TEP 2017 v.2 TEP 2017 ver.2 To better evaluate the risk factors our clients report, this information is being gathered in one central point. Question Title * 1. Sexual behavior/identity z72.52: exclusively homosexual z72.53: bisexual Question Title * 2. Are you on PrEP? Yes No Considering I am HIV positive Was considering/tested HIV positive Question Title * 3. How many SP w/in last 12 months? -1 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 4. How many SP w/in last the 90 days? -1 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 5. How many SP w/in last 30 days? -1 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 6. Out of those SP in the last 12 months, how many were first time/new SP? -1 50 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 7. How many of your partners were HIV positive? -1 100 Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 8. How did/do you meet your SP? Via friends/social settings Via school/work Grindr Scruff a4a Craigslist Vixen Video Over 19 Bar/party Question Title * 9. Do you engage in? Repsonse Mouth to Penis: giving Yes No Declined to answer or not asked Mouth to Penis: giving Repsonse menu Mouth to Penis: receiving Yes No Declined to answer or not asked Mouth to Penis: receiving Repsonse menu Mouth to rectum: giving Yes No Declined to answer or not asked Mouth to rectum: giving Repsonse menu Mouth to rectum: receiving Yes No Declined to answer or not asked Mouth to rectum: receiving Repsonse menu Penis to rectum: giving Yes No Declined to answer or not asked Penis to rectum: giving Repsonse menu Penis to rectum: receiving Yes No Declined to answer or not asked Penis to rectum: receiving Repsonse menu Question Title * 10. Topping v. bottoming 100% Top 75/25 Top/Bottom 50/50 25/75 Top/Bottom 100% Bottom Question Title * 11. How often do you top vs. bottom? 100% Top 50/50 vers 100% Bottom Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 12. How often did you use condoms/barriers when? Percent of time Oral sex (MtoP): giving Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Oral sex (MtoP): giving Percent of time menu Oral sex (MtoP): receiving Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Oral sex (MtoP): receiving Percent of time menu Oral sex (MtoR): giving Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Oral sex (MtoR): giving Percent of time menu Oral sex (MtoR): receiving Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Oral sex (MtoR): receiving Percent of time menu Anal: top Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Anal: top Percent of time menu Anal: bottom Never 1-10% 11-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-99% 100% NA Anal: bottom Percent of time menu Question Title * 13. In the last 12 months, have you had: Chlamydia - N/A Chlamydia - Throat Chlamydia - Urine Chlamydia - Rectal Gonorrhea - N/A Gonorrhea - Throat Gonorrhea - Urine Gonorrhea - Rectal Syphilis - Blood Question Title * 14. In the last 12 months, have you had: A B C D E Gonorrhea NA Throat Urine Rectal Systemic Gonorrhea A menu NA Throat Urine Rectal Systemic Gonorrhea B menu NA Throat Urine Rectal Systemic Gonorrhea C menu NA Throat Urine Rectal Systemic Gonorrhea D menu NA Throat Urine Rectal Systemic Gonorrhea E menu Chlamydia NA Throat Urine Rectal Systemic Chlamydia A menu NA Throat Urine Rectal Systemic Chlamydia B menu NA Throat Urine Rectal Systemic Chlamydia C menu NA Throat Urine Rectal Systemic Chlamydia D menu NA Throat Urine Rectal Systemic Chlamydia E menu Syphilis NA Throat Urine Rectal Systemic Syphilis A menu NA Throat Urine Rectal Systemic Syphilis B menu NA Throat Urine Rectal Systemic Syphilis C menu NA Throat Urine Rectal Systemic Syphilis D menu NA Throat Urine Rectal Systemic Syphilis E menu Done