NIGERIA PrEP DEMONSTRATION STUDY
Risk Taking Behaviours 2 HIV Positive
VISIT MONTH:
Screening ID:
Site
1
2
Study
Participant ID:
Screening Number
Site
Study
Visit Date:
Couple
I/P Chk
dd
mm
yy
Imagine I have 10 balls, one of which is red and nine of which are black. If you pick one of
these balls without looking, how likely it is that you will pick the red ball? Question to the
interviewer: did the respondent said 1 chance out of 10, 10%?
Circle the correct answer
Yes
No
I will ask you several questions about the chance that certain events are going to happen. I
would like you to use this scale that goes from 0 to 100 to indicate the chance that the event
occurs. If you chose 0, this means that you are sure that the event will not occur. The higher
the number you chose is, the more likely is the event to happen. For example if you answer
50, it means that it is just as likely that the event happens as it does not happen (fifty-fifty). If
you indicate a number below 50 it means that the event has more chances to not happen than
to happen. If you indicate a number greater than 50 it means that the event has more chances
to happen than to not happen. If you answer 100, it means you are certain that the event will
occur.
Answer
a
b
c
What is the likelihood that your partner is infected with HIV according to you?
What is the likelihood that you are infected with HIV according to you?
What is the likelihood that you use a condom with your partner during the next sexual
intercourse?
d What is the probability that you will use a condom for each TEN of the next sexual
intercourses with your partner?
e What is the probability that you accept to take ART?
f What is your probability that you take ART consistently i.e. everyday?
g What is the probability that you will experience side effects while on ART?
h What is the probability that you will take ART consistently if you experience any
mild side effects occur?
i If you do not use ART consistently, what is the likelihood that your partner get
infected with HIV in the next year according to you?
j If you use ART consistently, what is the likelihood that your partner get infected with
HIV in the next year according to you?
k What is the probability that you will use condom in the next 10 sexual intercourses
with your infected partner if your partner takes PrEP?
l If you have one unprotected sexual act with your HIV negative partner, what is the
probability that your partner becomes infected with HIV as a result?
m If you have one protected sexual act with your HIV negative partner, what is the
probability that your partner becomes infected with HIV as a result?
Completed by: (initials/date) _________________________________________
NIGERIA PrEP DEMONSTRATION STUDY
Forms Instruction
The Risk taking behaviours 2 CRF is completed at Enrollment and annually (Months 12
and 24) by both the PrEP user AND the partner, use the correct form depending on the
HIV status of the respondent. The same form is used for male and female partner
participants.
Item1
Items 2
This question measures the knowledge of probabilities of the respondent. Circle
“yes” only if the respondent has responded correctly i.e. that the respondent has
given the following answer:1 chance out of 10 or 10 chances out of 100 or10%
If the respondent responded incorrectly, did not know or did not respond circle
“no”.
These questions are directly asked to the respondent.
Please present the scale to the respondent and ask them to indicate the likelihood
that the event will occur on the scale.