Form 0920-22FZ Att 4d_Patient Quarterly Assessment English

[NCHHSTP] mChoice: Improving PrEP Uptake and Adherence among Minority MSM through Tailored Provider Training and Adherence Assistance in Two High Priority Settings

Att 4d_Patient Quarterly Assessment English

Patient Quarterly Assessment

OMB: 0920-1428

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1428 can be found here:

2024-11-19 - No material or nonsubstantive change to a currently approved collection
2024-02-14 - No material or nonsubstantive change to a currently approved collection

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Form Approved

OMB No. 0920-New

Expiration Date: XX/XX/XXXX

mChoice: Improving PrEP Uptake and Adherence among Minority MSM through Provider Training and Adherence Assistance in Two High Priority Settings

Attachment 4d

Patient Quarterly Assessment English

Public reporting burden of this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-New)

mChoice Follow-Up Assessment

This survey will be used for the 3-, 6-, 9-, 12-, and 18-month follow up surveys. Question B6 will only require a response at the 6-, 12- and 18-month intervals. Section Q will not be part of the 18-month follow up assessment.

Table of Contents

A. SOCIOECONOMIC AND RISK CORRELATES

B. HEALTHCARE ACCESS, COMMUNICATION, AND STI TESTING/DIAGNOSIS

C. HIV

D. PrEP ROUTING

E. CURRENT PrEP USE

F. PrEP RESTART

G. PREVIOUS PrEP USE: NO PLANS TO RESTART/UNSURE

H. PrEP CHOICES

I. PREP ADHERENCE AND BARRIERS

J. TECHNOLOGY USE AND ONLINE PARTNER SEEKING BEHAVIOR

K. RELATIONSHIPS AND SEXUAL HEALTH PRIORITIES

L. SEXUAL BEHAVIORS

M. SUBSTANCE USE

N. MENTAL HEALTH

O. EVERYDAY DISCRIMINATION

P. SOCIAL SUPPORT AND ISOLATION

Q. MCHOICE APP SATISFACTION

Welcome to mChoice!

Thank you for your participation in this important project. This survey will take approximately 45 minutes to complete.

In this survey, we will ask some questions to try to learn about you and your health. This survey also includes some questions around sensitive topics. All the information you enter in this survey is kept completely confidential. Your answers are private--the information you provide us will be kept secure and known only to study staff. The survey includes some personal questions about your sexual behavior, health, substance use, and other areas some people may consider sensitive. We take your privacy very seriously and will keep all responses confidential, so please be as honest as you can.

You can skip questions if you need to, but we encourage you to answer every question. All of this information will help this study learn more about PrEP, HIV prevention, and other important topics.

Time-based Recall Questions

Many questions ask you to think back over the past week, weeks, month, or even several months. Please read each question to see if it is asking you to think back over a certain period and note that the period will switch between some questions.

As a reminder, today's date is [current date]

A Note about Language

We want to acknowledge that some of the language used in our study questions may include some outdated language or lack the diversity of experiences that we now understand exist. Although we do our best to use measures that reflect emerging language, at times the items available in research are not where they need to be and are drawn from items developed years ago. Wherever possible, we have updated the language or are working with developers to get new versions. Please remember that you can always decline to answer items that do not reflect you.

If you have any questions or comments, let your study staff know.

Please click the button below to get started with the survey.

A. SOCIOECONOMIC AND RISK CORRELATES

A1. In the past 3 months, have you been homeless? By homeless, we mean you were living on the street, in a shelter, in a Single Room Occupancy hotel (SRO), or in a car.

[Yes = A2, otherwise A3]

No
Yes
Don’t know

A2. Are you currently homeless?

No
Yes
Don’t know

A3. What zip code do you live in? _________________

Don’t know

A4. What is your current marital status?

Married
Living together as married
Separated
Divorced
Widowed
Never married
Don’t know

A5. Are you currently in school?

No
Yes, full-time
Yes, part-time
Enrolled in a program but on a temporary leave of absence
Decline to answer

A6. What best describes your employment status? Are you:

Employed full-time
Employed part-time
A homemaker
A full-time student
Retired
Unable to work for health reasons
Unemployed
Other
Don’t know

A7. In the past 3 months, was there a time where there wasn’t enough money in your house for rent, food, phone, or utilities such as gas or electric?

No
Yes
Don’t know

A8. In the past 3 months, did you or other adults in the household ever cut the size of your meals or skip meals because there wasn't enough money for food?

Yes
No
Don't know
Prefer not to answer

A9. What is your primary means of transportation?

Personal automobile or motorcycle
Friend, relative, or neighbor
Public transportation (bus, metro, train)
Bicycle
Walking
Lyft, Uber, or other ride share service
Something else
Don’t know

A10. Have you been arrested in the last 3 months?

[Yes = A11, otherwise next Section B]

No
Yes
Don’t know

A11. Have you been put in jail, prison, or juvenile detention (juvy) in the last 3 months?

No
Yes
Don’t know

B. HEALTHCARE ACCESS, COMMUNICATION, AND STI TESTING/DIAGNOSIS

B1. Do you currently have health insurance or health care coverage? This includes private health insurance (for example: Blue Cross Blue Shield or parent's private insurance) and public health care insurance or coverage (for example: Medicaid or Medicare).

[Yes = B2, otherwise B3]

Yes, I have my own
Yes, I am covered by my parent/guardian
Yes, I am covered by my spouse/partner.
No
Don’t Know

B2. What kind of health insurance or coverage do you currently have? Select all that apply.

A private health plan - through an employer or purchased directly
Medicaid - for some people with low incomes
Medicare - for the elderly and people with disabilities
Some other government plan
TRICARE / CHAMPUS
Veterans Administration coverage
Some other health insurance
Don’t know

The following questions ask about testing for sexually transmitted infections or STIs such as genital herpes, gonorrhea, chlamydia, syphilis, and genital or anal warts.

B3. In the past 3 months have you been tested for an STI that was not HIV?

[Yes = B4, otherwise B5]

No
Yes
Don’t know

B4. In the last 3 months has your doctor or a health care professional told you that you had any of the following STIs? (Check all that apply. If none apply, please check “None of these”)

Genital Herpes
Gonorrhea
Chlamydia
Syphilis
Genital or Anal Warts
Another STI, specify: ____
None of these
Don’t know

B5. How likely are you to get tested for STIs in the next 3 months?

Very Unlikely
Somewhat Unlikely
Somewhat Likely
Very Likely
Don’t know

B6. [This section to be completed at only the 6-, 12- and 18-month assessments.] How sure are you that you could communicate about the following (if necessary) with healthcare providers:

	Not at all sure	Somewhat sure	Moderately sure	Very sure	Totally sure
Ask your healthcare provider things about an illness you have/had that concerns you?
Discuss openly with your healthcare provider any problems that may be related to your medications?
Work out differences with your healthcare provider when they arise?
Ask your healthcare provider things about your health (like tests or treatments) that concern you?
Discuss openly with your healthcare provider your past or current drug and/or alcohol use?
Discuss openly with your healthcare provider your sexual activity?

C. HIV

In this next part of the survey, we will ask you some questions about your experiences with and thoughts about HIV. Once again, we remind you that all questions will be kept completely confidential.

C1. In the past 3 months, have you had an HIV test?

[Yes = C2 otherwise C3]

No
Yes
Don’t know

C2. When did you have your HIV test? Please enter the month and year. It is OK if you don’t know the exact date. Please make your best guess.

[Month]
[Year]
Don’t know

C3. Overall, how concerned are you about getting HIV?

Not at all concerned Extremely concerned

0 ----------------------------------------------10

C4. Please consider the following statements and select how much you agree or disagree with them

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
Most people in my community would discriminate against someone with HIV	1	2	3	4	5
Most people in my community would support the rights of a person with HIV to live and work wherever they wanted to	1	2	3	4	5
Most people in my community would not be friends with someone with HIV	1	2	3	4	5
Most people in my community think that people who got HIV though sex or drug use have gotten what they deserve	1	2	3	4	5

D. PrEP Routing

HIV pre-exposure prophylaxis, or PrEP, is a medication that can be used to reduce the risk of HIV infection. PrEP is prescribed by a doctor/health care provider.

D1. Are you currently using PrEP?

[Yes = skip to Section E]

D2. Have you previously used PrEP?

D3. Are you planning on restarting PrEP soon (by soon, we mean in the next 1-2 weeks), if you briefly stopped taking PrEP after the baseline visit?

[Yes = skip to Section F; Otherwise skip to Section G]

Yes
No
Not sure

E. Current PrEP Use

E1. In the past 3 months, what kinds of PrEP have you heard about and/or discussed? (Choose all that apply)

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

E2. In the past 3 months, where have you gotten most of your information about PrEP? (Choose all that apply).

Doctor, nurse pratitioner, or other health care provider
Friend or relative
School
A person you have sex with
A person you use drugs with
HIV counselor
TV
News
Social media (Please specify):
Other (Please specify):
I have not received information about PrEP
Don’t know

E3. Please choose all the kinds of PrEP that you have discussed with a doctor/health care provider:

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

E4. What kind of PrEP are you currently using?

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

E5. When did you start this medication: [pull answer from E4]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]
[Year]
Don’t know

E6a. Why do you currently use PrEP? (Choose all that apply)

I’m having sex with or thinking about having sex with someone who is living with 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 always use condoms (or don’t like using them)
My partner(s) won’t use condoms
I had a previous HIV scare
My health care provider recommended it
I was recently diagnosed with a sexually transmitting infection (STI)
Many people in my community take PrEP
Other, please specify:

[Selected multiple options=E6b, otherwise E7]

E6b. Please rank the reasons why you are currently using PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from E6a] rank order list

E7. In the past 3 months have you used any other kind of PrEP, a kind of PrEP other than what you are currently using?

[Yes=E8, otherwise E17]

No
Yes
Don’t know

E8. What other kind(s) of PrEP have you used? Please rank them in order of use (1=first type of PrEP used, 2 = 2^nd type of PrEP used, etc.).

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

[Questions E9- E17 pertain to the first PrEP method selected in E8]

E9. When did you start this medication: [pull answer #1 from E8]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

E10. When did you stop this medication: [pull answer #1 from E8]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

E11. Why did you switch to a different kind of PrEP from [pull answer #1 from E8]? (Choose all that apply)

Recommended by doctor/health care provider
Recommended by a friend, partner, or family member
Cost
Side effects
Insurance issues
Easier to use
Safer to use
More effective at preventing HIV infection
Required fewer visits/labs/pharmacy visits
Dosing schedule was easier to remember
People were less likely to find out I was taking PrEP
Other, specify: __________
Don’t know

E12. Please rank the reasons why you switched PrEP at that time in order of importance, with 1 being the most important reason you switched, 2 being the next most important reason, all the way to the least important reason.

[Answers from E11] rank order list

[If >1 PrEP method selected in E8 =E13; Otherwise skip to E17].

E13. When did you start this medication: [pull answer #2 from E8]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

E14. When did you stop this medication: [pull answer #2 from E8]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

E15. Why did you switch to a different kind of PrEP from [answer #2 from E9]? (Check all that apply)

Recommended by doctor/health care provider
Recommended by a friend, partner, or family member
Cost
Side effects
Insurance issues
Easier to use
Safer to use
More effective at preventing HIV infection
Required fewer visits/labs/pharmacy visits
Dosing schedule was easier to remember
People were less likely to find out I was taking PrEP
Other, specify: __________
Don’t know

[Selected multiple options=E15, otherwise E16]

E16. Please rank the reasons why you switched to a different type of PrEP in order of importance, with 1 being the most important reason you switched, 2 being the next most important reason, all the way to the least important reason.

[Answers from E15] rank order list

[Skip to E17]

E17. How satisfied are you with the kind of PrEP you are currently using?

Very satisfied
Moderately satisfied
Neither satisfied nor dissatisfied
Moderately dissatisfied
Very dissatisfied

E18. What do you think about how effective PrEP is at preventing someone from getting HIV, when it is taken the way it is prescribed?

Very/completely effective
Somewhat effective
Minimally effective
Not at all effective
Don't know

E19. What do you think about whether PrEP helps prevent other kinds of sexually transmitted infections (STIs), like gonorhea or chlamydia?

HIV PrEP has no effect on other STIs
HIV PrEP helps to prevent other STIs
Don’t know

E20. To what extent do you think taking PrEP affects your likelihood to use condoms?

Significantly less likely
Somewhat less likely
Will not change
Somewhat more likely
Significantly more likely
Don’t know

E21. Who knows that you use PrEP? (Check all that apply)

Family member(s)
Friend(s)
Romantic partner(s)
Sex partner(s)
Health care provider (other than your PrEP provider)
Other(s), please specify
No one
Don’t know

Now we want to ask you a few questions about your experiences and feelings related to using PrEP.

E22. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I have been rejected romantically for taking PrEP
I have been judged by a health care provider because of taking PrEP
I have been blamed by people in my community for spreading HIV through PrEP use
I have been slut-shamed for taking PrEP (or told that I am a "Truvada or Descovy slut/whore")
I have been unfairly discriminated against for taking PrEP
I have been yelled at or scolded because of taking PrEP
I have experienced physical violence because of taking PrEP

E23. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I worry people will assume I sleep around if they know I take PrEP
I worry people will assume that I am HIV+ if they know I take PrEP
I worry people will think my partner(s) are HIV+ if they know I take PrEP
I worry about listing PrEP as one of my current medications during doctor appointments
I feel ashamed to tell other people 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 sex 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

[Skip to Section J]

F. PrEP Restart

F1 In the past 3 months, what kinds of PrEP have you heard about and/or discussed? (Choose all that apply)

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

F2. Where did you get information about PrEP? (Choose all that apply).

Doctor, nurse pratitioner, or other health care provider
Friend or relative
School
A person you have sex with
A person you use drugs with
HIV counselor
TV
News
Social media (Please specify):
Other (Please specify):
I have not received information about PrEP
Don’t know

F3. Please choose all the kinds of PrEP that you have discussed with a doctor/health care provider:

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

F4. What kind of PrEP are you currently using, if any? If you are not using PrEP currently, what was the most recent kind of PrEP you were taking?

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

F5. Have you stopped and restarted PrEP?

F6. What kinds of PrEP have you used, besides the one you already mentioned in F4? Please rank them in order of use (1=first type of PrEP used, 2 = 2^nd type of PrEP used, etc.).

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
N/A
Don’t know

F7. When did you start this medication: [pull answer from F4]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

F8. When did you stop this medication: [pull answer from F4]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

F9. Why did you stop taking this medication, [pull answer from F4]? (Choose all that apply)

I couldn't afford it anymore
I didn’t think that I was at risk for HIV anymore
My insurance would not cover it, or I lost my insurance
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 had trouble getting to follow-up appointments
I had issues getting PrEP or with the pharmacy
I was having side effects
People reacted negatively when they found out I was taking PrEP
I was worried about the long term effects of PrEP on my health
I had a medical problem that made it unsafe to continue taking PrEP
I started using condoms all of the time
I couldn’t take the medication (tasted bad, pill was too big)
Other, please specify: _________________________________________________
Don’t know

F10. Please rank the reasons why you stopped PrEP at that time in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from F9] rank order list

[If multiple options selected in F6 = Repeat question series F7-F10 for all selections; otherwise G9]

F11. Did you talk with your doctor/health care provider before stopping PrEP?

No
Yes
Don’t know

F12. Please choose the statements that describe your sexual behavior after you stopped taking PrEP. (Choose all that apply)

I did not have any sexual contact after I stopped taking PrEP [Skip to G14]

I had oral sex after I stopped taking PrEP
I had anal sex after I stopped taking PrEP
I had vaginal sex when I stopped taking PrEP (put your penis in a vagina or neovagina)
Don’t know

F13. Please choose the statements that describe your use of condoms after you stopped taking PrEP. (Choose all that apply)

I used a codom with every sexual contact after I stopped taking PrEP
I used a condom for most sexual contacts after I stopped taking PrEP
I used a condom for some sexual contacts after I stopped taking PrEP
I did not use condoms after I stopped taking PrEP
Don’t know

F14. What kind of PrEP are you planning to start?

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

F15. When are you planning on restarting PrEP. It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

F16. Why have you decided to restart PrEP? (Choose all that apply)

I’m having sex with or thinking about having sex with someone who is living with 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 always use condoms (or don’t like them)
My partner won’t use condoms
I had a previous HIV scare
My health care provider recommended it
I was recently diagnosed with a sexually transmitting infection (STI)
Many people in my community take PrEP
Other, please specify:

[Selected multiple options=F17, otherwise F18]

F17. Please rank the reasons why you are restarting PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G16] rank order list

F18. Who knows that you are planning to restart PrEP? (Check all that apply)

Family member(s)
Friend(s)
Romantic partner(s)
Sex partner(s)
Health care provider (other than your PrEP provider)
Other(s), please specify
No one
Don’t know

F19. What do you think about how effective PrEP is at preventing someone from getting HIV, when it is taken the way it is prescribed?

Very/completely effective
Somewhat effective
Minimally effective
Not at all effective
Don't know

F20. What do you think about whether PrEP helps prevent other kinds of sexually transmitted infections (STIs), like gonorhea or chlamydia?

HIV PrEP has no effect on other STIs
HIV PrEP helps to prevent other STIs
Don’t know

F21. To what extent do you think restarting PrEP will affect your likelihood to use condoms?

Significantly less likely
Somewhat less likely
Will not change
Somewhat more likely
Significantly more likely
Don’t know

Now we want to ask you a few questions about your feelings related to previously taking PrEP.

F22. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I have been rejected romantically for taking PrEP
I have been judged by a health care provider because of taking PrEP
I have been blamed by people in my community for spreading HIV through PrEP use
I have been slut-shamed for taking PrEP (or told that I am a "Truvada or Descovy slut/whore")
I have been unfairly discriminated against for taking PrEP
I have been yelled at or scolded because of taking PrEP
I have experienced physical violence because of taking PrEP

Now we want to ask you a few questions about your feelings related to restarting PrEP.

F23. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I worry people will assume I sleep around if they know I take PrEP
I worry people will assume that I am HIV+ if they know I take PrEP
I worry people will think my partner(s) are HIV+ if they know I take PrEP
I worry about listing PrEP as one of my current medications during doctor appointments
I feel ashamed to tell other people 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 sex 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

G. Previous PrEP users: not restarting/unsure

G1. In the past 3 months, what kinds of PrEP have you heard about and/or discussed (Choose all that apply)

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

G2. Where did you get information about PrEP? (Choose all that apply).

Doctor, nurse pratitioner, or other health care provider
Friend or relative
School
A person you have sex with
A person you use drugs with
HIV counselor
TV
News
Social media (Please specify):
Other (Please specify):
I have not received information about PrEP
Don’t know

G3. Please choose all the kinds of PrEP that you have discussed with a doctor/health care provider:

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

G4. What kinds of PrEP have you ever used? Please rank them in order of use (1=first type of PrEP used, 2 = 2^nd type of PrEP used, etc.).

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

G5. When did you start this medication: [pull answer #1 from G4]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

G6. When did you stop this medication: [pull answer #1 from G4]? It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]

[Year]

Don’t know

G7. Why did you stop taking this medication, [pull answer #1 from G4]? (Choose all that apply)

I couldn't afford it anymore
I didn’t think that I was at risk for HIV anymore
My insurance would not cover it, or I lost my insurance
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 had trouble getting to follow-up appointments
I had issues getting PrEP or with the pharmacy
I was having side effects
People reacted negatively when they found out I was taking PrEP
I was worried about the long term effects of PrEP on my health
I had a medical problem that made it unsafe to continue taking PrEP
I started using condoms all of the time
I couldn’t take the medication (tasted bad, pill was too big)
Other, please specify: _________________________________________________
Don’t know

G8. Please rank the reasons why you stopped PrEP at that time in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G7] rank order list

[If multiple options selected in G4 = Repeat question series G5-G8 for all selections; otherwise G9]

G9. Did you talk with your doctor/health care provider before stopping PrEP?

No
Yes
Don’t know

G10. Please choose the statements that describe your sexual behavior after you stopped taking PrEP. (Choose all that apply)

I did not have any sexual contact after I stopped taking PrEP [Skip to H12]
I had oral sex after I stopped taking PrEP
I had anal sex after I stopped taking PrEP
I had vaginal sex when I stopped taking PrEP (put your penis in a vagina)
Don’t know

G11. Please choose the statements that describe your use of condoms after you stopped taking PrEP. (Choose all that apply)

I used a codom with every sexual contact after I stopped taking PrEP
I used a condom for most sexual contacts after I stopped taking PrEP
I used a condom for some sexual contacts after I stopped taking PrEP
I did not use condoms after I stopped taking PrEP
Don’t know

[If D3=No, skip to G19]

G12. What kind of PrEP are considering starting? [one response]

Daily oral PrEP	A pill taken daily	Truvada®, Descovy®, emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide
Intermittent oral PrEP	A pill taken before and after sex. Also called PrEP 2-1-1, on-demand, intermittent, or event-driven PrEP	Truvada®, emtricitabine/tenofovir disoproxil fumarate
Injectable PrEP	A shot, an injection given by a doctor/health care provider	Apretude®, cabotegravir

Other (please specify): ________
Don’t know

G13. When are you planning on possibly restarting PrEP. It’s OK if you don’t know the exact date. Please provide your best guess.

[Month]
[Year]
Don’t know

G14. Why are you considering restarting PrEP? (Choose all that apply)

I’m having sex with or thinking about having sex with someone who is living with 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 always use condoms (or don’t like them)
My partner won’t use condoms
I had a previous HIV scare
My health care provider recommended it
I was recently diagnosed with a sexually transmitting infection (STI)
Many people in my community take PrEP
Other, please specify:

[Selected multiple options=G15, otherwise G16]

G15. Please rank the reasons why you are considering restarting PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G14] rank order list

G16. Who knows that you are considering restarting PrEP? (Check all that apply)

Family member(s)
Friend(s)
Romantic partner(s)
Sex partner(s)
Health care provider (other than your PrEP provider)
Other(s), please specify
No one
Don’t know

G17. Why are you unsure about whether you want to restart PrEP? Select all that apply.

I’m concerned about potential side effects
I don’t know if I want to use this type of PrEP [pipe in type from I12]
I’m not at risk for HIV
My insurance might not cover it or I lost my insurance
I don’t want my parent(s) or guardian(s) to find out I’m taking PrEP
It will be hard to get to follow-up appointments
People might react negatively if they find out I’m taking PrEP
I’m using condoms all the time
Other, please specify: _________
Don’t know

G18. Please rank the reasons why you are unsure about restaring PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G17] rank order list

[Only if D3=No; otherwise skip to G21]

G19. What are the reasons why you are not planning to restart PrEP at this time. Select all that apply.

I can’t afford it right now
I’m not at risk for HIV
My insurance will not cover it, or I don’t have insurance
I don’t want to take a pill every day
My parent(s) or guardian(s) will find out
I will forget to take my pill
I will have trouble getting to follow-up appointments
I will have issues getting PrEP or with the pharmacy
I am concerned about side effects
People will react negatively if they find out I’m taking PrEP
I am worried about the long term effects of PrEP on my health
I have a medical problem that makes it unsafe to take PrEP
I use condoms all of the time
Other, please specify: _________________________________________________
Don’t know

G20. Please rank the reasons why you do not plan to restart PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G19] rank order list

G21. What would motivate you to restart PrEP? Select all that apply.

Having sex with someone who is living with HIV
Having sex with someone whose HIV status is unknown
Having sex with multiple partners
Not using condoms regularly or partner(s) do/does not want to use condoms
Receiving more information on the safety of [pipe in PrEP modality from I12]
Receiving more information on the effectiveness of [pipe in PrEP modality from I12]
More people in your community start using PrEP
It was easier to attend follow-up visits
Fewer follow-up appointments/labs needed
Having better health insurance
Support from family and/or friends
Support from medical providers
Support from my partner(s)
Other, specify: ______
Don’t know

G22. Please rank the reasons what would motivate you to restart PrEP in order of importance, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from G21] rank order list

Now we want to ask you a few questions about your feelings related to previously taking PrEP.

G23. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I have been rejected romantically for taking PrEP
I have been judged by a health care provider because of taking PrEP
I have been blamed by people in my community for spreading HIV through PrEP use
I have been slut-shamed for taking PrEP (or told that I am a "Truvada or Descovy slut/whore")
I have been unfairly discriminated against for taking PrEP
I have been yelled at or scolded because of taking PrEP
I have experienced physical violence because of taking PrEP

Now we want to ask you a few questions about your feelings related to possibly restarting PrEP.

G24. Please select how much you agree with the following statements:

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
I worry people will assume I sleep around if they know I take PrEP
I worry people will assume that I am HIV+ if they know I take PrEP
I worry people will think my partner(s) are HIV+ if they know I take PrEP
I worry about listing PrEP as one of my current medications during doctor appointments
I feel ashamed to tell other people 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 sex 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

G25. What do you think about how effective PrEP is at preventing someone from getting HIV, when it is taken the way it is prescribed?

Very/completely effective
Somewhat effective
Minimally effective
Not at all effective
Don't know

G26. What do you think about whether PrEP helps prevent other kinds of sexually transmitted infections (STIs), like herpes?

HIV PrEP has no effect on other STIs
HIV PrEP helps to prevent other STIs
Don’t know

G27. To what extent do you think restarting PrEP would affect your likelihood to use condoms?

Significantly less likely
Somewhat less likely
Will not change
Somewhat more likely
Significantly more likely
Don’t know

H. PrEP Choices

[If E4, F12 = Daily oral PrEP then H1-H2]

[If E4, F12 = Intermittent oral PrEP then H3-H4]

[If E4, F12 = Injectable PrEP then H5-H6]

[If E4, F12 = Other or Don’t know then H13]

[If G12 = Daily oral PrEP then H7-H8]

[If G12= Intermittent oral PrEP then H9-H10]

[If G12= Injectable PrEP then H11-H12]

[If G12 = Other or Don’t know then H13]

H1. Why have you chosen to use daily oral PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to get shots/injections
I don’t want to have to attend an appointment every two months for a shot/injection
With a shot/injection I would be concerned about long-acting side effects (that is, side effects that don’t go away for a long time because I received an injection)
I don’t think I would remember to take intermittent PrEP as prescribed
I don’t think intermittent PrEP would work for me because it is difficult to predict when I’m going to have sex
I prefer to have a regular routine of taking PrEP
Other, please specify

[Selected multiple options=H2, otherwise H13]

H2. Please rank the reasons why you have chosen daily oral PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H1] rank order list

-------------------------------

H3. Why have you chosen to use intermittent oral PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to get shots/injections
I don’t want to have to attend an appointment every two months for a shot/injection
With a shot/injection I would be concerned about long-acting side effects (that is, side effects that don’t go away for a long time because I received an injection)
I don’t want to have to take a pill every day
I think it is easier to take PrEP only when I need it
Intermitent PrEP is less expensive
Other, please specify

[Selected multiple options=H4, otherwise Section H13]

H4. Please rank the reasons why you have chosen intermittent oral PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H3] rank order list

-------------------------------

H5. Why have you chosen to use injectable PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to take a pill every day
I don’t think I would remember to take daily oral PrEP the way it is prescribed
I’m concerned that someone would find out I use PrEP if I had to take pills
I don’t think I would remember to take intermittent PrEP as prescribed
I don’t think intermittent PrEP would work for me because it is difficult to predict when I’m going to have sex
Other, please specify

[Selected multiple options=H6, otherwise Section H14]

H6. Please rank the reasons why you have injectable PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H5] rank order list

H7. Why are you considering daily oral PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to get shots/injections
I don’t want to have to attend an appointment every two months for a shot/injection
With a shot/injection I would be concerned about long-acting side effects (that is, side effects that don’t go away for a long time because I received an injection)
I don’t think I would remember to take intermittent PrEP as prescribed
I don’t think intermittent PrEP would work for me because it is difficult to predict when I’m going to have sex
I prefer to have a regular routine of taking PrEP
Other, please specify

[Selected multiple options=H8, otherwise H13]

H8. Please rank the reasons why you are considering daily oral PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H7] rank order list

-------------------------------

H9. Why are you considering intermittent oral PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to get shots/injections
I don’t want to have to attend an appointment every two months for a shot/injection
With a shot/injection I would be concerned about long-acting side effects (that is, side effects that don’t go away for a long time because I received an injection)
I don’t want to have to take a pill every day
I think it is easier to take PrEP only when I need it
Intermitent PrEP is less expensive
Other, please specify

[Selected multiple options=H10, otherwise Section H13]

H10. Please rank the reasons why you are considering intermittent oral PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H9] rank order list

H11. Why are you considering injectable PrEP, rather than a different kind of PrEP? (Choose all that apply)

My doctor/health care provider recommended this kind for me
I know people who use this kind of PrEP
I think this kind of PrEP is more effective than other kinds
I think this kind of PrEP is safer than other kinds
I don’t want to have to take a pill every day
I don’t think I would remember to take daily oral PrEP the way it is prescribed
I’m concerned that someone would find out I use PrEP if I had to take pills
I don’t think I would remember to take intermittent PrEP as prescribed
I don’t think intermittent PrEP would work for me because it is difficult to predict when I’m going to have sex
Other, please specify

[Selected multiple options=H12, otherwise Section H14]

H12. Please rank the reasons why you are considering injectable PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from H11] rank order list

[If E4,, F12 = Injectable PrEP then Skip to H14]

H13. Compared to taking oral PrEP pills, how difficult do you think it would be to use injectable PrEP as prescribed (getting your PrEP shot every two months on time)?

Injectable PrEP would be LESS difficult to take as prescribed, compared to oral PrEP
SAME, the type of PrEP would not change my ability to take PrEP as prescribed
Injectable PrEP would be MORE difficult to take as prescribed, compared to oral PrEP
I don't know/Prefer not to answer

[If E4,, F12 = Intermittent PrEP then Skip to Section I]

H14. Compared to [pipe in current PrEP modality], how difficult do you think it would be to use on-demand PrEP (taking two pills 2-24 hours before sex, one pill 24 hours after the first dose, and one pill 24 hours after the second dose)?

On-demand PrEP would be LESS difficult to take, compared to [pipe in current PrEP modality]
SAME, on-demand PrEP would not change my ability to take PrEP
On-demand PrEP would be MORE difficult to [pipe in current PrEP modality]
I don't know/Prefer not to answer

I. PREP ADHERENCE AND BARRIERS

[If E4,, F12 = Daily oral PrEP then I1-I5]

[If E4,, F12 = Intermittent oral PrEP then I6-I10]

[If E4,, F12 = Injectable PrEP then I11-I17]

[If G12, = Daily oral PrEP then I5]

[If G12, = Intermittent oral PrEP then I10]

[If G12, = Injectable PrEP then I17]

[ALL PARTICIPANTS SHOULD ANSWER I18 REGARDLESS OF PREP USE]

I1. In the past 7 days, how many days did you take PrEP?

Text box: 1-7

I2. In the past 3 months, 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

I3. What has gotten in the way of you taking your PrEP on a daily basis? (Choose all that apply)

I have not had any trouble taking my regular PrEP doses
Couldn't get my pills at the drug store or pharmacy
Ran out of my prescription and never started again
Did not have health insurance to pay for the prescriptions
Made me sick to my stomach or tasted bad
Forgot to take my pill
I got a headache, rash, or other physical symptom
It got in the way of my daily schedule
Didn't feel like taking it, needed a break
Change in living situation/moved
Worried that someone will think I have HIV
Got sick with another illness, wasn't feeling well (e.g., cold, flu, etc.)
Don't think I need the pills anymore, I can stay healthy without them
Family and/or friends didn't help me remember
Family and/or friends told me I shouldn't take them
Nowhere to keep the pills at school or work
Didn't understand why I had to take the pills
I kept getting sick even when I did take the pills
Taking it reminded me of HIV
Other, please specify
Don’t know

[Selected multiple options=I4, otherwise I5]

I4. Please rank the things that have gotten in the way of taking PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from I3] rank order list

I5. 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).

How confident are you that you can...

Take PrEP on a weekend:

Take PrEP on a weekday

Take PrEP when dealing with schedule changes:

Take PrEP while traveling:

Take PrEP when out with friends:

Take PrEP at work/school:

Take PrEP when having medication side effects:

Take PrEP when having a crisis:

Take PrEP when drinking or using drugs:

Keep your PrEP medical appointments:

Follow a plan for taking PrEP:

[Skip to I18]

-------------------------------

I6. In the past 3 months, what percent of the time did you take your full dose of intermittent PrEP as prescribed (i.e., before & after any condomless anal sex)? A full dose includes the pills taken before sex and after sex as in the figure. 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

I did not have any condomless anal sex.
Don’t know

Figure.

Shape2
Shape1

[IF I6 =100%, skip to I10]

I7. In the past 3 months, what percent of the time did you do the following before having any condomless anal sex? Note: Your responses should add up to 100%. If any of the categories do not apply to you, please enter “0”. [Add logic so that these responses must sum to 100%]

Did not take any of the 4 pills: ___%
Took 1 of the 4 pills: ____ %
Took 2 of the 4 pills: ____ %
Took 3 of the 4 pills: ___ %

I8. What has gotten in the way of you taking your intermitent PrEP as prescribed (i.e., before & after having any condomless anal sex)? (Choose all that apply)

I have not had any trouble taking my PrEP doses
Couldn't get my pills at the drug store or pharmacy
Ran out of my prescription and never started again
Forgot to take my pills before sex
Forgot to take my pills after sex
Didn’t know I was going to have sex and I didn’t have any PrEP with me
Didn’t think I needed to take all the pills
Did not have health insurance to pay for the prescriptions
Made me sick to my stomach or tasted bad
I got a headache, rash, or other physical symptom
Didn't feel like taking it, needed a break
Change in living situation/moved
Worried that someone will think I have HIV
Got sick with another illness, wasn't feeling well (e.g., cold, flu, etc.)
Don't think I need the pills anymore, I can stay healthy without them
Family and/or friends didn't help me remember
Family and/or friends told me I shouldn't take them
Nowhere to keep the pills at school or work
Didn't understand why I had to take the pills
I kept getting sick even when I did take the pills
Taking it reminded me of HIV
Other, please specify
Don’t know

[Selected multiple options=I9, otherwise I10]

I9. Please rank the things that have gotten in the way of taking PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from I8] rank order list

I10. 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).

How confident are you that you can...

Take PrEP on a weekend if needed:

Take PrEP on a weekday if needed:

Take PrEP when dealing with schedule changes:

Take PrEP while traveling if needed:

Take PrEP when out with friends if needed:

Take PrEP at work/school if needed:

Take PrEP when having medication side effects:

Take PrEP when having a crisis:

Take PrEP when drinking or using drugs if needed:

Keep your PrEP medical appointments:

Follow a plan for taking PrEP:

[Skip to I18]

-------------------------------

I11. When was the date of your last PrEP injection? (If exact date is unknown, then use the 1^st of the month of injection).

___dd/mm/yyyy____

I12. When is the date of your next PrEP injection? (If exact date is unknown, then use the 1^st of the month of injection).

___dd/mm/yyyy____

I13. Have you ever gone more than 2 months between PrEP injections?

[Yes=I14, otherwise I15]

No
Yes
Don’t know

I14. How many times have you gone more than 2 months between PrEP injections? It is OK if you don’t know the exact answer; provide your best guess.

[Free text]

I15. What has gotten in the way of you getting your PrEP injections? (Choose all that apply)

I have not had any trouble getting my regular PrEP injections
Couldn't get an injection appointment
Appointment location was too far away or couldn’t get transportation
Dissatified with quality of clinic services
Negative attitudes held by clinic staff
Worried about paying for the injection
Irritation at the injection site
I had some other physical symptom
Forgot to schedule or attend my appointment
It got in the way of my schedule
Didn't feel like taking it, needed a break
Change in living situation/moved
Worried that someone will think I have HIV
Got sick with another illness, wasn't feeling well (e.g., cold, flu, etc.)
Don't think I need the injections anymore, I can stay healthy without them
Family and/or friends didn't help me remember
Family and/or friends told me I shouldn't get them
Didn't understand why I had to get the injections
I kept getting sick even when I did get the injections
Getting them reminded me of HIV
Other, please specficy
Don’t know

[Selected multiple options=I16, otherwise I17]

I16. Please rank the things that have gotten in the way of taking PrEP, with 1 being the most important reason, 2 being the next most important reason, all the way to the least important reason.

[Answers from I15] rank order list

I17. 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).

How confident are you that you can...

Keep your injectable PrEP appointments:

Follow a plan for getting your PrEP:

[ALL PARTICIPANTS]

I18. Please rate how much each of the following items influences your decision about taking PrEP.

	Not at all	A little bit	A moderate amount	A lot
Having to talk to a healthcare provider about my sex life
Having to talk to a healthcare provider about PrEP
Friends finding out that I am on PrEP
Sexual partner(s) finding out that I am on PrEP
Family members finding out that I am on PrEP
The long-term effects of PrEP on my health
The possibility that PrEP might not provide complete protection against HIV
The possibility that if I become HIV positive, certain medications won’t work
The potential side effects of PrEP
Having to remember to take a pill or get an injection
Getting transportation to PrEP appointments/labs
Returning for PrEP follow-up appointments and labs
Getting a PrEP prescription refilled
Using insurance to get coverage for PrEP costs
Getting the costs of PrEP covered (including office visits or office visit co-pays, lab costs, transportation costs)

J. TECHNOLOGY USE AND ONLINE PARTNER SEEKING BEHAVIOR

In this section, we will ask questions about your devices and your social media and internet use.

J1. On average, how many hours a day do you spend on the Internet, other than for work or school? (Round to the nearest hour) _______ [integer 0-24]

J2. Which of the following devices do you own? (Check all that apply)

[If cell phone then J4, if smartphone then J3, otherwise J4]

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)
Desktop computer
Laptop computer
Tablet computer
E-book reader
Fitness tracker or smart watch
Other, please specify

J3. How often do you use apps on your smartphone (for example: TikTok, Instagram, 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

J4. Do you regularly share your phone with one or more other people (such as a partner, family member, or friends)?

J5. What kind of phone service do you have?

I have a prepaid account
I have a monthly contract
I’m on a shared plan
Other, please specify
Don’t know

J6. How many times in the past 3 months has your phone been disconnected, because the bill was not paid, or because your phone was lost or stolen?

[Never=J8, otherwise J7]

Never
Once
Twice
3 to 5 times
More than 5 times
Other, please specify
Don’t know

J7. The last time your phone was disconnected, for how long was it disconnected?

1 day or less
2 to 7 days
1 to 4 weeks
1 month or more
Other, please specify
Don’t know

J8. How often do you use websites or apps for the following reasons:

	Never	Rarely	Sometimes	Often
Make new friends
Chat with friends
Find a date
Meet partners for sex
Look for work opportunities
Track your health behaviors (diet, exercise, medication management, etc.)
Create event reminders (take a daily pill, exercise, etc.)

J9. What are the 3 social media platforms you use most often?

YouTube
LinkedIn
Reddit
WhatsApp
Snapchat
Twitter
Facebook
Instagram
TikTok
Other, please specify
Don’t know

J10. [Ybarra scale] In the past 12 months, have you searched online for any of the following topics for yourself? (Check all that apply)

Sexuality or sexual attraction
How to have sex or sexual positions
HIV/AIDS or other sexually transmitted diseases
Condoms or other types of birth control
PrEP (Pre-Exposure Prophylaxis)
PEP (Post Exposure Prophylaxis)
Fitness or weight issues
Drugs or alcohol
Violence or abuse
Medications or medication side effects
Depression, anxiety, or suicide
None

J11. Please indicate your agreement with the following statements

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
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 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.	( )	( )	( )	( )	( )

K. RELATIONSHIPS AND SEXUAL HEALTH PRIORITIES

K1. How do you define your primary relationship status? [Routing question, may not skip]

Single [Skip to Section L]
Casually dating/friends with benefits [Skip to Section L]
In a relationship (Have a partner/partners or spouse)
Other, please specify [Skip to Section L]
Don’t know [Skip to Section L]

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.

K2. For these next questions, we are interested in you and your primary romantic partner’s sexual health priorities. Thinking about you and your primary partner’s sexual health priorities, please indicate the extent to which you agree or disagree with the following statements.

	Strongly Agree	Agree	Neither Agree nor Disagree	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	( )	( )	( )	( )	( )
Making sexual health decisions with my partner can be difficult because we have different priorities	( )	( )	( )	( )	( )

L. SEXUAL BEHAVIORS

This set of questions will ask about your sexual behaviors. Sometimes sharing information about sexual behaviors can make people feel uncomfortable. We want you to remember that all this information is kept confidential and is collected only for research purposes. This information will help this study learn more about PrEP and HIV prevention. Please be as honest as possible.

L1. In the past 3 months, how many sexual partners have you had sex with? [NumSexPartner] ______ (range 0-99) (text field)

[If NumSexPartner =0 then skip to Section N]

[If NumSexPartner = 1 then M2-M5]

[If NumSexPartner > 1 then M6-M9]

[ANAL RECEPTIVE]

The following questions ask about your sexual behavior during the past 3 months. Our focus in this section will be exclusively on anal sex. Therefore, only include partners with whom you had anal sex.

L2. In the past 3 months, did you have receptive anal sex with this person (you were the bottom)? [ReceptiveAI]

[Yes = L3, otherwise L10]

Yes
No
Don’t know

L3. About this person, did they put their penis in your rectum without a condom? [ReceptiveAINoCondom]

Yes
No
Don’t know

L4. Regarding this person… [OneRecAIHIVStatus]

They told you they were HIV negative and you had no reason to doubt it. [Negative]
They told you they were HIV positive and they were undetectable
They told you they were HIV positive but did NOT say they were undetectable.
You were not completely sure of this person’s HIV status. [StatusUnknown]
Don’t know

L5. Was this person using PrEP? [OneRecAIPrep]

Yes
No
Don’t know

[Skip to L10]

-------------------------------

L6. In the past 3 months, with how many of these [NumSexPartner] people did you have receptive anal sex (you were the bottom)? [ReceptiveAI]

_________ (range 0-[NumSexPartner]) (fill-in) [If >0 then L7, otherwise L14]

L7. Of these [ReceptiveAI] people, how many put their penises in your rectum without a condom? ___ [ReceptiveAINoCondom] (Range 0-[ReceptiveAI]) (fill-in)

L8. Of the [ReceptiveAI] people you had receptive anal sex with, how many… (Please enter a number in each box. Enter 0 (zero) if none. Your answers must add up to [ReceptiveAI]).

Told you they were HIV negative and you had no reason to doubt it? ____
Told you they were HIV positive and they were undetectable? ____
Told you they were HIV positive but did NOT say they were undetectable. ____
Were you not completely sure of their HIV status? ____

_____(TOTAL) [MultRecAIHIVTotal] This number must be the sum of the previous 3 responses, and should tally as the answers are populated. Validate that [MultRecUAIHIVTotal] = [ReceptiveAI]

L9. To your knowledge, how many of these people were taking PrEP? [MultRecAIPrep] ____ (range 0-[ReceptiveAI]) (fill-in)

[Skip to L14]

-------------------------------

[ANAL INSERTIVE]

[If NumSexPartner = 1 then L10-L13]

[If NumSexPartner > 1 then L14-L17]

L10. We have a few more questions about your sexual behavior with the person who was your anal sex partner in the past 3 months.

In the past 3 months, did you have insertive anal sex with this person (you were the top)? [InsertiveAI]

[Yes = L11, otherwise L22]

Yes
No
Don’t know

L11. About this person, did you put your penis in their rectum without a condom? [InsertiveAINoCondom]

Yes
No
Don’t know

[If answered L4, skip to L13]

L12. Regarding this person… [OneRecAIHIVStatus]

They told you they were HIV negative and you had no reason to doubt it. [Negative]
They told you they were HIV positive and they were undetectable
They told you they were HIV positive but did NOT say they were undetectable.
You were not completely sure of this person’s HIV status. [StatusUnknown]
Don’t know

[If answered L5, skip to L18]

L13. Was this person using PrEP? [OneRecAIPrep]

Yes
No
Don’t know

[Skip to L18]

-------------------------------

L14. We have a few more questions about your sexual behavior with the people who were your anal sex partners in the past 3 months.

In the past 3 months, with how many of these [NumSexPartner] people did you have insertive anal sex (you were the top)? [InsertiveAI] ___ (range 0-[NumSexPartner]) (fill-in) [If >0 then L15, otherwise L22]

L15. Of these [InsertiveAI] people, how many of their rectums did you put your penis into without a condom? _____ [InsertiveAINoCondom] (range 0-[InsertiveAI]) (fill-in)

L16. Of the [InsertiveAI] people you had insertive anal sex with, how many… (Please enter a number in each box. Enter 0 (zero) if none. Your answers must add up to [InsertiveAI]).

Told you they were HIV negative and you had no reason to doubt it? ____
Told you they were HIV positive and they were undetectable? ____
Told you they were HIV positive but did NOT say they were undetectable. ____
Were you not completely sure of their HIV status? ____

_____(TOTAL) [MultInsAIHIVTotal] This number must be the sum of the previous 3 responses, and should tally as the answers are populated. Validate that [MultInsUAIHIVTotal] = [InsertiveAI]

L17. To your knowledge, how many of these people were taking PrEP?

[MultRecAIPrep] ____ (range 0-[InsertiveAI]) (fill-in)

[Skip to L22]

-------------------------------

[VAGINAL]

We will now ask you questions about your experience with vaginal sex in the past 3 months. Our focus in this section is exclusively on vaginal sex.

[If NumSexPartner = 1 then L18-L21]

[If NumSexPartner > 1 then L22-L25]

L18. In the past 3 months, did you have vaginal sex with this person (did you put your penis in their vagina)? [VI]

[Yes = L19, otherwise ]

Yes
No
Don’t know

L19. About this person, did you put your penis in their vagina without a condom? [InsertiveVINoCondom]

Yes
No
Don’t know

L20. Regarding this person… [OneRecAIHIVStatus]

They told you they were HIV negative and you had no reason to doubt it. [Negative]
They told you they were HIV positive and they were undetectable
They told you they were HIV positive but did NOT say they were undetectable.
You were not completely sure of this person’s HIV status. [StatusUnknown]
Don’t know

L21. Was this person using PrEP? [OneRecAIPrep]

Yes
No
Don’t know

[Skip to routing before L26]

-------------------------------

L22. In the past 3 months, with how many sexual partners did you have vaginal sex (you put your penis in someone’s vagina)? [VI] ___ (range 0-[NumVagSexPartner]) (fill-in) [If >0 then L23, otherwise routing before L26]

L23. Of these [InsertiveVI] people, how many of their vaginas did you put your penis into without a condom?___ [InsertiveVINoCondom] (range 0-[InsertiveAI]) (fill-in)

L24. Of the [InsertiveVI] people you had vaginal sex with, how many… (Please enter a number in each box. Enter 0 (zero) if none. Your answers must add up to [InsertiveVI]).

Told you they were HIV negative and you had no reason to doubt it? ____
Told you they were HIV positive and they were undetectable? ____
Told you they were HIV positive but did NOT say they were undetectable. ____
Were you not completely sure of their HIV status? ____

_____(TOTAL) [MultInsVIHIVTotal] This number must be the sum of the previous 3 responses, and should tally as the answers are populated. Validate that [MultInsVIHIVTotal] = [InsertiveVI]

L25. To your knowledge, how many of these people were taking PrEP?

[MultRecVIPrep] ____ (range 0-[InsertiveVI]) (fill-in)

[If L2 = NO, L6 = 0, L10 = LO, L14 = 0 then no anal sex reported, skip to L27]

L26. Now we are going to ask you to think back to any anal sex you had in the last 2 months (8 weeks). If you are unsure of any answers below, please make your best guess.

Thinking back to the past week, [pipe in date range here with calendar]:

How many times did you have any anal sex?