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Manual for the

Administration and Coding of the

Sexual Activities & Attitudes Questionnaire


(SAAQ)
Noll, J.G., P.K. Trickett, and F.W. Putnam, A prospective investigation of the
impact of childhood sexual abuse on the development of sexuality. Journal
of Consulting and Clinical Psychology, 2003. 71(3): p. 575-586.

All intellectual content contained within this document is


property of Dr. Jennie G. Noll.
To request an electronic copy of the SAAQ measure contained on CD-ROM,
please contact:
Jennie G Noll
Cincinnati Childrens Hospital
Behavioral Medicine and Clinical Psychology
ML 3015
3333 Burnet Avenue
Cincinnati, OH 45229
Jennie.Noll@cchmc.org

Introduction
The SAAQ is a 44-item self report measure which assesses (I) sexual activities
as well as (II) sexual attitudes.
I. Sexual activities include
1. Age at first intercourse
2. Birth control efficacy
3. Intercourse partners
4. HIV-risk behaviors
5. STDs
6. Pregnancies
7. Sexual behaviors of peers
II. Sexual attitudes assessed include
1. Sexual preoccupation. This subscale assesses positive attitudes
toward, and high frequency of, masturbation, being turned-on by pornographic
pictures or sexual themes, and thinking about sex frequently. This scale has 15
items ( = .91) and has been shown to be correlated with teen pregnancy and
sexual abuse.
2. Sexual permissiveness. This 12-item subscale ( = .96) assesses
permissive attitudes toward a relatively normative set of desires and behaviors,
including intimate affection, light and heavy petting, and voluntary intercourse.
3. Internal and external pressure to engage in sex. This 6-item subscale
( = .70) assesses the belief that a sense of maturity and respect from friends will
be gained, that is sex is expected, and that one will feel more loved and wanted
upon having sex.
4. Negative attitude toward sex. This 10-item subscale ( = .85)
assesses attitudes that sex is dirty and embarrassing, being frightened by sex,
believing that sex results in the loss of respect for self and from friends, and
worrying about becoming pregnant.
5. Sexual Aversion. The SAAQ measures this construct by the following
equation: -1 * (permissiveness) + (negative attitude toward sex). The construct
ahs been shown to be related to childhood sexual behavior problems earlier in
development for sexually abused females.
6. Sexual Ambivalence. The SAAQ measures this construct by the
following equation: (preoccupation) + (aversion). Thus, this is a measure of
simultaneous compulsion coupled with an aversion (see preliminary studies
section1). This construct has been shown to be related to dissociative symptoms
earlier in development for adolescents sexually abused in childhood.

Calculating Subscales for the SAAQ:

Sexual Preoccupation:
Items 3, 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i, 4j, 4k, 4l, 4m, 4n, 5, 13a, 13i
Sexual Permissiveness:
Items 2b, 2c, 2d, 2e, 2f, 8, 10, 10a, 13d
Internal and external pressure to engage in sex:
Items 13b, 14c, 14d, 14g, 14i, 14j
Negative attitude toward sex:
Items 13c, 13f, 13h, 13j, 13k, 14a, 14b, 14e, 14f, 14h,
Sexual Aversion = (-1*permissiveness) + (negative attitude toward sex)
Sexual Ambivalence = (preoccupation) + (aversion)

Other noteworthy groupings:


Risky sexual behavior = 2g, 2h, 2i, 2j, 2k
Peers exhibiting risky sexual behavior = 12g, 12h, 12i, 12j, 12k, 12l, 12m
Risk for HIV contraction = 24a, 24b, 24c, 24d, 24e, 24f, 24g, 24h, 24i, 24j, 24k
Intercourse ever = 8
If Intercourse ever = 0 then Risk for HIV contraction2 = 24b, 24e, 24f, 24g
HIV Positive = 62
Number of STDs = 56, 57, 58, 59, 60, 61, 62, 63, 64

Sexual Attitudes and Activities Questionnaire (SAAQ)

Female V2.2

Introduction:
In this section you will answer some questions having to do with your attitudes and feelings
about sex and your sexual behavior. For each question choose the answer that best represents
how YOU feel or what YOU do.
Your answers to these questions are strictly confidential. Your name will never be associated
with any of your responses. The information that you provide is very valuable and will help us
understand how adolescents think and feel about sex so it is important that you answer honestly
and as accurately as possible.
In this section we are only interested in your behavior regarding consensual or voluntary sexual
experiences. When asked about sexual behavior, only report about situations when you agreed to
participate in sexual activity. Disregard any situations when sex was either forced on you or
when you did not give your full consent.
Now begin to answer all of the questions.

1. Indicate the number of romantic partners with which you have done the following during the
PAST YEAR.
0
none,
never

1
partner

2 or 3
partners

4-7
partners

a. Gone out on unsupervised dates


b. Held hands
c. French or tongue kissing
d. Made out
e. Felt their private parts under clothing
f. Had your private parts felt under clothing
g. Given oral sex (mouth on private parts)
h. Received oral sex
i. Had sexual intercourse in a one night stand
j. Had sexual intercourse without contraceptionhad
unprotected sex
k. Had sexual intercourse while drunk on alcohol or
high on drugs

8-10
partners

more than 10
partners

_____
______
______
______
______
______
______
______
_____
______
______

2. Indicate the number of romantic partners with which you have done the following during the
YOUR ENTIRE LIFETIME.
0
none,
never

1
partner

2 or 3
partners

4-7
partners

a. Gone out on unsupervised dates


b. Held hands
c. French or tongue kissing
d. Made out
e. Felt their private parts under clothing
f. Had your private parts felt under clothing
g. Given oral sex (mouth on private parts)
h. Received oral sex
i. Had sexual intercourse in a one night stand
j. Had sexual intercourse without contraceptionhad
unprotected sex
k. Had sexual intercourse while drunk on alcohol or
high on drugs

8-10
partners
_____
______
______
______
______
______
______
______
_____
______
______

more than 10
partners

3.
0
Never

4.

How often do you find yourself thinking a lot about sex?


1
once or twice
every few months

2
about once
a month

3
about once
a week

4
several times
a week

5
several times
a day

Are you, or do you think you would be, turned on sexually by: (circle a number for each):

not at all
1

a little
2

some
3

a lot
4

4b. Romantic Dancing

4c. Romantic pictures in magazines or books

4d. Movie or TV shows that have love scenes

4e. Songs with romantic or sexy words

4f. Dreams while you are sleeping

4g. Women without clothes on

4h. Men without clothes on

4i. Fantasies or day dreams about sex

4j. An attractive male

4k. An attractive female

4l. Literature (books/magazines) that tell stories


about sex or have sexual pictures

4m. Websites that have sexual content

4n. Chat rooms or websites where people chat about


sexual things.

4a. Looking at your own body

very much
5

5. Some people sometimes masturbate, or play with their private parts to have a good feeling.
How often have you done this? (circle one):
0
Never

1
once or twice
every few months

2
about once
a month

3
about once
a week

4
several times
a week

5
almost every
day

6. In the LAST YEAR how many times have you had voluntary sexual intercourse?
0
none,
never

1
time

2 or 3
times

4-7
times

8-10
times

more than 10
times

IF NEVER SKIP TO QUESTION #8.


7. In the LAST YEAR how many voluntary sexual intercourse partners have you had?
0
none,
never

1
partner

2 or 3
partners

4-7
partners

8-10
partners

more than 10
partners

8. How many voluntary sexual intercourse partners have you had in your LIFETIME: (circle one):
0
none,
never

1
partner

2 or 3
partners

4-7
partners

8-10
partners

more than 10
partners

IF NEVER SKIP TO QUESTION #10.


9. As best you can recall, how old were you the first time you had consensual intercourse? (Please place
a check in front of your answer.)

__younger than age 12


__12 years-old
__13 years-old
__13 years-old
__14 years-old
__14 years-old

__15 years-old
__15 years-old
__16 years-old
__16 years-old
__17 years-old
__17 years-old

__18 years-old
__18 years-old
__19 years-old
__19 years-old
__20 years-old
__20 years-old

__21 years or older

10. How likely is it that you will have sexual intercourse with someone in the next year?
1
2
3
4
5

sure it wont happen


probably wont happen
even chance (50-50) it will happen
probably will happen
sure it will happen

10a. How much do you think you would like to have sexual intercourse with someone in the
next year?
1
2
3
4
5

would dislike very much


would dislike a little
would neither like nor dislike
would like a little
would like very much

11. If you were to have sexual intercourse with someone in the next year, how likely is it that
you would use birth control?
1
2
3
4
5

sure I wouldnt use it


probably I wouldnt use it
even chance (50-50) I would use it
probably I would use it
sure I would use it

12. Please indicate whether or not you think your best friend has done each of the following
with a romantic partner.
1= definitely no
2= probably no
3= I dont really know
4= probably yes
5 = definitely yes
12a. Gone out on unsupervised dates
12b. Held hands with a partner
12c. French or tongue kissed a partner
12d. Necked or made-out with a partner
12e. Felt a partners private parts under clothes or without clothes
12f. Had private parts felt under clothes or without clothes
12g. Given oral sex (mouth on private parts)
12h. Received oral sex (mouth on private parts)
12i. Had sexual intercourse
12j. Had sexual intercourse with more than one partner within a few weeks
12k. Had sexual intercourse in a one night stand
12l. Had sexual intercourse while drunk or high on drugs
12m. Had sexual intercourse without contraceptionhad unprotected sex

_____
______
______
______
______
______
______
______
______
______
______
______
______

str
on
gly

dis
agr
dis
ee
agr
ee
nei
the
ra
gre
en
agr
or
ee
dis
agr
ee
str
on
gly
agr
ee

13. Choose the response that best represents how you think or feel:

13a.Masturbation doesnt hurt you

13b.It is OK for girls my age to do sexual things


because others expect them to

13c. Sex is dirty.

13d. Its okay for people my age to have sex

13e. There is a lot of pressure to go further


in sexual activity than girls really want to

13f. I wish there was no such thing


as sex.

13g. I think about sex even when I don't want to.

13h. I get frightened when I think about sex

13i. I sometimes have sexual feelings when I see


people kiss on TV or movies

13j. Thinking about sex upsets me

13k. I hope I never have to think about sex again

13l. I only have sex or plan to have sex with people


that I love.

13m. Its okay for people my age to have more than


one sexual partner at a time

13n. It is important for me to care about a person in


order to feel okay about having sex with them

def
init
el

yn

ot
pro
bab
ly n
ot
eve
nc
han
ce
pro
(50
-50
bab
)
ly y
e
s
def
init
ely
yes

14. If you were to have sex next month with someone you know well, how likely do you think
it is that each thing would happen to you?

14a. I would be embarrassed while having sex

14b. I would lose the respect of my friends

14c. I would feel more loved and wanted by the person

14d. The person would like me more

14e. I would lose respect for myself

14f. I would worry about getting pregnant

14g. It would show the person I liked them

14h. It would hurt my health

14i. I would gain the respect of my friends

14j. I would feel more mature

15.

Are you currently trying to get pregnant? (circle one):


0
NO

1
YES

IF YOU HAVE NEVER HAD


VOLUNTARY SEXUAL
INTERCOURSE, PLEASE SKIP
TO QUESTION # 17.

IF YES PLEASE ANSWER THE


FOLLOWING QUESTIONS WITH
RESPECT TO A TIME WHEN YOU
WERE NOT TRYING TO GET
PREGNANT.

16.

How often do you use birth control when you have sex? (circle one):
1
2
3
4
5
6

I never use birth control


I hardly ever use birth control when I have sex
sometimes I use birth control when I have sex, but not very often
I use birth control about half of the time I have sex
almost every time I have sex I use birth control
for sure every time I have sex I use birth control

17.
If you were to have sexual intercourse with someone in the near future, how likely is it
that you would use birth control? (circle one):
1
2
3
4
5

Im sure I wouldnt use it


probably I wouldnt use it
even chance (50-50) I would use it
probably I would use it
sure I would use it

18. Indicate if you learned about birth control methods in any of the following ways:
Rate each in the following ways:
0 = NO, never learned this way
1 = YES learned this way but found it to be NOT VERY EFFECTIVE in teaching me about birth
control methods
2 = YES learned this way but found it to be ONLY SOMEWHAT EFFECTIVE in teaching me
about birth control methods
3 = YES learned this way and found it to be ADEQUATELY EFFECTIVE in teaching me about
birth control methods
4 = YES learned this way and found it to be VERY EFFECTIVE in teaching me about birth
control methods
18a. _____ Learned from an older brother or sister
18b. _____ Learned from my mother (or mother figure)
18c. _____ Learned from my father (or father figure)
18d. _____ Learned from another relative (Aunt, Uncle, Cousin, Grandparent)
18e. _____ Learned from a friend
18f. _____ Learned from a boyfriend or romantic partner
18g. _____ Learned from my Doctor
18h. _____ Learned in a program at my school
18i. _____ Learned on my own
18j. _____ Other explain:__________________

19.
Please rate the following methods of birth control methods according to your preference
for each type of birth control.
Not
Preferred

Somewhat
Preferred

Most
Preferred

19a. Rhythm methodtiming when I have


sex according to where I am in my
menstrual cycle

19b. Make sure the other person pulls out


in time

19c. Birth control pills

19d. Sponge

19e. Spermicides and/or creams or foams

19f. Intrauterine device (e.g. IUD, coil,


loop)

19g. Monthly vaginal ring, The Ring


(e.g. NuvaRing)

19h. Diaphragm or cervical cap

19i. Condoms

19j. The Shot (e.g. Depo Provera)

19k. Implant under theskin. (e.g. Norplant)

19l. Contraceptive patch (e.g. Ortho Evra)

19m. Morning after pill

19n. None

19o. Other (explain):_________________

20. Please rate how likely you are to use the following methods of birth control if you choose to
have sexual intercourse in the future.

Least
Likely

Somewhat
Likely

Most
Likely

20a. Rhythm methodtiming when I have


sex according to where I am in my menstrual
cycle

20b. Make sure the other person pulls out


in time

20c. Birth control pills

20d. Sponge

20e. Spermicides and/or creams or foams

20f. Intrauterine device (e.g. IUD, coil,


loop)

20g. Monthly vaginal ring, The Ring


(e.g. NuvaRing)

20h. Diaphragm or cervical cap

20i. Condoms

20j. The Shot (e.g. Depo Provera)

20k. Implant under the skin. (e.g. Norplant)

20l. Contraceptive patch (e.g. Ortho Evra)

20m. Morning after pill

20n. None

20o. Other (explain):_________________

10

IF YOU HAVE NEVER HAD VOLUNTARY SEXUAL INTERCOURSE, SKIP TO


QUESTION #22
21. What types or types of birth control did you use the LAST time you had sexual intercourse?
1
0
YES NO
____ ____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____

____
____
____
____
____
____
____
____
____
____
____
____
____
____
____

21a. Rhythm methodtiming when I have sex according to where I


am in my menstrual cycle
21b. Make sure the other person pulls out in time
21c. Birth control pills
21d. Sponge
21e. Spermicides and/or creams or foams
21f. Intrauterine device (e.g. IUD, coil, loop)
21g. Monthly vaginal ring, The Ring (e.g. NuvaRing)
21h. Diaphragm or cervical cap
21i. Condoms
21j. The Shot (e.g. Depo Provera)
21k. Implant under the skin (e.g. Norplant)
21l. Contraceptive patch (Ortho Evra)
21m. Morning after pill
21n. none
21o. I dont remember or I am unsure
21p. other (explain):_______________________________________

22. How confident are you that your preferred method(s) of birth control would be effective at
preventing pregnancy?
0
not at all
confident

1
a little
confident

2
in between

3
somewhat
confident

4
very
confident

23. How confident are you that your preferred the method(s) of birth control would be effective
at preventing the spread of sexually transmitted diseases?
0
not at all
confident

1
a little
confident

2
in between

11

3
somewhat
confident

4
very
confident

24. Have you ever:


1
YES
____

0
NO
____

24a. had sexual intercourse without a condom

____ ____ 24b. engaged in oral sex without a condom or dental dam
____

____

24c. had a condom fall off or break during sexual intercourse

____

____

24d. had sexual intercourse or oral sex with an intravenous (IV) drug user

____

____

24e. used intravenous (IV) drugs (e.g., injected heroine)

____

____

24f. shared hypodermic needles with others

____ ____ 24g. had sexual intercourse or oral sex with someone who is bisexual
____

____

24h. had sexual intercourse with a homosexual male

____

____

24i. had sexual intercourse with someone who was also sexually involved with
others during that same

____

____

24j. had sexual intercourse in a one night stand relationship

____

____

24k. had sexual intercourse while drunk on alcohol or high on drugs

The following questions are about pregnancy:


25.

Have you ever been pregnant?


1 YES
0 NO

IF YES GO TO QUESTION 26.


IF NO SKIP TO QUESTION 36.

26. How many times have you been pregnant?


1

12

6+

27. What type or types of birth control were you using when you conceived the
(If you have only been pregnant once, just fill out the first column, if youve been pregnant twice, please fill out
the first column for the first pregnancy and the second column for the second pregnancy, and so on.)

Please make a mark or a check in the box(es) that apply, you may mark more than one.
Type of Birth
Control
a. Rhythm method
timing when I have
sex according to
where I am in my
menstrual cycle
b. Make sure the
other person pulls
out in time
c. Birth control pills
d. Sponge

FIRST
TIME

SECOND
TIME

THIRD
TIME

e. Spermicides
and/or creams or
foams
f. Intrauterine device
(e.g. IUD, coil, loop)
g. Monthly vaginal
ring, The Ring (e.g.
NuvaRing)
h. Diaphragm or
cervical cap
i. Condoms
j. The Shot (e.g.
Depo Provera)
k. Implant under the
skin (e.g. Norplant)
l. Contraceptive
patch (Ortho Evra)
m. Morning after
pill
n. None
o. I dont remember
or I am unsure
p. Other (please
describe)

13

FOURTH
TIME

FIFTH
TIME

SIXTH
TIME

28. If you answered None (meaning you were using NO birth control) for any of
the times you have gotten pregnant, please answer why you were not using birth
control at this time.
(Please mark the reason in the same column you answered None for above)
Reason for no Birth Control

FIRST
time

SECOND
time

1. I wanted to get pregnant.


2. I did not think I could get pregnant
at the time
3. I was not having sex, regularly.
4. I could not afford birth control.
5. I had my tubes tied.
6. I did not believe in birth control.
7. My partner did not want me to use
birth control.
8. I did not know how to get birth
control.
9. I did not know where to find out
about birth control
10. Other (please describe):

14

THIRD
time

FOURTH
time

FIFTH
time

SIXTH
time

29.

How many live births have you had?


0

IF 0 PLEASE SKIP AHEAD TO QUESTION 31


29. Please record your age at the birth of each child (e.g., if you circled 1 record
your age at the birth of the child, if you circled 2 record your age at the birth of
the first child as well as your age at the birth of the second child and so on).
29a. Age at first birth (record age in years): _____
29b. Age at second birth (record age in years):_____
29c. Age at third birth (record age in years): _____
29d. Age at fourth birth (record age in years):_____
29e. Age at fifth birth (record age in years): _____
29f. Age at sixth birth (record age in years): _____
30.
How did you know you were pregnant or how was this pregnancy
confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember
30a. Method of confirmation at first birth (choose 1-7 from above):______
30b. Method of confirmation at second birth (choose 1-7 from above):______
30c. Method of confirmation at third birth (choose 1-7 from above):______
30d Method of confirmation at fourth birth (choose 1-7 from above):______
30e. Method of confirmation at fifth birth (choose 1-7 from above):______
30f. Method of confirmation at sixth birth (choose 1-7 from above):______

15

6+

31. How many abortions have you had?


0

IF 0 SKIP AHEAD TO QUESTION 34.


32. Please record your age at each abortion (e.g., if you circled 1 record your age
at the first abortion, if you circled 2 record your age at the second abortion and
so on).
32a. Age at first abortion (record age in years):
32b. Age at second abortion (record age in years):
32c. Age at third abortion (record age in years):
32d. Age at fourth abortion (record age in years):
32e. Age at fifth abortion (record age in years):
32f. Age at sixth abortion (record age in years):

_____
_____
_____
_____
_____
_____

33.
How did you know you were pregnant or how was this pregnancy
confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember
33a. Method of confirmation at first abortion (choose 1-7 from above):______
33b. Method of confirmation at second abortion (choose 1-7 from above):______
33c. Method of confirmation at third abortion (choose 1-7 from above):______
33d. Method of confirmation at fourth abortion (choose 1-7 from above):______
33e. Method of confirmation at fifth abortion (choose 1-7 from above):______
33f. Method of confirmation at sixth abortion (choose 1-7 from above):______

16

6+

34. How many miscarriage or still births have you had?


0

6+

IF 0 SKIP TO QUESTION 36.


34. Please record your age at each miscarriage (e.g., if you circled 1 record your
age at the first miscarriage, if you circled 2 record your age at the second
miscarriage and so on).
34a. Age at first miscarriage (record age in years): _____
34b. Age at second miscarriage (record age in years):_____
34c. Age at third miscarriage (record age in years): _____
34d. Age at fourth miscarriage (record age in years):_____
34e. Age at fifth miscarriage (record age in years): _____
34f. Age at sixth miscarriage (record age in years):_____
35.
How did you know you were pregnant or how was this pregnancy
confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember

35a. Method of confirmation at first miscarriage (choose 1-7 from above):______


35b. Method of confirmation at second miscarriage (choose 1-7 from above):______
35c. Method of confirmation at third miscarriage (choose 1-7 from above):______
35d. Method of confirmation at fourth miscarriage (choose 1-7 from above):______
35e. Method of confirmation at fifth miscarriage (choose 1-7 from above):______
35f. Method of confirmation at sixth miscarriage (choose 1-7 from above):______

17

The following sets of questions are about Sexually


Transmitted Diseases (STDs):
36. Have you ever had Chlamydia?
0
never

1
time

2
times

3
times

4
times

5+
times

If NEVER SKIP TO QUESTION 37


36a. If 1 or greater:
How old were you when you first knew you had this? (record age in
years):_____
36b. If 2 or greater:
How old were you the last time you had this? (record age in years):

_____

36c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

37. Have you ever had Gonorrhea?


0
never

1
times

2
times

3
times

4
times

5+
times

If NEVER SKIP TO QUESTION 38


37a. If 1 or greater:
How old were you when you first knew you had this? (record age in
years):_____
37b. If 2 or greater:
How old were you the last time you had this? (record age in years):
37c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

18

_____

38. Have you ever had Syphilis?


0
never

1
time

2
times

3
times

4
times

5+
times

If NEVER SKIP TO QUESTION 39


38a. If 1 or greater:
How old were you when you first knew you had this? (record age in years):
_____
38b. If 2 or greater:
How old were you the last time you had this? (record age in years):

_____

38c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

39. Have you ever had Pelvic Inflammatory Disease (PID)?


0
never

1
time

2
times

3
times

4
times

5+
times

If NEVER SKIP TO QUESTION 40


39a. If 1 or greater:
How old were you when you first knew you had this? (record age in
years):_____
39b. If 2 or greater:
How old were you the last time you had this? (record age in years):
39c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

19

_____

40. Have you ever had Genital Warts:


1
YES

0
NO

If NO SKIP TO QUESTION 41

40a. If Yes:
How old were you when you first knew you had this? (record age in
years):_____

40b. If Yes:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

41. Have you ever had Genital Herpes:


1
YES

0
NO

If NO SKIP TO QUESTION 42

41a. If Yes:
How old were you when you first knew you had this? (record age in
years):_____

41b. If Yes:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

20

42. Have you been diagnosed with HIV:


1
YES

0
NO

If NO SKIP TO QUESTION 43

42a. If Yes:
How old were you when you first knew you had this? (record age in
years):_____

42b. If Yes:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

43. Have you ever had Fertility Problems:


1
YES

0
NO

If NO SKIP TO QUESTION 44

43a. If Yes:
How old were you when you first knew you had this? (record age in
years):_____

43b. If Yes:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
YES

0
NO

21

44. Have you ever had Hepatitis B or Hepatitis C:


1
YES

0
NO

If NO SKIP QUESTIONS 44a & 44b

44a. If Yes:
How old were you when you first knew you had this? (record age in
years):_____

44b. If Yes:
Have you ever received treatment from a doctor or a clinic for this
condition?
1
0
YES
NO

THE END

22

Sexual Attitudes and Activities Questionnaire (SAAQ)

Female V2.2
Female / English
RESEARCHER INDICATE THE FOLLOWING:
ID
FAMID
VISIT
Introduction:
In this section you will hear some questions having to do with your attitudes and feelings about sex and
your sexual behavior. For each question choose the answer that best represents how YOU feel or what
YOU do.
Your answers to these questions are strictly confidential. Your responses will go directly into the
computer and no one will ever know how you, personally answer these questions. Your name will
never be associated with any of your responses. The information that you provide is very valuable and
will help us understand how adolescents think and feel about sex so it is important that you answer
honestly and as accurately as possible.
In this section we are only interested in your behavior regarding consensual or voluntary sexual
experiences. When asked about sexual behavior, only report about situations when you agreed to
participate in sexual activity. Disregard any situations when sex was either forced on you or when you
did not give your full consent.
Now begin to answer all of the questions.

R1. Indicate the number of romantic partners with which you have done the following during the PAST
YEAR.
0
none,
never

1
1
partner

2
2 or 3
partners

3
4-7
partners

a. Gone out on unsupervised dates


b. Held hands
c. French or tongue kissing
d. Made out
e. Felt their private parts under clothing
f. Had your private parts felt under clothing
g. Given oral sex (mouth on private parts)
h. Received oral sex
i. Had sexual intercourse in a one night stand
j. Had sexual intercourse without contraceptionhad
unprotected sex
k. Had sexual intercourse while drunk on alcohol or
high on drugs

4
8-10
partners

5
more than 10
partners

_____
______
______
______
______
______
______
______

_____
______
______

R2. Indicate the number of romantic partners with which you have done the following during the YOUR
ENTIRE LIFETIME.
0
none,
never

1
1
partner

2
2 or 3
partners

3
4-7
partners

a. Gone out on unsupervised dates


b. Held hands
c. French or tongue kissing
d. Necked or made out
e. Felt their private parts under clothing
f. Had your private parts felt under clothing
g. Given oral sex (mouth on private parts)
h. Received oral sex
i. Had sexual intercourse in a one night stand
j. Had sexual intercourse without contraceptionhad
unprotected sex
k. Had sexual intercourse while drunk on alcohol or
high on drugs

R3.
0
Never

4
8-10
partners

5
more than 10
partners

_____
______
______
______
______
______
______
______

_____
______
______

How often do you find yourself thinking a lot about sex?


1
once or twice
every few months

2
about once
a month

3
about once
a week

4
several times
a week

5
several times
a day

R4.

Are you, or do you think you would be, turned on sexually by: (circle a number for each):

not at all
1

a little
2

some
3

a lot
4

R4b. Romantic Dancing

R4c. Romantic pictures in magazines or books

R4d. Movie or TV shows that have love scenes

R4e. Songs with romantic or sexy words

R4f. Dreams while you are sleeping

R4g. Women without clothes on

R4h. Men without clothes on

R4i. Fantasies or day dreams about sex

R4j. An attractive male

R4k. An attractive female

R4l. Literature (books/magazines) that tell stories


about sex or have sexual pictures

R4m. Websites that have sexual content

R4n. Chat rooms or websites where people chat about


sexual things.

R4a. Looking at your own body

very much
5

R5. Some people sometimes masturbate, or play with their private parts to have a good feeling. How
often have you done this? (circle one)
0
1
2
3
4
5
Never
once or twice
about once
about once
several times
almost every
every few months
a month
a week
a week
day

R6. In the last year how many times have you had voluntary sexual intercourse?
0
none,
never

1
1
time

2
2 or 3
times

3
4-7
times

4
8-10
times

5
more than 10
times

IF NEVER SKIP TO QUESTION #8.


R7. In the last year how many voluntary sexual intercourse partners have you had?
0
none,
never

1
1
partner

2
2 or 3
partners

3
4-7
partners

4
8-10
partners

5
more than 10
partners

R8. How many voluntary sexual intercourse partners have you had in your LIFETIME: (circle one):
0
none,
never

1
1
partner

2
2 or 3
partners

3
4-7
partners

4
8-10
partners

5
more than 10
partners

IF NEVER SKIP TO QUESTION 10. IF SUBJECT ANSWERS NEVER TO QUESTION 8,


THEY SHOULD ALSO SKIP 9, 15, 16, 21, 24A, 24C, 24D, 24H, 24I, 24J AND 24K.
R9. As best you can recall, how old were you the first time you had consensual intercourse?
01_younger than age 12
02__12 years-old
03_13 years-old
04_13 years-old
05_14 years-old
06__14 years-old

07_15 years-old
08_15 years-old
09_16 years-old
10_16 years-old
11_17 years-old
12_17 years-old

13__18 years-old
14_18 years-old
15_19 years-old
16_19 years-old
17_20 years-old
18_20 years-old

19_21 years or older

R10. How likely is it that you will have sexual intercourse with someone in the next year?
1
2
3
4
5

sure it wont happen


probably wont happen
even chance (50-50) it will happen
probably will happen
sure it will happen

R10a. How much do you think you would like to have sexual intercourse with someone in the next
year?
1
2
3
4
5

would dislike very much


would dislike a little
would neither like nor dislike
would like a little
would like very much

R11. If you were to have sexual intercourse with someone in the next year, how likely is it that you
would use birth control?
1
2
3
4
5

sure I wouldnt use it


probably I wouldnt use it
even chance (50-50) I would use it
probably I would use it
sure I would use it

R12. Please indicate whether or not you think your best friend has done each of the following with a
romantic partner.
1= definitely no
2= probably no
3= I dont really know
4= probably yes
5 = definitely yes
R12a. Gone out on unsupervised dates
_____
R12b. Held hands with a partner
______
R12c. French or tongue kissed a partner
______
R12d. Necked or made-out with a partner
______
______
R12e. Felt a partners private parts under clothes or without clothes
R12f. Had private parts felt under clothes or without clothes
______
R12g. Given oral sex (mouth on private parts)
______
______
R12h. Received oral sex (mouth on private parts)
R12i. Had sexual intercourse
______
R12j. Had sexual intercourse with more than one partner within a few weeks______
R12k. Had sexual intercourse in a one night stand
______
R12l. Had sexual intercourse while drunk or high on drugs
______
R12m. Had sexual intercourse without contraceptionhad unprotected sex______

str
on
gly

dis
agr
ee

dis
agr
ee
nei
the
ra
gre
en
agr
or
ee
dis
agr
ee
str
on
gly
agr
ee

R13. Choose the response that best represents how you think or feel:

R13a.Masturbation doesnt hurt you

R13b.It is OK for girls my age to do sexual things


because others expect them to

R13c. Sex is dirty.

R13d. Its okay for people my age to have sex

R13e. There is a lot of pressure to go further


in sexual activity than girls really want to

R13f. I wish there was no such thing


as sex.

R13g. I think about sex even when I don't want to.

R13h. I get frightened when I think about sex

R13i. I sometimes have sexual feelings when I see


people kiss on TV or movies

R13j. Thinking about sex upsets me

R13k. I hope I never have to think about sex again

R13l. I only have sex or plan to have sex with people


that I love.

R13m. Its okay for people my age to have more than


one sexual partner at a time

R13n. It is important for me to care about a person in


order to feel okay about having sex with them

def
init
el

yn
ot
pro
bab
ly n
ot
eve
nc
han
ce
pro
(50
-50
bab
)
ly y
e
s
def
init
ely
yes

R14. If you were to have sex next month with someone you know well, how likely do you think it is
that each thing would happen to you?

R14a. I would be embarrassed while having sex

R14b. I would lose the respect of my friends

R14c. I would feel more loved and wanted by the person

R14d. The person would like me more

R14e. I would lose respect for myself

R14f. I would worry about getting pregnant

R14g. It would show the person I liked them

R14h. It would hurt my health

R14i. I would gain the respect of my friends

R14j. I would feel more mature

R15.

Are you currently trying to get pregnant? (circle one):


0

NO

YES

IF YES PLEASE ANSWER THE FOLLOWING QUESTIONS WITH RESPECT TO A TIME


WHEN YOU WERE NOT TRYING TO GET PREGNANT. ** SUBJECTS WHO ANSWERED
NONE/NEVER TO QUESTION 8 WILL SKIP QUESTIONS 16.**
R16.

How often do you use birth control when you have sex? (circle one):
1
2
3
4
5
6

I never use birth control


I hardly ever use birth control when I have sex
sometimes I use birth control when I have sex, but not very often
I use birth control about half of the time I have sex
almost every time I have sex I use birth control
for sure every time I have sex I use birth control

R17. If you were to have sexual intercourse with someone in the near future, how likely is it that you
would use birth control? (circle one):
1
2
3
4
5

sure I wouldnt use it


probably I wouldnt use it
even chance (50-50) I would use it
probably I would use it
sure I would use it

R18. Indicate if you learned about birth control methods in any of the following ways:
Rate each in the following ways:
0 = NO, never learned this way
1 = YES learned this way but found it to be NOT VERY EFFECTIVE in teaching me about birth
control methods
2 = YES learned this way but found it to be ONLY SOMEWHAT EFFECTIVE in teaching me about
birth control methods
3 = YES learned this way and found it to be ADEQUATELY EFFECTIVE in teaching me about birth
control methods
4 = YES learned this way and found it to be VERY EFFECTIVE in teaching me about birth control
methods
R18a. _____ Learned from an older brother or sister
R18b. _____ Learned from my mother (or mother figure)
R18c. _____ Learned from my father (or father figure)
R18d. _____ Learned from another relative (Aunt, Uncle, Cousin, Grandparent)
R18e. _____ Learned from a friend
R18f. _____ Learned from a boyfriend or romantic partner
R18g. _____ Learned from my Doctor
R18h. _____ Learned in a program at my school
R18i. _____ Learned on my own
R18j. _____ Other explain:__________________

R19. Please rate the following methods of birth control methods according to your preference for each
type of birth control?
Not
Preferred
0
1

Somewhat
Preferred
2
3

0
0
0
0
0

1
1
1
1
1

2
2
2
2
2

3
3
3
3
3

4
4
4
4
4

Most
Preferred
5
R19a. Rhythm methodtiming when I have sex
according to where I am in my menstrual
cycle
5
R19b. Make sure the other person pulls out
in time
5
R19c. Birth control pills
5
R19d. sponge
5
R19e. Spermicides and/or creams or foams
5
R19f. Intrauterine device (e.g. IUD, coil, loop)
5
R19g. Monthly vagina ring, The Ring (e.g.
NuvaRing)

0
0
0
0
0
0
0
0

1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2

3
3
3
3
3
3
3
3

4
4
4
4
4
4
4
4

5
5
5
5
5
5
5
5

R19h.Diaphragm or cervical cap


R19i. Condoms
R19j. The Shot (e.g. Depo Provera)
R19k. Implant under the skin (e.g. Norplant)
R19l. Contraceptive patch (e.g. Ortho Evra)
R19m. Morning after pill
R19n. None
R19o. Other (explain):_________________

ONLY SUBJECTS WHO ANSWERED NONE, NEVER FOR QUESTION #8 SHOULD


ANSWER QUESTION #20.

R20. Please rate how likely you are to use the following methods of birth control if you choose to have
sexual intercourse in the future.

Least
Likely
0

Somewhat
Likely
2
3

Most
Likely
4

0
0
0
0

1
1
1
1

2
2
2
2

3
3
3
3

4
4
4
4

0
0
0

1
1
1

2
2
2

3
3
3

4
4
4

0
0
0
0

1
1
1
1

2
2
2
2

3
3
3
3

4
4
4
4

R20a. Rhythm methodtiming when I have


sex according to where I am in my menstrual
cycle
R20b. Make sure the other person pulls out
in time
R20c. Birth control pills
R20d. Sponge
R20e. Spermicides and/or creams or foams
R20f. Intrauterine device (e.g. IUD, coil,
loop)
R20g. Monthly vaginal ring, The Ring
(e.g. NuvaRing)
R20h. Diaphragm or cervical cap
R20i. Condoms
R20j. The Shot (e.g. Depo Provera)
R20k. Implant under the
skin. (e.g. Norplant)
R20l. Contraceptive patch (e.g. Ortho Evra)
R20m. Morning after pill
R20n. None
R20o. Other (explain):_________________

SUBJECTS WHO ANSWERED NONE/NEVER FOR QUESTION # 8 SHOULD SKIP


QUESTION #21.

R21.

What types or types of birth control did you use the LAST time you had sexual intercourse?

1
0
YES NO
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____
____ ____

R21a. Rhythm methodtiming when I have sex according to where I


am in my menstrual cycle
R21b. Make sure the other person pulls out in time
R21c. Birth control pills
R21d. Sponge
R21e. Spermicides and/or creams or foams
R21f. Intrauterine device (e.g. IUD, coil, loop)
R21g. Monthly vaginal ring, The Ring (e.g. NuvaRing)
R21h. Diaphragm or cervical cap
R21i. Condoms
R21j. The Shot (e.g. Depo Provera)
R21k. Implant under the skin (e.g. Norplant)
R21l. Contraceptive patch (Ortho Evra)
R21m. Morning after pill
R21n. none
R21o. I dont remember or I am unsure
R21p. other (explain):________________________________________

R22. How confident are you that your preferred method(s) of birth control would be effective at
preventing pregnancy?
0
not at all
confident

1
a little
confident

2
in between

3
somewhat
confident

4
very
confident

R23. How confident are you that your preferred the method(s) of birth control would be effective at
preventing the spread of sexually transmitted diseases?
0
not at all
confident

1
a little
confident

2
in between

3
somewhat
confident

4
very
confident

R24. Have you ever:


1
0
YES NO
____ ____ R24a. had sexual intercourse without a condom ** (Subjects who answered
NONE/NEVER to question 8 will skip this question)
____ ____ R24b. engaged in oral sex without a condom or dental dam
____ ____ R24c. had a condom fall off or break during sexual intercourse ** (Subjects who
answered NONE/NEVER to question 8 will skip this question)
____ ____ R24d. had sexual intercourse or oral sex with an intravenous (IV) drug user ** (Subjects
who answered NONE/NEVER to question 8 will skip this question)

____ ____ R24e. used intravenous (IV) drugs (e.g., injected heroine)
____ ____ R24f. shared hypodermic needles with others
____ ____ R24g. had sexual intercourse or oral sex with someone who is bisexual
____ ____ R24h. had sexual intercourse with a homosexual male ** (Subjects who answered
NONE/NEVER to question 8 will skip this question)
____ ____ R24i. had sexual intercourse with someone who was also sexually involved with
others during that same period ** (Subjects who answered NONE/NEVER to question 8 will
skip this question)
____ ____ R24j. had sexual intercourse in a one night stand relationship ** (Subjects who
answered NONE/NEVER to question 8 will skip this question)
____ ____ R24k. had sexual intercourse while drunk on alcohol or high on drugs may want to
separate out ** (Subjects who answered NONE/NEVER to question 8 will skip this question)

R25.
0
NO

Have you ever been pregnant?


1
YES

IF YES GO TO QUESTION 26.


IF NO SKIP TO QUESTION 36.
R26.

How many times have you been pregnant?


1
1

2
2

3
3

4
4

5
5

6+
6

R27. What type or types of birth control were you using when you conceived the
(If you have only been pregnant once, just fill out the first column, if youve been pregnant twice, please fill out

the first column for the first pregnancy and the second column for the second pregnancy, and so on.)
Please make a mark or a check in the box(es) that apply, you may mark more than one.
Type of Birth Control
a. Rhythm method
timing when I have sex
according to where I am
in my menstrual cycle
b. Make sure the other
person pulls out in time

FIRST
TIME

SECOND
TIME

THIRD
TIME

FOURTH
TIME

FIFTH
TIME

SIXTH
TIME

R271a

R272a

R273a

R274a

R275a

R276a

R271b

R272b

R273b

R274b

R275b

R276b

R271c

R272c

R273c

R274c

R275c

R276c

R271d

R272d

R273d

R274d

R275d

R276d

R271e

R272e

R273e

R274e

R275e

R276e

R271f

R272f

R273f

R274f

R275f

R276f

g. Monthly vaginal ring,


The Ring (e.g.
NuvaRing)

R271g

R272g

R273g

R274g

R275g

R276g

h. Diaphragm or cervical
cap
i. Condoms

R271h

R272h

R273h

R274h

R275h

R276h

R271i

R272i

R273i

R274i

R275i

R276i

R271j

R272j

R273j

R274j

R275j

R276j

R271k

R272k

R273k

R274k

R275k

R276k

R271l
R271m

R272l
R272m

R273l
R273m

R274l
R274m

R275l
R275m

R276l
R276m

n. None

R271n

R272n

R273n

R274n

R275n

R276n

o. I dont remember or I
am unsure
p. Other (please describe)

R271o

R272o

R273o

R274o

R275o

R276o

R271p

R272p

R273p

R274p

R275p

276p

c. Birth control pills


d. Sponge
e. Spermicides and/or
creams or foams
f. Intrauterine device
(e.g. IUD, coil, loop)

j. The Shot (e.g. Depo


Provera)
k. Implant under the skin
(e.g. Norplant)
l. Contraceptive patch
(Ortho Evra)
m. Morning after pill

R28. If you answered None (meaning you were using NO birth control) for any of the times you
have gotten pregnant, please answer why you were not using birth control at this time.
(Please mark the reason in the same column you answered None for above)
Reason for no Birth Control

FIRST
time

SECOND
time

R281a
R281b

R282a
R282b

R281c

R282c

THIRD
time

FOURTH
time

FIFTH
time

SIXTH
time

a. I wanted to get pregnant.


b. I did not think I could get pregnant at the
time
c. I was not having sex, regularly.

R283a
R283b

R284a
R284b

R285a
R285b

R286a
R286b

R283c

R284c

R285c

R286c

d. I could not afford birth control.


R281d

R282d

R283d

R284d

R285d

R286d

R281e

R282e

R283e

R284e

R285e

R286e

R281f

R282f

R283f

R284f

R285f

R286f

R281g

R282g

R283g

R284g

R285g

R286g

R281h

R282h

R283h

R284h

R285h

R286h

R281i

R282i

R283i

R284i

R285i

R286i

R281j

R282j

R283j

R284j

R285j

R286j

e. I had my tubes tied.


f. I did not believe in birth control.
g. My partner did not want me to use birth
control.
h. I did not know how to get birth control.
i. I did not know where to find out about birth
control
j. Other (please describe):

R29. How many live births have you had?


0
0

1
1

2
2

3
3

4
4

5
5

6+
6

R29. Please record your age at the birth of each child (e.g., if you circled 1 record your
age at the birth of the child, if you circled 2 record your age at the birth of the first child
as well as your age at the birth of the second child and so on).
R29a. Age at first birth (record age in years): _____
R29b. Age at second birth (record age in years):_____
R29c. Age at third birth (record age in years): _____
R29d. Age at fourth birth (record age in years):_____
R29e. Age at fifth birth (record age in years): _____
R29f. Age at sixth birth (record age in years):____

R30.

How did you know you were pregnant or how was this pregnancy confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember

R30a. Method of confirmation at first birth (choose 1-7 from above):______


R30b. Method of confirmation at second birth(choose 1-7 from above):______
R30c. Method of confirmation at third birth (choose 1-7 from above):______
R30d Method of confirmation at fourth birth (choose 1-7 from above):______
R30e. Method of confirmation at fifth birth (choose 1-7 from above):______
R30f. Method of confirmation at sixth birth (choose 1-7 from above):______

R31.

How many abortions have you had?


0
0

1
1

2
2

3
3

4
4

5
5

6+
6

IF 0 SKIP TO QUESTION 34.


R32. Please record your age at each abortion (e.g., if you circled 1 record your age at the
first abortion, if you circled 2 record your age at the second abortion and so on).
R32a. Age at first abortion (record age in years): _____
R32b. Age at second abortion (record age in years):_____
R32c. Age at third abortion (record age in years): _____
R32d. Age at fourth abortion (record age in years):_____
R32e. Age at fifth abortion (record age in years): _____
R32f. Age at sixth abortion (record age in years):_____
R33.

How did you know you were pregnant or how was this pregnancy confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember

R33a. Method of confirmation at first abortion (choose 1-7 from above):______


R33b. Method of confirmation at second abortion(choose 1-7 from above):______
R33c. Method of confirmation at third abortion (choose 1-7 from above):______
R33d. Method of confirmation at fourth abortion (choose 1-7 from above):______
R33e. Method of confirmation at fifth abortion (choose 1-7 from above):______
R33f. Method of confirmation at sixth abortion (choose 1-7 from above):______

R34.

How many miscarriage or still births have you had?


0
0

1
1

2
2

3
3

4
4

5
5

6+
6

IF 0 SKIP TO QUESTION 36.


R34. Please record your age at each miscarriage (e.g., if you circled 1 record your age at
the first miscarriage, if you circled 2 record your age at the second miscarriage and so
on).
R34a. Age at first miscarriage (record age in years): _____
R34b. Age at second miscarriage (record age in years):_____
R34c. Age at third miscarriage (record age in years): _____
R34d. Age at fourth miscarriage (record age in years):_____
R34e. Age at fifth miscarriage (record age in years): _____
R34f. Age at sixth miscarriage (record age in years):_____
R35.

How did you know you were pregnant or how was this pregnancy confirmed?
1= I missed my period.
2= I felt ill.
3= I took an over-the-counter pregnancy test.
4= The pregnancy was confirmed by a doctor.
5= Other: explain ____________________.
6= The pregnancy was never formally confirmed.
7= I dont know/dont remember

R35a. Method of confirmation at first miscarriage (choose 1-7 from above):______


R35b. Method of confirmation at second miscarriage(choose 1-7 from above):______
R35c. Method of confirmation at third miscarriage (choose 1-7 from above):______
R35d. Method of confirmation at fourth miscarriage (choose 1-7 from above):______
R35e. Method of confirmation at fifth miscarriage (choose 1-7 from above):______
R35f. Method of confirmation at sixth miscarriage (choose 1-7 from above):______

R36. Have you ever had Chlamydia?


0
never

1
1
time

2
2
times

3
3
times

4
4
times

5
5+
times

If NEVER SKIP TO QUESTION 37


R36a. If 1 or greater:
How old were you when you first knew you had this? (record age in years):
_____
R36b. If 2 or greater:
How old were you the last time you had this? (record age in years): _____
R36c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R37. Have you ever had Gonorrhea?


0
never

1
1
time

2
2
times

3
3
times

4
4
times

5
5+
times

If NEVER SKIP TO QUESTION 38


R37a. If 1 or greater:
How old were you when you first knew you had this? (record age in years):
_____
R37b. If 2 or greater:
How old were you the last time you had this? (record age in years): _____
R37c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R38. Have you ever had Syphilis?


0
never

1
1
time

2
2
times

3
3
times

4
4
times

5
5+
times

If NEVER SKIP TO QUESTION 39


R38a. If 1 or greater:
How old were you when you first knew you had this? (record age in years):
_____
R38b. If 2 or greater:
How old were you the last time you had this? (record age in years): _____
R38c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R39. Have you ever had Pelvic Inflammatory Disease (PID)?


0
never

1
1
time

2
2
times

3
3
times

4
4
times

5
5+
times

If NEVER SKIP TO QUESTION 40


R39a. If 1 or greater:
How old were you when you first knew you had this? (record age in years):
_____
R39b. If 2 or greater:
How old were you the last time you had this? (record age in years): _____
R39c. If 1 or greater:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R40. Have you ever had Genital Warts:


1
YES

0
NO

If NO SKIP TO QUESTION 41

R40a. If Yes:
How old were you when you first knew you had this? (record age in years):
_____
R40b. If Yes:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R41. Have you ever had Genital Herpes:


1
YES

0
NO

If NO SKIP TO QUESTION 42

R41a. If Yes:
How old were you when you first knew you had this? (record age in years):
_____
R41b. If Yes:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R42. Have you been diagnosed with HIV:


1
YES

0
NO

If NO SKIP TO QUESTION 43

R42a. If Yes:
How old were you when you first knew you had this? (record age in years):
_____
R42b. If Yes:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R43. Have you ever had Fertility Problems:


1
YES

0
NO

If NO SKIP TO QUESTION 44

R43a. If Yes:
How old were you when you first knew you had this? (record age in years):
_____
R43b. If Yes:
Have you ever received treatment from a doctor or a clinic for this condition?
1
YES

0
NO

R44. Have you ever had Hepatitis B or Hepatitis C:


1
YES

0
NO If NO SKIP QUESTIONS 44a & 44b

R44a. If Yes:
How old were you when you first knew you had this? (record age in years):
_____
R44b. If Yes:
Have you ever received treatment from a doctor or a clinic for this condition?
1
0
YES
NO

THE END

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