EMIS 2017: Second community consultation
Acceptability (EnglishVersion)
22March 2017
The process so far
We used MailChimp for first round of consultation (on topic priorities), sent out 25 November 2016 to 318 ESTICOM subscribers with a reminder sent 19 December. Overall, more than 50 agencies responded, from 21 European countries, plus pan-European agencies and the US (survey improvement only).
The basis for consultation was the question stems (without response sets) of the EMIS 2010 survey. We asked people to: nominate questions for cutting; suggest new topics to be included; and highlight problems with existing question stems.
The consultation has given us a very clear steer on modifying the EMIS 2010 survey for 2017. We counted every nomination for cutting questions and considered every comment. The nominations directly led the selection of questions to drop. We made numerous changes to existing questions and have accounted for major decisions to in/exclude or change items.
The survey design process has a number of in-built tensions:
• Keeping topics we asked about in 2010 to examine change, versus replacing them with new topics we have not covered before;
• Keeping questions identical toEMIS 2010 for comparability, versus changing questions to improve measurements;
• Using larger numbers of responses to reflect people’s experience and increase data specificity, versus smaller numbers of responses to increase ease of completion and data management;
• A longer survey capturing more variables but with more people dropping out and the sample becoming less representative of disadvantaged groups, versus a shorter survey capturing fewer variables while retaining more men, especially those from disadvantaged groups.
This version of the survey is the current outcome of our balancing of these tensions. The survey will never satisfy all stakeholders and be acceptable to all the men we want to complete it. While prioritising respondent experience, we aim to make the survey as useful as possible to the largest number of stakeholders.
What we are asking of you here
Please use the Review–Comment tool in Word to answer the following:
1. The main question for this consultation round is “IS THIS SURVEY ACCEPTABLE?”If a question is offensive, illogical or obscure, please comment on it.
2. Please look at the regional/area codes for your country in the Appendix. Is this a useful breakdown of your country?
3. This is the second open consultation on EMIS 2017. If, in the first round you made a suggestion you feel strongly about that is not reflected here, please make it again and if possible a justification.
We welcome responses to the above questions and any other comments on this draft by09:00 hours on Monday 10th April 2017.
Please email responses to
This document
This document contains the proposed complete text of the EMIS 2017 on-line questionnaire, in English. It includes the introductory text, exit texts and page headings. Routing instructions and notes appear within [ ] and will not appear on-screen.
Questions are not numbered but are sequentially as they will appear in the questionnaire. Words within < > refer to the answer to a previous question.
Many questions offer one of six standard sets of possible responses. These are:
Page 1No-Yes response set
1=No
2=Yes
5 point disagree-agree response set
1=Strongly disagree
2=Disagree
3=Neither / not sure
4=Agree
5=Strongly agree
Recency response set
1=Never
2=Within the last 24 hours
3=Within the last 7 days
4=Within the last 4 weeks
5=Within the last 6 months
6=Within the last 12 months
7=Within the last 5 years
8=More than 5 years ago
Knowledge response set
1=I already knew this
2=I wasn’t sure about this
3=I didn’t know this already
4=I don’t understand this
5=I do not believe this
Frequency response set
1=Never
2=Rarely
3=Sometimes
4=Often
5=Very often
6=Does not apply to me
7 point disagree-agree with does not applyresponse set
1=1 Strongly disagree
2=2
3=3
4=4 Undecided
5=5
6=6
7=7 Strongly agree
8=Does not apply to me
[INTRODUCTORY TEXT]
EMIS: European Man-for-Man Internet Survey 2017
Welcome to the largest ever survey of gay men, bisexual men and other men who are attracted to men. It is happening across Europe.
Please take part if you are…
- a man who is attracted to other men AND/OR
- a man who has sex with men AND/OR
- a man who thinks he might have sex with men in the future
You must be old enough to legally have sex in the country where you live.
What’s it about?
It asks about relationships, sex life, risks and precautions, and use of health services. One of the goals is to see whether gay men and other men who have sex with men have access to HIV testing and prevention. Most men take 20 to 30 minutes to complete the survey.
What about data protection?
We guarantee your anonymity. We will NOT collect the IP-address of your computer or try to install any cookies on it. We will not collect any information about you that would allow anybody to identify you.
A report of the survey results will be produced in 2018. It will be available from the project's website.
Who are we?
We are an international group of researchers and health workers in public health institutes, universities and non-governmental organisations working in HIV, gay health and human rights, from over 30 European countries.
The survey is funded by the European Commission Health Programme 2014-2020 to deliver evidence about the sexual health of gay men, bisexual men and other MSM across Europe. It is supported by the European Centre for Prevention and Disease Control, the European Regional Office of the World Health Organization, and many national and international gay organisations and websites.
You can get more information about the survey at
Please complete this survey ONCE ONLY this summer.
Tick both of these boxes to say that you have read and understood what the questionnaire is about and that you wish to take part.
□ I have read and understood the above information.
□ In the country I live in, I am old enough to legally have sex with men.
ABOUT YOU
Q. What sex were you assigned at birth?
1=Male
2=Female
3=Decline to state
Q. What is your current gender identity?
1=Man
2=Transman
3=Woman
4=Transwoman
5=Non-binary or genderqueer
6=Other answer
Q. [If 3, 4, 5 or 6] This survey is for people who identify as a man or a transman. You are very welcome to read and complete the rest of the survey however we will be unable to use your data. What would you like to do?
1=Exit the survey now
2=Continue reading the survey
[If 1] Thank you for your interest in EMIS, the results will be available across Europe in 2018. You can get more information at [go to exit page]
Q. How old are you? [compulsory question]
[write in answer]
ABOUT WHERE YOU LIVE
Q. How would you describe the place you live in?
1=A very big city or town (a million or more people)
2=A big city or town (500,000-999,999 people)
3=A medium-sized city or town (100,000-499,999 people)
4=A small city or town (10,000-99,999 people)
5=A village / the countryside (less than 10,000 people)
Q. Which country do you currently live in? [compulsory question]
[see Appendix for response set]
Q4b. [If not Europe] This research is about men living in European countries. You are very welcome to read and complete the rest of the survey, however we will be unable to use your data.
What would you like to do?
1=Exit the survey now
2=Continue reading the survey
[If 1] Thank you for your interest in EMIS, the results will be available across Europe in 2018. You can get more information at [go to exit page]
Q. Which [region/area/post-code etc.] do you live in?
[see Appendix for response sets]
Q. Would you describe yourself as being a member of a group that is discriminated against in this country?
[No/Yes]
Q[set]. [IF YES] On what grounds is your group discriminated against? (Tick as many as apply)
Q. Colour or race
[No/Yes]
Q. Nationality
[No/Yes]
Q. Religion
[No/Yes]
Q. Language
[No/Yes]
Q. Ethnic group
[No/Yes]
Q. Age
[No/Yes]
Q. Sex (being male or female)
[No/Yes]
Q. Gender (being masculine or feminine)
[No/Yes]
Q. Sexuality
[No/Yes]
Q. Disability
[No/Yes]
Q. Other answer
[No/Yes]
Q. [If 11 Other answer] Please describe your answer.
[write in answer]
YOUR COUNTRY OF BIRTH
Q. Were you born in <country living in>?
[No-Yes]
Q. [If No] Which country were you born in? (If it does not exist anymore, please select the country that best applies.)
[see Appendix for response set]
Q. [If Not born in country living in] How many years have you been living in <country living in>?
1=Less than a year
2=1
3=2
...
111=110
Q[set]. Why did you come to <country living in>? (Tick as many as apply)
Q. I was brought as a child
[No-Yes]
Q. To study
[No-Yes]
Q. To work
[No-Yes]
Q. To be with a partner
[No-Yes]
Q. To live openly as gay or bisexual
[No-Yes]
Q. To seek asylum
[No-Yes]
Q. I came as a refugee
[No-Yes]
Q. Other answer
[No-Yes]
Q. [If other answer] Please describe you other answer
[write in answer]
ABOUT YOUR HEALTH GENERALLY
Q. How is your health in general? Is it...
1=Very good
2=Good
3=Fair
4=Bad
5=Very bad
Q. Do you have any longstanding illness or longstanding health problem? (By longstanding, we mean illnesses or health problems that have lasted, or are expected to last, for 6 months or more.)
[No-Yes response set]
Q. For at least the past 6 months, to what extent have you been limited because of a health problem in activities people usually do? Would you say you have been ...
1=Severely limited
2=Limited but not severely
3=Not limited at all
ABOUT YOUR SEXUALITY
Q. Who are you sexually attracted to?
1=Only to men
2=Mostly to men and sometimes to women
3=Both to men and women equally
4=Mostly to women and sometimes to men
5=Only to women
Q. Which of the following options best describes how you think of yourself?
1=Gay or homosexual
2=Bisexual
3=Straight or heterosexual
4=Any other term
5=I don’t usually use a term
Q. [If Q11=1, 2 3 or 4] Thinking about all the people who know you (including family, friends and work or study colleagues), what proportion know that you are attracted to men?
1=All or almost all
2=More than half
3=Less than half
4=Few
5=None
HOW YOU FEEL ABOUT YOUR SEX LIFE
Q. Do you disagree or agree with the following statements?
Q. The sex I have is always as safe as I want it to be.
[5 point disagree-agree]
Q. I find it easy to say ‘no’ to sex I don’t want.
[5 point disagree-agree]
Q. On a scale of 1 to 10 (where 1 is the most unhappy and 10 is the most happy), how happy are you with your sex life?
[1 to 10]
ABOUT YOUR RELATIONSHIPS AND FRIENDSHIPS
Q. Are you currently in a steady relationship? Tick as many as apply
Q. Yes, with a man
[No-Yes]
Q. Yes, with more than one man
[No-Yes]
Q. Yes, with a woman
[No-Yes]
Q. Yes, with more than one woman
[No-Yes]
Q. No, I'm single
[No-Yes]
Q. [IfSingle] When did your most recent steady relationship break-up?
[recency response set + I’ve never had a steady relationship]
Q. [Ifsteady with man] How many years have you been in a steady relationship with this man? (If you have more than one steady relationship with a man, please tell us about the longest)
1=Less than a year
2=1
3=2
...
26=25
27=More than 25 years
Q. [Ifsteady with man] Do you and this steady male partner have the same HIV status?
1=Yes, we have the same HIV status (either both positive or both negative).
2=No, one of us is positive and the other is negative.
3=Don’t know whether we have the same status or not.
Q. [If steady with man] Does your steady male partner have HIV infection?
1=No, he is HIV negative
2=Yes, and he has an undetectable viral load
3=Yes, and his viral load is detectable
4=Yes, and I do not know what his viral load is
5=I don’t know whether he has HIV or not
Q. Is your steady relationship with this man sexually exclusive?
1=Yes, we only have sex with each other
2=No, one or both of us has sex with other people
3=I don’t know
Q. [Ifsteady with woman] How many years have you been in a steady relationship with this woman? (If you have more than one steady relationship with a woman, please tell us about the longest)
1=Less than a year
2=1
3=2
...
26=25
27=More than 25 years
Q. [If ] Do you and this steady femalepartner have the same HIV status?
1=Yes, we have the same HIV status (either both positive or both negative).
2=No, one of us is positive and the other is negative.
3=Don’t know whether we have the same status or not.
Q. [If steady with man] Does your steady female partner have HIV infection?
1=No, she is HIV negative
2=Yes, and she has an undetectable viral load
3=Yes, and her viral load is detectable
4=yes, and I do not know what her viral load is
5=I don’t know whether she has HIV or not
Q. Is your steady relationship with this woman sexually exclusive?
1=Yes, we only have sex with each other
2=No, one or both of us has sex with other people
3=I don’t know
Q. In terms of your civil status in the country where you live, are you currently:
1=Single
2=Married/in a registered partnership with a man
3=Married/in a registered partnership with a woman
4=Other answer
Q. [If 4] Please describe you other answer
[write in answer]
Q[set]. Who do you live with? Tick as many as apply.
Q. Male partner
[No-Yes]
Q. Female partner
[No-Yes]
Q. Child(ren)
[No-Yes]
Q. Friends
[No-Yes]
Q. One or both of my parents
[No-Yes]
Q. Other family members
[No-Yes]
Q. Others
[No-Yes]
Q. I live by myself
[No-Yes]
Q[set]. Do you disagree or agree with the following statements?
Q. There are people I can count on in an emergency
Q. I feel a lack of intimacy with another person
Q. If something went wrong no one would help me
Q. I feel part of a group of people who share my attitudes and beliefs
Q. There is no one who shares my interests and concerns
Q. I feel a strong emotional bond with at least one other person
Q. There is no one who likes to do the things I do
Q. There is no one I can depend on for aid if I really need it
Q. I feel that I do not have close personal relationships with other people
Q. There are people who enjoy the same social activities as I do
Q. There are people I can depend on to help me if I really need it
Q. I have close relationships that provide me with a sense of emotional security and well-being
1=strongly disagree
2=disagree
3=agree
4=strongly agree
DID YOU KNOW THIS ABOUT HIV, TESTING AND TREATMENT
[Text]The following seven statements are all TRUE. Did you know this already?
Q. AIDS is caused by a virus called HIV.
[knowledge response set]
Q. You cannot be confident about whether someone has HIV or not from their appearance.
[knowledge response set]
Q. There is a medical test that can show whether or not you have HIV.
[knowledge response set]
Q. There is a medical test that can show whether or not you have HIV.
[knowledge response set]
Q. If someone becomes infected with HIV it may take several weeks before it can be detected in a test.
[knowledge response set]
Q. There is currently no cure for HIV infection.
[knowledge response set]
Q. HIV infection can be controlled with medicines so that its impact on health is much less.
[knowledge response set]
Q. A person with HIV who is on effective treatment cannot pass their virus to someone else during sex.
[knowledge response set]
ABOUT TAKING AN HIV TEST
Q. What do you think your current HIV status is (whether or not you've ever tested for HIV)?
1=Definitely negative (I don't have HIV)
2=Probably negative
3=Not sure / I don't know
4=Probably positive
5=Definitely positive (I do have HIV)
Q. Have you ever received an HIV test result?
1=No, I've never received an HIV test result
2=Yes, I've tested positive (I have HIV infection)
3=Yes, my last test was negative (I did not have HIV infection at the time of the test)
Q. [If never tested] Why have you never tested for HIV? (Tick as many as apply)
1=I have not put myself at risk of picking up HIV
2=I do not know where to get an HIV test
3=The places I know about are not convenient for me
4=I do not want to use the only places I know offer HIV tests
5=I am too scared in case I have HIV
6=It is not a priority for me / I have not got around to it
7=Other answer
[If other /7] Please describe your other answer
[write in answer]
[if 4 Do not want to use places I know] Why do you not want to use the places you know offer HIV tests? (Tick as many as apply)
1=They are not confidential enough
2=They are homophobic / anti-gay
3=I know people who work there
4=I don’t want anyone to know I have sex with men
5=Other answer
[If 5 Other answer] Please describe your other answer
[write in answer]
TESTING POSITIVE FOR HIV [If diagnosed HIV positive]
Q. In which year were you diagnosed HIV positive?
1=1984
2=1985
...
33=2016
34=2017
Q. [If diagnosed HIV positive in 2016] Were you diagnosed with HIV within the last 12 months?
[No-Yes]
Q. Where were you first diagnosed with HIV?
1=General Practitioner / family doctor
2=A doctor in private practice
3=At a hospital or clinic as an out-patient
4=At a hospital as an in-patient
5=At an HIV testing service (that is not in a hospital or clinic)
6=At a blood bank, while donating blood
7=I used a home-sampling kit (I took my own sample then sent it away to be analysed)
8=I used a home-testing kit (I found out the result on the spot)
9=In a bar/pub, club or sauna
10=Mobile medical unit
11=Elsewhere
Q. [If 3 or 4 At a hospital] What type of doctors were involved? (Tick as many as apply)
Q. Urologist
[No/Yes]
Q. Anaesthetist