Eligibility Screener for STI Testing Service Users

Responses to questions marked * are required to be eligible to participate

Question Title

* 1. Which of the following best describes your ethnicity and/or racial background? Check all that apply.

Asian – East (e.g., Chinese, Japanese, Korean)

Asian – South (e.g. Indian, Pakistani, Sri Lankan)

Asian - South East (e.g., Malaysian, Filipino, Vietnamese)

Black - African (e.g., Ghanaian, Kenyan, Somali)

Black - Caribbean (e.g., Barbadian, Jamaican)

Black - North American (e.g., Canadian, American)

First Nations

Indigenous/Aboriginal (non-Inuit; non-Métis)

Inuit

Métis

Indian - Caribbean (e.g., Guyanese with origins in India)

Latin American (e.g., Argentinean, Chilean, Salvadorian)

Middle Eastern (e.g., Egyptian, Iranian, Lebanese)

White - European (e.g., English, Italian, Portuguese, Russian)

White - North American (e.g., Canadian, American)

I prefer not to answer

Other, please specify:

Question Title

* 2. What is your gender identity?

Man

Woman

Two-spirit

I don't know

I prefer not to answer

Other, please specify:

Question Title

* 3. Do you identify as two-spirit, trans, non-binary, or cisgender?

Two-spirit

Trans

Non-binary

Cisgender

I don't know

I prefer not to answer

Question Title

* 4. What is your sexual identity? (check all that apply).

Gay

Bi (bisexual)

Queer

Asexual

Pansexual

Heteroflexible

Straight

I prefer not to answer

Other, please specify:

Question Title

* 5. When were you last tested for any STIs or HIV?

In the past 3 months

4-6 months ago

7-12 months ago

Longer than a year ago

Never

Don't know

I prefer not to answer

Question Title

* 6. In the last 12 months, have you:

Had insertive anal/front hole/vaginal sex (you topped your partner/partners)

Had receptive anal/front hole/vaginal sex (your partner/partners topped you)

Had oral sex performed on you (your partner’s/partners’ mouth on your genitals)

Performed oral sex on someone (your mouth on your partner’s/partners’ genitals)

Question Title

* 7. Which of the following situation best describe you?

I live in Toronto

I work in Toronto

I often go out to clubs, restaurants in Toronto

I mostly hook-up (have sex) in Toronto

I go to a sexual health clinic (STI/HIV testing) in Toronto

None of the above, but I visit Toronto quite often

I am a resident of Ontario who lives outside of Toronto and I have used STI testing services in Ontario

None of the above

Question Title

* 8. Are you willing and able to participate in a 60-90 minute online (MS Teams or Skype) Focus Group discussion to talk about STI/HIV testing services in Ontario?

Yes

Question Title

* 9. Please enter your age and let us know the best way to get in contact with you? (please provide at least one option):

You age (in years):

Email:

Phone:

Thank you for your responses.

A member of the GCO Acceptability Study will contact you if you are found eligible to participate.