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1SupplementalfileCHERRIEScriteriaandadditionaldetailsforGermanMSMonlinesurvey2013(SMA2013)ContentCHERRIEScriteriaforSMA2013onlinesurveypage1-4AnnexI:Entrypageoftheonlinequestionnairepage5-6AnnexII:Invitationmailformenwithaprofileonplanetromeo.
compage7DetailsonScalesandothersurveymeasurespage8-9CHERRIEScriteriaforSMA2013DesignThesurveywasdesignedasanationwide,anonymousonline-surveytargetingMSM.
Participantswererecruitedforthesurveythroughprivatemessagesandbannersonseveralsocialnetworkinganddatingsitesforgaymen.
PrivatemessagesweresenttoallsitemembershavingaprofileinGermanlanguageandresidinginGermany.
Thustheresultingsamplewasaconveniencesample.
IRB(InstitutionalReviewBoard)approvalandinformedconsentprocessTheonlinesurveyprotocolwasevaluatedandapprovedbytheethicalreviewboardoftheCharitéUniversityClinicinBerlin(EA1/266/13).
InformedconsentThesurvey'sentrysitecontainedinformationaboutwhotheinvestigatorwas,thegoalsandcontentsofthesurvey,termsofparticipation,dataprivacy,andapproximatelengthoftimeofthesurvey.
Byclickingonabutton"Ihavereadandunderstoodtheinformationabove"theparticipantgavehisinformedconsentandwasreferredtotheonlinequestionnaire(fortheinformationincludedontheentrysiteseeAnnexI).
DataprotectionWedidnotcollectanypersonaldatawhichwouldallowtheidentificationofparticipants.
SeveralsuggestionsbythedataprotectionofficeofthefederalstateofBerlintoimprovedataprotectionforsurveyparticipantswereimplemented.
Developmentandpre-testingThequestionnairewasdevelopedbyusingitemsofformerGermansurveyswiththispopulation.
Thequestionnaireusedquestionsfromthe2010EuropeanMSMInternetsurvey(www.
emis-project.
eu)asmuchaspossible.
Severalnewquestionsandscaleswereincluded.
Expertsandstakeholdersofthetargetgroupwereaskedtoevaluatethequestionnaire.
Thesurvey2wasinformallypretestedfortechnicalfunctionality,usabilityandwordingwithmembersofthetargetpopulation.
RecruitmentprocessanddescriptionofthesamplehavingaccesstothequestionnaireAdvertisingthesurveyThesurveywasannouncedonseveralhomepages(datingsitesandnewssites)directedatthetargetpopulation.
Onmosthomepagesabannerortextswereprovidedwithalinktothequestionnaire.
OnelargedatingsiteforMSM(planetromeo.
com;numberofactiveprofilesinGermanyasofMarch18,2015:433,781.
Morethanoneprofileperpersonispossible.
EstimatednumberofMSMaged15-64yearslivinginGermanyasof2010:approximately656,000[MarcusU,etal.
EstimatingthesizeoftheMSMpopulationsfor38Europeancountriesbycalculatingthesurveysurveillancediscrepancies(SSD)betweenself-reportednewHIVdiagnosesfromtheEuropeanMSMinternetsurvey(EMIS)andsurveillancereportedHIVdiagnosesamongMSMin2009.
BMCPublicHealth2013,13:919http://www.
biomedcentral.
com/1471-2458/13/919])sentoutamessagetoeveryGermanmemberwithalinktothequestionnaireaskingthememberstoparticipateinthesurvey(forthewordingofthemessageseeAnnexII).
Thesurveywasannouncedonplanetromeo.
cominatime-staggeredmanner(eightbatches,~50,000profileseach),originallywiththeintentiontopreventexcessivedemandforfreetestingatthecooperatingtestingsites,wherefreetestvouchersofferedattheendofthequestionnairecouldbeused.
Duetothelowerthanexpecteddemandthisturnedouttobeunnecessary.
However,unexpectedlythecapacityoftheserverofthesurveywebsitewasnotsufficienttomanagethedemand,sothatlongwaitingtimesforusersresultedandonsomeofthefirstdaysthesurveywaspracticallydysfunctional.
Thesurveywasnotspecificallyadaptedforsmartphoneusers.
Themainrecruitmentwebsiteofferstraditionalonlinewebsitesaswellasagps-basedsmartphoneapptomanageuserprofiles.
Bothtypesofclientswereinvitedtoparticipateinthesurvey,however,thelackofsmartphone-adaptationwasmentionedintheinvitationmail.
Duetothelackofsmartphoneadaptationandthetechnicalserverproblemsitisverylikelythatthesurveywasfilledinpreferentiallywithapersonalcomputeronlineinsteadbysmartphone.
Comparedwiththepreviousonlinesurvey(EMIS2010)youngeragegroups(25-35years)werelesswellrepresentedamongrespondents,whichmaybeduetothehigherfrequencyofapp-useinthisagegroup.
SurveyadministrationThesurveywasaWeb-basedsurveywhichwasfilledinonline.
Responseswereautomaticallycapturedanddirectlystoredinadatabase.
ContextSeeabove.
Mandatory/voluntaryParticipationinthesurveywasvoluntary.
IncentivesNoincentiveswereoffered.
Time/DateDatawerecollectedbetweenNovember2013andJanuary20143RandomizationofitemsorquestionnairesRandomizationoralternatingofitemswasnotused.
AdaptivequestioningAdaptivequestioningwasusedthroughoutthequestionnairetoreducenumberandcomplexityofthequestions.
E.
g.
separatequestionswereaskedtorespondentswhoindicatedthattheyhadreceivedanHIVdiagnosisandthosewhodidn't.
NumberofItemsandscreens(pages)Thequestionnaireincluded344itemsand218questions,presentedonlineonapproximately100pages.
Duetotheadaptivedesignofthequestionnairetheactualnumberofpagesthatwereseenbyanaveragerespondentwasmuchless.
CompletenesscheckNoconsistencyorcompletenesscheckwasimplementedbeforethequestionnairewassubmitted.
Severalquestions(e.
g.
gender,age,HIVtest,etc.
)wereregardedasespeciallyimportant.
Incasetherespondentdidn'tansweroneofthesequestions,theywereremindedusingapop-upwindow,toanswerthisquestion.
Iftherespondentstillwasnotwillingtoanswerthequestionhewasabletocontinuethequestionnaire.
ReviewstepRespondentswereabletochangeanswersonpreviouspagesusingaBackbutton.
ResponseratesUniquesitevisitors:NoIPaddresseswerestoredandnocookieswereused.
Foreverynewfirstpagevisitorauniquecodewasgenerated.
Thetotalnumberofcodesgeneratedwas51,277.
However,asmentionedabove,thesurveypagewasatcertaintimesdysfunctional,whichmayhaveresultedinimmediatediscontinuationandlaterre-startofthesurvey.
Thefirstsurveyquestionwasansweredby27,337respondents;thelastsetofquestionswasansweredby14,392respondents.
DuetothedecisionnottostoreIPaddressesandnottousecookies,incombinationwiththetechnicaldifficultiesduringtheimplementationofthesurveyitisnotpossibletogivemeaningfulnumbersfortheviewrateandtheparticipationrate.
Thecompletionratecanbecalculatedas14,329/27,337=52%PreventingmultipleentriesfromthesameindividualNotechnicaltoolssuchascookieswereusedtopreventmultipleentriesfromthesameindividual.
However,duetothelengthofthequestionnaire,technicalcapacityproblemsonthesurveywebsitewhichresultedinlongerwaitingtimesbetweenscreensfurtherprolongingthetimeneededtofillinthequestionnaire,andthelackofanymaterialincentives,wethinkitishighlyunlikelythatindividualsfilledinthequestionnairemorethanonce.
Itishoweverpossiblethatrespondentsinterruptedfillinginthequestionnaireanddecidedtorestartatalatertimepoint.
Topreventusingsuchpossiblemultipleentriesfromthesameindividual,thefinaldatasetwasrestrictedtoquestionnairesinwhichatleastthequestionsregardinggender,age,country,sexualorientationandHIVtestingbehaviourwereanswered.
Theserepresentthefirstapproximately104pagescreens,andsurveysectionswhichdidnotincludeadaptivequestions(27,337respondentsansweredthefirstquestionongender;19,630respondentsansweredthequestiononHIVtesting).
IPcheckNoIPaddressesoftheclientcomputerwereusedtoidentifypotentialduplicateentriesfromthesameuser.
LogfileanalysisNoothertechniquestoanalyzethelogfileforidentificationofmultipleentrieswereused.
AnalysisIncompletequestionnaireswerealsoanalysedwhenquestionsregardinggender,age,country,sexualorientationandHIVtestingbehaviourwereanswered.
QuestionnairessubmittedwithanatypicaltimestampTimetofilloutthequestionnairewasnotusedasanexclusioncriterion.
StatisticalcorrectionNoweightingofitemsorpropensityscoreshavebeenusedtoadjustforthenon-representativesample.
5AnnexI:EntrypageoftheonlinequestionnaireSubscriberinformationWelcometothesurvey!
Pleasetakepartinthissurveyifyou.
.
.
areagaymanand/orareamanwhofeelsattractedtomenand/orareamanwhohassexwithmenandareatleast16yearsold.
Wewanttoknowit!
Thissurvey,thestudy"GayMenandHIV/AIDS2013"referstothesexyouhave,yourknowledgeandattitudestoHIVpreventionandHIVtestingandyourlifeasagayman,oramanwhohassexwithmen,andhowyouaredealingwithHIVandothersexuallytransmittedinfections.
Thequestionnairewilltakeapproximately30minutes.
PrivacyPolicyParticipationisanonymous.
WeguaranteethatwewillnotsaveyourIPaddressorcollectinformationaboutyouthatcouldenableyouridentificationbythirdparties.
FornotesonthesafeuseofPCs,pleaserefertowww.
bsi.
de.
Replyingtothequestionnaireisvoluntaryandcanbecancelledatanytime,withoutanydisadvantagesforyou.
Moreinformationaboutobjectivesofthisstudycanbefoundfurtherdownonthispage.
Herewego!
Startthequestionnairebyclickingonthefollowingbutton:[Button]FormoreinformationonthisstudyWearepsychologistsandhealthscientistsoftheFreeUniversityBerlin.
ThisstudyhasbeenfinancedbytheFederalCentreforHealthEducation(BZgA).
Forquestions,commentsorsuggestionsaboutthestudypleasecontactusatthee-mailaddressmsm@zedat.
fu-berlin.
deGoalsTheprimaryobjectiveofthissurveyistoobtaincurrentinformationabouthowgayandothermenwhohavesexwithmen(MSM)aredealingandlivingwithHIV/AIDSandothersexuallytransmittedinfections(STI).
Thecollectedanswerswillallowanassessmentoftheextenttowhichyouandthe6otherparticipantsprotectthemselves,butalsowhatrisksyouarewillingtotake.
Questionsabouttheuseofpreventiveservices,andknowledgeaboutprogressinthetreatabilityofHIV,willalsoallowtoassessinformationneedsandtobetteraddresstheseissuesinHIVprevention.
InadditiontothesepointsthegenerallifesituationofgayandothermenwhohavesexwithmenlivinginGermanyisanimportantpartofthissurvey.
Inadditiontodealingwithdiscriminationagainsthomosexuality,mentalwell-beingisdiscussedinthissurveyforthefirsttime.
Wewanttoinvestigatewhetherandwhygayandbisexualmenaremorefrequentlyaffectedbypsychologicalstress.
Also,theuseofpsychoactivesubstances(alcoholanddrugs)willbeinvestigated.
WhathappenstoyourdataTakingintoaccountthelegalrequirementsofdataprotectionwewillevaluateyourinformationtogetherwiththatoftheotherparticipantstopreparescientificpublicationsforaspecialistaudience.
Inthiswaywecreatetheconditionsthatyourinformationcanbeincludedintheoptimizationofpreventionservicesforgaymenandothermenwhohavesexwithmen.
Thecentralresultsofthissurveycanbeexpectedtobecomeavailablebyautumn2014,accessibleonwww.
sma2013.
de.
ThisstudywasreviewedbytheethicscommitteeoftheCharitéBerlin,whichconfirmedtheethicalacceptabilityofthisstudy.
TheDataProtectionOfficeroftheStateofBerlinhasexaminedthecompliancewithdataprotectionandhissuggestionsforchangeshavebeenimplemented.
7AnnexII:Invitationmailformenwithaprofileonplanetromeo.
comHello,Wewouldliketoinviteyoutoparticipateinasurveyofgayandothermenwhohavesexwithmen.
Thissurveydealswithyourlife,yoursexandyourrelationships,yourknowledgeandattitudestorecentdevelopmentsinHIV/AIDS,andhowyouaredealingwithHIVandothersexuallytransmittedinfections.
Thissurveyisdoneanonymouslyandtakesabout30minutes.
Thesurveyisnotoptimizedforfillinginonsmartphones.
(Nowstartwiththequestionnaire!
)Yourparticipationinthissurveycannotonlyhelptoensurethatyoulearnsomethingnew.
Throughyourparticipation,youalsosupportthepreventionofHIVandothersexuallytransmitteddiseasesamonggayandothermenwhohavesexwithmeninGermany.
Theresultsofthestudyaredirectlyfeedingintothispreventionwork.
Inthiswaythepreventionmaytakeyourneedsbetterintoconsideration.
Formoreinformationaboutthisstudy,pleasegotothehomepageofthequestionnaire.
Yourexperiencesandyourvisionareimportanttous.
Wewouldthereforebeveryhappyifyouparticipateinthissurvey:Clickhereforthequestionnaire!
8ScalesandothermeasuresThequestionnaireincludedtwonewad-hocscalesdescribingHIV-relatedstigmaoftherespondentsandanticipatedstigmaincaseofbeingdiagnosedwithHIVandthevalidatedinternalizedhomonegativityscale.
1)HIV-stigmascale.
Question:HowwouldyoudealwithpeoplewhogotinfectedwithHIVThisscaleisanadhocscalewhichconsistsofsixitems:(1)Iwouldn'tkisssomebodyonthelipswhoisHIVpositive(2)Idon'wanttohavedirectcontactwithsomebodywhoisHIVpositive(3)Ican'timaginetohaveanHIVpositivesteadypartner(4)SomeonewhonowadaysstillgetsinfectedwithHIVmustbestupid(5)SomebodywhonowadaysstillgetsinfectedwithHIVhasdeservedit(6)HIVpositivepersonsareirresponsible[4pointdisagree–agreescale]Forthecalculationofthescale-valueallitemswerecoded,summed-up,anddividedbythenumberofitems.
Ifanyoftheitemswasmissing,thescale-valuewassettomissing.
Scalevaluescouldbebetween1and4,withhigherscalevaluesrepresentingmorestigmatisingattitudes.
2)AnticipatedStigma.
Question:HowlikelyisitfromyourpointofviewthatoneofthefollowingthingswillhappentoyouifyouwouldbecomeinfectedwithHIVThisscaleisanadhocscaleaswellwhichconsistsofsixitems:(1)FriendsandacquaintanceswouldthinkIfailed(2)Friendsandacquaintanceswouldblamemeforgettinginfected(3)Myfamilywouldfeeldisappointedaboutme(4)Potentialsexpartnerswouldrejectme(5)Familymembersandfriendswouldavoidme(6)Iwouldgetproblemswithmyjob(withmyeducation)Forthecalculationofthescale-valueallitemswerecoded,summed-up,anddividedbythenumberofitems.
Ifanyoftheitemswasmissing,thescale-valuewassettomissing.
Scalevaluescouldbebetween1and4,withhigherscalevaluesrepresentingmorestigmatisingattitudes.
[4pointlikely–unlikelyscale]93)InternalizedHomonegativityScalewith8items,firstitemwasleftout.
Maximumonemissingitemwasallowed.
Theoption"doesnotapplyforme"wassettomissingbeforecalculatingthescale.
(1)Obviouslyeffeminatehomosexualmenmakemefeeluncomfortable.
(2)Ifeelcomfortableingaybars.
(3)Socialsituationswithgaymenmakemefeeluncomfortable.
(4)Ifeelcomfortablebeingseeninpublicwithanobviouslygayperson.
(5)Ifeelcomfortablediscussinghomosexualityinapublicsituation.
(6)Ifeelcomfortablebeingahomosexualman.
(7)Homosexualityismorallyacceptabletome.
(8)EvenifIcouldchangemysexualorientation,Iwouldn't.
[7pointdisagree-agreewithdoesnotapply]Higherscalevaluesrepresentinghigherinternalizedhomonegativity.
4)SubcultureinvolvementGaysubcultureinvolvementwasassessedbyaquestionaskingforthefrequencyofvisitingvenuessuchas(1)gaycommunitycentres,gaysocialgroups,(2)cafes,bars,(3)discothequesordanceclubs(1-3summarizedassocialvenues),(4)barswithdarkrooms,sex-clubs,publicsexparties,(5)privatesexparties,(6)gaysaunas,porncinemas,(7)othercruisingsitessuchasparksorpublictoilets(4-7summarizedassexvenues),and(8)chatordatingwebsitesoruseofsmartphoneappstomeetnewpartners.
Frequencyoptionsofvisitingthesevenuesinthelast12monthsoptionswereseveraltimesperweek,severaltimespermonth,severaltimesperyear,lessfrequent,andnever.
Foranalysis,frequenciesofvisitstophysicalvenues(1-7)weredichotomizedasfrequentifvisitswerereportedseveraltimespermonthormoreoften,andthethreeotheroptionsweresummarizedasinfrequent/never.
Ifanyofthevenues1-3wasvisitedfrequently,thiswasdefinedas'frequentlyvisitingsocialvenues',ifanyofthevenues4-7wasvisitedfrequently,thiswasdefinedas'frequentlyvisitingsexvenues'.
compage7DetailsonScalesandothersurveymeasurespage8-9CHERRIEScriteriaforSMA2013DesignThesurveywasdesignedasanationwide,anonymousonline-surveytargetingMSM.
Participantswererecruitedforthesurveythroughprivatemessagesandbannersonseveralsocialnetworkinganddatingsitesforgaymen.
PrivatemessagesweresenttoallsitemembershavingaprofileinGermanlanguageandresidinginGermany.
Thustheresultingsamplewasaconveniencesample.
IRB(InstitutionalReviewBoard)approvalandinformedconsentprocessTheonlinesurveyprotocolwasevaluatedandapprovedbytheethicalreviewboardoftheCharitéUniversityClinicinBerlin(EA1/266/13).
InformedconsentThesurvey'sentrysitecontainedinformationaboutwhotheinvestigatorwas,thegoalsandcontentsofthesurvey,termsofparticipation,dataprivacy,andapproximatelengthoftimeofthesurvey.
Byclickingonabutton"Ihavereadandunderstoodtheinformationabove"theparticipantgavehisinformedconsentandwasreferredtotheonlinequestionnaire(fortheinformationincludedontheentrysiteseeAnnexI).
DataprotectionWedidnotcollectanypersonaldatawhichwouldallowtheidentificationofparticipants.
SeveralsuggestionsbythedataprotectionofficeofthefederalstateofBerlintoimprovedataprotectionforsurveyparticipantswereimplemented.
Developmentandpre-testingThequestionnairewasdevelopedbyusingitemsofformerGermansurveyswiththispopulation.
Thequestionnaireusedquestionsfromthe2010EuropeanMSMInternetsurvey(www.
emis-project.
eu)asmuchaspossible.
Severalnewquestionsandscaleswereincluded.
Expertsandstakeholdersofthetargetgroupwereaskedtoevaluatethequestionnaire.
Thesurvey2wasinformallypretestedfortechnicalfunctionality,usabilityandwordingwithmembersofthetargetpopulation.
RecruitmentprocessanddescriptionofthesamplehavingaccesstothequestionnaireAdvertisingthesurveyThesurveywasannouncedonseveralhomepages(datingsitesandnewssites)directedatthetargetpopulation.
Onmosthomepagesabannerortextswereprovidedwithalinktothequestionnaire.
OnelargedatingsiteforMSM(planetromeo.
com;numberofactiveprofilesinGermanyasofMarch18,2015:433,781.
Morethanoneprofileperpersonispossible.
EstimatednumberofMSMaged15-64yearslivinginGermanyasof2010:approximately656,000[MarcusU,etal.
EstimatingthesizeoftheMSMpopulationsfor38Europeancountriesbycalculatingthesurveysurveillancediscrepancies(SSD)betweenself-reportednewHIVdiagnosesfromtheEuropeanMSMinternetsurvey(EMIS)andsurveillancereportedHIVdiagnosesamongMSMin2009.
BMCPublicHealth2013,13:919http://www.
biomedcentral.
com/1471-2458/13/919])sentoutamessagetoeveryGermanmemberwithalinktothequestionnaireaskingthememberstoparticipateinthesurvey(forthewordingofthemessageseeAnnexII).
Thesurveywasannouncedonplanetromeo.
cominatime-staggeredmanner(eightbatches,~50,000profileseach),originallywiththeintentiontopreventexcessivedemandforfreetestingatthecooperatingtestingsites,wherefreetestvouchersofferedattheendofthequestionnairecouldbeused.
Duetothelowerthanexpecteddemandthisturnedouttobeunnecessary.
However,unexpectedlythecapacityoftheserverofthesurveywebsitewasnotsufficienttomanagethedemand,sothatlongwaitingtimesforusersresultedandonsomeofthefirstdaysthesurveywaspracticallydysfunctional.
Thesurveywasnotspecificallyadaptedforsmartphoneusers.
Themainrecruitmentwebsiteofferstraditionalonlinewebsitesaswellasagps-basedsmartphoneapptomanageuserprofiles.
Bothtypesofclientswereinvitedtoparticipateinthesurvey,however,thelackofsmartphone-adaptationwasmentionedintheinvitationmail.
Duetothelackofsmartphoneadaptationandthetechnicalserverproblemsitisverylikelythatthesurveywasfilledinpreferentiallywithapersonalcomputeronlineinsteadbysmartphone.
Comparedwiththepreviousonlinesurvey(EMIS2010)youngeragegroups(25-35years)werelesswellrepresentedamongrespondents,whichmaybeduetothehigherfrequencyofapp-useinthisagegroup.
SurveyadministrationThesurveywasaWeb-basedsurveywhichwasfilledinonline.
Responseswereautomaticallycapturedanddirectlystoredinadatabase.
ContextSeeabove.
Mandatory/voluntaryParticipationinthesurveywasvoluntary.
IncentivesNoincentiveswereoffered.
Time/DateDatawerecollectedbetweenNovember2013andJanuary20143RandomizationofitemsorquestionnairesRandomizationoralternatingofitemswasnotused.
AdaptivequestioningAdaptivequestioningwasusedthroughoutthequestionnairetoreducenumberandcomplexityofthequestions.
E.
g.
separatequestionswereaskedtorespondentswhoindicatedthattheyhadreceivedanHIVdiagnosisandthosewhodidn't.
NumberofItemsandscreens(pages)Thequestionnaireincluded344itemsand218questions,presentedonlineonapproximately100pages.
Duetotheadaptivedesignofthequestionnairetheactualnumberofpagesthatwereseenbyanaveragerespondentwasmuchless.
CompletenesscheckNoconsistencyorcompletenesscheckwasimplementedbeforethequestionnairewassubmitted.
Severalquestions(e.
g.
gender,age,HIVtest,etc.
)wereregardedasespeciallyimportant.
Incasetherespondentdidn'tansweroneofthesequestions,theywereremindedusingapop-upwindow,toanswerthisquestion.
Iftherespondentstillwasnotwillingtoanswerthequestionhewasabletocontinuethequestionnaire.
ReviewstepRespondentswereabletochangeanswersonpreviouspagesusingaBackbutton.
ResponseratesUniquesitevisitors:NoIPaddresseswerestoredandnocookieswereused.
Foreverynewfirstpagevisitorauniquecodewasgenerated.
Thetotalnumberofcodesgeneratedwas51,277.
However,asmentionedabove,thesurveypagewasatcertaintimesdysfunctional,whichmayhaveresultedinimmediatediscontinuationandlaterre-startofthesurvey.
Thefirstsurveyquestionwasansweredby27,337respondents;thelastsetofquestionswasansweredby14,392respondents.
DuetothedecisionnottostoreIPaddressesandnottousecookies,incombinationwiththetechnicaldifficultiesduringtheimplementationofthesurveyitisnotpossibletogivemeaningfulnumbersfortheviewrateandtheparticipationrate.
Thecompletionratecanbecalculatedas14,329/27,337=52%PreventingmultipleentriesfromthesameindividualNotechnicaltoolssuchascookieswereusedtopreventmultipleentriesfromthesameindividual.
However,duetothelengthofthequestionnaire,technicalcapacityproblemsonthesurveywebsitewhichresultedinlongerwaitingtimesbetweenscreensfurtherprolongingthetimeneededtofillinthequestionnaire,andthelackofanymaterialincentives,wethinkitishighlyunlikelythatindividualsfilledinthequestionnairemorethanonce.
Itishoweverpossiblethatrespondentsinterruptedfillinginthequestionnaireanddecidedtorestartatalatertimepoint.
Topreventusingsuchpossiblemultipleentriesfromthesameindividual,thefinaldatasetwasrestrictedtoquestionnairesinwhichatleastthequestionsregardinggender,age,country,sexualorientationandHIVtestingbehaviourwereanswered.
Theserepresentthefirstapproximately104pagescreens,andsurveysectionswhichdidnotincludeadaptivequestions(27,337respondentsansweredthefirstquestionongender;19,630respondentsansweredthequestiononHIVtesting).
IPcheckNoIPaddressesoftheclientcomputerwereusedtoidentifypotentialduplicateentriesfromthesameuser.
LogfileanalysisNoothertechniquestoanalyzethelogfileforidentificationofmultipleentrieswereused.
AnalysisIncompletequestionnaireswerealsoanalysedwhenquestionsregardinggender,age,country,sexualorientationandHIVtestingbehaviourwereanswered.
QuestionnairessubmittedwithanatypicaltimestampTimetofilloutthequestionnairewasnotusedasanexclusioncriterion.
StatisticalcorrectionNoweightingofitemsorpropensityscoreshavebeenusedtoadjustforthenon-representativesample.
5AnnexI:EntrypageoftheonlinequestionnaireSubscriberinformationWelcometothesurvey!
Pleasetakepartinthissurveyifyou.
.
.
areagaymanand/orareamanwhofeelsattractedtomenand/orareamanwhohassexwithmenandareatleast16yearsold.
Wewanttoknowit!
Thissurvey,thestudy"GayMenandHIV/AIDS2013"referstothesexyouhave,yourknowledgeandattitudestoHIVpreventionandHIVtestingandyourlifeasagayman,oramanwhohassexwithmen,andhowyouaredealingwithHIVandothersexuallytransmittedinfections.
Thequestionnairewilltakeapproximately30minutes.
PrivacyPolicyParticipationisanonymous.
WeguaranteethatwewillnotsaveyourIPaddressorcollectinformationaboutyouthatcouldenableyouridentificationbythirdparties.
FornotesonthesafeuseofPCs,pleaserefertowww.
bsi.
de.
Replyingtothequestionnaireisvoluntaryandcanbecancelledatanytime,withoutanydisadvantagesforyou.
Moreinformationaboutobjectivesofthisstudycanbefoundfurtherdownonthispage.
Herewego!
Startthequestionnairebyclickingonthefollowingbutton:[Button]FormoreinformationonthisstudyWearepsychologistsandhealthscientistsoftheFreeUniversityBerlin.
ThisstudyhasbeenfinancedbytheFederalCentreforHealthEducation(BZgA).
Forquestions,commentsorsuggestionsaboutthestudypleasecontactusatthee-mailaddressmsm@zedat.
fu-berlin.
deGoalsTheprimaryobjectiveofthissurveyistoobtaincurrentinformationabouthowgayandothermenwhohavesexwithmen(MSM)aredealingandlivingwithHIV/AIDSandothersexuallytransmittedinfections(STI).
Thecollectedanswerswillallowanassessmentoftheextenttowhichyouandthe6otherparticipantsprotectthemselves,butalsowhatrisksyouarewillingtotake.
Questionsabouttheuseofpreventiveservices,andknowledgeaboutprogressinthetreatabilityofHIV,willalsoallowtoassessinformationneedsandtobetteraddresstheseissuesinHIVprevention.
InadditiontothesepointsthegenerallifesituationofgayandothermenwhohavesexwithmenlivinginGermanyisanimportantpartofthissurvey.
Inadditiontodealingwithdiscriminationagainsthomosexuality,mentalwell-beingisdiscussedinthissurveyforthefirsttime.
Wewanttoinvestigatewhetherandwhygayandbisexualmenaremorefrequentlyaffectedbypsychologicalstress.
Also,theuseofpsychoactivesubstances(alcoholanddrugs)willbeinvestigated.
WhathappenstoyourdataTakingintoaccountthelegalrequirementsofdataprotectionwewillevaluateyourinformationtogetherwiththatoftheotherparticipantstopreparescientificpublicationsforaspecialistaudience.
Inthiswaywecreatetheconditionsthatyourinformationcanbeincludedintheoptimizationofpreventionservicesforgaymenandothermenwhohavesexwithmen.
Thecentralresultsofthissurveycanbeexpectedtobecomeavailablebyautumn2014,accessibleonwww.
sma2013.
de.
ThisstudywasreviewedbytheethicscommitteeoftheCharitéBerlin,whichconfirmedtheethicalacceptabilityofthisstudy.
TheDataProtectionOfficeroftheStateofBerlinhasexaminedthecompliancewithdataprotectionandhissuggestionsforchangeshavebeenimplemented.
7AnnexII:Invitationmailformenwithaprofileonplanetromeo.
comHello,Wewouldliketoinviteyoutoparticipateinasurveyofgayandothermenwhohavesexwithmen.
Thissurveydealswithyourlife,yoursexandyourrelationships,yourknowledgeandattitudestorecentdevelopmentsinHIV/AIDS,andhowyouaredealingwithHIVandothersexuallytransmittedinfections.
Thissurveyisdoneanonymouslyandtakesabout30minutes.
Thesurveyisnotoptimizedforfillinginonsmartphones.
(Nowstartwiththequestionnaire!
)Yourparticipationinthissurveycannotonlyhelptoensurethatyoulearnsomethingnew.
Throughyourparticipation,youalsosupportthepreventionofHIVandothersexuallytransmitteddiseasesamonggayandothermenwhohavesexwithmeninGermany.
Theresultsofthestudyaredirectlyfeedingintothispreventionwork.
Inthiswaythepreventionmaytakeyourneedsbetterintoconsideration.
Formoreinformationaboutthisstudy,pleasegotothehomepageofthequestionnaire.
Yourexperiencesandyourvisionareimportanttous.
Wewouldthereforebeveryhappyifyouparticipateinthissurvey:Clickhereforthequestionnaire!
8ScalesandothermeasuresThequestionnaireincludedtwonewad-hocscalesdescribingHIV-relatedstigmaoftherespondentsandanticipatedstigmaincaseofbeingdiagnosedwithHIVandthevalidatedinternalizedhomonegativityscale.
1)HIV-stigmascale.
Question:HowwouldyoudealwithpeoplewhogotinfectedwithHIVThisscaleisanadhocscalewhichconsistsofsixitems:(1)Iwouldn'tkisssomebodyonthelipswhoisHIVpositive(2)Idon'wanttohavedirectcontactwithsomebodywhoisHIVpositive(3)Ican'timaginetohaveanHIVpositivesteadypartner(4)SomeonewhonowadaysstillgetsinfectedwithHIVmustbestupid(5)SomebodywhonowadaysstillgetsinfectedwithHIVhasdeservedit(6)HIVpositivepersonsareirresponsible[4pointdisagree–agreescale]Forthecalculationofthescale-valueallitemswerecoded,summed-up,anddividedbythenumberofitems.
Ifanyoftheitemswasmissing,thescale-valuewassettomissing.
Scalevaluescouldbebetween1and4,withhigherscalevaluesrepresentingmorestigmatisingattitudes.
2)AnticipatedStigma.
Question:HowlikelyisitfromyourpointofviewthatoneofthefollowingthingswillhappentoyouifyouwouldbecomeinfectedwithHIVThisscaleisanadhocscaleaswellwhichconsistsofsixitems:(1)FriendsandacquaintanceswouldthinkIfailed(2)Friendsandacquaintanceswouldblamemeforgettinginfected(3)Myfamilywouldfeeldisappointedaboutme(4)Potentialsexpartnerswouldrejectme(5)Familymembersandfriendswouldavoidme(6)Iwouldgetproblemswithmyjob(withmyeducation)Forthecalculationofthescale-valueallitemswerecoded,summed-up,anddividedbythenumberofitems.
Ifanyoftheitemswasmissing,thescale-valuewassettomissing.
Scalevaluescouldbebetween1and4,withhigherscalevaluesrepresentingmorestigmatisingattitudes.
[4pointlikely–unlikelyscale]93)InternalizedHomonegativityScalewith8items,firstitemwasleftout.
Maximumonemissingitemwasallowed.
Theoption"doesnotapplyforme"wassettomissingbeforecalculatingthescale.
(1)Obviouslyeffeminatehomosexualmenmakemefeeluncomfortable.
(2)Ifeelcomfortableingaybars.
(3)Socialsituationswithgaymenmakemefeeluncomfortable.
(4)Ifeelcomfortablebeingseeninpublicwithanobviouslygayperson.
(5)Ifeelcomfortablediscussinghomosexualityinapublicsituation.
(6)Ifeelcomfortablebeingahomosexualman.
(7)Homosexualityismorallyacceptabletome.
(8)EvenifIcouldchangemysexualorientation,Iwouldn't.
[7pointdisagree-agreewithdoesnotapply]Higherscalevaluesrepresentinghigherinternalizedhomonegativity.
4)SubcultureinvolvementGaysubcultureinvolvementwasassessedbyaquestionaskingforthefrequencyofvisitingvenuessuchas(1)gaycommunitycentres,gaysocialgroups,(2)cafes,bars,(3)discothequesordanceclubs(1-3summarizedassocialvenues),(4)barswithdarkrooms,sex-clubs,publicsexparties,(5)privatesexparties,(6)gaysaunas,porncinemas,(7)othercruisingsitessuchasparksorpublictoilets(4-7summarizedassexvenues),and(8)chatordatingwebsitesoruseofsmartphoneappstomeetnewpartners.
Frequencyoptionsofvisitingthesevenuesinthelast12monthsoptionswereseveraltimesperweek,severaltimespermonth,severaltimesperyear,lessfrequent,andnever.
Foranalysis,frequenciesofvisitstophysicalvenues(1-7)weredichotomizedasfrequentifvisitswerereportedseveraltimespermonthormoreoften,andthethreeotheroptionsweresummarizedasinfrequent/never.
Ifanyofthevenues1-3wasvisitedfrequently,thiswasdefinedas'frequentlyvisitingsocialvenues',ifanyofthevenues4-7wasvisitedfrequently,thiswasdefinedas'frequentlyvisitingsexvenues'.
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