redcap.sac-cu.org
Open in
urlscan Pro
67.221.180.200
Public Scan
Submitted URL: http://columbiahero.org/
Effective URL: https://redcap.sac-cu.org/surveys/?s=EEMHPCYKXJ
Submission: On March 12 via api from US — Scanned from DE
Effective URL: https://redcap.sac-cu.org/surveys/?s=EEMHPCYKXJ
Submission: On March 12 via api from US — Scanned from DE
Form analysis 3 forms found in the DOM
Name: form — POST /surveys/index.php?s=EEMHPCYKXJ
<form action="/surveys/index.php?s=EEMHPCYKXJ" enctype="multipart/form-data" target="_self" method="post" name="form" id="form" data-mlm-text-align="left"><input type="hidden" name="redcap_csrf_token" value="">
<div data-mlm-text-align="left">
<script type="text/javascript">
if (typeof lang == 'undefined') {
var lang = {}
};
lang.global_143 = 'Checked';
lang.global_144 = 'Unchecked';
</script>
<script type="text/javascript">
var missing_data_replacement_js = '______';
var piping_receiver_class_field_js = '.piping_receiver.piperec-';
</script>
<span id="maxchecked_tag_label" class="" style="display:none;z-index:1000;" data-rc-lang="data_entry_421" data-mlm-text-align="left">Cannot select choice! The maximum number of choices has been selected.</span><span id="matrix_rank_remove_label"
class="opacity75" style="display:none;" data-rc-lang="data_entry_203" data-mlm-text-align="left">Value removed!</span>
<div id="questiontable_loading" style="display: none; visibility: visible;" data-mlm-text-align="center">
<img alt="Loading..." src="/redcap_v13.1.16/Resources/images/progress_circle.gif"> <span data-rc-lang="data_entry_64" data-mlm-text-align="center">Loading...</span>
</div>
<script type="text/javascript">
setTimeout(function() {
document.getElementById('questiontable_loading').style.visibility = 'visible';
}, 750);
</script>
<table role="presentation" class="form_border container-fluid" style="display: table;" id="questiontable" data-mlm-text-align="left">
<tbody class="formtbody" data-mlm-text-align="left">
<tr class="@NOW @HIDDEN-SURVEY @READONLY" id="psq_timestamp-tr" sq_id="psq_timestamp" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-6" data-mlm-text-align="left"><label class="fl" id="label-psq_timestamp" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_timestamp" data-mlm-type="label" data-mlm-text-align="left">Timestamp</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label></td>
<td class="data col-5" data-mlm-text-align="left"><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_timestamp"
class="x-form-text x-form-field datetime_mdy hasDatepicker calcChanged" type="text" name="psq_timestamp" value="" disabled="" onchange="clean_datetime(this,'datetime_mdy');calculate('psq_timestamp');doBranching('psq_timestamp');"
onblur="redcap_validate(this,'','','soft_typed','datetime_mdy',1)" tabindex="0" onkeydown="dateKeyDown(event,'psq_timestamp')" fv="datetime_mdy" id="dp1678599907853"><img class="ui-datepicker-trigger d-print-none"
src="/redcap_v13.1.16/Resources/images/datetime.png" alt="Click to select a date/time" title="Click to select a date/time" style="display: none;"></span>
<button ignore="Yes" class="jqbuttonsm ml-2 today-now-btn d-print-none ui-button ui-corner-all ui-widget" onclick="setNowDateTime('psq_timestamp',0,'datetime_mdy');return false;" data-mlm-text-align="center" style="display: none;"><span
data-rc-lang="form_renderer_29" data-mlm-text-align="center">Now</span></button><span class="df" data-rc-lang="multilang_113" data-mlm-text-align="left">M-D-Y H:M</span>
<div id="psq_timestamp_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="@HIDDEN-SURVEY" id="psq_reviewsubst-tr" sq_id="psq_reviewsubst" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_reviewsubst" data-mlm-type="label" data-mlm-text-align="left"><br>
<center>
<h5>
<div class="font-color: red">Review substance use.</div>
</h5>
</center>
</div>
</div>
</td>
</tr>
<tr class="@HIDDEN-SURVEY" id="psq_reviewmedhx-tr" sq_id="psq_reviewmedhx" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_reviewmedhx" data-mlm-type="label" data-mlm-text-align="left"><br>
<center>
<h5>
<div class="font-color: red">Review medical history.</div>
</h5>
</center>
</div>
</div>
</td>
</tr>
<tr class="@HIDDEN-SURVEY" id="psq_screenfail-tr" sq_id="psq_screenfail" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_screenfail" data-mlm-type="label" data-mlm-text-align="left"><br>
<center>
<h5>
<div class="font-color: red">Screen fail.</div>
</h5>
</center>
</div>
</div>
</td>
</tr>
<tr id="psq_header-tr" sq_id="psq_header" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_header" data-mlm-type="label" data-mlm-text-align="left"><br>
<center>Columbia Research Unit thanks you for your interest in learning more about HIV prevention research we conduct and for considering the potentials to participate. The next step is to complete a brief questionnaire to find out if
you may be eligible for any studies we're currently conducting or studies we will soon conduct. Generally, we look for HIV-negative people between 18 and 60 years old.<br><br>If you are potentially eligible, you will be invited to
attend a 1-on-1 educational visit at our clinic. The educational visit lasts about 1.5 hours. You may be asked to sign a consent form when you come in for your visit. We will tell you about the research we do and the study for which
you may eligible. We will also teachyou about HIV, HIV prevention, and what you can expect if you join an HIV prevention study with us. You will be compensated up to $25 for the educational visit.<br><br>Some of these questions are
personal, including questions about gender identity. Taking part is up to you. There is no benefit to you for participating. Your responses will be kept private. You can refuse to answer a question or stop at any time. <br><br>The
information you give us will be joined with information from everybody else taking the survey, so that if you join the study, we can describe the group, not the individuals, taking part in the study. <br><br>The risk of answering
these questions is a possible of loss of confidentiality, but we will do everything we can to protect your information. If you do not qualify for the educational visit, or if you do qualify but you do not come in for your visit, the
information collected will be discarded and will not be used for any purpose.<br><br></center>
</div>
</div>
</td>
</tr>
<tr id="psq_consent-tr" sq_id="psq_consent" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_consent" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_consent" data-mlm-type="label" data-mlm-text-align="left">Do you want to continue with the questions?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_consent" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_consent"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_consent_1" tabindex="-1" name="psq_consent___radio" aria-labelledby="label-psq_consent label-psq_consent-1"
onclick="document.forms['form'].psq_consent.value=this.value;" value="1"> <label data-mlm-field="psq_consent" data-mlm-type="enum" data-mlm-value="1" id="label-psq_consent-1" for="opt-psq_consent_1" class="mc"
data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_consent_0" tabindex="-1" name="psq_consent___radio"
aria-labelledby="label-psq_consent label-psq_consent-0" onclick="document.forms['form'].psq_consent.value=this.value;" value="0"> <label data-mlm-field="psq_consent" data-mlm-type="enum" data-mlm-value="0" id="label-psq_consent-0"
for="opt-psq_consent_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_consent_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_consent,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_consent label-psq_consent-1" data-mlm-field="psq_consent"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_consent_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_consent,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_consent label-psq_consent-0" data-mlm-field="psq_consent"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_consent','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_consent_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="@HIDDEN-FORM" id="psq_progressbar1-tr" sq_id="psq_progressbar1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_progressbar1" data-mlm-type="label" data-mlm-text-align="left">
<div class="progress">
<div class="progress-bar " role="progress bar" style="width: 7.7%"><spanclass="sr-only">8% Complete</spanclass="sr-only"></div>
</div>
</div>
</div>
</td>
</tr>
<tr class="hidden" id="psq_birthsex-tr" sq_id="psq_birthsex" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_birthsex" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_birthsex" data-mlm-type="label" data-mlm-text-align="left">What sex were you assigned at birth?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_birthsex" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_birthsex"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_birthsex_1" tabindex="-1" name="psq_birthsex___radio" aria-labelledby="label-psq_birthsex label-psq_birthsex-1"
onclick="document.forms['form'].psq_birthsex.value=this.value;doBranching('psq_birthsex');" value="1"> <label data-mlm-field="psq_birthsex" data-mlm-type="enum" data-mlm-value="1" id="label-psq_birthsex-1" for="opt-psq_birthsex_1"
class="mc" data-mlm-text-align="left">Male</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_birthsex_2" tabindex="-1" name="psq_birthsex___radio"
aria-labelledby="label-psq_birthsex label-psq_birthsex-2" onclick="document.forms['form'].psq_birthsex.value=this.value;doBranching('psq_birthsex');" value="2"> <label data-mlm-field="psq_birthsex" data-mlm-type="enum"
data-mlm-value="2" id="label-psq_birthsex-2" for="opt-psq_birthsex_2" class="mc" data-mlm-text-align="left">Female</label></span><span class="choicehoriz hidden hidden" data-mlm-text-align="left"> <label
data-mlm-field="psq_birthsex" data-mlm-type="enum" data-mlm-value="3" id="label-psq_birthsex-3" for="opt-psq_birthsex_3" class="mc" data-mlm-text-align="left">Intersex</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_birthsex_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_birthsex,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_birthsex label-psq_birthsex-1" data-mlm-field="psq_birthsex"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Male</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_birthsex_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_birthsex,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_birthsex label-psq_birthsex-2" data-mlm-field="psq_birthsex"
data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">Female</span></label></div>
<div class="enhancedchoice hidden col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_birthsex_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_birthsex,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_birthsex label-psq_birthsex-3" data-mlm-field="psq_birthsex"
data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Intersex</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_birthsex','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_birthsex_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_gender-tr" sq_id="psq_gender" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_gender" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_gender" data-mlm-type="label" data-mlm-text-align="left">What is your gender?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_gender" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_gender">
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_1" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-1"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="1"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="1" id="label-psq_gender-1" for="opt-psq_gender_1" class="mc"
data-mlm-text-align="left">Cisman (assigned male at birth, identify as a man)</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_2" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-2"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="2"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="2" id="label-psq_gender-2" for="opt-psq_gender_2" class="mc"
data-mlm-text-align="left">Ciswoman (assigned female at birth, identify as a woman)</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_3" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-3"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="3"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="3" id="label-psq_gender-3" for="opt-psq_gender_3" class="mc"
data-mlm-text-align="left">Transman (assigned female at birth, identify as a man)</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_4" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-4"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="4"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="4" id="label-psq_gender-4" for="opt-psq_gender_4" class="mc"
data-mlm-text-align="left">Transwoman (assigned male at birth, identify as a woman)</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_5" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-5"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="5"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="5" id="label-psq_gender-5" for="opt-psq_gender_5" class="mc"
data-mlm-text-align="left">Gender non-conforming (gender identity does not match masculine or feminine gender norms)</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_gender_6" tabindex="-1" name="psq_gender___radio" aria-labelledby="label-psq_gender label-psq_gender-6"
onclick="document.forms['form'].psq_gender.value=this.value;doBranching('psq_gender');" value="6"> <label data-mlm-field="psq_gender" data-mlm-type="enum" data-mlm-value="6" id="label-psq_gender-6" for="opt-psq_gender_6" class="mc"
data-mlm-text-align="left">Other</label></div>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-1" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Cisman (assigned male at birth, identify as a man)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-2" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">Ciswoman (assigned female at birth, identify as a woman)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-3" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Transman (assigned female at birth, identify as a man)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_4" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,4" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-4" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="center">Transwoman (assigned male at birth, identify as a woman)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_5" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,5" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-5" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="5" data-mlm-text-align="center">Gender non-conforming (gender identity does not match masculine or feminine gender norms)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_gender_6" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_gender,value,6" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_gender label-psq_gender-6" data-mlm-field="psq_gender"
data-mlm-type="enum" data-mlm-value="6" data-mlm-text-align="center">Other</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_gender','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_gender_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sexwith-tr" sq_id="psq_sexwith" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sexwith" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sexwith" data-mlm-type="label" data-mlm-text-align="left">Whom do you have sex with? (Sexual Preference)<br><br><i>Check all that apply</i></div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div>
<div style="overflow:hidden;" data-mlm-text-align="left">
<div data-kind="field-value" data-mlm-text-align="left">
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-1" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_1" name="__chkn__psq_sexwith" code="1" onclick="checkboxClick('psq_sexwith','1',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_1"> <label id="label-psq_sexwith-1" class="mc"
for="id-__chk__psq_sexwith_RC_1" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="left">Cismen (assigned male at birth, identify as men)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-2" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_2" name="__chkn__psq_sexwith" code="2" onclick="checkboxClick('psq_sexwith','2',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_2"> <label id="label-psq_sexwith-2" class="mc"
for="id-__chk__psq_sexwith_RC_2" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="left">Ciswomen (assigned female at birth, identify as women)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-3" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_3" name="__chkn__psq_sexwith" code="3" onclick="checkboxClick('psq_sexwith','3',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_3"> <label id="label-psq_sexwith-3" class="mc"
for="id-__chk__psq_sexwith_RC_3" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="left">Transmen (assigned female at birth, identify as men)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-4" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_4" name="__chkn__psq_sexwith" code="4" onclick="checkboxClick('psq_sexwith','4',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_4"> <label id="label-psq_sexwith-4" class="mc"
for="id-__chk__psq_sexwith_RC_4" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="left">Transwomen (assigned male at birth, identify as women)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-5" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_5" name="__chkn__psq_sexwith" code="5" onclick="checkboxClick('psq_sexwith','5',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_5"> <label id="label-psq_sexwith-5" class="mc"
for="id-__chk__psq_sexwith_RC_5" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="5" data-mlm-text-align="left">No one</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-6" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_6" name="__chkn__psq_sexwith" code="6" onclick="checkboxClick('psq_sexwith','6',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_6"> <label id="label-psq_sexwith-6" class="mc"
for="id-__chk__psq_sexwith_RC_6" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="6" data-mlm-text-align="left">Gender non-conforming (GNC, gender identify does not match masculine or feminine gender
norms)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_sexwith label-psq_sexwith-7" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_sexwith');"
id="id-__chk__psq_sexwith_RC_7" name="__chkn__psq_sexwith" code="7" onclick="checkboxClick('psq_sexwith','7',this,event,0);"><input type="hidden" value="" name="__chk__psq_sexwith_RC_7"> <label id="label-psq_sexwith-7" class="mc"
for="id-__chk__psq_sexwith_RC_7" data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="7" data-mlm-text-align="left">Other</label></div>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,1" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-1"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="left">Cismen (assigned male at birth, identify as men)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,2" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-2"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="left">Ciswomen (assigned female at birth, identify as women)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,3" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-3"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="left">Transmen (assigned female at birth, identify as men)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_4" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,4" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-4"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="left">Transwomen (assigned male at birth, identify as women)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_5" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,5" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-5"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="5" data-mlm-text-align="left">No one</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_6" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,6" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-6"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="6" data-mlm-text-align="left">Gender non-conforming (GNC, gender identify does not match masculine or feminine gender norms)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_sexwith_RC_7" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_sexwith,code,7" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexwith label-psq_sexwith-7"
data-mlm-field="psq_sexwith" data-mlm-type="enum" data-mlm-value="7" data-mlm-text-align="left">Other</span></label></div>
</div>
</div>
</div>
<div class="space" data-mlm-text-align="left"></div>
<div id="psq_sexwith_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_dob-tr" sq_id="psq_dob" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-6" data-mlm-text-align="left"><label class="fl" id="label-psq_dob" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_dob" data-mlm-type="label" data-mlm-text-align="left">What is your date of birth?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label></td>
<td class="data col-5" data-mlm-text-align="left"><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_dob"
class="x-form-text x-form-field date_mdy hasDatepicker" type="text" name="psq_dob" value="" onchange="clean_datetime(this,'date_mdy');calculate('psq_dob');doBranching('psq_dob');"
onblur="redcap_validate(this,'','','soft_typed','date_mdy',1)" tabindex="0" onkeydown="dateKeyDown(event,'psq_dob')" fv="date_mdy" id="dp1678599907852"><img class="ui-datepicker-trigger d-print-none"
src="/redcap_v13.1.16/Resources/images/date.png" alt="Click to select a date" title="Click to select a date"></span>
<button ignore="Yes" class="jqbuttonsm ml-2 today-now-btn d-print-none ui-button ui-corner-all ui-widget" onclick="setToday('psq_dob','date_mdy');return false;" data-mlm-text-align="center"><span data-rc-lang="dashboard_32"
data-mlm-text-align="center">Today</span></button><span class="df" data-rc-lang="multilang_110" data-mlm-text-align="left">M-D-Y</span>
<div id="psq_dob_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_age-tr" sq_id="psq_age" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-6" data-mlm-text-align="left"><label class="fl" id="label-psq_age" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_age" data-mlm-type="label" data-mlm-text-align="left">How old are you?</div>
</div>
</label></td>
<td class="data col-5" data-mlm-text-align="left"><span data-kind="field-value" data-mlm-text-align="left"><input type="text" aria-labelledby="label-psq_age" name="psq_age" value="" sv="" tabindex="-1" readonly="readonly"
class="x-form-text x-form-field rci-calc"
autocomplete="new-password"></span> <a href="javascript:;" ignore="Yes" class="viewEq d-print-none" tabindex="-1" onclick="viewEq('psq_age',0,0);" data-mlm-text-align="left"><span data-rc-lang="form_renderer_21" data-mlm-text-align="left">View equation</span></a>
</td>
</tr>
<tr class="hidden" id="psq_sex6mo-tr" sq_id="psq_sex6mo" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sex6mo" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sex6mo" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months, did you have vaginal or anal sex?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sex6mo" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sex6mo"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex6mo_1" tabindex="-1" name="psq_sex6mo___radio" aria-labelledby="label-psq_sex6mo label-psq_sex6mo-1"
onclick="document.forms['form'].psq_sex6mo.value=this.value;doBranching('psq_sex6mo');" value="1"> <label data-mlm-field="psq_sex6mo" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sex6mo-1" for="opt-psq_sex6mo_1" class="mc"
data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex6mo_0" tabindex="-1" name="psq_sex6mo___radio"
aria-labelledby="label-psq_sex6mo label-psq_sex6mo-0" onclick="document.forms['form'].psq_sex6mo.value=this.value;doBranching('psq_sex6mo');" value="0"> <label data-mlm-field="psq_sex6mo" data-mlm-type="enum" data-mlm-value="0"
id="label-psq_sex6mo-0" for="opt-psq_sex6mo_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex6mo_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex6mo,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex6mo label-psq_sex6mo-1" data-mlm-field="psq_sex6mo"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex6mo_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex6mo,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex6mo label-psq_sex6mo-0" data-mlm-field="psq_sex6mo"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sex6mo','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sex6mo_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sex6mo_num-tr" sq_id="psq_sex6mo_num" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sex6mo_num" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sex6mo_num" data-mlm-type="label" data-mlm-text-align="left">How MANY people did you have vaginal or anal sex with in the past 6 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_sex6mo_num"
class="x-form-text x-form-field rci-left" type="text" name="psq_sex6mo_num" value="" onchange="clean_datetime(this,'integer');doBranching('psq_sex6mo_num');" onblur="redcap_validate(this,'','','soft_typed','integer',1)" tabindex="0"
onkeydown="if(event.keyCode==9){doBranching('psq_sex6mo_num');}" fv="integer"></span>
<div id="psq_sex6mo_num_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_insertive-tr" sq_id="psq_insertive" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_insertive" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_insertive" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months, did you have <i>insertive</i> vaginal or anal sex (top) with a cisman (who was born male and identifies as male) or a
transgender <i>person</i>?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_insertive" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_insertive"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_insertive_1" tabindex="-1" name="psq_insertive___radio" aria-labelledby="label-psq_insertive label-psq_insertive-1"
onclick="document.forms['form'].psq_insertive.value=this.value;doBranching('psq_insertive');" value="1"> <label data-mlm-field="psq_insertive" data-mlm-type="enum" data-mlm-value="1" id="label-psq_insertive-1"
for="opt-psq_insertive_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_insertive_0" tabindex="-1" name="psq_insertive___radio"
aria-labelledby="label-psq_insertive label-psq_insertive-0" onclick="document.forms['form'].psq_insertive.value=this.value;doBranching('psq_insertive');" value="0"> <label data-mlm-field="psq_insertive" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_insertive-0" for="opt-psq_insertive_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_insertive_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_insertive,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_insertive label-psq_insertive-1" data-mlm-field="psq_insertive"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_insertive_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_insertive,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_insertive label-psq_insertive-0" data-mlm-field="psq_insertive"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_insertive','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_insertive_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_receptive-tr" sq_id="psq_receptive" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_receptive" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_receptive" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months, did you have <i>receptive</i> vaginal or anal sex (bottom) with a cisman (who was born male and identifies as male) or a
transgender <i>person</i>?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_receptive" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_receptive"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_receptive_1" tabindex="-1" name="psq_receptive___radio" aria-labelledby="label-psq_receptive label-psq_receptive-1"
onclick="document.forms['form'].psq_receptive.value=this.value;doBranching('psq_receptive');" value="1"> <label data-mlm-field="psq_receptive" data-mlm-type="enum" data-mlm-value="1" id="label-psq_receptive-1"
for="opt-psq_receptive_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_receptive_0" tabindex="-1" name="psq_receptive___radio"
aria-labelledby="label-psq_receptive label-psq_receptive-0" onclick="document.forms['form'].psq_receptive.value=this.value;doBranching('psq_receptive');" value="0"> <label data-mlm-field="psq_receptive" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_receptive-0" for="opt-psq_receptive_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_receptive_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_receptive,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_receptive label-psq_receptive-1" data-mlm-field="psq_receptive"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_receptive_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_receptive,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_receptive label-psq_receptive-0" data-mlm-field="psq_receptive"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_receptive','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_receptive_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_insert_condomless-tr" sq_id="psq_insert_condomless" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_insert_condomless" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_insert_condomless" data-mlm-type="label" data-mlm-text-align="left">How MANY of these men or transgender persons did you have <i>insertive</i> anal sex (top) WITHOUT a condom in the past 6 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_insert_condomless"
class="x-form-text x-form-field rci-left" type="text" name="psq_insert_condomless" value="" onchange="clean_datetime(this,'integer');doBranching('psq_insert_condomless');" onblur="redcap_validate(this,'','','soft_typed','integer',1)"
tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_insert_condomless');}" fv="integer"></span>
<div id="psq_insert_condomless_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_recept_condomless-tr" sq_id="psq_recept_condomless" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_recept_condomless" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_recept_condomless" data-mlm-type="label" data-mlm-text-align="left">How MANY of these men or transgender persons did you have <i>receptive</i> anal sex (bottom) WITHOUT a condom in the past 6 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_recept_condomless"
class="x-form-text x-form-field rci-left" type="text" name="psq_recept_condomless" value="" onchange="clean_datetime(this,'integer');doBranching('psq_recept_condomless');" onblur="redcap_validate(this,'','','soft_typed','integer',1)"
tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_recept_condomless');}" fv="integer"></span>
<div id="psq_recept_condomless_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_partnerhiv-tr" sq_id="psq_partnerhiv" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_partnerhiv" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_partnerhiv" data-mlm-type="label" data-mlm-text-align="left">What is the HIV status of the partner with whom you had condomless receptive anal sex?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_partnerhiv" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_partnerhiv"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partnerhiv_1" tabindex="-1" name="psq_partnerhiv___radio" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-1"
onclick="document.forms['form'].psq_partnerhiv.value=this.value;doBranching('psq_partnerhiv');" value="1"> <label data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="1" id="label-psq_partnerhiv-1"
for="opt-psq_partnerhiv_1" class="mc" data-mlm-text-align="left">Positive</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partnerhiv_2" tabindex="-1"
name="psq_partnerhiv___radio" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-2" onclick="document.forms['form'].psq_partnerhiv.value=this.value;doBranching('psq_partnerhiv');" value="2"> <label
data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="2" id="label-psq_partnerhiv-2" for="opt-psq_partnerhiv_2" class="mc" data-mlm-text-align="left">Negative</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_partnerhiv_3" tabindex="-1" name="psq_partnerhiv___radio" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-3"
onclick="document.forms['form'].psq_partnerhiv.value=this.value;doBranching('psq_partnerhiv');" value="3"> <label data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="3" id="label-psq_partnerhiv-3"
for="opt-psq_partnerhiv_3" class="mc" data-mlm-text-align="left">Don't know</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnerhiv_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnerhiv,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-1"
data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Positive</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnerhiv_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnerhiv,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-2"
data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">Negative</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnerhiv_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnerhiv,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnerhiv label-psq_partnerhiv-3"
data-mlm-field="psq_partnerhiv" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Don't know</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_partnerhiv','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_partnerhiv_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_partnervl-tr" sq_id="psq_partnervl" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_partnervl" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_partnervl" data-mlm-type="label" data-mlm-text-align="left">Is this partner's viral load (copies of virus in the blood) undetectable (so low that tests cannot measure it)?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_partnervl" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_partnervl"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partnervl_1" tabindex="-1" name="psq_partnervl___radio" aria-labelledby="label-psq_partnervl label-psq_partnervl-1"
onclick="document.forms['form'].psq_partnervl.value=this.value;doBranching('psq_partnervl');" value="1"> <label data-mlm-field="psq_partnervl" data-mlm-type="enum" data-mlm-value="1" id="label-psq_partnervl-1"
for="opt-psq_partnervl_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partnervl_2" tabindex="-1" name="psq_partnervl___radio"
aria-labelledby="label-psq_partnervl label-psq_partnervl-2" onclick="document.forms['form'].psq_partnervl.value=this.value;doBranching('psq_partnervl');" value="2"> <label data-mlm-field="psq_partnervl" data-mlm-type="enum"
data-mlm-value="2" id="label-psq_partnervl-2" for="opt-psq_partnervl_2" class="mc" data-mlm-text-align="left">No</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partnervl_3"
tabindex="-1" name="psq_partnervl___radio" aria-labelledby="label-psq_partnervl label-psq_partnervl-3" onclick="document.forms['form'].psq_partnervl.value=this.value;doBranching('psq_partnervl');" value="3"> <label
data-mlm-field="psq_partnervl" data-mlm-type="enum" data-mlm-value="3" id="label-psq_partnervl-3" for="opt-psq_partnervl_3" class="mc" data-mlm-text-align="left">Don't know</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnervl_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnervl,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnervl label-psq_partnervl-1" data-mlm-field="psq_partnervl"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnervl_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnervl,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnervl label-psq_partnervl-2" data-mlm-field="psq_partnervl"
data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">No</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partnervl_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partnervl,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partnervl label-psq_partnervl-3" data-mlm-field="psq_partnervl"
data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Don't know</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_partnervl','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_partnervl_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_partner_monog-tr" sq_id="psq_partner_monog" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_partner_monog" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_partner_monog" data-mlm-type="label" data-mlm-text-align="left">Are you in a monogamous relationship with this partner (you and your partner have sex only with each other and don't have any other sex
partners)?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_partner_monog" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_partner_monog"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partner_monog_1" tabindex="-1" name="psq_partner_monog___radio" aria-labelledby="label-psq_partner_monog label-psq_partner_monog-1"
onclick="document.forms['form'].psq_partner_monog.value=this.value;doBranching('psq_partner_monog');" value="1"> <label data-mlm-field="psq_partner_monog" data-mlm-type="enum" data-mlm-value="1" id="label-psq_partner_monog-1"
for="opt-psq_partner_monog_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_partner_monog_0" tabindex="-1"
name="psq_partner_monog___radio" aria-labelledby="label-psq_partner_monog label-psq_partner_monog-0" onclick="document.forms['form'].psq_partner_monog.value=this.value;doBranching('psq_partner_monog');" value="0"> <label
data-mlm-field="psq_partner_monog" data-mlm-type="enum" data-mlm-value="0" id="label-psq_partner_monog-0" for="opt-psq_partner_monog_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partner_monog_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partner_monog,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partner_monog label-psq_partner_monog-1"
data-mlm-field="psq_partner_monog" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_partner_monog_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_partner_monog,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_partner_monog label-psq_partner_monog-0"
data-mlm-field="psq_partner_monog" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_partner_monog','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_partner_monog_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_relationshipdur12mo-tr" sq_id="psq_relationshipdur12mo" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_relationshipdur12mo" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_relationshipdur12mo" data-mlm-type="label" data-mlm-text-align="left">Did this relationship last MORE than 12 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_relationshipdur12mo" value="" tabindex="-1" class="hiddenradio"
aria-labelledby="label-psq_relationshipdur12mo"><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_relationshipdur12mo_1" tabindex="-1" name="psq_relationshipdur12mo___radio"
aria-labelledby="label-psq_relationshipdur12mo label-psq_relationshipdur12mo-1" onclick="document.forms['form'].psq_relationshipdur12mo.value=this.value;doBranching('psq_relationshipdur12mo');" value="1"> <label
data-mlm-field="psq_relationshipdur12mo" data-mlm-type="enum" data-mlm-value="1" id="label-psq_relationshipdur12mo-1" for="opt-psq_relationshipdur12mo_1" class="mc" data-mlm-text-align="left">Yes</label></span><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_relationshipdur12mo_0" tabindex="-1" name="psq_relationshipdur12mo___radio"
aria-labelledby="label-psq_relationshipdur12mo label-psq_relationshipdur12mo-0" onclick="document.forms['form'].psq_relationshipdur12mo.value=this.value;doBranching('psq_relationshipdur12mo');" value="0"> <label
data-mlm-field="psq_relationshipdur12mo" data-mlm-type="enum" data-mlm-value="0" id="label-psq_relationshipdur12mo-0" for="opt-psq_relationshipdur12mo_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_relationshipdur12mo_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_relationshipdur12mo,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_relationshipdur12mo label-psq_relationshipdur12mo-1"
data-mlm-field="psq_relationshipdur12mo" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_relationshipdur12mo_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_relationshipdur12mo,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_relationshipdur12mo label-psq_relationshipdur12mo-0"
data-mlm-field="psq_relationshipdur12mo" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_relationshipdur12mo','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_relationshipdur12mo_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sexciswoman-tr" sq_id="psq_sexciswoman" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sexciswoman" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sexciswoman" data-mlm-type="label" data-mlm-text-align="left">In the past 6 months, have you had vaginal or anal sex with a cisgender woman (who was born female and identifies as female)?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sexciswoman" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sexciswoman"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexciswoman_1" tabindex="-1" name="psq_sexciswoman___radio" aria-labelledby="label-psq_sexciswoman label-psq_sexciswoman-1"
onclick="document.forms['form'].psq_sexciswoman.value=this.value;doBranching('psq_sexciswoman');" value="1"> <label data-mlm-field="psq_sexciswoman" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sexciswoman-1"
for="opt-psq_sexciswoman_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexciswoman_0" tabindex="-1"
name="psq_sexciswoman___radio" aria-labelledby="label-psq_sexciswoman label-psq_sexciswoman-0" onclick="document.forms['form'].psq_sexciswoman.value=this.value;doBranching('psq_sexciswoman');" value="0"> <label
data-mlm-field="psq_sexciswoman" data-mlm-type="enum" data-mlm-value="0" id="label-psq_sexciswoman-0" for="opt-psq_sexciswoman_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexciswoman_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexciswoman,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexciswoman label-psq_sexciswoman-1"
data-mlm-field="psq_sexciswoman" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexciswoman_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexciswoman,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexciswoman label-psq_sexciswoman-0"
data-mlm-field="psq_sexciswoman" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sexciswoman','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sexciswoman_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_num_ciswoman-tr" sq_id="psq_num_ciswoman" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_num_ciswoman" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_num_ciswoman" data-mlm-type="label" data-mlm-text-align="left">With how many women in the past 6 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_num_ciswoman"
class="x-form-text x-form-field rci-left" type="text" name="psq_num_ciswoman" value="" onchange="clean_datetime(this,'integer');doBranching('psq_num_ciswoman');" onblur="redcap_validate(this,'','','soft_typed','integer',1)"
tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_num_ciswoman');}" fv="integer"></span>
<div id="psq_num_ciswoman_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sexmale_12mo-tr" sq_id="psq_sexmale_12mo" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sexmale_12mo" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sexmale_12mo" data-mlm-type="label" data-mlm-text-align="left">In the last 12 months have you had vaginal or anal sex with a man (who was born male and identifies as male)?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sexmale_12mo" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sexmale_12mo"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexmale_12mo_1" tabindex="-1" name="psq_sexmale_12mo___radio" aria-labelledby="label-psq_sexmale_12mo label-psq_sexmale_12mo-1"
onclick="document.forms['form'].psq_sexmale_12mo.value=this.value;doBranching('psq_sexmale_12mo');" value="1"> <label data-mlm-field="psq_sexmale_12mo" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sexmale_12mo-1"
for="opt-psq_sexmale_12mo_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexmale_12mo_0" tabindex="-1"
name="psq_sexmale_12mo___radio" aria-labelledby="label-psq_sexmale_12mo label-psq_sexmale_12mo-0" onclick="document.forms['form'].psq_sexmale_12mo.value=this.value;doBranching('psq_sexmale_12mo');" value="0"> <label
data-mlm-field="psq_sexmale_12mo" data-mlm-type="enum" data-mlm-value="0" id="label-psq_sexmale_12mo-0" for="opt-psq_sexmale_12mo_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexmale_12mo_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexmale_12mo,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexmale_12mo label-psq_sexmale_12mo-1"
data-mlm-field="psq_sexmale_12mo" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexmale_12mo_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexmale_12mo,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexmale_12mo label-psq_sexmale_12mo-0"
data-mlm-field="psq_sexmale_12mo" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sexmale_12mo','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sexmale_12mo_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sexmale_6mo-tr" sq_id="psq_sexmale_6mo" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sexmale_6mo" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sexmale_6mo" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months have you had vaginal or anal sex with a man (who was born male and identifies as male)?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sexmale_6mo" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sexmale_6mo"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexmale_6mo_1" tabindex="-1" name="psq_sexmale_6mo___radio" aria-labelledby="label-psq_sexmale_6mo label-psq_sexmale_6mo-1"
onclick="document.forms['form'].psq_sexmale_6mo.value=this.value;doBranching('psq_sexmale_6mo');" value="1"> <label data-mlm-field="psq_sexmale_6mo" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sexmale_6mo-1"
for="opt-psq_sexmale_6mo_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sexmale_6mo_0" tabindex="-1"
name="psq_sexmale_6mo___radio" aria-labelledby="label-psq_sexmale_6mo label-psq_sexmale_6mo-0" onclick="document.forms['form'].psq_sexmale_6mo.value=this.value;doBranching('psq_sexmale_6mo');" value="0"> <label
data-mlm-field="psq_sexmale_6mo" data-mlm-type="enum" data-mlm-value="0" id="label-psq_sexmale_6mo-0" for="opt-psq_sexmale_6mo_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexmale_6mo_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexmale_6mo,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexmale_6mo label-psq_sexmale_6mo-1"
data-mlm-field="psq_sexmale_6mo" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sexmale_6mo_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sexmale_6mo,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sexmale_6mo label-psq_sexmale_6mo-0"
data-mlm-field="psq_sexmale_6mo" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sexmale_6mo','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sexmale_6mo_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_num_male-tr" sq_id="psq_num_male" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_num_male" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_num_male" data-mlm-type="label" data-mlm-text-align="left">With how many men in the past 6 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_num_male"
class="x-form-text x-form-field rci-left" type="text" name="psq_num_male" value="" onchange="clean_datetime(this,'integer');doBranching('psq_num_male');" onblur="redcap_validate(this,'','','soft_typed','integer',1)" tabindex="0"
onkeydown="if(event.keyCode==9){doBranching('psq_num_male');}" fv="integer"></span>
<div id="psq_num_male_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sex_hiv-tr" sq_id="psq_sex_hiv" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sex_hiv" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sex_hiv" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months, did you have oral, vaginal, or anal sex with someone who lives with HIV?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sex_hiv" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sex_hiv"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex_hiv_1" tabindex="-1" name="psq_sex_hiv___radio" aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-1"
onclick="document.forms['form'].psq_sex_hiv.value=this.value;doBranching('psq_sex_hiv');" value="1"> <label data-mlm-field="psq_sex_hiv" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sex_hiv-1" for="opt-psq_sex_hiv_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex_hiv_2" tabindex="-1" name="psq_sex_hiv___radio"
aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-2" onclick="document.forms['form'].psq_sex_hiv.value=this.value;doBranching('psq_sex_hiv');" value="2"> <label data-mlm-field="psq_sex_hiv" data-mlm-type="enum" data-mlm-value="2"
id="label-psq_sex_hiv-2" for="opt-psq_sex_hiv_2" class="mc" data-mlm-text-align="left">No</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex_hiv_3" tabindex="-1"
name="psq_sex_hiv___radio" aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-3" onclick="document.forms['form'].psq_sex_hiv.value=this.value;doBranching('psq_sex_hiv');" value="3"> <label data-mlm-field="psq_sex_hiv"
data-mlm-type="enum" data-mlm-value="3" id="label-psq_sex_hiv-3" for="opt-psq_sex_hiv_3" class="mc" data-mlm-text-align="left">Don't know</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex_hiv_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex_hiv,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-1" data-mlm-field="psq_sex_hiv"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex_hiv_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex_hiv,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-2" data-mlm-field="psq_sex_hiv"
data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">No</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex_hiv_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex_hiv,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex_hiv label-psq_sex_hiv-3" data-mlm-field="psq_sex_hiv"
data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Don't know</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sex_hiv','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sex_hiv_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sex_exchange-tr" sq_id="psq_sex_exchange" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sex_exchange" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sex_exchange" data-mlm-type="label" data-mlm-text-align="left">Did you give or receive money, drugs, gifts, or services in exchange for sex?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sex_exchange" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sex_exchange"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex_exchange_1" tabindex="-1" name="psq_sex_exchange___radio" aria-labelledby="label-psq_sex_exchange label-psq_sex_exchange-1"
onclick="document.forms['form'].psq_sex_exchange.value=this.value;doBranching('psq_sex_exchange');" value="1"> <label data-mlm-field="psq_sex_exchange" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sex_exchange-1"
for="opt-psq_sex_exchange_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_sex_exchange_0" tabindex="-1"
name="psq_sex_exchange___radio" aria-labelledby="label-psq_sex_exchange label-psq_sex_exchange-0" onclick="document.forms['form'].psq_sex_exchange.value=this.value;doBranching('psq_sex_exchange');" value="0"> <label
data-mlm-field="psq_sex_exchange" data-mlm-type="enum" data-mlm-value="0" id="label-psq_sex_exchange-0" for="opt-psq_sex_exchange_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex_exchange_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex_exchange,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex_exchange label-psq_sex_exchange-1"
data-mlm-field="psq_sex_exchange" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sex_exchange_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_sex_exchange,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sex_exchange label-psq_sex_exchange-0"
data-mlm-field="psq_sex_exchange" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sex_exchange','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sex_exchange_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_injection-sh-tr" sq_id="{}" data-mlm-text-align="left">
<td class="header toolbar" colspan="3" data-mlm-text-align="left">
<div data-mlm-field="psq_injection" data-mlm-type="header" data-mlm-text-align="left"> </div>
</td>
</tr>
<tr class="hidden" id="psq_injection-tr" sq_id="psq_injection" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_injection" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_injection" data-mlm-type="label" data-mlm-text-align="left">Did you inject drugs or other substances without a prescription?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_injection" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_injection"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_injection_1" tabindex="-1" name="psq_injection___radio" aria-labelledby="label-psq_injection label-psq_injection-1"
onclick="document.forms['form'].psq_injection.value=this.value;doBranching('psq_injection');" value="1"> <label data-mlm-field="psq_injection" data-mlm-type="enum" data-mlm-value="1" id="label-psq_injection-1"
for="opt-psq_injection_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_injection_0" tabindex="-1" name="psq_injection___radio"
aria-labelledby="label-psq_injection label-psq_injection-0" onclick="document.forms['form'].psq_injection.value=this.value;doBranching('psq_injection');" value="0"> <label data-mlm-field="psq_injection" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_injection-0" for="opt-psq_injection_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_injection_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_injection,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_injection label-psq_injection-1" data-mlm-field="psq_injection"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_injection_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_injection,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_injection label-psq_injection-0" data-mlm-field="psq_injection"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_injection','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_injection_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_drugs-tr" sq_id="psq_drugs" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_drugs" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_drugs" data-mlm-type="label" data-mlm-text-align="left">Did you use any of the drugs on the list? Check all that apply</div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div>
<div style="overflow:hidden;" data-mlm-text-align="left">
<div data-kind="field-value" data-mlm-text-align="left">
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-1" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_1" name="__chkn__psq_drugs" code="1" onclick="checkboxClick('psq_drugs','1',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_1"> <label id="label-psq_drugs-1" class="mc"
for="id-__chk__psq_drugs_RC_1" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="left">Cocaine or crack</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-2" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_2" name="__chkn__psq_drugs" code="2" onclick="checkboxClick('psq_drugs','2',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_2"> <label id="label-psq_drugs-2" class="mc"
for="id-__chk__psq_drugs_RC_2" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="left">Meth (methamphetamines like "crystal meth") or other amphetamines</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-3" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_3" name="__chkn__psq_drugs" code="3" onclick="checkboxClick('psq_drugs','3',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_3"> <label id="label-psq_drugs-3" class="mc"
for="id-__chk__psq_drugs_RC_3" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="left">Opiates (heroin, fentanyl, opium, etc.)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-4" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_4" name="__chkn__psq_drugs" code="4" onclick="checkboxClick('psq_drugs','4',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_4"> <label id="label-psq_drugs-4" class="mc"
for="id-__chk__psq_drugs_RC_4" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="left">Dissociatives (ketamine, PCP, etc.)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-5" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_5" name="__chkn__psq_drugs" code="5" onclick="checkboxClick('psq_drugs','5',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_5"> <label id="label-psq_drugs-5" class="mc"
for="id-__chk__psq_drugs_RC_5" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="5" data-mlm-text-align="left">Hallucinogens (LSD, magic mushrooms, peyote, etc.)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-6" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_6" name="__chkn__psq_drugs" code="6" onclick="checkboxClick('psq_drugs','6',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_6"> <label id="label-psq_drugs-6" class="mc"
for="id-__chk__psq_drugs_RC_6" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="6" data-mlm-text-align="left">Empathogens (MDMA, ecstasy, molly, etc.)</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-7" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_7" name="__chkn__psq_drugs" code="7" onclick="checkboxClick('psq_drugs','7',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_7"> <label id="label-psq_drugs-7" class="mc"
for="id-__chk__psq_drugs_RC_7" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="7" data-mlm-text-align="left">Marijuana</label></div>
<div class="choicevert hidden" onclick="" data-mlm-text-align="left"><input type="checkbox" aria-labelledby="label-psq_drugs label-psq_drugs-8" tabindex="-1" onchange="clean_datetime(this,'');doBranching('psq_drugs');"
id="id-__chk__psq_drugs_RC_8" name="__chkn__psq_drugs" code="8" onclick="checkboxClick('psq_drugs','8',this,event,0);"><input type="hidden" value="" name="__chk__psq_drugs_RC_8"> <label id="label-psq_drugs-8" class="mc"
for="id-__chk__psq_drugs_RC_8" data-mlm-field="psq_drugs" data-mlm-type="enum" data-mlm-value="8" data-mlm-text-align="left">K2, Spice, Synthetic Cannabinoids</label></div>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,1" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-1" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="left">Cocaine or crack</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,2" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-2" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="left">Meth (methamphetamines like "crystal meth") or other amphetamines</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,3" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-3" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="left">Opiates (heroin, fentanyl, opium, etc.)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_4" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,4" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-4" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="left">Dissociatives (ketamine, PCP, etc.)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_5" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,5" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-5" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="5" data-mlm-text-align="left">Hallucinogens (LSD, magic mushrooms, peyote, etc.)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_6" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,6" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-6" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="6" data-mlm-text-align="left">Empathogens (MDMA, ecstasy, molly, etc.)</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_7" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,7" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-7" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="7" data-mlm-text-align="left">Marijuana</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="id-__chk__psq_drugs_RC_8" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,0); }"
onclick="enhanceChoiceSelect(this,event,0);" comps="psq_drugs,code,8" class="hover unselectedchkbox" data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugs label-psq_drugs-8" data-mlm-field="psq_drugs"
data-mlm-type="enum" data-mlm-value="8" data-mlm-text-align="left">K2, Spice, Synthetic Cannabinoids</span></label></div>
</div>
</div>
</div>
<div class="space" data-mlm-text-align="left"></div>
<div id="psq_drugs_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_drugsinject-tr" sq_id="psq_drugsinject" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_drugsinject" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_drugsinject" data-mlm-type="label" data-mlm-text-align="left">Do you inject (i.e. use needles) any of the drugs listed above?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_drugsinject" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_drugsinject"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_drugsinject_1" tabindex="-1" name="psq_drugsinject___radio" aria-labelledby="label-psq_drugsinject label-psq_drugsinject-1"
onclick="document.forms['form'].psq_drugsinject.value=this.value;doBranching('psq_drugsinject');" value="1"> <label data-mlm-field="psq_drugsinject" data-mlm-type="enum" data-mlm-value="1" id="label-psq_drugsinject-1"
for="opt-psq_drugsinject_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_drugsinject_0" tabindex="-1"
name="psq_drugsinject___radio" aria-labelledby="label-psq_drugsinject label-psq_drugsinject-0" onclick="document.forms['form'].psq_drugsinject.value=this.value;doBranching('psq_drugsinject');" value="0"> <label
data-mlm-field="psq_drugsinject" data-mlm-type="enum" data-mlm-value="0" id="label-psq_drugsinject-0" for="opt-psq_drugsinject_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_drugsinject_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_drugsinject,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugsinject label-psq_drugsinject-1"
data-mlm-field="psq_drugsinject" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_drugsinject_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_drugsinject,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_drugsinject label-psq_drugsinject-0"
data-mlm-field="psq_drugsinject" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_drugsinject','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_drugsinject_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_shareworks-tr" sq_id="psq_shareworks" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_shareworks" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_shareworks" data-mlm-type="label" data-mlm-text-align="left">Do you share needles with other people?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_shareworks" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_shareworks"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_shareworks_1" tabindex="-1" name="psq_shareworks___radio" aria-labelledby="label-psq_shareworks label-psq_shareworks-1"
onclick="document.forms['form'].psq_shareworks.value=this.value;doBranching('psq_shareworks');" value="1"> <label data-mlm-field="psq_shareworks" data-mlm-type="enum" data-mlm-value="1" id="label-psq_shareworks-1"
for="opt-psq_shareworks_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_shareworks_0" tabindex="-1" name="psq_shareworks___radio"
aria-labelledby="label-psq_shareworks label-psq_shareworks-0" onclick="document.forms['form'].psq_shareworks.value=this.value;doBranching('psq_shareworks');" value="0"> <label data-mlm-field="psq_shareworks" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_shareworks-0" for="opt-psq_shareworks_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_shareworks_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_shareworks,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_shareworks label-psq_shareworks-1"
data-mlm-field="psq_shareworks" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_shareworks_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_shareworks,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_shareworks label-psq_shareworks-0"
data-mlm-field="psq_shareworks" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_shareworks','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_shareworks_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_sti-sh-tr" sq_id="{}" data-mlm-text-align="left">
<td class="header toolbar" colspan="3" data-mlm-text-align="left">
<div data-mlm-field="psq_sti" data-mlm-type="header" data-mlm-text-align="left"> </div>
</td>
</tr>
<tr class="hidden" id="psq_sti-tr" sq_id="psq_sti" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_sti" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_sti" data-mlm-type="label" data-mlm-text-align="left">In the last 6 months, were you diagnosed with gonorrhea, chlamydia, or syphilis?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_sti" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_sti"><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_sti_1" tabindex="-1" name="psq_sti___radio" aria-labelledby="label-psq_sti label-psq_sti-1" onclick="document.forms['form'].psq_sti.value=this.value;doBranching('psq_sti');"
value="1"> <label data-mlm-field="psq_sti" data-mlm-type="enum" data-mlm-value="1" id="label-psq_sti-1" for="opt-psq_sti_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_sti_0" tabindex="-1" name="psq_sti___radio" aria-labelledby="label-psq_sti label-psq_sti-0" onclick="document.forms['form'].psq_sti.value=this.value;doBranching('psq_sti');"
value="0"> <label data-mlm-field="psq_sti" data-mlm-type="enum" data-mlm-value="0" id="label-psq_sti-0" for="opt-psq_sti_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sti_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_sti,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sti label-psq_sti-1" data-mlm-field="psq_sti" data-mlm-type="enum" data-mlm-value="1"
data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_sti_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_sti,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_sti label-psq_sti-0" data-mlm-field="psq_sti" data-mlm-type="enum" data-mlm-value="0"
data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_sti','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_sti_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_stithroat-tr" sq_id="psq_stithroat" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_stithroat" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_stithroat" data-mlm-type="label" data-mlm-text-align="left">Was this infection only found in your throat?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_stithroat" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_stithroat"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_stithroat_1" tabindex="-1" name="psq_stithroat___radio" aria-labelledby="label-psq_stithroat label-psq_stithroat-1"
onclick="document.forms['form'].psq_stithroat.value=this.value;doBranching('psq_stithroat');" value="1"> <label data-mlm-field="psq_stithroat" data-mlm-type="enum" data-mlm-value="1" id="label-psq_stithroat-1"
for="opt-psq_stithroat_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_stithroat_0" tabindex="-1" name="psq_stithroat___radio"
aria-labelledby="label-psq_stithroat label-psq_stithroat-0" onclick="document.forms['form'].psq_stithroat.value=this.value;doBranching('psq_stithroat');" value="0"> <label data-mlm-field="psq_stithroat" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_stithroat-0" for="opt-psq_stithroat_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_stithroat_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_stithroat,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_stithroat label-psq_stithroat-1" data-mlm-field="psq_stithroat"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_stithroat_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_stithroat,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_stithroat label-psq_stithroat-0" data-mlm-field="psq_stithroat"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_stithroat','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_stithroat_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_seizures-sh-tr" sq_id="{}" data-mlm-text-align="left">
<td class="header toolbar" colspan="3" data-mlm-text-align="left">
<div data-mlm-field="psq_seizures" data-mlm-type="header" data-mlm-text-align="left"> </div>
</td>
</tr>
<tr class="hidden" id="psq_seizures-tr" sq_id="psq_seizures" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_seizures" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_seizures" data-mlm-type="label" data-mlm-text-align="left">Have you had a seizure in the last 3 years or have you taken medication to specifically treat seizures in the last 3 years?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_seizures" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_seizures"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_seizures_1" tabindex="-1" name="psq_seizures___radio" aria-labelledby="label-psq_seizures label-psq_seizures-1"
onclick="document.forms['form'].psq_seizures.value=this.value;doBranching('psq_seizures');" value="1"> <label data-mlm-field="psq_seizures" data-mlm-type="enum" data-mlm-value="1" id="label-psq_seizures-1" for="opt-psq_seizures_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_seizures_0" tabindex="-1" name="psq_seizures___radio"
aria-labelledby="label-psq_seizures label-psq_seizures-0" onclick="document.forms['form'].psq_seizures.value=this.value;doBranching('psq_seizures');" value="0"> <label data-mlm-field="psq_seizures" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_seizures-0" for="opt-psq_seizures_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_seizures_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_seizures,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_seizures label-psq_seizures-1" data-mlm-field="psq_seizures"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_seizures_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_seizures,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_seizures label-psq_seizures-0" data-mlm-field="psq_seizures"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_seizures','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_seizures_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_tb-tr" sq_id="psq_tb" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_tb" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_tb" data-mlm-type="label" data-mlm-text-align="left">Do you have active tuberculosis?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_tb" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_tb"><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_tb_1" tabindex="-1" name="psq_tb___radio" aria-labelledby="label-psq_tb label-psq_tb-1" onclick="document.forms['form'].psq_tb.value=this.value;doBranching('psq_tb');"
value="1"> <label data-mlm-field="psq_tb" data-mlm-type="enum" data-mlm-value="1" id="label-psq_tb-1" for="opt-psq_tb_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_tb_0" tabindex="-1" name="psq_tb___radio" aria-labelledby="label-psq_tb label-psq_tb-0" onclick="document.forms['form'].psq_tb.value=this.value;doBranching('psq_tb');"
value="0"> <label data-mlm-field="psq_tb" data-mlm-type="enum" data-mlm-value="0" id="label-psq_tb-0" for="opt-psq_tb_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_tb_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_tb,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_tb label-psq_tb-1" data-mlm-field="psq_tb" data-mlm-type="enum" data-mlm-value="1"
data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_tb_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_tb,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_tb label-psq_tb-0" data-mlm-field="psq_tb" data-mlm-type="enum" data-mlm-value="0"
data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_tb','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_tb_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_hepc-tr" sq_id="psq_hepc" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_hepc" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_hepc" data-mlm-type="label" data-mlm-text-align="left">Do you have Hepatitis C?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_hepc" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_hepc"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_hepc_1" tabindex="-1" name="psq_hepc___radio" aria-labelledby="label-psq_hepc label-psq_hepc-1"
onclick="document.forms['form'].psq_hepc.value=this.value;doBranching('psq_hepc');" value="1"> <label data-mlm-field="psq_hepc" data-mlm-type="enum" data-mlm-value="1" id="label-psq_hepc-1" for="opt-psq_hepc_1" class="mc"
data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_hepc_0" tabindex="-1" name="psq_hepc___radio" aria-labelledby="label-psq_hepc label-psq_hepc-0"
onclick="document.forms['form'].psq_hepc.value=this.value;doBranching('psq_hepc');" value="0"> <label data-mlm-field="psq_hepc" data-mlm-type="enum" data-mlm-value="0" id="label-psq_hepc-0" for="opt-psq_hepc_0" class="mc"
data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_hepc_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_hepc,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_hepc label-psq_hepc-1" data-mlm-field="psq_hepc" data-mlm-type="enum"
data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_hepc_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_hepc,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_hepc label-psq_hepc-0" data-mlm-field="psq_hepc" data-mlm-type="enum"
data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_hepc','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_hepc_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_hiv-tr" sq_id="psq_hiv" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_hiv" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_hiv" data-mlm-type="label" data-mlm-text-align="left">Do you have HIV?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_hiv" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_hiv"><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_hiv_1" tabindex="-1" name="psq_hiv___radio" aria-labelledby="label-psq_hiv label-psq_hiv-1" onclick="document.forms['form'].psq_hiv.value=this.value;doBranching('psq_hiv');"
value="1"> <label data-mlm-field="psq_hiv" data-mlm-type="enum" data-mlm-value="1" id="label-psq_hiv-1" for="opt-psq_hiv_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_hiv_0" tabindex="-1" name="psq_hiv___radio" aria-labelledby="label-psq_hiv label-psq_hiv-0" onclick="document.forms['form'].psq_hiv.value=this.value;doBranching('psq_hiv');"
value="0"> <label data-mlm-field="psq_hiv" data-mlm-type="enum" data-mlm-value="0" id="label-psq_hiv-0" for="opt-psq_hiv_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_hiv_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_hiv,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_hiv label-psq_hiv-1" data-mlm-field="psq_hiv" data-mlm-type="enum" data-mlm-value="1"
data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_hiv_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }" onclick="enhanceChoiceSelect(this,event,null);"
comps="psq_hiv,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_hiv label-psq_hiv-0" data-mlm-field="psq_hiv" data-mlm-type="enum" data-mlm-value="0"
data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_hiv','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_hiv_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_diabetes-tr" sq_id="psq_diabetes" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_diabetes" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_diabetes" data-mlm-type="label" data-mlm-text-align="left">Do you have diabetes or high blood sugar?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_diabetes" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_diabetes"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_diabetes_1" tabindex="-1" name="psq_diabetes___radio" aria-labelledby="label-psq_diabetes label-psq_diabetes-1"
onclick="document.forms['form'].psq_diabetes.value=this.value;doBranching('psq_diabetes');" value="1"> <label data-mlm-field="psq_diabetes" data-mlm-type="enum" data-mlm-value="1" id="label-psq_diabetes-1" for="opt-psq_diabetes_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_diabetes_0" tabindex="-1" name="psq_diabetes___radio"
aria-labelledby="label-psq_diabetes label-psq_diabetes-0" onclick="document.forms['form'].psq_diabetes.value=this.value;doBranching('psq_diabetes');" value="0"> <label data-mlm-field="psq_diabetes" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_diabetes-0" for="opt-psq_diabetes_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_diabetes_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_diabetes,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_diabetes label-psq_diabetes-1" data-mlm-field="psq_diabetes"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_diabetes_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_diabetes,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_diabetes label-psq_diabetes-0" data-mlm-field="psq_diabetes"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_diabetes','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_diabetes_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_diabetestype-tr" sq_id="psq_diabetestype" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_diabetestype" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_diabetestype" data-mlm-type="label" data-mlm-text-align="left">What kind of diabetes?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_diabetestype" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_diabetestype"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_diabetestype_1" tabindex="-1" name="psq_diabetestype___radio" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-1"
onclick="document.forms['form'].psq_diabetestype.value=this.value;doBranching('psq_diabetestype');" value="1"> <label data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="1" id="label-psq_diabetestype-1"
for="opt-psq_diabetestype_1" class="mc" data-mlm-text-align="left">Type 1</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_diabetestype_2" tabindex="-1"
name="psq_diabetestype___radio" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-2" onclick="document.forms['form'].psq_diabetestype.value=this.value;doBranching('psq_diabetestype');" value="2"> <label
data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="2" id="label-psq_diabetestype-2" for="opt-psq_diabetestype_2" class="mc" data-mlm-text-align="left">Type 2</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_diabetestype_3" tabindex="-1" name="psq_diabetestype___radio" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-3"
onclick="document.forms['form'].psq_diabetestype.value=this.value;doBranching('psq_diabetestype');" value="3"> <label data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="3" id="label-psq_diabetestype-3"
for="opt-psq_diabetestype_3" class="mc" data-mlm-text-align="left">Don't know</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_diabetestype_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_diabetestype,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-1"
data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Type 1</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_diabetestype_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_diabetestype,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-2"
data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">Type 2</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_diabetestype_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_diabetestype,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_diabetestype label-psq_diabetestype-3"
data-mlm-field="psq_diabetestype" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Don't know</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_diabetestype','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_diabetestype_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_thyroid-tr" sq_id="psq_thyroid" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_thyroid" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_thyroid" data-mlm-type="label" data-mlm-text-align="left">Has your thyroid been removed or do you take medication for your thyroid?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_thyroid" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_thyroid"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_thyroid_1" tabindex="-1" name="psq_thyroid___radio" aria-labelledby="label-psq_thyroid label-psq_thyroid-1"
onclick="document.forms['form'].psq_thyroid.value=this.value;doBranching('psq_thyroid');" value="1"> <label data-mlm-field="psq_thyroid" data-mlm-type="enum" data-mlm-value="1" id="label-psq_thyroid-1" for="opt-psq_thyroid_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_thyroid_0" tabindex="-1" name="psq_thyroid___radio"
aria-labelledby="label-psq_thyroid label-psq_thyroid-0" onclick="document.forms['form'].psq_thyroid.value=this.value;doBranching('psq_thyroid');" value="0"> <label data-mlm-field="psq_thyroid" data-mlm-type="enum" data-mlm-value="0"
id="label-psq_thyroid-0" for="opt-psq_thyroid_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_thyroid_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_thyroid,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_thyroid label-psq_thyroid-1" data-mlm-field="psq_thyroid"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_thyroid_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_thyroid,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_thyroid label-psq_thyroid-0" data-mlm-field="psq_thyroid"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_thyroid','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_thyroid_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_autoimmune-tr" sq_id="psq_autoimmune" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_autoimmune" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_autoimmune" data-mlm-type="label" data-mlm-text-align="left">Have you ever had an autoimmune disorder (except psoriasis) like rheumatoid arthritis, celiac disease, sarcoidosis, or multiple sclerosis?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_autoimmune" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_autoimmune"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_autoimmune_1" tabindex="-1" name="psq_autoimmune___radio" aria-labelledby="label-psq_autoimmune label-psq_autoimmune-1"
onclick="document.forms['form'].psq_autoimmune.value=this.value;doBranching('psq_autoimmune');" value="1"> <label data-mlm-field="psq_autoimmune" data-mlm-type="enum" data-mlm-value="1" id="label-psq_autoimmune-1"
for="opt-psq_autoimmune_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_autoimmune_0" tabindex="-1" name="psq_autoimmune___radio"
aria-labelledby="label-psq_autoimmune label-psq_autoimmune-0" onclick="document.forms['form'].psq_autoimmune.value=this.value;doBranching('psq_autoimmune');" value="0"> <label data-mlm-field="psq_autoimmune" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_autoimmune-0" for="opt-psq_autoimmune_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_autoimmune_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_autoimmune,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_autoimmune label-psq_autoimmune-1"
data-mlm-field="psq_autoimmune" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_autoimmune_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_autoimmune,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_autoimmune label-psq_autoimmune-0"
data-mlm-field="psq_autoimmune" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_autoimmune','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_autoimmune_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_height_feet-tr" sq_id="psq_height_feet" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_height_feet" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_height_feet" data-mlm-type="label" data-mlm-text-align="left">Feet</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_height_feet"
class="x-form-text x-form-field rci-left" type="text" name="psq_height_feet" value="" onchange="clean_datetime(this,'integer');calculate('psq_height_feet');doBranching('psq_height_feet');"
onblur="redcap_validate(this,'2','8','soft_typed','integer',1)" tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_height_feet');}" fv="integer"></span>
<div id="psq_height_feet_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_height_inches-tr" sq_id="psq_height_inches" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_height_inches" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_height_inches" data-mlm-type="label" data-mlm-text-align="left">Inches</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_height_inches"
class="x-form-text x-form-field rci-left" type="text" name="psq_height_inches" value="" onchange="clean_datetime(this,'integer');calculate('psq_height_inches');doBranching('psq_height_inches');"
onblur="redcap_validate(this,'0','11','soft_typed','integer',1)" tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_height_inches');}" fv="integer"></span>
<div id="psq_height_inches_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_weight-tr" sq_id="psq_weight" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-6" data-mlm-text-align="left"><label class="fl" id="label-psq_weight" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_weight" data-mlm-type="label" data-mlm-text-align="left">About how much do you weigh?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label></td>
<td class="data col-5" data-mlm-text-align="left"><span data-kind="field-value" data-mlm-text-align="left"><input autocomplete="new-password" aria-required="true" aria-labelledby="label-psq_weight note-psq_weight"
class="x-form-text x-form-field " type="text" name="psq_weight" value="" onchange="clean_datetime(this,'number');calculate('psq_weight');doBranching('psq_weight');" onblur="redcap_validate(this,'','','soft_typed','number',1)"
tabindex="0" onkeydown="if(event.keyCode==9){doBranching('psq_weight');}" fv="number"></span>
<div id="note-psq_weight" class="note" data-mlm-field="psq_weight" data-mlm-type="note" aria-hidden="true" data-mlm-text-align="left">(in lbs)</div>
<div id="psq_weight_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_bmi-tr" sq_id="psq_bmi" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-6" data-mlm-text-align="left"><label class="fl" id="label-psq_bmi" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_bmi" data-mlm-type="label" data-mlm-text-align="left">BMI</div>
</div>
</label></td>
<td class="data col-5" data-mlm-text-align="left"><span data-kind="field-value" data-mlm-text-align="left"><input type="text" aria-labelledby="label-psq_bmi" name="psq_bmi" value="" sv="" tabindex="-1" readonly="readonly"
class="x-form-text x-form-field rci-calc"
autocomplete="new-password"></span> <a href="javascript:;" ignore="Yes" class="viewEq d-print-none" tabindex="-1" onclick="viewEq('psq_bmi',0,0);" data-mlm-text-align="left"><span data-rc-lang="form_renderer_21" data-mlm-text-align="left">View equation</span></a>
</td>
</tr>
<tr class="hidden" id="psq_pregnant-tr" sq_id="psq_pregnant" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_pregnant" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_pregnant" data-mlm-type="label" data-mlm-text-align="left">Are you pregnant or breast-feeding now?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_pregnant" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_pregnant"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_pregnant_1" tabindex="-1" name="psq_pregnant___radio" aria-labelledby="label-psq_pregnant label-psq_pregnant-1"
onclick="document.forms['form'].psq_pregnant.value=this.value;doBranching('psq_pregnant');" value="1"> <label data-mlm-field="psq_pregnant" data-mlm-type="enum" data-mlm-value="1" id="label-psq_pregnant-1" for="opt-psq_pregnant_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_pregnant_0" tabindex="-1" name="psq_pregnant___radio"
aria-labelledby="label-psq_pregnant label-psq_pregnant-0" onclick="document.forms['form'].psq_pregnant.value=this.value;doBranching('psq_pregnant');" value="0"> <label data-mlm-field="psq_pregnant" data-mlm-type="enum"
data-mlm-value="0" id="label-psq_pregnant-0" for="opt-psq_pregnant_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_pregnant_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_pregnant,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_pregnant label-psq_pregnant-1" data-mlm-field="psq_pregnant"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_pregnant_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_pregnant,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_pregnant label-psq_pregnant-0" data-mlm-field="psq_pregnant"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_pregnant','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_pregnant_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_pregnancy_12mo-tr" sq_id="psq_pregnancy_12mo" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_pregnancy_12mo" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_pregnancy_12mo" data-mlm-type="label" data-mlm-text-align="left">Do you plan to get pregnant in the next 12 months?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_pregnancy_12mo" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_pregnancy_12mo"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_pregnancy_12mo_1" tabindex="-1" name="psq_pregnancy_12mo___radio" aria-labelledby="label-psq_pregnancy_12mo label-psq_pregnancy_12mo-1"
onclick="document.forms['form'].psq_pregnancy_12mo.value=this.value;doBranching('psq_pregnancy_12mo');" value="1"> <label data-mlm-field="psq_pregnancy_12mo" data-mlm-type="enum" data-mlm-value="1" id="label-psq_pregnancy_12mo-1"
for="opt-psq_pregnancy_12mo_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_pregnancy_12mo_0" tabindex="-1"
name="psq_pregnancy_12mo___radio" aria-labelledby="label-psq_pregnancy_12mo label-psq_pregnancy_12mo-0" onclick="document.forms['form'].psq_pregnancy_12mo.value=this.value;doBranching('psq_pregnancy_12mo');" value="0"> <label
data-mlm-field="psq_pregnancy_12mo" data-mlm-type="enum" data-mlm-value="0" id="label-psq_pregnancy_12mo-0" for="opt-psq_pregnancy_12mo_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_pregnancy_12mo_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_pregnancy_12mo,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_pregnancy_12mo label-psq_pregnancy_12mo-1"
data-mlm-field="psq_pregnancy_12mo" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_pregnancy_12mo_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_pregnancy_12mo,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_pregnancy_12mo label-psq_pregnancy_12mo-0"
data-mlm-field="psq_pregnancy_12mo" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_pregnancy_12mo','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_pregnancy_12mo_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_otherresearch-sh-tr" sq_id="{}" data-mlm-text-align="left">
<td class="header toolbar" colspan="3" data-mlm-text-align="left">
<div data-mlm-field="psq_otherresearch" data-mlm-type="header" data-mlm-text-align="left"> </div>
</td>
</tr>
<tr class="hidden" id="psq_otherresearch-tr" sq_id="psq_otherresearch" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_otherresearch" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_otherresearch" data-mlm-type="label" data-mlm-text-align="left">Are you currently participating in any research studies that involve HIV testing or receiving any medications?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_otherresearch" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_otherresearch"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_otherresearch_1" tabindex="-1" name="psq_otherresearch___radio" aria-labelledby="label-psq_otherresearch label-psq_otherresearch-1"
onclick="document.forms['form'].psq_otherresearch.value=this.value;doBranching('psq_otherresearch');" value="1"> <label data-mlm-field="psq_otherresearch" data-mlm-type="enum" data-mlm-value="1" id="label-psq_otherresearch-1"
for="opt-psq_otherresearch_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_otherresearch_0" tabindex="-1"
name="psq_otherresearch___radio" aria-labelledby="label-psq_otherresearch label-psq_otherresearch-0" onclick="document.forms['form'].psq_otherresearch.value=this.value;doBranching('psq_otherresearch');" value="0"> <label
data-mlm-field="psq_otherresearch" data-mlm-type="enum" data-mlm-value="0" id="label-psq_otherresearch-0" for="opt-psq_otherresearch_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_otherresearch_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_otherresearch,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_otherresearch label-psq_otherresearch-1"
data-mlm-field="psq_otherresearch" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_otherresearch_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_otherresearch,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_otherresearch label-psq_otherresearch-0"
data-mlm-field="psq_otherresearch" data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_otherresearch','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_otherresearch_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_prepnow-tr" sq_id="psq_prepnow" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_prepnow" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_prepnow" data-mlm-type="label" data-mlm-text-align="left">Are you taking PrEP now?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_prepnow" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_prepnow"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepnow_1" tabindex="-1" name="psq_prepnow___radio" aria-labelledby="label-psq_prepnow label-psq_prepnow-1"
onclick="document.forms['form'].psq_prepnow.value=this.value;doBranching('psq_prepnow');" value="1"> <label data-mlm-field="psq_prepnow" data-mlm-type="enum" data-mlm-value="1" id="label-psq_prepnow-1" for="opt-psq_prepnow_1"
class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepnow_0" tabindex="-1" name="psq_prepnow___radio"
aria-labelledby="label-psq_prepnow label-psq_prepnow-0" onclick="document.forms['form'].psq_prepnow.value=this.value;doBranching('psq_prepnow');" value="0"> <label data-mlm-field="psq_prepnow" data-mlm-type="enum" data-mlm-value="0"
id="label-psq_prepnow-0" for="opt-psq_prepnow_0" class="mc" data-mlm-text-align="left">No</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepnow_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepnow,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepnow label-psq_prepnow-1" data-mlm-field="psq_prepnow"
data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepnow_0" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepnow,value,0" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepnow label-psq_prepnow-0" data-mlm-field="psq_prepnow"
data-mlm-type="enum" data-mlm-value="0" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_prepnow','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_prepnow_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_prepbreaks-tr" sq_id="psq_prepbreaks" req="1" data-mlm-text-align="left" style="display: none;">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_prepbreaks" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_prepbreaks" data-mlm-type="label" data-mlm-text-align="left">Did you take any breaks from PrEP?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_prepbreaks" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_prepbreaks">
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepbreaks_1" tabindex="-1" name="psq_prepbreaks___radio" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-1"
onclick="document.forms['form'].psq_prepbreaks.value=this.value;doBranching('psq_prepbreaks');" value="1"> <label data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="1" id="label-psq_prepbreaks-1"
for="opt-psq_prepbreaks_1" class="mc" data-mlm-text-align="left">Yes, I stopped PrEP</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepbreaks_2" tabindex="-1" name="psq_prepbreaks___radio" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-2"
onclick="document.forms['form'].psq_prepbreaks.value=this.value;doBranching('psq_prepbreaks');" value="2"> <label data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="2" id="label-psq_prepbreaks-2"
for="opt-psq_prepbreaks_2" class="mc" data-mlm-text-align="left">Yes, I stopped it but only for short period of time and then restarted it</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepbreaks_3" tabindex="-1" name="psq_prepbreaks___radio" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-3"
onclick="document.forms['form'].psq_prepbreaks.value=this.value;doBranching('psq_prepbreaks');" value="3"> <label data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="3" id="label-psq_prepbreaks-3"
for="opt-psq_prepbreaks_3" class="mc" data-mlm-text-align="left">I take breaks from PrEP when I don't think I am at risk of HIV/not having sex</label></div>
<div class="choicevert hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_prepbreaks_4" tabindex="-1" name="psq_prepbreaks___radio" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-4"
onclick="document.forms['form'].psq_prepbreaks.value=this.value;doBranching('psq_prepbreaks');" value="4"> <label data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="4" id="label-psq_prepbreaks-4"
for="opt-psq_prepbreaks_4" class="mc" data-mlm-text-align="left">No</label></div>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepbreaks_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepbreaks,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-1"
data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes, I stopped PrEP</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepbreaks_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepbreaks,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-2"
data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">Yes, I stopped it but only for short period of time and then restarted it</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepbreaks_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepbreaks,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-3"
data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">I take breaks from PrEP when I don't think I am at risk of HIV/not having sex</span></label></div>
<div class="enhancedchoice col-12 col-md-12 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_prepbreaks_4" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_prepbreaks,value,4" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_prepbreaks label-psq_prepbreaks-4"
data-mlm-field="psq_prepbreaks" data-mlm-type="enum" data-mlm-value="4" data-mlm-text-align="center">No</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_prepbreaks','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_prepbreaks_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<tr class="hidden" id="psq_preprestart-tr" sq_id="psq_preprestart" req="1" data-mlm-text-align="left">
<td class="labelrc questionnum col-1" valign="top" data-mlm-text-align="right"></td>
<td class="labelrc col-11" colspan="2" data-mlm-text-align="left"><label class="fl" id="label-psq_preprestart" data-mlm-text-align="left">
<div data-kind="field-label" data-mlm-text-align="left">
<div data-mlm-field="psq_preprestart" data-mlm-type="label" data-mlm-text-align="left">In the next 18 months, do you plan on starting or re-starting PrEP?</div>
<div class="requiredlabel" aria-label="Question required." data-mlm-text-align="left">* <span data-rc-lang="data_entry_39" data-mlm-text-align="left">must provide value</span></div>
</div>
</label>
<div class="space" data-mlm-text-align="left"></div><span data-kind="field-value" data-mlm-text-align="left"><input name="psq_preprestart" value="" tabindex="-1" class="hiddenradio" aria-labelledby="label-psq_preprestart"><span
class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_preprestart_1" tabindex="-1" name="psq_preprestart___radio" aria-labelledby="label-psq_preprestart label-psq_preprestart-1"
onclick="document.forms['form'].psq_preprestart.value=this.value;doBranching('psq_preprestart');" value="1"> <label data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="1" id="label-psq_preprestart-1"
for="opt-psq_preprestart_1" class="mc" data-mlm-text-align="left">Yes</label></span><span class="choicehoriz hidden" data-mlm-text-align="left"><input type="radio" id="opt-psq_preprestart_2" tabindex="-1"
name="psq_preprestart___radio" aria-labelledby="label-psq_preprestart label-psq_preprestart-2" onclick="document.forms['form'].psq_preprestart.value=this.value;doBranching('psq_preprestart');" value="2"> <label
data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="2" id="label-psq_preprestart-2" for="opt-psq_preprestart_2" class="mc" data-mlm-text-align="left">No</label></span><span class="choicehoriz hidden"
data-mlm-text-align="left"><input type="radio" id="opt-psq_preprestart_3" tabindex="-1" name="psq_preprestart___radio" aria-labelledby="label-psq_preprestart label-psq_preprestart-3"
onclick="document.forms['form'].psq_preprestart.value=this.value;doBranching('psq_preprestart');" value="3"> <label data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="3" id="label-psq_preprestart-3"
for="opt-psq_preprestart_3" class="mc" data-mlm-text-align="left">Don't know</label></span>
<div class="enhancedchoice_wrapper" data-mlm-text-align="left">
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_preprestart_1" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_preprestart,value,1" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_preprestart label-psq_preprestart-1"
data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="1" data-mlm-text-align="center">Yes</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_preprestart_2" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_preprestart,value,2" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_preprestart label-psq_preprestart-2"
data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="2" data-mlm-text-align="center">No</span></label></div>
<div class="enhancedchoice col-12 col-md-6 " data-mlm-text-align="left"><label tabindex="0" for="opt-psq_preprestart_3" onkeydown="if(event.keyCode==32){ enhanceChoiceSelect(this,event,null); }"
onclick="enhanceChoiceSelect(this,event,null);" comps="psq_preprestart,value,3" class="hover " data-mlm-text-align="left"><span class="ec" aria-labelledby="label-psq_preprestart label-psq_preprestart-3"
data-mlm-field="psq_preprestart" data-mlm-type="enum" data-mlm-value="3" data-mlm-text-align="center">Don't know</span></label></div>
</div>
</span>
<div data-kind="reset-link" class="resetLinkParent d-print-none" data-mlm-text-align="right">
<a href="javascript:;" class="smalllink " tabindex="0" style="display:;" onclick="radioResetVal('psq_preprestart','form');return false;" data-mlm-text-align="left"><span data-rc-lang="form_renderer_20" data-mlm-text-align="left">reset</span></a>
</div>
<div id="psq_preprestart_MDLabel" class="MDLabel" style="display:none" code="" label="" data-mlm-text-align="left"></div>
</td>
</tr>
<input type="hidden" name="submit-action" id="submit-action" value="<span data-rc-lang="data_entry_206">Save Record</span>">
<input type="hidden" name="__start_time__" id="__start_time__" value="2023-03-12 00:45:06">
<input type="hidden" name="ptid" id="ptid" value="1">
<input type="hidden" name="__page__" value="1">
<input type="hidden" name="__page_hash__" value="944a4bb6469d12a722416a04b5e51a41">
<input type="hidden" name="__response_hash__" value="">
<input type="hidden" name="prescreening_questionnaire_complete" value="">
<tr class="surveysubmit" data-mlm-text-align="left">
<td class="labelrc col-12" style="padding:5px;" colspan="3" data-mlm-text-align="left">
<table cellspacing="0" data-mlm-text-align="left">
<tbody data-mlm-text-align="left">
<tr data-mlm-text-align="left">
<td colspan="2" style="text-align:center;padding:15px 0;" data-mlm-text-align="center">
<button name="submit-btn-saverecord" tabindex="0" class="jqbutton nowrap ui-button ui-corner-all ui-widget" style="color:#800000;min-width:140px;" onclick="$(this).button("disable");dataEntrySubmit(this);return false;"
data-mlm-text-align="center"><span data-rc-lang="data_entry_536" data-mlm-text-align="center">Next Page >></span></button>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
</tbody>
</table>
</div><input type="hidden" name="external-modules-temporary-record-id" value="external-modules-temporary-record-id-1678599906-1448969057">
</form>Name: form__interactions_arm_1 —
<form name="form__interactions_arm_1" enctype="multipart/form-data" data-mlm-text-align="left">
<input type="hidden" name="interaction_type____I1" value="">
<input type="hidden" name="contact1____I1" value="">
<input type="hidden" name="contact2____I1" value="">
<input type="hidden" name="gsv_completed_now____I1" value="">
<input type="hidden" name="gsv_completed_ever____I1" value="">
<input type="hidden" name="interaction_outcome____I1" value="">
<input type="hidden" name="gsv_now____I1" value="">
<input type="hidden" name="gsv_ever____I1" value="">
<input type="hidden" name="hve_completed_now____I1" value="">
<input type="hidden" name="hve_completed_ever____I1" value="">
<input type="hidden" name="hve_now____I1" value="">
<input type="hidden" name="hve_ever____I1" value="">
</form>Name: form__participant_info_arm_1 —
<form name="form__participant_info_arm_1" enctype="multipart/form-data" data-mlm-text-align="left">
<input type="hidden" name="dob" value="">
<input type="hidden" name="protocol_enrollmentdate" value="">
</form>Text Content
Working...
0% means
50% means
100% means
This value you provided is not a number. Please try again.
This value you provided is not an integer. Please try again.
The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to
9-digit number, excluding leading zeros). Please try again.
The value you provided must be within the suggested range
The value you provided is outside the suggested range
This value is admissible, but you may wish to double check it.
The value entered must be a time value in the following format HH:MM within the
range 00:00-23:59 (e.g., 04:32 or 23:19).
This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it
now.
This field must be a 10 digit U.S. phone number (like 415 555 1212). Please
re-enter it now.
This field must be a valid email address (like joe@user.com). Please re-enter it
now.
The value you provided could not be validated because it does not follow the
expected format. Please try again.
Required format:
/^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$/
/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))$/
/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/
/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/
/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))
(\d|[0-1]\d|[2][0-3]):[0-5]\d$/
/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))
(\d|[0-1]\d|[2][0-3]):[0-5]\d$/
/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))
(\d|[0-1]\d|[2][0-3]):[0-5]\d$/
/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))
(\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/
/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))
(\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/
/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))
(\d|[0-1]\d|[2][0-3])(:[0-5]\d){2}$/
/^(?!\.)((?!.*\.{2})[a-zA-Z0-9\u0080-\u00FF\u0100-\u017F\u0180-\u024F\u0250-\u02AF\u0300-\u036F\u0370-\u03FF\u0400-\u04FF\u0500-\u052F\u0530-\u058F\u0590-\u05FF\u0600-\u06FF\u0700-\u074F\u0750-\u077F\u0780-\u07BF\u07C0-\u07FF\u0900-\u097F\u0980-\u09FF\u0A00-\u0A7F\u0A80-\u0AFF\u0B00-\u0B7F\u0B80-\u0BFF\u0C00-\u0C7F\u0C80-\u0CFF\u0D00-\u0D7F\u0D80-\u0DFF\u0E00-\u0E7F\u0E80-\u0EFF\u0F00-\u0FFF\u1000-\u109F\u10A0-\u10FF\u1100-\u11FF\u1200-\u137F\u1380-\u139F\u13A0-\u13FF\u1400-\u167F\u1680-\u169F\u16A0-\u16FF\u1700-\u171F\u1720-\u173F\u1740-\u175F\u1760-\u177F\u1780-\u17FF\u1800-\u18AF\u1900-\u194F\u1950-\u197F\u1980-\u19DF\u19E0-\u19FF\u1A00-\u1A1F\u1B00-\u1B7F\u1D00-\u1D7F\u1D80-\u1DBF\u1DC0-\u1DFF\u1E00-\u1EFF\u1F00-\u1FFF\u20D0-\u20FF\u2100-\u214F\u2C00-\u2C5F\u2C60-\u2C7F\u2C80-\u2CFF\u2D00-\u2D2F\u2D30-\u2D7F\u2D80-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u309F\u30A0-\u30FF\u3100-\u312F\u3130-\u318F\u3190-\u319F\u31C0-\u31EF\u31F0-\u31FF\u3200-\u32FF\u3300-\u33FF\u3400-\u4DBF\u4DC0-\u4DFF\u4E00-\u9FFF\uA000-\uA48F\uA490-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF\.!#$%&'*+-/=?^_`{|}~\-\d]+)@(?!\.)([a-zA-Z0-9\u0080-\u00FF\u0100-\u017F\u0180-\u024F\u0250-\u02AF\u0300-\u036F\u0370-\u03FF\u0400-\u04FF\u0500-\u052F\u0530-\u058F\u0590-\u05FF\u0600-\u06FF\u0700-\u074F\u0750-\u077F\u0780-\u07BF\u07C0-\u07FF\u0900-\u097F\u0980-\u09FF\u0A00-\u0A7F\u0A80-\u0AFF\u0B00-\u0B7F\u0B80-\u0BFF\u0C00-\u0C7F\u0C80-\u0CFF\u0D00-\u0D7F\u0D80-\u0DFF\u0E00-\u0E7F\u0E80-\u0EFF\u0F00-\u0FFF\u1000-\u109F\u10A0-\u10FF\u1100-\u11FF\u1200-\u137F\u1380-\u139F\u13A0-\u13FF\u1400-\u167F\u1680-\u169F\u16A0-\u16FF\u1700-\u171F\u1720-\u173F\u1740-\u175F\u1760-\u177F\u1780-\u17FF\u1800-\u18AF\u1900-\u194F\u1950-\u197F\u1980-\u19DF\u19E0-\u19FF\u1A00-\u1A1F\u1B00-\u1B7F\u1D00-\u1D7F\u1D80-\u1DBF\u1DC0-\u1DFF\u1E00-\u1EFF\u1F00-\u1FFF\u20D0-\u20FF\u2100-\u214F\u2C00-\u2C5F\u2C60-\u2C7F\u2C80-\u2CFF\u2D00-\u2D2F\u2D30-\u2D7F\u2D80-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u309F\u30A0-\u30FF\u3100-\u312F\u3130-\u318F\u3190-\u319F\u31C0-\u31EF\u31F0-\u31FF\u3200-\u32FF\u3300-\u33FF\u3400-\u4DBF\u4DC0-\u4DFF\u4E00-\u9FFF\uA000-\uA48F\uA490-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF\-\.\d]+)((\.([a-zA-Z\u0080-\u00FF\u0100-\u017F\u0180-\u024F\u0250-\u02AF\u0300-\u036F\u0370-\u03FF\u0400-\u04FF\u0500-\u052F\u0530-\u058F\u0590-\u05FF\u0600-\u06FF\u0700-\u074F\u0750-\u077F\u0780-\u07BF\u07C0-\u07FF\u0900-\u097F\u0980-\u09FF\u0A00-\u0A7F\u0A80-\u0AFF\u0B00-\u0B7F\u0B80-\u0BFF\u0C00-\u0C7F\u0C80-\u0CFF\u0D00-\u0D7F\u0D80-\u0DFF\u0E00-\u0E7F\u0E80-\u0EFF\u0F00-\u0FFF\u1000-\u109F\u10A0-\u10FF\u1100-\u11FF\u1200-\u137F\u1380-\u139F\u13A0-\u13FF\u1400-\u167F\u1680-\u169F\u16A0-\u16FF\u1700-\u171F\u1720-\u173F\u1740-\u175F\u1760-\u177F\u1780-\u17FF\u1800-\u18AF\u1900-\u194F\u1950-\u197F\u1980-\u19DF\u19E0-\u19FF\u1A00-\u1A1F\u1B00-\u1B7F\u1D00-\u1D7F\u1D80-\u1DBF\u1DC0-\u1DFF\u1E00-\u1EFF\u1F00-\u1FFF\u20D0-\u20FF\u2100-\u214F\u2C00-\u2C5F\u2C60-\u2C7F\u2C80-\u2CFF\u2D00-\u2D2F\u2D30-\u2D7F\u2D80-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u309F\u30A0-\u30FF\u3100-\u312F\u3130-\u318F\u3190-\u319F\u31C0-\u31EF\u31F0-\u31FF\u3200-\u32FF\u3300-\u33FF\u3400-\u4DBF\u4DC0-\u4DFF\u4E00-\u9FFF\uA000-\uA48F\uA490-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF]){2,63})+)$/i
/^[-+]?\b\d+\b$/
/^[a-z]+$/i
/^\d{10}$/
/^[a-z0-9-_]+$/i
/^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/
/^-?\d+,\d$/
/^-?\d+\.\d$/
/^-?\d+,\d{2}$/
/^-?\d+\.\d{2}$/
/^-?\d+,\d{3}$/
/^-?\d+\.\d{3}$/
/^-?\d+,\d{4}$/
/^-?\d+\.\d{4}$/
/^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$/
/^(\(0[2-8]\)|0[2-8])\s*\d{4}\s*\d{4}$/
/^(?:\(?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)\)?)\s*(?:[.-]\s*)?([0-9]{3})\s*(?:[.-]\s*)?([0-9]{4})(?:\s*(?:#|x\.?|ext\.?|extension)\s*(\d+))?$/
/^((((\+44|0044)\s?\d{4}|\(?0\d{4}\)?)\s?\d{3}\s?\d{3})|(((\+44|0044)\s?\d{3}|\(?0\d{3}\)?)\s?\d{3}\s?\d{4})|(((\+44|0044)\s?\d{2}|\(?0\d{2}\)?)\s?\d{4}\s?\d{4}))(\s?\#(\d{4}|\d{3}))?$/
/^\d{4}$/
/^[ABCEGHJKLMNPRSTVXY]{1}\d{1}[A-Z]{1}\s*\d{1}[A-Z]{1}\d{1}$/i
/^(0[1-9]|[1-9]\d)\d{3}$/
/^\d{3}-\d\d-\d{4}$/
/^(\d|[01]\d|(2[0-3]))(:[0-5]\d){2}$/
/^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$/
/^[0-5]\d:[0-5]\d$/
/^[0-9]{4,9}$/
/^\d{5}(-\d{4})?$/
zSupKcL9sXzDVLqF6VypFMNSz
PRE-SCREENING QUESTIONNAIRE
A A A
Cannot select choice! The maximum number of choices has been selected.Value
removed!
Loading...
Timestamp
* must provide value
NowM-D-Y H:M
REVIEW SUBSTANCE USE.
REVIEW MEDICAL HISTORY.
SCREEN FAIL.
Columbia Research Unit thanks you for your interest in learning more about HIV
prevention research we conduct and for considering the potentials to
participate. The next step is to complete a brief questionnaire to find out if
you may be eligible for any studies we're currently conducting or studies we
will soon conduct. Generally, we look for HIV-negative people between 18 and 60
years old.
If you are potentially eligible, you will be invited to attend a 1-on-1
educational visit at our clinic. The educational visit lasts about 1.5 hours.
You may be asked to sign a consent form when you come in for your visit. We will
tell you about the research we do and the study for which you may eligible. We
will also teachyou about HIV, HIV prevention, and what you can expect if you
join an HIV prevention study with us. You will be compensated up to $25 for the
educational visit.
Some of these questions are personal, including questions about gender identity.
Taking part is up to you. There is no benefit to you for participating. Your
responses will be kept private. You can refuse to answer a question or stop at
any time.
The information you give us will be joined with information from everybody else
taking the survey, so that if you join the study, we can describe the group, not
the individuals, taking part in the study.
The risk of answering these questions is a possible of loss of confidentiality,
but we will do everything we can to protect your information. If you do not
qualify for the educational visit, or if you do qualify but you do not come in
for your visit, the information collected will be discarded and will not be used
for any purpose.
Do you want to continue with the questions?
* must provide value
Yes No
Yes
No
reset
8% Complete
What sex were you assigned at birth?
* must provide value
Male Female Intersex
Male
Female
Intersex
reset
What is your gender?
* must provide value
Cisman (assigned male at birth, identify as a man)
Ciswoman (assigned female at birth, identify as a woman)
Transman (assigned female at birth, identify as a man)
Transwoman (assigned male at birth, identify as a woman)
Gender non-conforming (gender identity does not match masculine or feminine
gender norms)
Other
Cisman (assigned male at birth, identify as a man)
Ciswoman (assigned female at birth, identify as a woman)
Transman (assigned female at birth, identify as a man)
Transwoman (assigned male at birth, identify as a woman)
Gender non-conforming (gender identity does not match masculine or feminine
gender norms)
Other
reset
Whom do you have sex with? (Sexual Preference)
Check all that apply
* must provide value
Cismen (assigned male at birth, identify as men)
Ciswomen (assigned female at birth, identify as women)
Transmen (assigned female at birth, identify as men)
Transwomen (assigned male at birth, identify as women)
No one
Gender non-conforming (GNC, gender identify does not match masculine or feminine
gender norms)
Other
Cismen (assigned male at birth, identify as men)
Ciswomen (assigned female at birth, identify as women)
Transmen (assigned female at birth, identify as men)
Transwomen (assigned male at birth, identify as women)
No one
Gender non-conforming (GNC, gender identify does not match masculine or feminine
gender norms)
Other
What is your date of birth?
* must provide value
TodayM-D-Y
How old are you?
View equation
In the last 6 months, did you have vaginal or anal sex?
* must provide value
Yes No
Yes
No
reset
How MANY people did you have vaginal or anal sex with in the past 6 months?
* must provide value
In the last 6 months, did you have insertive vaginal or anal sex (top) with a
cisman (who was born male and identifies as male) or a transgender person?
* must provide value
Yes No
Yes
No
reset
In the last 6 months, did you have receptive vaginal or anal sex (bottom) with a
cisman (who was born male and identifies as male) or a transgender person?
* must provide value
Yes No
Yes
No
reset
How MANY of these men or transgender persons did you have insertive anal sex
(top) WITHOUT a condom in the past 6 months?
* must provide value
How MANY of these men or transgender persons did you have receptive anal sex
(bottom) WITHOUT a condom in the past 6 months?
* must provide value
What is the HIV status of the partner with whom you had condomless receptive
anal sex?
* must provide value
Positive Negative Don't know
Positive
Negative
Don't know
reset
Is this partner's viral load (copies of virus in the blood) undetectable (so low
that tests cannot measure it)?
* must provide value
Yes No Don't know
Yes
No
Don't know
reset
Are you in a monogamous relationship with this partner (you and your partner
have sex only with each other and don't have any other sex partners)?
* must provide value
Yes No
Yes
No
reset
Did this relationship last MORE than 12 months?
* must provide value
Yes No
Yes
No
reset
In the past 6 months, have you had vaginal or anal sex with a cisgender woman
(who was born female and identifies as female)?
* must provide value
Yes No
Yes
No
reset
With how many women in the past 6 months?
* must provide value
In the last 12 months have you had vaginal or anal sex with a man (who was born
male and identifies as male)?
* must provide value
Yes No
Yes
No
reset
In the last 6 months have you had vaginal or anal sex with a man (who was born
male and identifies as male)?
* must provide value
Yes No
Yes
No
reset
With how many men in the past 6 months?
* must provide value
In the last 6 months, did you have oral, vaginal, or anal sex with someone who
lives with HIV?
* must provide value
Yes No Don't know
Yes
No
Don't know
reset
Did you give or receive money, drugs, gifts, or services in exchange for sex?
* must provide value
Yes No
Yes
No
reset
Did you inject drugs or other substances without a prescription?
* must provide value
Yes No
Yes
No
reset
Did you use any of the drugs on the list? Check all that apply
Cocaine or crack
Meth (methamphetamines like "crystal meth") or other amphetamines
Opiates (heroin, fentanyl, opium, etc.)
Dissociatives (ketamine, PCP, etc.)
Hallucinogens (LSD, magic mushrooms, peyote, etc.)
Empathogens (MDMA, ecstasy, molly, etc.)
Marijuana
K2, Spice, Synthetic Cannabinoids
Cocaine or crack
Meth (methamphetamines like "crystal meth") or other amphetamines
Opiates (heroin, fentanyl, opium, etc.)
Dissociatives (ketamine, PCP, etc.)
Hallucinogens (LSD, magic mushrooms, peyote, etc.)
Empathogens (MDMA, ecstasy, molly, etc.)
Marijuana
K2, Spice, Synthetic Cannabinoids
Do you inject (i.e. use needles) any of the drugs listed above?
* must provide value
Yes No
Yes
No
reset
Do you share needles with other people?
* must provide value
Yes No
Yes
No
reset
In the last 6 months, were you diagnosed with gonorrhea, chlamydia, or syphilis?
* must provide value
Yes No
Yes
No
reset
Was this infection only found in your throat?
* must provide value
Yes No
Yes
No
reset
Have you had a seizure in the last 3 years or have you taken medication to
specifically treat seizures in the last 3 years?
* must provide value
Yes No
Yes
No
reset
Do you have active tuberculosis?
* must provide value
Yes No
Yes
No
reset
Do you have Hepatitis C?
* must provide value
Yes No
Yes
No
reset
Do you have HIV?
* must provide value
Yes No
Yes
No
reset
Do you have diabetes or high blood sugar?
* must provide value
Yes No
Yes
No
reset
What kind of diabetes?
* must provide value
Type 1 Type 2 Don't know
Type 1
Type 2
Don't know
reset
Has your thyroid been removed or do you take medication for your thyroid?
* must provide value
Yes No
Yes
No
reset
Have you ever had an autoimmune disorder (except psoriasis) like rheumatoid
arthritis, celiac disease, sarcoidosis, or multiple sclerosis?
* must provide value
Yes No
Yes
No
reset
Feet
* must provide value
Inches
* must provide value
About how much do you weigh?
* must provide value
(in lbs)
BMI
View equation
Are you pregnant or breast-feeding now?
* must provide value
Yes No
Yes
No
reset
Do you plan to get pregnant in the next 12 months?
* must provide value
Yes No
Yes
No
reset
Are you currently participating in any research studies that involve HIV testing
or receiving any medications?
* must provide value
Yes No
Yes
No
reset
Are you taking PrEP now?
* must provide value
Yes No
Yes
No
reset
Did you take any breaks from PrEP?
* must provide value
Yes, I stopped PrEP
Yes, I stopped it but only for short period of time and then restarted it
I take breaks from PrEP when I don't think I am at risk of HIV/not having sex
No
Yes, I stopped PrEP
Yes, I stopped it but only for short period of time and then restarted it
I take breaks from PrEP when I don't think I am at risk of HIV/not having sex
No
reset
In the next 18 months, do you plan on starting or re-starting PrEP?
* must provide value
Yes No Don't know
Yes
No
Don't know
reset
Next Page >>
YOU HAVE SELECTED AN OPTION THAT TRIGGERS THIS SURVEY TO END RIGHT NOW.
To save your responses and end the survey, click the 'End Survey' button below.
If you have selected the wrong option by accident and/or wish to return to the
survey, click the 'Return and Edit Response' button.
Powered by REDCap