Table 1:

Survey Domains and specific areas and illustrative questions

Domain	Areas	Sample questions with sources
Sociodemographics and health care	Age, ethnicity, education, insurance, usual source of care
Health care utilization	Regular sources of care, HIV testing	What type of place best describes your regular healthcare provider? Health Center Doctor’s office HMO Pharmacy clinic Emergency department Somewhere else Don’t want to respond
HIV risk	Sexual partners and practices, STIs, IDU	With how many men did you have vaginal sex in the last 6 months?19 Vaginal sex is where a man puts his penis into your vagina. How frequently did you use a condom when you had vaginal sex in the last 6 months? Always Most of the time Sometimes Never
HIV knowledge	Transmission and treatment	HIV can be transmitted in the following ways (check all that are true) Sex, sharing needles, pregnancy/childbirth, sharing a drinking glass, kissing on the check, using public toilets There are medications which can cure HIV (true/false)
Self-perceived HIV risk	Risk, worry	I think my chances of getting infected with HIV are: Zero, Almost zero, Small, Moderate, Large, Very Large I worry about getting infected with HIV: None of the time, rarely, some of the time, a moderate amount of time, a lot of the time, all of the time19
PrEP Knowledge and experience	PrEP Knowledge1, ever recommended to use, ever used	5 point Likert: When on Prep I don’t’ need to use a condom PrEP is effective for preventing HIV if taken on a daily basis8
PrEP attitudes interest and willingness,	PrEP Stigma4, interest in using, willingness to use	People who are on PREP sleep around (5 point Likert scale)
Preferred sources of PrEP information	Usual source of health information, trusted sources for PrEP	What source(s) would you trust the most for information on PrEP (Choose all that apply) Friend, family member, my PCP, another doctor or nurse, Family planning clinic, another clinic or medical providers, internet search, social media, HIV prevention organization, somewhere else
Preferences for PrEP access	Source of initial and follow-up PrEP	If you were to start PrEP where would you prefer to have your first PrEP-related visit? My PCP, family planning clinic, STI clinic, Pharmacy, somewhere else What would be the most important factor in choosing where you would get PrEP?2 Cost of appointment Familiarity with clinic Anonymity Hours open Length of waiting time Easy to access clinic How welcoming they are Confidentiality
Potential barriers to PrEP	Cost, confidentiality, PrEP stigma	If you were to decide to take PrEP, which of the following are concerns that you have related to taking PrEP? [Choose all that apply] Side effects of PrEP PrEP may interact with a medication I’m already taking PrEP may not protect me completely from HIV Having to take a pill once a day Might make me more likely to have sex without a condom My partner would be angry or think that I am not being faithful People will see me taking medication and think I have HIV Having to talk to a healthcare provider about my sex life I will not be able to afford the cost of medication I would not know where to go to get PrEP I am too busy with childcare I want to become pregnant in the near future I have no concerns
Support needs for PREP	Cost, adherence, disclosure	If you were to take PrEP, what support do you think you would need? Help remembering to take the education every day Support telling my partner I am taking PrEP Support telling my family or friends I am taking PrEP Financial support to pay for the medications or medical visits Other I would not need support

^1.Schneider personal communication

^2.Adapted from World Health Organization Health System Responsiveness domains²⁸