Items:

Sexual Hisory
1. Ask how many partners they have had?
2. Ask if they have ever shared needles?
3. Ask if they are having sex with other people?
4. Ask if they have ever had a sexually transmitted infection?

Condom Negotiation
5. Ask if a condom could be used for sex with them?
6. Demand that a condom be used?
7. Refuse to have sex if they won’t use a condom?

Negative Sexual Messages
8. Tell them a certain sexual activity hurts you?
9. Tell them if a certain sexual activity makes you uncomfortable?
10. Tell them that a certain sexual activity is not making you feel good?
11. Tell them you do not want to have sex?

Positive Sexual Messages
12. Suggest a new sexual activity (e.g., a new sexual position)?
13. Tell them you would like to have sex more often?
14. Tell them that a sexual activity feels good?
15. Tell them that you want to have sex?
16. Tell them that you like a specific sexual activity?
17. Initiate sex?

Contraceptive Communication
18. Talk about how it feels to use a condom?
19. Talk about how to put on a condom?
20. Talk about whether a condom is on correctly?

Response Options:
Very difficult - 1
Difficult - 2
Easy - 3
Very easy - 4