Table 1 Proyecto Parejas primary screener questions

1.

What is your first name?*

2.

What is your age, in years?

3.

What is your date of birth?

4.

Where do you live?

5.

How long have you lived there?*

6.

How much longer do you think you'll live in (name of the city)?

7.

Have you ever been to the United States?*

8.

When was the last time you were in the United States?*

9.

Do you have any family currently living in the United States?*

10.

If yes, what family members live in the United States? *

11.

Have you ever used an illegal drug?

12.

What drugs have you ever used?

13.

Have you used any drugs in the past three months?*

14.

What drugs have you used in the past three months?*

15.

Have you ever injected an illicit drug?*

16.

Have you ever had an HIV test?*

17.

When was the last time you had an HIV test?*

18.

Have you ever been tested for any sexually transmitted infection such as chlamydia, gonorrhea, or syphilis?*

19.

When was the last time you were tested for any sexually transmitted infection such as chlamydia, gonorrhea, or syphilis?*

20.

If you were to test positive for HIV or a sexually transmitted infection such as chlamydia, gonorrhea, or syphilis, would you agree to receive treatment from a doctor?

21.

Have you ever had sex in exchange for money, drugs, goods or shelter?

22.

When was the first time that you had sex in exchange for money, drugs, goods or shelter?*

23.

When was the last time that you had sex in exchange for money, drugs, goods or shelter?

24.

Are you currently registered with the Municipal Health Services as a Sex worker?*

25.

What is your marital status?*

26.

Do you currently have a spouse or steady partner?

27.

What is your partner's first name?*

28.

How old is your steady partner?*

29.

Is your spouse or steady partner male or female?

30.

How long have you been with your steady partner?

31.

When was the last time you had sex with your spouse or steady partner?

32.

How many children do you and your steady partner have together?*

33.

Who primarily takes care of the children?*

34.

Does your spouse or partner have any children with other women?*

35.

Do you have any plans to end your relationship with your spouse or steady partner in the near future?

36.

If yes, can you please tell me the reason you are thinking about ending your relationship?

37.

Have you ever experienced any physical, sexual, economic, or verbal abuse from your partner? ⁺⁺

Yes

No (skip the rest of the section, to Q42)

Refuse to Answer**

38.

In the past three months, have you experienced physical, sexual, economic, or verbal abuse from your partner? ⁺⁺

Yes

No (skip the rest of the section, to Q42)

Refuse to Answer**

39.

In the past three months, how often have you experienced abuse from your partner? ⁺⁺

Daily

Every month

Occasionally

Almost never

Refuse to Answer**

40.

In the past three months, how serious would you describe the level of abuse in your relationship with [your partner]? Can you give me some examples? ^{++, +++}

NONE (for example, has not suffered from any insults, mistreatment or yelling from the partner in the last three months)

MILD (for example, my partner has insulted, swore, or yelled at me at least once in the past 3 months)

MODERATE (for example, my partner has pushed, shoved, or slapped me at least once in the past 3 months)

SEVERE (my partner has punched me, kicked me, or beat me up to the point where I had serious injuries, or has pulled a weapon on me and threatened to kill me one or more times in the past 3 months)

Refuse to Answer**

41.

Are you currently worried that your life is in danger because of abuse from your partner? ⁺⁺

Yes

No

Refuse to Answer**

Are you currently participating in a research study or program with our group?*

43.

Specify other research study or program in which respondent is currently participating*

44.

Would you be willing to come to our office with your spouse or steady partner to see if you are both eligible for a study?