had condomless 
receptive anal sex with (where you were the bottom), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 

369 
 
 
Logic: Hidden by default 
ID: 1017 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_botunp_gender 
ID: 996 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: #179 Question "In the past 3 months, how many times did 
you have anal sex with sexual partner(s) whose HIV status you were not sure of where you were the 
top?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 832 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 833 

370 
 
This number cannot be greater than the number of times you had anal sex with sexual partner(s) 
whose HIV status you were not sure of where you were the top ([question('value'), id='816']). 
Please correct this. 
 
Shortname / Alias: hivunk_timestopunp 
ID: 834 
In the past 3 months, how many of the [question('value'), id='816'] times you had anal sex 
with sexual partner(s) whose HIV status you were not sure of where you were the top 
were without a condom?* 
_________________________________________________ 
 
 
 
Action: Custom Script: Script to check number condomless is not greater than the totals 
 
 
Page entry logic: This page will show when: #183 Question "In the past 3 months, how many of 
the [question('value'), id='816'] times you had anal sex with sexual partner(s) whose HIV status you were 
not sure of where you were the top were without a condom?" is greater than "0" 
HIV Status Unknown Partners - Condomless Insertive AI 
 
ID: 836 
The next set of questions will ask only about your [question('option value'), id='676', 
option='12280'] sexual partner(s) in the last 3 months whose HIV status you were not sure 
of. 
 
Logic: Hidden by default 
ID: 1020 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_typ 

371 
 
ID: 838 
Regarding the partners whose HIV status you were not sure of who you had condomless 
insertive anal sex with (where you were the top), how many were...  
 
Enter numerical values.* 
________Romantic partner(s), someone you are in a relationship with 
________Casual hook-up(s) or one-night stand(s) 
________A transactional partner(s), who you had sex with in exchange for money, housing, food, drugs, 
etc. 
 
Logic: Hidden by default 
ID: 1021 
The total number cannot be greater than the number of sexual partner(s) in the last 3 months 
whose HIV status you were not sure of ([question('option value'), id='676', option='12280']). 
Please correct this.  
 
Validation: Must be numeric 
Shortname / Alias: hivunk_topunp_gender 
ID: 997 
How many were...  
 
Enter numerical values.* 
________Men 
________Transwomen 
________Non-binary, genderqueer, or gender non-conforming 
 
 
Action: Custom Script: Script to check continuous sum totals 
 
Action: Custom Script: Script to check continuous sum totals 
 
 
Page entry logic: This page will show when: Num HIV Unk partners is greater than "0" 
HIV Status Unknown Partners - PrEP 
 
Logic: Hidden by default 

372 
 
ID: 839 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Shortname / Alias: hivunk_toldyouprep 
ID: 840 
How many of your sexual partners whose HIV status you were not sure of told you they 
were taking PrEP?    
Number must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 
Logic: Show/hide trigger exists.  
Shortname / Alias: hivunk_youtoldprep 
ID: 841 
Regarding your sexual partners whose HIV status you were not sure of, did you tell any of them 
that you were taking PrEP?* 
( ) Yes 
( ) No 
( ) I was not taking PrEP at this time 
 
Logic: Hidden by default 
ID: 842 
This number cannot be greater than the number of partners whose HIV status you were not sure 
of ([question('option value'), id='676', option='12280']). Please correct this. 
 
Logic: Hidden unless: #187 Question "Regarding your sexual partners whose HIV status you 
were not sure of, did you tell any of them that you were taking PrEP?" is one of the following 
answers ("Yes") 
Shortname / Alias: hivunk_youtoldprepnum 
ID: 843 
How many of your sexual partner(s) whose HIV status you were not sure of did you tell 
you were taking PrEP? 
Numbers must be less than or equal to [question('option value'), id='676', option='12280'].* 
_________________________________________________ 
 

373 
 
Shortname / Alias: hivunk_timesdrunk 
ID: 847 
In the past 3 months, how many of the times you had anal sex with partners whose HIV 
status you were not sure of were you or this person under the influence of alcohol or 
drugs?* 
_________________________________________________ 
 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
Action: Custom Script: Script to check PrEP number not greater than the total number of partners 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk1 
ID: 762 
Based on your reported sexual activities over the last 3 months, how at risk do you think you 
were for contracting HIV in the last 3 months?* 
( ) Not at all at risk for contracting HIV 
( ) Somewhat at risk for contracting HIV 
( ) High risk for contracting HIV 
 
Shortname / Alias: perceivedrisk2 
ID: 763 
What is your gut feeling about how likely you are to get infected with HIV?* 
( ) Extremely unlikely 
( ) Very unlikely 
( ) Somewhat likely 
( ) Very likely 
( ) Extremely likely 
 
Shortname / Alias: perceivedrisk3 
ID: 764 

374 
 
I worry about getting infected with HIV:* 
( ) None of the time 
( ) Rarely 
( ) Some of the time 
( ) A moderate amount of time 
( ) A lot of the time 
( ) All of the time 
 
 
Perceived HIV Risk 
 
Shortname / Alias: perceivedrisk4 
ID: 765 
Getting HIV is something I am...* 
( ) Not concerned about 
( ) A little concerned about 
( ) Moderately concerned about 
( ) Concerned about a lot 
( ) Extremely concerned about 
 
Shortname / Alias: perceivedrisk5 
ID: 766 
There is a chance, no matter how small, I could get HIV:* 
( ) Strongly Disagree 
( ) Disagree 
( ) Agree 
( ) Strongly Agree 
 
Shortname / Alias: perceivedrisk6 
ID: 767 
I think my chances of getting infected with HIV are:* 
( ) Zero 
( ) Almost zero 
( ) Small 
( ) Moderate 
( ) Large 

375 
 
( ) Very large 
 
 
PHQ-2/GAD-2 
 
ID: 768 
Now we are going to ask you about your mental health and how you have been feeling 
recently. 
 
Shortname / Alias: mentalhealthscreener 
ID: 388 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Little 
interest or 
pleasure in 
doing 
things 
( )  
( )  
( )  
( )  
Feeling 
down, 
depressed, 
or 
hopeless 
( )  
( )  
( )  
( )  
Feeling 
nervous, 
anxious or 
on edge 
( )  
( )  
( )  
( )  
Not being 
able to 
stop or 
control 
worrying 
( )  
( )  
( )  
( )  
 
 

376 
 
 
Page entry logic: This page will show when: psychdistress1 is greater than or equal to "3" 
PHQ-8 
 
Shortname / Alias: phq8 
ID: 397 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Trouble 
falling or 
staying 
asleep, or 
sleeping too 
much 
( )  
( )  
( )  
( )  
Feeling tired 
or having 
little energy 
( )  
( )  
( )  
( )  
Poor appetite 
or overeating 
( )  
( )  
( )  
( )  
Feeling bad 
about 
yourself - or 
that you are 
a failure or 
have let 
yourself or 
your family 
down 
( )  
( )  
( )  
( )  
Trouble 
concentrating 
on things, 
such as 
reading the 
newspaper 
or watching 
television 
( )  
( )  
( )  
( )  
Moving or 
speaking so 
( )  
( )  
( )  
( )  

377 
 
slowly that 
other people 
could have 
noticed, or 
the opposite 
- being so 
fidgety or 
restless that 
you have 
been moving 
around a lot 
more than 
usual 
 
 
Page entry logic: This page will show when: psychdistress2 is greater than or equal to "3" 
GAD-7 
 
Shortname / Alias: gad7 
ID: 404 
Over the past 2 weeks, how often have you been bothered by any of the following problems?* 
 
Not 
at 
all 
Several 
days 
More 
than 
half 
the 
days 
Nearly 
every 
day 
Worrying 
too much 
about 
different 
things 
( )  
( )  
( )  
( )  
Trouble 
relaxing 
( )  
( )  
( )  
( )  
Being so 
restless 
that it is 
hard to sit 
still 
( )  
( )  
( )  
( )  
Becoming 
easily 
( )  
( )  
( )  
( )  

378 
 
annoyed 
or irritable 
Feeling 
afraid as if 
something 
awful 
might 
happen 
( )  
( )  
( )  
( )  
 
 
Social Isolation 
 
Shortname / Alias: socialisolation 
ID: 432 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I feel 
left out. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
barely 
know 
me. 
( )  
( )  
( )  
( )  
( )  
I feel 
isolated 
from 
others. 
( )  
( )  
( )  
( )  
( )  
I feel 
that 
people 
are 
around 
me but 
not with 
me. 
( )  
( )  
( )  
( )  
( )  
 
 

379 
 
Emotional Support 
 
Shortname / Alias: emotionalsupport 
ID: 411 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
I have 
someone 
who will 
listen to me 
when I need 
to talk. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
confide in or 
talk to about 
myself or 
my 
problems. 
( )  
( )  
( )  
( )  
( )  
I have 
someone 
who makes 
me feel 
appreciated. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
talk with 
when I have 
a bad day. 
( )  
( )  
( )  
( )  
( )  
 
 
Informational Support 
 
Shortname / Alias: informationalsupport 
ID: 417 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 

380 
 
I have 
someone to 
give me 
good 
advice 
about a 
crisis if I 
need it. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
turn to for 
suggestions 
about how 
to deal with 
a problem. 
( )  
( )  
( )  
( )  
( )  
I have 
someone to 
give me 
information 
if I need it. 
( )  
( )  
( )  
( )  
( )  
I get useful 
advice 
about 
important 
things in 
life. 
( )  
( )  
( )  
( )  
( )  
 
 
 
Instrumental Support 
 
Shortname / Alias: instrumentalsupport 
ID: 422 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you 
have 
someone 
to help 
you if 
you are 
( )  
( )  
( )  
( )  
( )  

381 
 
confined 
to bed? 
Do you 
have 
someone 
to take 
you to 
the 
doctor if 
you need 
it? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to help 
with your 
daily 
chores if 
you are 
sick? 
( )  
( )  
( )  
( )  
( )  
Do you 
have 
someone 
to run 
errands 
if you 
need it? 
( )  
( )  
( )  
( )  
( )  
 
 
Companionship 
 
Shortname / Alias: companionship 
ID: 427 
Please respond to each item by marking one circle per row.* 
 
Never 
Rarely 
Sometimes 
Usually 
Always 
Do you have 
someone with 
whom to have 
fun? 
( )  
( )  
( )  
( )  
( )  
Do you have 
someone with 
( )  
( )  
( )  
( )  
( )  

382 
 
whom to 
relax? 
Do you have 
someone with 
whom you can 
do something 
enjoyable? 
( )  
( )  
( )  
( )  
( )  
Do you find 
companionship 
when you want 
it? 
( )  
( )  
( )  
( )  
( )  
 
 
Thank You! 
 
ID: 1 
Thank you for taking this survey and for participating! We greatly appreciate your 
involvement! 

383 
 
In-depth Interview Guide 
Participant study Id:  
 
 
 
 
PRE-INTERVIEW PARTICIPANT DATA CHECK 
 
Check participants use to determine whether they are low or high use. Note we want to know the average number 
of days per week participants used a key component of the app (medication tracker, daily quest, social wall).   
 
 
Average 
# days 
per week 
 
Moderate to high use 
(n ~ 5) 
>4 
Low to no use 
(n ~ 5) 
<4 
 
 
Circle participants defined use:  
MODERATE TO HIGH USE   
LOW TO NO USE   
 
 
INTERVIEW GUIDE  
Introduction 
Hello, my name is ______. I am a P3-T study staff member and I want to thank you for taking time out of your day 
to talk to me today.   
 
We are talking to you today about the P3-T app study that you have been participating in. I am going to ask you 
questions about your experience and impressions of the app, how you used it, and how it may have impacted your 
behaviors over the past 3 months. I will also ask for your suggestions on how we might improve the app to make it 
more useful to others like yourself.  
 
There are no right or wrong answers and you are really the expert here today. I am most interested in your honest 
thoughts and opinions. If there are any questions I ask that you don’t wish to answer, you can just say “skip” and 
we will just move on to the next question. Our talk today will last about 30-45 minutes and we will be audio 
recording your responses so that we can better remember everything you say. We will not be using your name or 
any other personal identifying information and we will destroy the recording within 6 months of the end of the 
study. Anything we talk about today is confidential and we will not be sharing your responses with any of your 
medical providers or anyone else outside of the study team. Ok, do you have any questions before we get 
started?   
 
Note for interviewers: the interview questions will split for moderate to high users and low to no users, and are 
noted as such. 
 
 
PrEP experience   
It’s helpful if you tell me a little bit about your experiences taking PrEP, so to start… 
 
What prompted you to start taking PrEP?  
 
Had you taken PrEP at any time before the P3-T study? 
If YES: 
Tell me about your experience taking PrEP before you joined P3-T 
What systems or routines did you have – if any - for taking PrEP every day?  
 
 
If NO: 
 
How was the experience of starting P3-T when you started taking PrEP?  
 

384 
 
Did you ever stop taking PrEP for a week or more during the trial?  
If YES: 
What led to that break in taking PrEP?  
 
Did you start taking PrEP again after that?  
 
If YES:  
What made you decide to restart taking PrEP?  
 
Are you taking PrEP now?  
If NO: 
What led you to stop?  
If YES: 
How long do you think you will stay on PrEP for? 
 
Do you have people in your life that you can talk to about being on PrEP?  
 
Overall experience  
When you first joined the study, what did you hope to get out of using the P3-T app? 
  
How well did your experience using the P3-T app meet these expectations?  
 
What were your favorite app features? (and why) 
 
How did P3-T impact your experience with PrEP? 
 
How useful were the daily P3-T reminders for taking PrEP? 
Did you start remembering to take PrEP without them?  
 
How long did it take for your P3-T PrEP-taking strategy to become routine? 
 
After it became routine, what kept you coming back to the app? 
 
Did you tell anyone or show anyone the app while you were using it?  
 
If YES: 
 
Why? 
 
 
FOR LOW TO NO USERS ONLY 
It looks like you didn’t use the app very much, can you tell me about that? 
 
What did you want from the app that you weren’t getting? 
 
What would have made you use the app more?  
 
Technical issues  
Did you receive notifications from the app? 
 
Could you describe any technical problems you had? 
 
Features 
Medication tracker  
How was your experience setting up the medication tracker? 
 
Tell me about setting it up for the first time, what strategy did you pick?  
 
How did that strategy work out for you?  
 
Did you ever change your strategy during the trial? 
 
If yes, can you tell me about what prompted you to change it?  
 
How did changing your strategy work for you?  
 
How easy was it to use the app to track whether or not you took PrEP each day?  
Can you tell me about days you didn’t log your meds? 
 
What was going on for you?  

385 
 
 
Did you ever notice a pattern to days you didn’t log meds (weekends?) 
 
How often did you review your medication calendar?  
 
Did you ever show it to anybody?  
 
 
Daily Quests 
Tell me about your experience with the daily quests… 
 
 
What suggestions do you have for new Daily Quests? (or other ways to improve this feature?) 
 
 
Knowledge Center 
Tell me about your experience with the knowledge center… 
 
Where else do you go to get health, and sexual health, information?  
 
What kind of sexual health questions do you google?  
 
What kind of information would you like to see more of in this app? 
 
Social Wall 
Tell me about your experience with the social wall… 
 
How often did you read the discussions on the social wall? 
How often did you comment or interact with other users? 
 
What were topics that you liked reading about on the social wall?  
 
How connected did you feel to the other users on the app? 
 
Could something be added that would make you feel more connected? 
 
What made you want to contribute/not contribute to the social wall? 
 
What would you change about this feature of the app to make it better?  
 
Rewards 
What did you think about the rewards that were offered within the app?  
 
 
How did the rewards motivate you to continue to use the app?  
 
Bank account 
What did you think about the bank account feature?  
 
Did you notice when your amount went up or down?  
 
How did the bank account impact your app use?  
 
Adherence Counseling 
Tell me about your experiences talking to the P3-T adherence counselor… 
 
What did you like about it? 
 
What did you not like about it? 
 
What was useful to you? 
 
What did you discuss with the adherence counselor? 
 
How did you feel about having those kinds of conversations over text?  

386 
 
 
How would you feel about having on a phone call? By video chat? 
 
How easy was it for you to get in touch with your counselor?  
 
How convenient were the times that the counselor was available?   
 
Wrap up 
Before we wrap up, I’d like to give you a chance to share any other thoughts you have about the P3-T app that I 
didn’t ask you about yet. What else would you like us to know about your experience with the app or with being in 
the study?  
 
Thank you for your time today and for your experiences and willingness to test the P3-T app!  
 
 
 

387 
 
DBS Collection Protocol 
 
   BA-CF-G-006 Version 6  
 
 
                             Reference: BA-SOP-G-011 
   Effective Date: 06Mar2019 
   
 
AMS-BAT 
 
Materials needed for methods of DBS and Plasma collection for TFV-DP testing 
1. Materials needed for methods of DBS and Plasma collection for one PK single time point  
1.1 Equipment needed 
1.1.1 Centrifuge (can centrifuge with 800xg for 10 minutes, non-temperature setting), 
1.1.2 Freezer (-20ºC or -70ºC or-80ºC). 
1.2 Materials needed for DBS and plasma preparation 
1.2.1 K2-EDTA Spray Dried Tube (1 tube), 
Product code; BD Vacutainer spray-coated K2 EDTA Tubes. 
1.2.2 Whatman Protein Saver Card (#903) (1 card), 
Product code; Whatman™ 10534612 | 903 Protein Saver Card 
1.2.3 Cryovial Tube (2 tubes per sample), 
Product code; SARSTEDT cryotubes (2 mL, product code: 72.694.006 
1.2.4 Gas-impermeable (zip-lock) bag (1 bag) 
Prodect code: Whatman 10534321 Foil-Barrier Ziploc Bags for Card,Pack of 100 
1.2.5 Desiccant (1 pack), 
Product code: Whatman™ 10548234 Desiccant Packs for 903 Protein Saver Cards (Pack of 
100) 
1.2.6 Pipette for DBS preparation: Auto Pipette (Max Vol. 100 uL), 
1.2.7 Pipette for transfer plasma: Auto Pipette (Max Vol. 1000 uL) or Transfer Pipette, 
1.2.8 Whatman card drying rack, 
1.2.9 Sample Sticker labels (waterproof sticker label), 
1.2.10 Gloves (preferably powder-free), 
1.2.11 Permanent marker and Pen. 
 
 

388 
 
2. DBS and Plasma Collection Procedure for TFV-DP testing 
2.1 EDTA Blood collection 
2.1.1 Collect the blood into K2-EDTA containing Tube (at least 2 mL size of K2-EDTA containing 
tube), 
2.1.2 Gently invert the tube (10 times) to mix the blood thoroughly, 
2.1.3 Label the tubes with the patient ID number, initial, visit, date and time of blood draw using label, 
2.1.4 Blood sample should be processed as soon as possible (within 1-2 hours), but need to be 
initiated within 24 hours of draw time. No more than 24 hours should elapse.  
2.1.5 If the site staff cannot process the DBS and plasma preparation within 1-2 hours, the EDTA 
whole blood sample should be kept at 4°C and ship with Ice or Gel Cold Shipping Pack (to remain 
temperature at 4-10°C).  
2.2 Dried Blood Spots (DBS) Collection  
2.2.1 Label the Whatman Protein Saver 903 Card with the patient ID number, initial, visit, date and 
time of blood draw using provided sticker label (waterproof sticker label), 
2.2.2 If the whole blood has been kept or shipped under the cold temperature (4-10°C).  The samples 
should sit at room temperature for about 15 mins in order to reach room temp before spotting.  
2.2.3 Gently invert the tube (8 to 10 times) to mix the blood thoroughly. After the blood is completely 
mixed, remove the cap, and apply 25 μL of the whole blood to a single spot on the Whatman 
Protein Saver 903 Card (Slowly expel blood from the tip and touch the drop to the paper, 
allowing the blood to absorb. Do not touch the card with the pipette tip). Repeat four times to fill 
all five spots on the card. Do not touch the DBS circle once blood is applied.  
2.2.4 Written down; initials of staff who spotted blood on card, date and time of spotting on the right 
bottom of filter paper. 
2.2.5 Allow the Dried Blood Spots Cards to air dry without the card flap covering the spots in a drying 
rack that is clean and dry and protected from rodents, insects and direct sunlight for at least 3 
hours or overnight is acceptable. (check that it completely dried before storage) 
Note; Do not use electric dryer or heat, stack or allow DBS to touch other surfaces during the 
drying process.  
2.2.6 Put the card in a gas-impermeable (zip-lock bag) containing 1 pack of desiccant. Store no more 
than one card per bag.  
DBS Preparation Flowchart:     
                                        
 
 
PID: PREP001 
Date: 22Sep18 

389 
 
2.3 Plasma Collection Procedure (should be performed after DBS sample is collected) 
2.3.1 Separate plasma from blood by centrifuging at least 800xg for 10 minutes at room temperature, 
2.3.2 Label the cryovials with the patient ID number, initial, visit, date and time of blood draw using 
provided sticker label, 
2.3.3 Transfer plasma (at least 0.25 mL/tube is required) into two storage cryovials with a screw cap. 
2.4 Freezer log Recording 
2.4.1 Record all sample information (site, patient identification number, patient initials, visit, date/time 
of blood draw and date/time etc) on the freezer record log form (BA-FM-G-046 Freezer Log for 
Plasma-Sample and BA-FM-G-047 Freezer Log for DBS).  
2.5 Sample Storage 
2.5.1 Store Dried Blood Spots Card (DBS) and Plasma in the freezer (-20°C or -70°C or -80°C) within 
1 hour after preparation. 
Note:   
• 
DBS should be stored at -20°C or lower (-70°C or -80°C are preferable) and it can be stored 
at 4°C for about one month.  
• 
DBS sample should not be stored at room temp more than one week because the sample is 
degraded in the first week of storage at room temperature. Note in the freezer log for if the 
DBS has been store at room temperature. 
2.6 Sample Shipment 
2.6.1 Ship Dried Blood Spots Card (DBS) and Plasma on dry ice. 

390 
 
RCT Eligibility Screening Form 
Informed Consent Script for Eligibility Screening 
Study Staff Instructions: Please read the script below before conducting eligibility screening. 
 
Thank you for your interest in the P3-T research study. The purpose of our research study is to test a PrEP 
adherence app for young gay and bisexual men who are starting PrEP. We are currently looking for young 
gay or bisexual men who can take part in our study. Participation in the P3-T study is six months long and 
involves 3 study visits: 1) an enrollment visit, 2) a follow-up visit at 3 months, and 3) a follow-up visit at 6 
months. Participants complete a survey at every study visit and give a blood sample at 3- and 6-months 
visits. Since this is a randomized control study, some participants will get the app and some participants 
will not. For those who get the app, participation will involve using the app daily during the first three 
months of the study. Daily app use takes about 5-10 minutes. 
 
Before we can move forward, we need to ensure that you meet a few eligibility requirements. The 
screening process is optional, and you may choose at any time not to participate. If you choose to 
proceed, you will be asked a few questions, and your answers will determine whether or not you are 
eligible to participate in the research study. This will take approximately 5 minutes. The screener asks 
questions about sensitive topics, such as age, gender identity and sexual partner preference(s). Some of 
these questions are of personal nature and you may feel uncomfortable or embarrassed answering them - 
you can decide to stop answering questions at any time. If you don't answer all the questions, we may not 
be able to find out if you meet the eligibility criteria for the study - therefore, we might not be able to 
schedule a study visit. If you meet the eligibility criteria for this study and are interested in participating, 
we will begin the study visit. Any information shared in this survey is strictly confidential and will only 
be used for research study purposes. All the information that is gathered from you is safely stored. 
 
Data collected in this screening survey will not be connected to the main study should you screen 
eligible and choose to participate in the main study. The information I am entering into this eligibility 
screening form on my laptop will be stored on a secure server. 
 
You may not benefit personally from screening for study eligibility. If you have questions, or concerns 
about the study eligibility screener you may call INSERT NUMBER. 
 
Study Staff Instructions: Please ask the following question and reply based on the response. 
 
Do you consent to be screened for the P3T study?   Yes No 
 
Great. Let's get started with the screener! 
 
Sorry, if you do not consent to be screened, you cannot continue the screener. Thank you for your time. 
 
Section 1: Inclusion Criteria 
 
Study Staff Instructions: Please ask the following question and reply based on the response. 
 
Do you understand, and are you comfortable speaking 
Yes 
and reading Thai? 
No 
(must be yes to be eligible) 
 
Are you between the ages of 16 to 24? 
Yes 
No 
(must be yes to be eligible) 
 
Do you currently own an Android or iOS smartphone? 
Yes 
No 
(must own a phone (iOS or Android) to be eligible) 
 

391 
 
 

392 
 
 
 
What sex were you assigned at birth? 
  Male        
Female 
(must be male to be eligible) 
 
What is your current  gender identity? 
Male 
Female 
Trans-female, trans-woman, or trans-feminine 
Trans-male, trans-man, or trans-masculine 
Genderqueer, gender non-conforming or non-
binary  
Another Gender 
(must be male to be eligible) 
 
If identified as 'another gender,' what is 
it? (please state) 
 
 
 
Who do you have sex with or intend to have sex 
with? (check all that apply) 
 Men 
Women 
Transmen 
Transwomen 
(must be men and/or transwomen to be eligible) 
 
 
Do you plan to start taking PrEP in the next 14 days? 
 Yes  
No 
(must be yes to be eligible) 
 
 
 
Section 2: Exclusion Criteria 
 
Are you participating in another experimental PrEP 
Yes 
adherence intervention? 
No 
(must be no to be eligible ) 
 
Do you plan move out of Bangkok in the next 6 
Yes 
months? 
No 
(must be no to be eligible ) 
 
Section 3: Staff Verification of Eligibility Criteria 
 
Does the participant have an Android or iPhone 
Yes 
smartphone with them? 
No 
(must be yes to be eligible) 
 
 
 
If yes, which type of operating system? 
Android 
iOS (iPhone)

393 
 
 
If Android which version: 
 
To check the operating system version: 
Go to settings > About phone 
or Device > tap Android 
Version 
 
 
If iOS (iPhone) which version: 
To check the operating system version: Go to settings 
  
 
> General > About > Version 
 
 
Does the smartphone meet the phone operating 
system 
Yes version requirements for 
the app? 
No 
(must be yes to be eligible) 
Requirements: 
Android: must have 
version 4.4 or newer 
iPhone: must have iOS 
10 or newer 
 
 
Is the individual unable to be consented due to an 
Yes 
active substance use or psychological condition? 
No 
 
This would only be yes if one of these conditions was 
(must 
be no to be eligible ) evident at the time of screening and might 
prevent 
the individual from providing informed consent. 
 
 
Is the participant eligible to participate in the 
Yes 
study? 
No 
(must be yes to be eligible) 
 
 
 
Appendix A 
 
All documents will be translated into Thai and back-translated into English by the Thai study 
team. 
 
Contents include: 
1. RCT Consent Form 

394 
 
2. RCT 3-month Blood Draw 
3. RCT 6-month Blood Draw 
Consent Form- Full Study 
P3-T Randomized Controlled Trial Consent  
 
Chulalongkorn University & Thai Red Cross AIDS Research Centre (TRC-ARC) 
Consent to Participate in a Research Study 
Participants ages 16-24 years old 
 
Duke IRB Study # xxxxxxx 
 
Consent Form Version Date: Version 1.0 dated DD-MM-YEAR 
 
Title of Study: P3-T: Novel mHealth Technologies to Enhance PrEP Adherence among 
Thai YMSM, Collaborative Adaptation and Evaluation 
 
Principal Investigators:  
Sara LeGrand, PhD 
+1 (919) 438-0448 
sara.legrand@duke.edu 
 
Wipaporn Natalie Songtaweesin, MBBS 
+66 (662) 256-4930 
wipaporn@doctors.org.uk 
 
Sponsor: Duke University 
 
Funding Source: National Institutes of Health (NIH)  
 
Study Contact: 
Wipaporn Natalie Songtaweesin, MBBS 
+66 (662) 256-4930 
wipaporn@doctors.org.uk 
 
 
Key Study Information 
• 
The purpose of this study is to gain your perspective as a young man who has sex with men 
on a mobile phone app called P3-T. The purpose of P3-T is to help young men who have 
sex with men take PrEP, a medicine that helps prevent HIV. 
• 
You are being asked to take part in a research study. You do not have to join. You can quit 
the study at any time, for any reason, and nothing bad will happen as a result.    
• 
This form contains details about the study that will help you make a choice about 
participating. 
• 
We are asking about 60 people to take part in the study. 
• 
Participants in the study will be randomly sorted into two groups. One group will get the P3-
T app and one group will not get the P3-T app. Research staff have no control over what 
group you are sorted into and no one can change what group you are in.   
• 
All participants will be in the study for 6 months.  

395 
 
• 
The study involves three clinic visits: 
o At the enrollment visit you will meet with research study staff who will guide you 
through the visit.  
 
You will complete a survey to collect information about your demographics, 
factors related to PrEP adherence, sexual risk, among other items, and 
review the intervention materials.  
o At the 3- and 6-month visits, a research study staff will guide you through the visit. 
 
You will complete a survey similar to the enrollment survey. 
 
A trained phlebotomist will draw a small amount of blood (2mL) from a vein in 
your arm or your hand. 
 
At the 3-month visit, some participants will have an opportunity to complete 
an interview with a study staff member about their experience using the app. 
• 
The study will include daily use of the intervention materials (about 5-10 minutes) for the first 
three months of the study period.   
• 
While you may not personally benefit from participating in the study, your feedback about 
the intervention and your experience in the study may help other young men who have sex 
with men by adding to the resources available to help them protect their health.  
• 
There are potential risks or discomforts involved with being in this study including:   
o While completing the survey, you may find some of the questions a little 
embarrassing or difficult to answer.   
o Study staff will make every effort to keep your information confidential, but there is a 
small possibility that your name and information that you share during this research 
study could become known to others. The efforts we will take to prevent this from 
happening are described in detail below. 
o For the blood draws, you may experience discomfort or bruising at site where the 
blood is drawn. There is a small risk of fainting and a rare risk of infection.  
• 
Study staff will make every effort to keep your information confidential. The efforts we will 
take to protect your confidentiality are described in detail below. 
• 
For participating in this study, you will receive $20 at each of the three visits (total $60). 
Depending on what group you are randomly sorted into, you may have the opportunity to 
earn additional money, up to $15 for app use and $20 for the qualitative interview (total 
$95).  
• 
There are no costs to you for participating in this study.  
 
What are some general things you should know about research studies? 
You are being asked to take part in a research study. You do not have to join. You can quit the 
study at any time, for any reason, and nothing bad will happen as a result.    
 
We are doing this research to learn information that could help young people like you, in the 
future. All research has risks and benefits. We will talk about these risks and benefits with you 
before you decide if you want to join the study.  
 
This form contains details about the study that will help you make a choice about participating. 
You will be given a copy of this form to keep. You can ask any questions you want of the study 
staff, or the researchers listed at the top of this form.  
 
What is the purpose of this study?  
The purpose of this study is to gain your perspective as a young man who has sex with men on 
a mobile phone app called P3-T. The purpose of P3-T is to help young men who have sex with 
men take PrEP, a medicine that helps prevent HIV. This study will help us see if the app helps 

396 
 
young men who have sex with men who are starting PrEP take it regularly. HIV rates are high 
among young men who have sex with men. If people at risk of HIV take an HIV treatment 
medicine on a regular basis, they are much less likely to get infected with HIV.  
 
The idea of taking a medicine to prevent HIV is called pre-exposure prophylaxis, or “PrEP” for 
short. Some people have trouble taking PrEP, so we developed P3-T to help them be active in 
their own health care and remember to take their PrEP. The P3-T app includes features such as 
a medication tracker and reminders, daily activities including a social wall where you can 
anonymously connect with other PrEP users, access to an adherence counselor, and resources 
about PrEP and sexual health. We don’t know if the app will work, and that is why we are testing 
it out.  
 
How many people will take part in this study? 
We are asking about 60 people to take part in the study. 
 
How long will your part in this study last?  
Your participation in the study will last 6 months. 
 
What will happen if you take part in the study? 
Participants in the study will be randomly sorted into two groups. One group will get the P3-T 
app and one group will not get the P3-T app. Research staff have no control over what group 
you are sorted into and no one can change what group you are in.  
  
All participants will be in the study for 6 months. This study involves three clinic visits as well as 
daily use of the intervention materials (about 5-10 minutes) for the first three months of the 
study period.   
 
At the enrollment visit you will meet with research study staff who will guide you through the 
visit. You will complete a survey to collect information about your demographics, factors related 
to PrEP adherence, sexual risk, among other items, and review the intervention materials. 
 
You will then have the intervention materials for 3 three months to use. During those months, 
we ask that you use them a little bit every day (about 5-10 minutes of use).  
 
After 3 months, you will come back in for a follow up visit. At the 3-month follow up visit you will 
meet again with a research study staff member. You will complete a survey similar to the one 
completed at enrollment and a trained phlebotomist will draw a small amount of blood (2mL) 
from a vein in your arm or your hand and several drops of the collected blood will be used to fill 
in a dried blood spot (DBS) card.   
 
Some participants will have an opportunity to complete an interview with a study staff member 
about your experience using the app. If you are chosen and are available to participate, audio 
from the interview will be recorded to make sure we have an accurate record of the information 
you give us.  
 
After this period, if you were in the group that got the P3-T app, you will still have access, but 
you will not be required to use it daily. You will not have access to some features, including the 
adherence counselor and the virtual bank account.  
 
After 6 months, you will come back in for the final follow-up visit. At the follow up visit you will 
meet again with a research study staff member to guide you through your visit. You will 

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complete a survey similar to those completed at prior visits and a trained phlebotomist will draw 
a small amount of blood (2mL) from a vein in your arm or your hand and several drops of the 
collected blood will be used to fill in a dried blood spot (DBS) card.   
 
At the end of the study, the DBS cards collected at 3- and 6-months will be sent to the Program 
for HIV Prevention and Treatment (PHPT) Research Unit at Chiang Mai University to be 
analyzed by Dr. Tim Cressey for the levels of PrEP in your blood. To protect your privacy, your 
name will not be recorded on any of the samples shipped to PHPT.  
 
We will not be able to provide you with the results of your blood test because samples will not 
be analyzed until all participants have completed the study.    
 
What are the possible benefits from being in this study? 
You may not benefit personally from being in this research study. However, your feedback 
about the intervention and your experience in the study may help other young men who have 
sex with men by adding to the resources available to help them protect their health.  
 
What are the possible risks or discomforts involved with being in this study?   
While completing the survey, you may find some of the questions a little embarrassing or 
difficult to answer. Your participation is entirely voluntary.  You may choose to not answer any 
question or leave the study at any time. If you are upset by anything we discuss, please let a 
research staff member know.     
 
You will have 2mL of blood drawn from a vein in your arm or hand at the follow up visits at 3 and 
6 months. The total amount of blood taken for the whole study will be 4mL. You may experience 
discomfort or bruising at site where the blood is drawn. There is a small risk of fainting and a 
rare risk of infection. Even though we are confident these risks are unlikely if you have any 
questions or concerns please let the research team know. If you have experienced discomfort, 
bruising, fainting, or infections from previous blood draws, please let us know.   
 
You will be informed if the study staff learns of any new risks associated with PrEP use or any 
study activities. 
 
What if you want to stop before your part in the study is complete?  
You can leave the study at any time you want. The investigators also have the right to stop your 
participation at any time. This could be because you have failed to follow instructions, have 
undermined the right or privacy of another participant, or because the entire study has been 
stopped. 
 
How will your confidentiality be protected?   
To protect you, all of the information collected about you during the study will be identified by a 
study ID number, not your name. A file that links your name to your study ID number will be kept 
in a secure folder on a secure server at Duke University separate from the secure folders where 
your study records are stored. This file will only be accessible to key study staff using a strong 
password only known to them.  
 
If you participate in an interview with a study staff member at your 3-month visit, your name will 
not be audio recorded during the interview and the recording will only be used by research team 
members. The audio recording will be kept confidential, meaning it will only be identified by your 
study ID number. It will be stored in a secure folder on a secure server at Duke University only 

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accessible to select study staff. All audio recordings will be permanently destroyed within six 
months of study completion.  
 
DBS cards sent to PHPT and sample results will only be identified by their study ID number, 
therefore, the lab at PHPT will not be able to link DBS cards or sample results to participant 
names. DBS cards will be stored in locked storage at PHPT. The results of the PrEP drug level 
testing will be sent in a password protected spreadsheet via secure email to the P3-T Principal 
Investigator in Thailand. The Principal Investigator will store the sample results in a secure 
folder on a secure server at Duke University only accessible to select study staff.  
 
Your original blood samples, identified only by your study ID number, will be stored securely at 
Chulalongkorn University. Your DBS card, identified only by your study ID number, will be 
stored securely at PHPT Research Unit at Chiang Mai University. These samples will be 
destroyed 3 years after the completion of the study. 
 
All data collected from you after you enroll in the study, including survey, interview, app use, 
and blood sample data will be linked by your study ID number only. 
 
The project's industry partner, Ayogo, may use de-identified app data from the study for quality 
improvement of their digital healthcare platform in commercial products such as health apps. 
 
A description of this study will be available on http://clinicaltrials.gov, as required by United 
States Law. This website will not include information that can identify you. At most, the website 
will include a summary of the study results. You can access this website at any time. 
 
To help further protect your privacy, we have obtained a Certificate of Confidentiality for the 
study from the United States Department of Health and Human Services (DHHS).  It adds 
special protection for research information that identifies you. It says that we do not have to 
identify you, even under a court order or subpoena. With this Certificate, the researchers cannot 
be forced to disclose information that may identify you, even by a court subpoena, in any United 
States federal, state, or local civil, criminal, administrative, legislative, or other proceedings. The 
researchers will use the Certificate to resist any demands for information that would identify you, 
except as explained below. 
 
The Certificate cannot be used to resist a demand for information from personnel of the United 
States Government that is used for auditing or evaluation of Federally funded projects or for 
information that must be disclosed in order to meet the requirements of the federal Food and 
Drug Administration (FDA). In addition, your records may be reviewed by certain agencies or 
people who make sure that the study staff are doing what they are supposed to and everyone in 
the study is being protected. Under the guidelines of the Federal Privacy Act, the sponsoring 
agency at the National Institutes of Health (NIH) and the Duke University and Chulalongkorn 
University IRBs may look at your records. If your study records are reviewed, your identity could 
become known to them. However, these persons are expected to maintain your individual 
confidentiality. This means that they will not tell others information about you or that you are in 
the study. By signing this form, you are allowing such access.  
 
You should understand that a Certificate of Confidentiality does not prevent you or a member of 
your family from voluntarily releasing information about yourself or your involvement in this 
research. If an insurer, employer, or other person obtains your written consent to receive 
research information, then the researchers may not use the Certificate to withhold that 
information. 

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While every effort will be made to keep your participation in the study and any personal 
information about you private and confidential, absolute confidentiality cannot be guaranteed. 
For example, if a study staff member learns something that would immediately put you or others 
in danger, the study staff member may be required by law to take steps to keep you and others 
safe. This means that study staff members have to report to the authorities (hospital, police, or 
social services) any information you say that suggests that you might be in danger, such as 
telling study staff that you plan to hurt or kill yourself, hurt or kill someone else, or if someone is 
abusing or neglecting you. 
 
Will you receive anything for being in this study? 
You will receive $20 at each of the three visits (total $60). Depending on what group you are 
randomly sorted into, you may have the opportunity to earn additional money, up to $15 for app 
use and $20 for the qualitative interview (total $95).  
 
Are there any costs to you for taking part in this study? 
You will not be charged for anything that is done for this study.  
 
Who is sponsoring this study? 
This research is being sponsored by Duke University and is funded by the National Institutes of 
Health (NIH). This means that the sponsor, Duke University, is providing money from the NIH to 
Chulalongkorn University and TRC-ARC to help conduct this study. The researchers do not, 
however, have a direct financial interest with the sponsor or funding source or in the final results 
of the study. 
 
What if you have questions about this study? 
You have the right to ask, and have answered, any questions you may have about this research 
at any time before, during, or after your participation. The Chulalongkorn University investigator 
in charge of this study is Dr. Wipaporn Natalie Songtaweesin. If you ever have questions, or 
concerns about this study, you may call or email Dr. Songtaweesin: +66 (662) 256-4930 
or wipaporn@doctors.org.uk 
 
What if you have questions about your rights as a research participant? 
All research on human volunteers is reviewed by a committee that works to protect your rights 
and welfare. If you have questions or concerns about your rights as a research subject you may 
contact, anonymously if you wish, the Duke University IRB at +1 (919) 684-3030 or 
campusirb@duke.edu 
 
 
Participant’s Agreement:  
I have read the information provided above.  I have asked all the questions I have at this time.  I 
voluntarily agree to participate in this research study. 
 
 
_________________________________________     
________________________ 
Signature of Research Participant 
 
 
  
Date 
 
 
_________________________________________ 
Printed Name of Research Participant 
 

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_________________________________________  
________________________ 
Signature of Person Obtaining Consent 
 
 
Date 
 
 
_________________________________________ 
Printed Name of Person Obtaining Consent