Form 0920-15AGK Att 3e HIV-Neg MSM In-depth Int_English

Attachment 3e.

Pulse In-depth-Interviewers Guide - English

Form Approved

OMB No: 0920-New

Exp. Date: XX/XX/XXXX

Understanding Barriers and Facilitators to HIV prevention for

Men Who Have Sex with Men (MSM) – Pulse Study

Attachment 3e HIV-Negative MSM In-depth Interview English

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

Date: _________

Interviewer Initials: _____

Case ID:___________

Location: __________

iQual Pulse In-depth Interview Guide

• Completed Consent

• Turned on Recorders

As you know from my explanation and the consent form we just reviewed, this project is focusing on male teenagers and adult men who are black and/or Latino and who have some attraction to other males. I know that not all male teenagers and adult men who have this attraction feel that they are gay or bisexual. You can use whatever words or way of talking about your sexuality, or sexual orientation, or who you are attracted to during the interview. I want you to feel comfortable talking about your thoughts, feelings and experiences when you answer the questions.

To make it as comfortable as possible, please tell me what word I should use when I ask questions. For example, if I want to ask about the experiences of guys who are attracted to other guys, how should I say that? Should I say “gay men”, “men who like men”, "guys who like guys", “same gender-loving men”…or just “guys”? It’s up to you, we just need to make sure you will know who I am asking about.

[Preferred terminology: ______________________________________________]

1. How old are you? ____________

   1. Under 13  Stop interview

   2. 13-15

   3. 16-17

   4. 18-24

   5. 25-34

   6. 35-44

   7. 45+

2. Do you consider yourself to be of Hispanic, Latino, or Spanish origin?

   1. Yes

   2. No

   3. Refused

   4. Don’t Know

3. Which racial group or groups do you consider yourself to be in? [May code more than one option]

   1. American Indian or Alaskan Native

   2. Asian

   3. Black or African American

   4. Native Hawaiian or Other Pacific Islander

   5. White

   6. REFUSED

   7. DON’T KNOW

In what country or territory were you born? [Don’t read choices. Code one.]

1. United States

2. Other (Specify: _________________________________________)

3. Refused

4. DON’T KNOW

5. What is the highest level of education you completed?

8. Never attended school ----> SKIP TO Q7

9. Grades 1 through 8

10. Grades 9 through 11

11. High School diploma or GED

12. Some college, associate’s degree, or technical degree

13. Bachelor’s Degree

14. Any post-graduate studies

15. REFUSED

16. DON’T KNOW

5. Are you currently enrolled in school? [Code one]

a. No ------> SKIP TO Q6.1

b. Yes, full-time

3. Yes, part-time

4. REFUSE TO ANSWER

6.1 [CURRENTLY IN SCHOOL/COLLEGE] What year/grade are you in school? _______________________

5. Are you currently working at a job that pays money?

1. No

2. Yes, full-time

3. Yes, part-time

4. REFUSE TO ANSWER

8. Do you currently receive any form of public assistance, i.e. food stamps/EBT, free or reduced school lunch?

1. Yes -- What is it? ______________

2. No

3. DON’T KNOW/ DON’T REMEMBER

9. In the past 12 months have you stayed on the street, in a shelter, or temporarily in someone's home because you had no regular place to live or stay?

   1. Yes

   2. No ---->SKIP TO Q10

   3. REFUSED--> SKIP TO Q10

   4. DON’T KNOW --> SKIP TO Q10

9.1 [IF YES] Do you consider yourself currently homeless?

1. Yes

2. No

3. REFUSED

4. DON’T KNOW/UNSURE

9. Who do you currently live with? (code all that apply)

1. ALONE

2. PARENTS/GUARDIANS

3. SIBLINGS (BROTHER/SISTER)

4. GRANDPARENTS

5. FRIENDS

6. ROMANTIC PARTNER/SIGNIFICANT OTHER

7. ON STREET

8. HOUSEMATES/ROOMATES

9. OTHER ____________________

10. REFUSED

9. What is your primary type of health insurance coverage, or are you currently uninsured? [Code one]

1. No health insurance ----> SKIP TO Q13

2. Private or work health insurance (Parents’ plan, Blue Cross, Kaiser, HMO, PPO)

3. Student plan

4. Medicare / Medicaid /

5. Other

6. DON’T KNOW

7. REFUSE TO ANSWER

12. During the past 12 months, was there a time that you didn’t have any health insurance or health coverage?

    1. Yes

    2. No

    3. REFUSED

    4. DON’T KNOW

12. Have you seen a doctor or nurse in the past 12 months for your own health?

    1. Yes

    2. No

    3. REFUSED

    4. DON’T KNOW

12. How often have you been tested for HIV? Would you say you have...

    1. Never been tested

    2. Tested every 3 months

    3. Every 6 months

    4. Every year, or

    5. Every few years

    6. REFUSED

    7. DON’T KNOW

12. Do you think of yourself as ...

1. Gay

2. Straight, that is, not gay

3. Bisexual

4. Something else (SPECIFY)__________________

5. DON’T KNOW/QUESTIONING

12. Of the people you know or see day-to-day, how many know that you are sexually attracted to other males? Would you say... [CHOOSE ONE]

    1. No one

    2. One or two people

    3. Some of the people you know

    4. About half the people you know

    5. Most of the people you know

    6. All but one or two people

    7. Everyone

    8. REFUSE TO ANSWER

12. In the last 6 months, have you met a new sex partner at the following places? (CODE AN ANSWER FOR EVERY ITEM)

School	a. Yes	b. No
Party	a. Yes	b. No
Work	a. Yes	b. No
Through friends	a. Yes	b. No
Gay bar, night club, or dance club	a. Yes	b. No
Straight bar, night club, or dance club	a. Yes	b. No
Internet	a. Yes	b. No
Bathhouse	a. Yes	b. No
Porn theatre / video arcade	a. Yes	b. No
Other public place, such as beach, park	a. Yes	b. No
Other __________________________	a. Yes	b. No
No new partner in the last 6 months	a. Yes	b. No
REFUSE TO ANSWER	a. Yes	b. No

12. Now thinking about sex, with how many guys have you had oral sex, that is penis in mouth or anal sex, that is penis in butt, within the past 6 months? ________________

12. Are you currently in a relationship (boyfriend, girlfriend, partner, etc.)?

    1. No ---> SKIP TO Q20

    2. Yes

    3. REFUSED ---> SKIP TO Q20

    4. DON’T KNOW ---> SKIP TO Q20

19.1 [If Yes] How long have you been in your current relationship? _____________

19.2 [If Yes] How old is your current partner? _________________

12. For which of the following things have you used the internet recreationally in the past 6 months? Code all that apply

To get information related to sex, sexuality, health (not pornography)	a. Yes	b. No
To chat with other [TERMINOLOGY]	a. Yes	b. No
To make friends	a. Yes	b. No
To find a boyfriend or long term, romantic partner	a. Yes	b. No
To meet guys for casual sex (oral and/or anal)	a. Yes	b. No
To access pornography	a. Yes	b. No
For online sex (cybersex)	a. Yes	b. No
To find out about music, movies, or local events	a. Yes	b. No
To read news and gossip sites	a. Yes	b. No
For some other purpose (specify____________)	a. Yes	b. No
DON’T KNOW	a. Yes	b. No
REFUSE TO ANSWER	a. Yes	b. No

12. IF e. ANSWERED YES IN Q20, ASK Q21. OTHERWISE SKIP TO Q22: How frequently have you used the internet to meet sexual partners in the past 6 months? [Choose only one]?

    1. Never

    2. Once a month

    3. 2-3 times a month

    4. About once a week

    5. 2-6 times a week

    6. About once a day

    7. More than once a day

    8. DON’T KNOW

    9. Refuse to Answer

21.1 [IF USED INTERNET FOR SEX SEEKING] What sites have you used? _____________________________

12. Do you feel that there is a community of [TERMINOLOGY] of your race and ethnicity in [JURISDICTION]?

    1. Yes

    2. No

    3. DON’T KNOW/UNSURE

    4. REFUSE TO ANSWER

22.1 How connected do you feel to the community of [TERMINOLOGY] of your race and ethnicity in [JURISDICTION]?

1. Not at all connected

2. Somewhat connected

3. Very connected

4. DON’T KNOW

5. REFUSE TO ANSWER

12. Think about your friends and the people you socialize with. How many of them are of the same race and ethnicity as you? Would you say...

    1. All of them

    2. Most of them

    3. Some of them

    4. A few of them

    5. None of them

    6. DON’T KNOW

    7. REFUSE TO ANSWER

12. How many of your friends and people you socialize with are other [TERMINOLOGY]? Would you say...

    1. All of them

    2. Most of them

    3. Some of them

    4. A few of them

    5. None of them

    6. DON’T KNOW

    7. REFUSE TO ANSWER

12. How much of your time with friends do you spend with other [INSERT RESPONDENT’S RACE/ETHNICITY] [TERMINOLOGY] here in [JURISIDICTION]? Would you say...

    1. All of my time

    2. Most of my time

    3. Some of my time

    4. Very little of my time

    5. None of my time

    6. DON’T KNOW

    7. Refuse to answer

12. [ASK FOR SPANISH ONLY] The rest of this interview is all in Spanish, but for classification purposes we need to ask: how well do you speak English? Would you say...

1. Very well

2. Well

3. Not well

4. Not at all

5. Refused

6. DON’T KNOW

iQual Pulse In-depth Interview Guide

Thank you for all the information you’ve provided so far! The questions I asked you so far were not the kind that lend themselves to a lot of conversation but in the rest of the interview I would like us to chat more informally. I have some things I want to ask you about and I really want to hear your story. So let's change gears a little and have more of a free-flowing discussion.

1. What is the first thing you think of when you hear 'HIV'?

THINGS THAT MAY COME UP HERE:

Knowledge

Impact

Relationships

Risks

Behaviors

social networks

misinformation

NOTE THEM FOR FOLLOW UP HERE OR IN LATER ITEMS BELOW

PROBES (checkmark  each probe once covered)

• how they feel about HIV

• fear

• stigma

• perceptions of HIV in jurisdiction

• awareness

• discrimination

2. Who among your family and friends (including guys you date or have sex with) do you talk with about HIV?

LIST PERSONS/GROUPS OFFERED

FOLLOW UP FOR EACH PERSON/GROUP: What do you discuss with _______?

PROBES (checkmark  each probe once covered)

• condoms/condom use

• frequency of testing

• relationships/sex partners

• HIV Status

Follow Up: [If no one specified] Why do you not talk about HIV with family and friends?

PROBES (checkmark  each probe once covered)

• stigma,

• fear,

• invincibility,

• awareness,

• self-protection

3. Who do you trust for information about sex, sexuality, or being [TERMINOLOGY]? Why?

PROBES (checkmark  each probe once covered)

• friends,

• family,

• doctors,

• school/teachers,

• community resources,

• internet

Follow-up Increase Prevention: Do (people mentioned) help you prevent HIV infection?

If yes: How do they help?

IF NEEDED: What do they do or say that helps you stay HIV negative?

Follow-Up decrease prevention: Do (people mentioned) do or say anything that could increase your chances of getting HIV?

If yes, Tell me about that.

IF NEEDED: What do they do or say that could increase your chance of getting HIV?

[INTERVIEWER: CHECK Q19. IF R IS IN A CURRENT RELATIONSHIP, TAILOR QS. HERE TO THAT. IF R NOT IN A RELATIONSHIP, ASK QS. HERE ABOUT MOST RECENT SEX PARTNER (FROM Q.18 IN EARLIER SURVEY QUESTIONS)

4. Tell me about your current relationship/most recent sex partner.

Follow Up: How does he/she (boyfriends, girlfriends, casual sex partners) affect your risk for getting HIV?

Follow up: Do they (persons mentioned) you prevent HIV infection?

If yes, what do they do or say that helps you stay HIV negative?

PROBES (checkmark  each probe once covered)

• trust,

• intimacy,

• someone to talk to about risk

Follow up: Do (persons mentioned) do or say anything that could increase your chance of getting HIV?

If yes, what do they do or say that could increase your chance of getting HIV?

PROBES (checkmark  each probe once covered)

• power differentials,

• older partners,

• lack of intimacy/trust,

• reinforcing risk

Follow Up: How do you help protect your [boyfriends, girlfriends, casual sex partners] from HIV?

INTERVIEWER: IF QS ABOVE WERE ASKED ABOUT CURRENT RELATIONSHIP, NOW ASK SAME ABOUT MOST RECENT SEX PARTNER (FROM Q18)

5. What do you think might put you at risk for getting HIV? How? Why?

PROBES (checkmark  each probe once covered)

• perception of personal risk,

• behaviors,

• optimism,

• fatalism,

• prevalence,

• conspiracy beliefs

6. Who do you personally know that is HIV-positive? Tell me about them without mentioning their names.

PROBES (checkmark  each probe once covered)

• awareness,

• How long have they been a PLWH,

• past sex partners,

• other relationships,

• similarities,

• differences,

• risks,

• stigma,

• impact on relationship,

• impact on perception of HIV/PLWH

7. If you thought you had HIV or an STD, what would you do? Where would you go?

PROBES (checkmark  each probe once covered)

• Getting tested,

• treatment,

• access to testing/treatment,

• costs,

• challenges/barriers,

• personal experiences,

• HIV Testing: Check Q14 (Frequency of HIV testing) You told me that you were tested (Frequency/never) thinking about that again, tell me a bit more about your testing history/has it always been this frequency?

8. If one of your friends told you they were afraid of getting HIV, Is there anything you would recommend they do?

IF YES: What would you recommend?

IF NO: Tell me why not.

9. Have you heard of pre-exposure prophylaxis (PrEP)? It is a pill that you can take every day and it will help prevent you from becoming infected if exposed to the virus.

Follow Up: if yes What else do you know about PrEP?

PROBES (checkmark  each probe once covered)

• How does it work?

• How can one get it?

• where,

• when,

• do you know anyone on PrEP,

• ever use PrEP,

• concerns,

• barriers,

• like/dislike,

• side effects,

• adherence,

• costs

Follow Up: if no What do you think about PrEP?

PROBES (checkmark  each probe once covered)

• concerns,

• barriers,

• access,

• cost,

• believability

Follow Up ALL: Is this something you or your friends might use? Why? Why not?

That is all of the questions that I have for you. Is there anything else that you think we should know about that I did not ask?

Thank you for your time!

• Turn off recorders

• Provide cash/gift card

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