VACS2013
DDI-KHM-NIS-VACS-2013-v01
Oun Sokunthea
2013-07-22
Nesstar Publisher
Version 01 (July 2013) - Original documentation.
Violence Against Children Survey in Cambodia 2013
VACS 2013
KHM-NIS-VACS-2013-v01
Ministry of Women's Affairs
Ministry of Social Affairs
Veterans and Youth Rehabilitation
National Institute of Statistics
Centers for Disease Control and Prevention
United Nations Children's Fund
National Institute of Statistics
VACS Steering Committee
(c) 2013, National Institute of Statistics, Phnom Penh, Cambodia
Nesstar Publisher
United Nations Children's Fund
Royal Government of Cambodia
Director, ICT Department
Priority Survey (hh/ps]
The Violence against Children Survey (VACS) 2013 is the first of its kind to be conducted in Cambodia. The VACS systematically measures the prevalence of physical, emotional, and sexual violence against children in addition to identifying risk and protective factors and health consequences of violence. VACS enhances countries' capacity to design, implement, and evaluate violence prevention programs and build successful child protection systems.
Version 1.0.
Cambodia
National
Urban and rural areas
Children aged 13-24 years old, male and female, who have been victims of physical, emotional, and sexual violence
Sample survey data [ssd]
National Institute of Statistics
Students
Face-to-face [f2f]
A total of 1121 female respondents and 1255 male respondents completed the survey. Response rates were 94% for and 92% for the female and male respondents, respectively.
Confidentiality of information is ascertained in Article 22 of the Statistics Law. It states that staff and employees working in the National Institute of Statistics of the Ministry of Planning and statistical units in ministries and other institutions of the Royal Government, as well as the designated statistical officers of these organizations shall ensure confidentiality of all individual information obtained from respondents, except under special circumstances with the consent of the Minister of Planning. The information collected under this Law is to be used only for statistical purposes.
Director General
Violence Against Children Survey in Cambodia (VACS2013) , National Institute of Statistics, Ministry of Planning, Cambodia.
The user of the data acknowledges that the National Institute of Statistics, Cambodia bears no responsibility for use of the data or for interpretations or inferences based upon such uses.
MALE_FINAL_FOR_NIS.NSDstat
The file contains data for the household and male questionnaires.
0
985
Nesstar 200801
National Institute of Statistics, Cambodia
FEMALE_FINAL_FOR_NIS.NSDstat
The file contains data for the household and female questionnaires.
0
1016
Nesstar 200801
National Institute of Statistics, Cambodia
IDENTIFICATION
Identification
0
0
IDENTIFICATION NUM.
Identification Number
0
0
EA IDENTIFICATION
EA Identification
0
0
PROVINCE
Province
0
0
DISTRICT
District
0
0
COMMUNE
Commune
0
0
EA
EA
0
0
HOUSEHOLD
Household
0
0
INTERVIEWER CODE
Interviewer Code
0
0
CLUSTER TYPE
Cluster Type
0
0
Final Visit Number
Final Visit Number
0
0
Final Visit Date
Final Visit Date
0
0
Final Visit Date -Year
Final Visit Date - Year
0
0
Final Visit Date -Month
Final Visit Date - Month
0
0
Final Visit Date -Day
Final Visit Date - Day
0
0
Final Household Listing Result
Final Household Listing Result
0
0
Final Household Questionnaire Result
Final Household Questionnaire Result
0
0
Final Respondent Questionnaire Result
Final Respondent Questionnaire Result
0
0
Visit Number Aux. 1
Visit Number Aux. 1
0
0
Visit Date -Year Aux. 1
Visit Date - Year Aux. 1
0
0
Visit Date -Month Aux. 1
Visit Date - Month Aux. 1
0
0
Visit Date -Day Aux. 1
Visit Date - Day Aux. 1
0
0
Household Listing Result Aux. 1
Household Listing Result Aux. 1
0
0
Visit Number Aux. 2
Visit Number Aux. 2
0
0
Visit Date -Year Aux. 2
Visit Date - Year Aux. 2
0
0
Visit Date -Month Aux. 2
Visit Date - Month Aux. 2
0
0
Visit Date -Day Aux. 2
Visit Date - Day Aux. 2
0
0
Household Listing Result Aux. 2
Household Listing Result Aux. 2
0
0
Visit Number Aux. 3
Visit Number Aux. 3
0
0
Visit Date -Year Aux. 3
Visit Date - Year Aux. 3
0
0
Visit Date -Month Aux. 3
Visit Date - Month Aux. 3
0
0
Visit Date -Day Aux. 3
Visit Date - Day Aux. 3
0
0
Household Listing Result Aux. 3
Household Listing Result Aux. 3
0
0
Visit Number(1)
Visit Number(1)
0
0
Visit Number(2)
Visit Number(2)
0
0
Visit Number(3)
Visit Number(3)
0
0
Visit Date -Year(1)
Visit Date - Year(1)
0
0
Visit Date -Year(2)
Visit Date - Year(2)
0
0
Visit Date -Year(3)
Visit Date - Year(3)
0
0
Visit Date -Month(1)
Visit Date - Month(1)
0
0
Visit Date -Month(2)
Visit Date - Month(2)
0
0
Visit Date -Month(3)
Visit Date - Month(3)
0
0
Visit Date -Day(1)
Visit Date - Day(1)
0
0
Visit Date -Day(2)
Visit Date - Day(2)
0
0
Visit Date -Day(3)
Visit Date - Day(3)
0
0
Household Listing Result(1)
Household Listing Result(1)
0
0
Household Listing Result(2)
Household Listing Result(2)
0
0
Household Listing Result(3)
Household Listing Result(3)
0
0
Household Questionnaire Result(1)
Household Questionnaire Result(1)
0
0
Household Questionnaire Result(2)
Household Questionnaire Result(2)
0
0
Household Questionnaire Result(3)
Household Questionnaire Result(3)
0
0
Respondent Questionnaire Result(1)
Respondent Questionnaire Result(1)
0
0
Respondent Questionnaire Result(2)
Respondent Questionnaire Result(2)
0
0
Respondent Questionnaire Result(3)
Respondent Questionnaire Result(3)
0
0
Number of people living in this household
Number of People Living In This Household
0
0
Number of males in this household
Number of Males in this Household
0
0
Line Number of Selected ER
Line Number of Selected ER
0
0
Line of ER Selected From HH Listing Form
Line of ER Selected From Hh Listing Form
0
0
Head of Household Available
Head of Household Available
0
0
Household Member Line(1)
Household Member Line(1)
0
0
Household Member Line(2)
Household Member Line(2)
0
0
Household Member Line(3)
Household Member Line(3)
0
0
Household Member Line(4)
Household Member Line(4)
0
0
Household Member Line(5)
Household Member Line(5)
0
0
Household Member Line(6)
Household Member Line(6)
0
0
Household Member Line(7)
Household Member Line(7)
0
0
Household Member Line(8)
Household Member Line(8)
0
0
Household Member Line(9)
Household Member Line(9)
0
0
Household Member Line(10)
Household Member Line(10)
0
0
Household Member Line(11)
Household Member Line(11)
0
0
Household Member Line(12)
Household Member Line(12)
0
0
Household Member Line(13)
Household Member Line(13)
0
0
Household Member Line(14)
Household Member Line(14)
0
0
Household Member Line(15)
Household Member Line(15)
0
0
Household Member Line(16)
Household Member Line(16)
0
0
Household Member Line(17)
Household Member Line(17)
0
0
Household Member Line(18)
Household Member Line(18)
0
0
Household Member Line(19)
Household Member Line(19)
0
0
Age of Household Member(1)
Age of Household Member(1)
0
0
Age of Household Member(2)
Age of Household Member(2)
0
0
Age of Household Member(3)
Age of Household Member(3)
0
0
Age of Household Member(4)
Age of Household Member(4)
0
0
Age of Household Member(5)
Age of Household Member(5)
0
0
Age of Household Member(6)
Age of Household Member(6)
0
0
Age of Household Member(7)
Age of Household Member(7)
0
0
Age of Household Member(8)
Age of Household Member(8)
0
0
Age of Household Member(9)
Age of Household Member(9)
0
0
Age of Household Member(10)
Age of Household Member(10)
0
0
Age of Household Member(11)
Age of Household Member(11)
0
0
Age of Household Member(12)
Age of Household Member(12)
0
0
Age of Household Member(13)
Age of Household Member(13)
0
0
Age of Household Member(14)
Age of Household Member(14)
0
0
Age of Household Member(15)
Age of Household Member(15)
0
0
Age of Household Member(16)
Age of Household Member(16)
0
0
Age of Household Member(17)
Age of Household Member(17)
0
0
Age of Household Member(18)
Age of Household Member(18)
0
0
Age of Household Member(19)
Age of Household Member(19)
0
0
Date of Birth(1)
Date of Birth(1)
0
0
Date of Birth(2)
Date of Birth(2)
0
0
Date of Birth(3)
Date of Birth(3)
0
0
Date of Birth(4)
Date of Birth(4)
0
0
Date of Birth(5)
Date of Birth(5)
0
0
Date of Birth(6)
Date of Birth(6)
0
0
Date of Birth(7)
Date of Birth(7)
0
0
Date of Birth(8)
Date of Birth(8)
0
0
Date of Birth(9)
Date of Birth(9)
0
0
Date of Birth(10)
Date of Birth(10)
0
0
Date of Birth(11)
Date of Birth(11)
0
0
Date of Birth(12)
Date of Birth(12)
0
0
Date of Birth(13)
Date of Birth(13)
0
0
Date of Birth(14)
Date of Birth(14)
0
0
Date of Birth(15)
Date of Birth(15)
0
0
Date of Birth(16)
Date of Birth(16)
0
0
Date of Birth(17)
Date of Birth(17)
0
0
Date of Birth(18)
Date of Birth(18)
0
0
Date of Birth(19)
Date of Birth(19)
0
0
Date of Birth -Year(1)
Date of Birth - Year(1)
0
0
Date of Birth -Year(2)
Date of Birth - Year(2)
0
0
Date of Birth -Year(3)
Date of Birth - Year(3)
0
0
Date of Birth -Year(4)
Date of Birth - Year(4)
0
0
Date of Birth -Year(5)
Date of Birth - Year(5)
0
0
Date of Birth -Year(6)
Date of Birth - Year(6)
0
0
Date of Birth -Year(7)
Date of Birth - Year(7)
0
0
Date of Birth -Year(8)
Date of Birth - Year(8)
0
0
Date of Birth -Year(9)
Date of Birth - Year(9)
0
0
Date of Birth -Year(10)
Date of Birth - Year(10)
0
0
Date of Birth -Year(11)
Date of Birth - Year(11)
0
0
Date of Birth -Year(12)
Date of Birth - Year(12)
0
0
Date of Birth -Year(13)
Date of Birth - Year(13)
0
0
Date of Birth -Year(14)
Date of Birth - Year(14)
0
0
Date of Birth -Year(15)
Date of Birth - Year(15)
0
0
Date of Birth -Year(16)
Date of Birth - Year(16)
0
0
Date of Birth -Year(17)
Date of Birth - Year(17)
0
0
Date of Birth -Year(18)
Date of Birth - Year(18)
0
0
Date of Birth -Year(19)
Date of Birth - Year(19)
0
0
Date of Birth -Month(1)
Date of Birth - Month(1)
0
0
Date of Birth -Month(2)
Date of Birth - Month(2)
0
0
Date of Birth -Month(3)
Date of Birth - Month(3)
0
0
Date of Birth -Month(4)
Date of Birth - Month(4)
0
0
Date of Birth -Month(5)
Date of Birth - Month(5)
0
0
Date of Birth -Month(6)
Date of Birth - Month(6)
0
0
Date of Birth -Month(7)
Date of Birth - Month(7)
0
0
Date of Birth -Month(8)
Date of Birth - Month(8)
0
0
Date of Birth -Month(9)
Date of Birth - Month(9)
0
0
Date of Birth -Month(10)
Date of Birth - Month(10)
0
0
Date of Birth -Month(11)
Date of Birth - Month(11)
0
0
Date of Birth -Month(12)
Date of Birth - Month(12)
0
0
Date of Birth -Month(13)
Date of Birth - Month(13)
0
0
Date of Birth -Month(14)
Date of Birth - Month(14)
0
0
Date of Birth -Month(15)
Date of Birth - Month(15)
0
0
Date of Birth -Month(16)
Date of Birth - Month(16)
0
0
Date of Birth -Month(17)
Date of Birth - Month(17)
0
0
Date of Birth -Month(18)
Date of Birth - Month(18)
0
0
Date of Birth -Month(19)
Date of Birth - Month(19)
0
0
Date of Birth -Day(1)
Date of Birth - Day(1)
0
0
Date of Birth -Day(2)
Date of Birth - Day(2)
0
0
Date of Birth -Day(3)
Date of Birth - Day(3)
0
0
Date of Birth -Day(4)
Date of Birth - Day(4)
0
0
Date of Birth -Day(5)
Date of Birth - Day(5)
0
0
Date of Birth -Day(6)
Date of Birth - Day(6)
0
0
Date of Birth -Day(7)
Date of Birth - Day(7)
0
0
Date of Birth -Day(8)
Date of Birth - Day(8)
0
0
Date of Birth -Day(9)
Date of Birth - Day(9)
0
0
Date of Birth -Day(10)
Date of Birth - Day(10)
0
0
Date of Birth -Day(11)
Date of Birth - Day(11)
0
0
Date of Birth -Day(12)
Date of Birth - Day(12)
0
0
Date of Birth -Day(13)
Date of Birth - Day(13)
0
0
Date of Birth -Day(14)
Date of Birth - Day(14)
0
0
Date of Birth -Day(15)
Date of Birth - Day(15)
0
0
Date of Birth -Day(16)
Date of Birth - Day(16)
0
0
Date of Birth -Day(17)
Date of Birth - Day(17)
0
0
Date of Birth -Day(18)
Date of Birth - Day(18)
0
0
Date of Birth -Day(19)
Date of Birth - Day(19)
0
0
Sex of Household Member(1)
Sex of Household Member(1)
0
0
Sex of Household Member(2)
Sex of Household Member(2)
0
0
Sex of Household Member(3)
Sex of Household Member(3)
0
0
Sex of Household Member(4)
Sex of Household Member(4)
0
0
Sex of Household Member(5)
Sex of Household Member(5)
0
0
Sex of Household Member(6)
Sex of Household Member(6)
0
0
Sex of Household Member(7)
Sex of Household Member(7)
0
0
Sex of Household Member(8)
Sex of Household Member(8)
0
0
Sex of Household Member(9)
Sex of Household Member(9)
0
0
Sex of Household Member(10)
Sex of Household Member(10)
0
0
Sex of Household Member(11)
Sex of Household Member(11)
0
0
Sex of Household Member(12)
Sex of Household Member(12)
0
0
Sex of Household Member(13)
Sex of Household Member(13)
0
0
Sex of Household Member(14)
Sex of Household Member(14)
0
0
Sex of Household Member(15)
Sex of Household Member(15)
0
0
Sex of Household Member(16)
Sex of Household Member(16)
0
0
Sex of Household Member(17)
Sex of Household Member(17)
0
0
Sex of Household Member(18)
Sex of Household Member(18)
0
0
Sex of Household Member(19)
Sex of Household Member(19)
0
0
Household Member live in this house(1)
Household Member live in this House(1)
0
0
Household Member live in this house(2)
Household Member live in this House(2)
0
0
Household Member live in this house(3)
Household Member live in this House(3)
0
0
Household Member live in this house(4)
Household Member live in this House(4)
0
0
Household Member live in this house(5)
Household Member live in this House(5)
0
0
Household Member live in this house(6)
Household Member live in this House(6)
0
0
Household Member live in this house(7)
Household Member live in this House(7)
0
0
Household Member live in this house(8)
Household Member live in this House(8)
0
0
Household Member live in this house(9)
Household Member live in this House(9)
0
0
Household Member live in this house(10)
Household Member live in this House(10)
0
0
Household Member live in this house(11)
Household Member live in this House(11)
0
0
Household Member live in this house(12)
Household Member live in this House(12)
0
0
Household Member live in this house(13)
Household Member live in this House(13)
0
0
Household Member live in this house(14)
Household Member live in this House(14)
0
0
Household Member live in this house(15)
Household Member live in this House(15)
0
0
Household Member live in this house(16)
Household Member live in this House(16)
0
0
Household Member live in this house(17)
Household Member live in this House(17)
0
0
Household Member live in this house(18)
Household Member live in this House(18)
0
0
Household Member live in this house(19)
Household Member live in this House(19)
0
0
Eligible Household Member(1)
Eligible Household Member(1)
0
0
Eligible Household Member(2)
Eligible Household Member(2)
0
0
Eligible Household Member(3)
Eligible Household Member(3)
0
0
Eligible Household Member(4)
Eligible Household Member(4)
0
0
Eligible Household Member(5)
Eligible Household Member(5)
0
0
Eligible Household Member(6)
Eligible Household Member(6)
0
0
Eligible Household Member(7)
Eligible Household Member(7)
0
0
Eligible Household Member(8)
Eligible Household Member(8)
0
0
Eligible Household Member(9)
Eligible Household Member(9)
0
0
Eligible Household Member(10)
Eligible Household Member(10)
0
0
Eligible Household Member(11)
Eligible Household Member(11)
0
0
Eligible Household Member(12)
Eligible Household Member(12)
0
0
Eligible Household Member(13)
Eligible Household Member(13)
0
0
Eligible Household Member(14)
Eligible Household Member(14)
0
0
Eligible Household Member(15)
Eligible Household Member(15)
0
0
Eligible Household Member(16)
Eligible Household Member(16)
0
0
Eligible Household Member(17)
Eligible Household Member(17)
0
0
Eligible Household Member(18)
Eligible Household Member(18)
0
0
Eligible Household Member(19)
Eligible Household Member(19)
0
0
AGE OF ELEGIBLE RESPONDEMENT(1)
Age of Elegible Respondement(1)
0
0
AGE OF ELEGIBLE RESPONDEMENT(2)
Age of Elegible Respondement(2)
0
0
AGE OF ELEGIBLE RESPONDEMENT(3)
Age of Elegible Respondement(3)
0
0
AGE OF ELEGIBLE RESPONDEMENT(4)
Age of Elegible Respondement(4)
0
0
AGE OF ELEGIBLE RESPONDEMENT(5)
Age of Elegible Respondement(5)
0
0
AGE OF ELEGIBLE RESPONDEMENT(6)
Age of Elegible Respondement(6)
0
0
AGE OF ELEGIBLE RESPONDEMENT(7)
Age of Elegible Respondement(7)
0
0
AGE OF ELEGIBLE RESPONDEMENT(8)
Age of Elegible Respondement(8)
0
0
DATE OF BIRTH OF ER -DAY(1)
Date of Birth of ER - Day(1)
0
0
DATE OF BIRTH OF ER -DAY(2)
Date of Birth of ER - Day(2)
0
0
DATE OF BIRTH OF ER -DAY(3)
Date of Birth of ER - Day(3)
0
0
DATE OF BIRTH OF ER -DAY(4)
Date of Birth of ER - Day(4)
0
0
DATE OF BIRTH OF ER -DAY(5)
Date of Birth of ER - Day(5)
0
0
DATE OF BIRTH OF ER -DAY(6)
Date of Birth of ER - Day(6)
0
0
DATE OF BIRTH OF ER -DAY(7)
Date of Birth of ER - Day(7)
0
0
DATE OF BIRTH OF ER -DAY(8)
Date of Birth of ER - Day(8)
0
0
DATE OF BIRTH OF ER -MONTH(1)
Date of Birth of ER - Month(1)
0
0
DATE OF BIRTH OF ER -MONTH(2)
Date of Birth of ER - Month(2)
0
0
DATE OF BIRTH OF ER -MONTH(3)
Date of Birth of ER - Month(3)
0
0
DATE OF BIRTH OF ER -MONTH(4)
Date of Birth of ER - Month(4)
0
0
DATE OF BIRTH OF ER -MONTH(5)
Date of Birth of ER - Month(5)
0
0
DATE OF BIRTH OF ER -MONTH(6)
Date of Birth of ER - Month(6)
0
0
DATE OF BIRTH OF ER -MONTH(7)
Date of Birth of ER - Month(7)
0
0
DATE OF BIRTH OF ER -MONTH(8)
Date of Birth of ER - Month(8)
0
0
DATE OF BIRTH OF ER -YEAR(1)
Date of Birth of ER - Year(1)
0
0
DATE OF BIRTH OF ER -YEAR(2)
Date of Birth of ER - Year(2)
0
0
DATE OF BIRTH OF ER -YEAR(3)
Date of Birth of ER - Year(3)
0
0
DATE OF BIRTH OF ER -YEAR(4)
Date of Birth of ER - Year(4)
0
0
DATE OF BIRTH OF ER -YEAR(5)
Date of Birth of ER - Year(5)
0
0
DATE OF BIRTH OF ER -YEAR(6)
Date of Birth of ER - Year(6)
0
0
DATE OF BIRTH OF ER -YEAR(7)
Date of Birth of ER - Year(7)
0
0
DATE OF BIRTH OF ER -YEAR(8)
Date of Birth of ER - Year(8)
0
0
LINE OF ER FROM THE HH LISTING FORM(1)
Line of ER from the HH Listing Form(1)
0
0
LINE OF ER FROM THE HH LISTING FORM(2)
Line of ER from the HH Listing Form(2)
0
0
LINE OF ER FROM THE HH LISTING FORM(3)
Line of ER from the HH Listing Form(3)
0
0
LINE OF ER FROM THE HH LISTING FORM(4)
Line of ER from the HH Listing Form(4)
0
0
LINE OF ER FROM THE HH LISTING FORM(5)
Line of ER from the HH Listing Form(5)
0
0
LINE OF ER FROM THE HH LISTING FORM(6)
Line of ER from the HH Listing Form(6)
0
0
LINE OF ER FROM THE HH LISTING FORM(7)
Line of ER from the HH Listing Form(7)
0
0
LINE OF ER FROM THE HH LISTING FORM(8)
Line of ER from the HH Listing Form(8)
0
0
CONTINUE HOUSEHOLD QUESTIONAIRE?
Continue household questionnaire?
0
0
H1. RECORD THE TIME THE INTERVIEW BEGAN -HOUR
H1. Record the time the Interview Began - Hour
0
0
H1. RECORD THE TIME THE INTERVIEW BEGAN -MIN
H1. Record the time the Interview Began - Min
0
0
H2. Sex of the head of household
H2. Sex of the head of household
0
0
H3. Age of the head of the household
H3. Age of the head of the household
0
0
H4. How is the selected respondent related to you?
H4. How is the selected respondent related to you?
0
0
H4. Other (Specify)
H4. Other (Specify)
0
0
H5. What is the main source of drinking water for members of your household?
H5. What is the main source of drinking water for members of your household?
0
0
H5. Other (Specify)
H5. Other (Specify)
0
0
H6. What is the main source of water used by your household for other purposes s
H6. What is the main source of water used by your household for other purposes such as cooking and hand washing?
0
0
H6. Other (Specify)
H6. Other (Specify)
0
0
H7. What kind of toilet facility do members of your household usually use?
H7. What kind of toilet facility do members of your household usually use?
IF “FLUSH” OR “POUR FLUSH”, PROBE:Where does it flush to?
0
0
H7. Other (Specify)
H7. Other (Specify)
0
0
H8. Do you share this facility with other households?
H8. Do you share this facility with other households?
0
0
H9A. Electricity
H9A. Does your household have: Electricity?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H9B. Radio
H9B. Does your household have: Radio?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H9C. Television
H9C. Does your household have: Television?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H9D. Mobile Telephone
H9D. Does your household have: Mobile Telephone?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H9E. Non-Mobile Telephone
H9E. Does your household have: Non-Mobile Telephone?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H9F. Refrigerator
H9F. Does your household have: Refrigerator?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
H10A. Table
H10A. Does your household have the following furniture: Table?
0
0
H10B. Chair
H10B. Does your household have the following furniture: Chair?
0
0
H10C. Sofa
H10C. Does your household have the following furniture: Sofa?
0
0
H10D. Bed
H10D. Does your household have the following furniture: Bed?
0
0
H10E. Wardrobe
H10E. Does your household have the following furniture: Wardrobe?
0
0
H10F. Kitchen Cabinet
H10F. Does your household have the following furniture: Kitchen Cabinet?
0
0
H11. What type of fuel does your household mainly use for cooking?
H11. What type of fuel does your household mainly use for cooking?
0
0
H11. Other (Specify)
H11. Other (Specify)
0
0
H12. Main material of the dwelling floor
H12. Main material of the dwelling floor
Observation only
0
0
H12. Other (Specify)
H12. Other (Specify)
0
0
H13. Main material of the roof
H13. Main material of the roof
Observation only
0
0
H13. Other (Specify)
H13. Other (Specify)
0
0
H14. Main material of the walls
H14. Main material of the walls
Observation only
0
0
H14. Other (Specify)
H14. Other (Specify)
0
0
H15. How many rooms are there in this household?
H15. How many rooms are there in this household?
This excludes bathroom, kitchen, garage and rice storage.
0
0
H16. How many rooms in this household are used for sleeping?
H16. How many rooms in this household are used for sleeping?
0
0
H17A. Watch
H17A. Does any member of your household own: Watch?
0
0
H17B. Bicycle
H17B. Does any member of your household own: Bicycle?
0
0
H17C. Motorcycle or scooter
H17C. Does any member of your household own: Motorcycle or scooter?
0
0
H17D. Animal drawn-cart
H17D. Does any member of your household own: Animal drawn-cart?
0
0
H17E. Car or van
H17E. Does any member of your household own: Car or van?
0
0
H17F. Boat without a motor?
H17F. Does any member of your household own: Boat without a motor?
0
0
H17G. Boat with a motor
H17G. Does any member of your household own: Boat with a motor?
0
0
H17H. Tractor
H17H. Does any member of your household own: Tractor?
0
0
H17I. Hand Tractor
H17I. Does any member of your household own: Hand Tractor?
0
0
H18. Does any member of this household have any land that can be used for agricu
H18. Does any member of this household have any land that can be used for agricultural purposes?
0
0
H19. Does this household own any livestock, herds, or farm animals?
H19. Does this household own any livestock, herds, or farm animals?
0
0
H20. Does any member of this household have a bank account?
H20. Does any member of this household have a bank account?
0
0
CONTINUE RESPONDENT QUESTIONAIRE?
Continue respondent questionnaire?
0
0
RECORD THE TIME THE INTERVIEW BEGAN -HOUR
M1. Record the time the interview began - Hour
0
0
RECORD THE TIME THE INTERVIEW BEGAN -MIN
M1. Record the time the interview began - Min
0
0
M2. How old are you?
M2. I would like to start by asking you questions about yourself:How old are you?
0
0
M3. Have you attended school?
M3. Have you attended school?
NO [2] -> M8DON'T KNOW/DECLINED [99] -> M8
0
0
M4. Are you currently attending school?
M4. Are you currently attending school?
YES [1] -> M6DON'T KNOW/DECLINED [99] -> M8
0
0
M5. What is the highest level of schooling you have completed?
M5. What is the highest level of schooling you have completed?
LESS THAN PRIMARY [1] -> M8PRIMARY [2] -> M8SECONDARY [3] -> M8
0
0
M6. What is your current level of school?
M6. What is your current level of school?
0
0
M7. How much do you feel connected or close to other students?
M7. How much do you feel connected or close to other students?
0
0
M8. How much do you talk to friends about important things?
M8. How much do you talk to friends about important things?
0
0
M9. Have you ever worked for money or any other form of payment?
M9. Have you ever worked for money or any other form of payment?
NO [2] -> M11DON'T KNOW/DECLINED [99] -> M11
0
0
M10. Do you currently work?
M10. Do you currently work?
0
0
M11. Is your biological mother living with you?
PARENTS: Now, I would like to ask you some questions about your biological parents, your natural parents who gave birth to you.
NO [2] -> M16DON'T KNOW/DECLINED [99] -> M16
0
0
M12. How old were you when you last lived with her?
M12. How old were you when you last lived with her?
0
0
M13. What was the main reason you stopped living with her?
M13. What was the main reason you stopped living with her?
MOTHER DIED [1] -> M15
0
0
M13. Other (Specify)
M13. Other (Specify)
0
0
M14. Is your biological mother still alive?
M14. Is your biological mother still alive?
YES [1] -> M16DON'T KNOW/DECLINED [99] -> M16
0
0
M15. How old were you when she died?
M15. How old were you when she died?
0
0
M16. How close do you/did you feel to your biological mother?
M16. How close do you/did you feel to your biological mother?
0
0
M17. Is your biological father living with you?
0
0
M18. How old were you when you last lived with your father?
M18. How old were you when you last lived with your father?
0
0
M19. What was the main reason you stopped living with him?
M19. What was the main reason you stopped living with him?
MOTHER DIED [1] -> M21
0
0
M19. Other (Specify)
M19. Other (Specify)
0
0
M20. Is your biological father still alive?
M20. Is your biological father still alive?
YES [1] -> M22DON'T KNOW/DECLINED [99] -> M22
0
0
M21. How old were you when he died?
M21. How old were you when he died?
0
0
M22. How close do you/did you feel to your biological father?
M22. How close do you/did you feel to your biological father?
0
0
M23. Have you ever been married?
M23. Have you ever been married?
YES [1] -> M27DON'T KNOW/DECLINED [99] -> M27
0
0
M24. How old were you when you first got married?
M24. How old were you when you first got married?
0
0
M25. What is your current marital status now?
M25. What is your current marital status now? Are you married, widowed, divorced, or separated?
WIDOWED [2] -> M31DIVORCED [3] -> M31 SEPARATED [4] -> M31
0
0
M26. Are you currently living with your spouse?
M26. Are you currently living with your spouse?
YES [1] -> M31DON'T KNOW/DECLINED [99] -> M31
0
0
M27. Have you ever lived together with someone as if you were married?
M27. Have you ever lived together with someone as if you were married?
DON'T KNOW/DECLINED [99] -> M30
0
0
M28. How old were you when you first started living together?
M28. How old were you when you first started living together?
0
0
M29. Are you currently living with that person now?
M29. Are you currently living with that person now?
YES [1] -> M31DON'T KNOW/DECLINED [99] -> M31
0
0
M30. Have you ever had a girlfriend or romantic partner?
M30. Have you ever had a girlfriend or romantic partner?
0
0
M31A. IF SHE GOES OUT WITHOUT TELLING HIM
M31A. Do you believe it is right for a man to hit or beat his wife: if she goes out without telling him?
Read categories below.
0
0
M31B. IF SHE NEGLECTS THE CHILDREN
M31B. Do you believe it is right for a man to hit or beat his wife: if she neglects the children?
Read categories below.
0
0
M31C. IF SHE ARGUES WITH HIM
M31C. Do you believe it is right for a man to hit or beat his wife: if she argues with him?
Read categories below.
0
0
M31D. IF SHE REFUSES TO HAVE SEX WITH HIM
M31D. Do you believe it is right for a man to hit or beat his wife: if she refuses to have sex with him?
Read categories below.
0
0
M31E. IF SHE MAKES BAD FOOD
M31E. Do you believe it is right for a man to hit or beat his wife: if she makes bad food?
Read categories below.
0
0
M32A. MEN DECIDE WHEN TO HAVE SEX
M32A. Do you believe: men decide when to have sex?
Read categories below.
0
0
M32B. MEN NEED MORE SEX
M32B. Do you believe: men need more sex?
Read categories below.
0
0
M32C. MEN NEED OTHER WOMEN
M32C. Do you believe: men need other women?
Read categories below.
0
0
M32D. WOMEN WHO CARRY CONDOMS HAVE SEX WITH A LOT OF MEN
M32D. Do you believe: women who carry condoms have sex with a lot of men?
Read categories below.
0
0
M32E. WOMEN SHOULD TOLERATE VIOLENCE
M32E. Do you believe: women should tolerate violence?
Read categories below.
0
0
M33. How much do you trust people living in your community?
M33. How much do you trust people living in your [insert culturally appropriate term for COMMUNITY] a lot, some, not too much, not at all?
Read categories below.
0
0
M34. How safe do you feel in your community?
M34. How safe do you feel in your [insert culturally appropriate term for COMMUNITY]?
Read categories below.
0
0
M36A. Have you seen anyone physically hurt or scare someone else in your communi
M36A. Have you seen anyone physically hurt or scare someone else in your [insert culturally appropriate term for COMMUNITY]: never, once, a few times, many times?
NEVER [1] -> M37AONCE [2] -> M36CDK/DTA [99] -> M37A
0
0
M36B. How old were you when this first happened?
M36B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
M36C. How old were you the most recent time this happened?
M36C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
M36D. Did this happen in the last 12 months?
M36D. Did this happen in the last 12 months?
0
0
M37A. Slapping, punching or kicking them?
M37A. Slapping, punching or kicking them?
0
0
M37B. Using or threatening to use a knife, gun, stick, rock or other similar wea
M37B. Using or threatening to use a knife, gun, stick, rock or other similar weapon?
IF M37A=1 AND M37B=2/99 -> M38IF M37A=1 AND M37B=1 -> M38 FOLLOWED BY M39IF M37A =2/99 AND M37B=1 -> M39
0
0
M38A. Did the slapping, punching or kicking occur once, a few times or many time
M38A. Did the slapping, punching or kicking occur once, a few times or many times?
NEVER [1] -> M38CDK/DTA [99] -> M39 OR M100
0
0
M38B. How old were you when this first happened?
M38B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
M38C. How old were you the most recent time this happened?
M38C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
M38D. Did this happen in the last 12 months?
M38D. Did this happen in the last 12 months?
0
0
M39A. Did the using or threatening to use a knife, gun, stick, rock or similar w
M39A. Did the using or threatening to use a knife, gun, stick, rock or similar weapon occur once, a few times or many times?
NEVER [1] -> M39CDK/DTA [99] -> M100
0
0
M39B. How old were you when this first happened?
M39B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
M39C. How old were you the most recent time this happened?
M39C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
M39D. Did this happen in the last 12 months?
M39D. Did this happen in the last 12 months?
0
0
M100A. Has a romantic partner, girlfriend or wife ever: slapped or pushed you?
PV: PHYSICAL VIOLENCEPV1: INTIMATE PARTNER VIOLENCE
0
0
M100B. Has a romantic partner, girlfriend or wife ever: punched, kicked, whipped
M100B. Has a romantic partner, girlfriend or wife ever: punched, kicked, whipped or beat you with an object?
0
0
M100C. Has a romantic partner, girlfriend or wife ever: choked, smothered, tried
M100C. Has a romantic partner, girlfriend or wife ever: choked, smothered, tried to drown you or burned you intentionally?
0
0
M100D. Has a romantic partner, girlfriend or wife ever: used or threatened you w
M100D. Has a romantic partner, girlfriend or wife ever: used or threatened you with a knife or other weapon?
IF M100A =1 AND M100B=2/99 AND M100C=2/99 AND M100D=2/99 -> M101 IF M100A =2/99 AND M100B=1 AND M100C=2/99 AND M100D=2/99 -> M114 IF M100A =2/99 AND M100B=2/99 AND M100C=1 AND M100D=2/99 -> M127
0
0
M101. How many times have you been slapped or pushed by a romantic partner /wife
PV1A:M101. How many times have you been slapped or pushed by a romantic partner /wife: once, a few times, many times?
ONCE [1] -> M108DON'T KNOW/DECLINED [99] -> M108
0
0
M102. How old were you the last time this happened?
PV1A: MOST RECENT TIMEM102. How old were you the last time this happened?
0
0
M103. Was this partner who did this to you this last time your girlfriend, roman
M103. Was this partner who did this to you this last time your girlfriend, romantic partner, wife?
0
0
M104. Was this partner older than you, younger than you, or about the same age?
M104. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M106ABOUT SAME AGE [3] -> M106DON’T KNOW/DECLINED [99] -> M106
0
0
M105. Would you say this partner was more than 10 years older than you, 5-10 yea
M105. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M106. Did this happen in the last 12 months?
M106. Did this happen in the last 12 months?
0
0
M107A. FEAR OR ANXIETY
M107A. As a result of the last time when your partner slapped/pushed you, did you experience FEAR OR ANXIETY?
0
0
M107B. CUTS, SCRATCHES, BRUISES
M107B. As a result of the last time when your partner slapped/pushed you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M107C. SPRAINS, DISLOCATIONS, BLISTERING
M107C. As a result of the last time when your partner slapped/pushed you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M107D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M107D. As a result of the last time when your partner slapped/pushed you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M107E. PERMANENT INJURY OR DISFIGUREMENT
M107E. As a result of the last time when your partner slapped/pushed you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M108. How old were you the first time this happened?
PV1A: FIRST TIMEM108. How old were you the first time this happened?
0
0
M109. Was this partner who did this to you this first time your girlfriend, roma
M109. Was this partner who did this to you this first time your girlfriend, romantic partner, wife?
0
0
M110. Was this partner older than you, younger than you, or about the same age?
M110. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M112ABOUT SAME AGE [3] -> M112DON’T KNOW/DECLINED [99] -> M112
0
0
M111. Would you say this partner was more than 10 years older than you, 5-10 yea
M111. Would you say this partner was more than 10 years older than you, 5-10 years older?
0
0
M112. Did this happen in the last 12 months?
M112. Did this happen in the last 12 months?
0
0
M113A. FEAR OR ANXIETY
M113A. As a result of this first time when your partner slapped/pushed you, did you experience FEAR OR ANXIETY?
0
0
M113B. CUTS, SCRATCHES, BRUISES
M113B. As a result of this first time when your partner slapped/pushed you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M113C. SPRAINS, DISLOCATIONS, BLISTERING
M113C. As a result of this first time when your partner slapped/pushed you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M113D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M113D. As a result of this first time when your partner slapped/pushed you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M113E. PERMANENT INJURY OR DISFIGUREMENT
M113E. As a result of this first time when your partner slapped/pushed you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M114. How many times have you been punched, kicked, whipped, or beat with an obj
PV1B:M114. How many times have you been punched, kicked, whipped, or beat with an object by a romantic partner /wife: once, a few times, many times?
ONCE [1] -> M121DON'T KNOW/DECLINED [99] -> M121
0
0
M115. How old were you the last time this happened?
PV1B: MOST RECENT TIMEM115. How old were you the last time this happened?
0
0
M116. Was this partner who did this to you this last time your girlfriend, roman
M116. Was this partner who did this to you this last time your girlfriend, romantic partner, wife?
0
0
M117. Was this partner older than you, younger than you, or about the same age?
M117. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M119ABOUT SAME AGE [3] -> M119DON’T KNOW/DECLINED [99] -> M119
0
0
M118. Would you say this partner was more than 10 years older than you, 5-10 yea
M118. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M119. Did this happen in the last 12 months?
M119. Did this happen in the last 12 months?
0
0
M120A. FEAR OR ANXIETY
M120A. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience FEAR OR ANXIETY?
0
0
M120B. CUTS, SCRATCHES, BRUISES
M120B. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M120C. SPRAINS, DISLOCATIONS, BLISTERING
M120C. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M120D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M120D. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M120E. PERMANENT INJURY OR DISFIGUREMENT
M120E. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M121. How old were you the first time this happened?
PV1B: FIRST TIMEM121. How old were you the first time this happened?
0
0
M122. Was this partner who did this to you this first time your girlfriend, roma
M122. Was this partner who did this to you this first time your girlfriend, romantic partner, wife?
0
0
M123. Was this partner older than you, younger than you, or about the same age?
M123. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M125ABOUT SAME AGE [3] -> M125DON’T KNOW/DECLINED [99] -> M125
0
0
M124. Would you say this partner was more than 10 years older than you, 5-10 yea
M124. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M125. Did this happen in the last 12 months?
M125. Did this happen in the last 12 months?
0
0
M126A. FEAR OR ANXIETY
M126A. As a result of this first time when your partner punched, kicked, whipped, or beat you, did you experience FEAR OR ANXIETY?
0
0
M126B. CUTS, SCRATCHES, BRUISES
M126B. As a result of this first time when your partner punched, kicked, whipped, or beat you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M126C. SPRAINS, DISLOCATIONS, BLISTERING
M126C. As a result of this first time when your partner punched, kicked, whipped, or beat you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M126D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M126D. As a result of this first time when your partner punched, kicked, whipped, or beat you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M126E. PERMANENT INJURY OR DISFIGUREMENT
M126E. As a result of this first time when your partner punched, kicked, whipped, or beat you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M127. How many times has a romantic partner/wife choked, smothered, tried to dro
PV1C:M127. How many times has a romantic partner/wife choked, smothered, tried to drown you, or burned or scalded you intentionally: once, a few times, many times?
ONCE [1] -> M134DON'T KNOW/DECLINED [99] -> M134
0
0
M128. How old were you the last time this happened?
PV1C: MOST RECENT TIMEM128. How old were you the last time this happened?
0
0
M129. Was this partner who did this to you this last time your girlfriend, roman
M129. Was this partner who did this to you this last time your girlfriend, romantic partner, wife?
0
0
M130. Was this partner older than you, younger than you, or about the same age?
M130. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M132ABOUT SAME AGE [3] -> M132DON’T KNOW/DECLINED [99] -> M132
0
0
M131. Would you say this partner was more than 10 years older than you, 5-10 yea
M131. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M132. Did this happen in the last 12 months?
M132. Did this happen in the last 12 months?
0
0
M133A. FEAR OR ANXIETY
M133A. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
M133B. CUTS, SCRATCHES, BRUISES
M133B. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M133C. SPRAINS, DISLOCATIONS, BLISTERING
M133C. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M133D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M133D. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M133E. PERMANENT INJURY OR DISFIGUREMENT
M133E. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M134. How old were you the first time this happened?
PV1C: FIRST TIMEM134. How old were you the first time this happened?
0
0
M135. Was this partner who did this to you this first time your girlfriend, roma
M135. Was this partner who did this to you this first time your girlfriend, romantic partner, wife?
0
0
M136. Was this partner older than you, younger than you, or about the same age?
M136. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M138ABOUT SAME AGE [3] -> M138DON’T KNOW/DECLINED [99] -> M138
0
0
M137. Would you say this partner was more than 10 years older than you, 5-10 yea
M137. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M138. Did this happen in the last 12 months?
M138. Did this happen in the last 12 months?
0
0
M139A. FEAR OR ANXIETY
M139A. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience FEAR OR ANXIETY?
0
0
M139B. CUTS, SCRATCHES, BRUISES
M139B. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M139C. SPRAINS, DISLOCATIONS, BLISTERING
M139C. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M139D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M139D. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M139E. PERMANENT INJURY OR DISFIGUREMENT
M139E. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M140. How many times has a romantic partner/wife used or threatened to use a kni
PV1D:M140. How many times has a romantic partner/wife used or threatened to use a knife or other weapon against you: once, a few times, many times?
ONCE [1] -> M147DON'T KNOW/DECLINED [99] -> M147
0
0
M141. How old were you the last time this happened?
M141. How old were you the last time this happened?
0
0
M142. Was this partner who did this to you this last time your girlfriend, roman
M142. Was this partner who did this to you this last time your girlfriend, romantic partner, wife?
0
0
M143. Was this partner older than you, younger than you, or about the same age?
M143. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> M145ABOUT SAME AGE [3] -> M145DON’T KNOW/DECLINED [99] -> M145
0
0
M144. Would you say this partner was more than 10 years older than you, 5-10 yea
M144. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M145. Did this happen in the last 12 months?
M145. Did this happen in the last 12 months?
0
0
M146A. FEAR OR ANXIETY
M146A. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M146B. CUTS, SCRATCHES, BRUISES
M146B. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M146C. SPRAINS, DISLOCATIONS, BLISTERING
M146C. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M146D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M146D. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M146E. PERMANENT INJURY OR DISFIGUREMENT
M146E. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M147. How old were you the first time this happened?
PV1D: FIRST TIMEM147. How old were you the first time this happened?
0
0
M148. Was this partner who did this to you this first time your girlfriend, roma
M148. Was this partner who did this to you this first time your girlfriend, romantic partner, wife?
0
0
M149. Was this partner older than you, younger than you, or about the same age?
M149. Was this partner older than you, younger than you, or about the same age?
0
0
M150. Would you say this partner was more than 10 years older than you, 5-10 yea
M150. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
YOUNGER [2] -> M151ABOUT SAME AGE [3] -> M151DON’T KNOW/DECLINED [99] -> M151
0
0
M151. Did this happen in the last 12 months?
M151. Did this happen in the last 12 months?
0
0
M152A. FEAR OR ANXIETY
M152A. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M152B. CUTS, SCRATCHES, BRUISES
M152B. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M152C. SPRAINS, DISLOCATIONS, BLISTERING
M152C. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M152D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M152D. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M152E. PERMANENT INJURY OR DISFIGUREMENT
M152E. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M153A. Has a parent or other adult relative ever: punched, kicked, whipped, or b
PV2: PARENTS AND OTHER ADULT RELATIVES The next questions are about parents or other adult relatives. Remember, you can ask to skip any question that you do not want to answer.
0
0
M153B. Has a parent or other adult relative ever: choked, smothered, tried to dr
M153B. Has a parent or other adult relative ever: choked, smothered, tried to drown you, or burned you intentionally?
0
0
M153C. Has a parent or other adult relative ever: used or threatened you with a
M153C. Has a parent or other adult relative ever: used or threatened you with a knife or other weapon?
IF M153A=1 AND M153B=2/99 AND M153C =2/99 -> M154 IF M153A=2/99 AND M153B=1 AND M153C =2/99 -> M165 IF M153A=2/99 AND M153B=2/99 AND M153C =1 -> M176
0
0
M154. How many times has a parent or other adult relative punched, kicked, whipp
PV2A:M154. How many times has a parent or other adult relative punched, kicked, whipped, or beat you with an object: once, a few times, many times?
ONCE [1] -> M160DON'T KNOW/DECLINED [99] -> M160
0
0
M155. How old were you the last time this happened?
PV2A: MOST RECENT TIMEM155. How old were you the last time this happened?
0
0
M156. What was your relationship to the relative who did this to you this last t
M156. What was your relationship to the relative who did this to you this last time?
0
0
M156. Other (Specify)
M156. Other (Specify)
0
0
M157. Did this relative live within the same household as you when this last eve
M157. Did this relative live within the same household as you when this last event occurred?
0
0
M158. Did this happen in the last 12 months?
M158. Did this happen in the last 12 months?
0
0
M159A. FEAR OR ANXIETY
M159A. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
M159B. CUTS, SCRATCHES, BRUISES
M159B. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M159C. SPRAINS, DISLOCATIONS, BLISTERING
M159C. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M159D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M159D. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M159E. PERMANENT INJURY OR DISFIGUREMENT
M159E. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M160. How old were you the first time this happened?
M160. How old were you the first time this happened?
0
0
M161. What was your relationship to the relative who did this to you the first t
M161. What was your relationship to the relative who did this to you the first time?
0
0
M161. Other (Specify)
M161. Other (Specify)
0
0
M162. Did this relative live within the same household as you when this first ev
M162. Did this relative live within the same household as you when this first event occurred?
0
0
M163. Did this happen in the last 12 months?
M163. Did this happen in the last 12 months?
0
0
M164A. FEAR OR ANXIETY
M164A. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
M164B. CUTS, SCRATCHES, BRUISES
M164B. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M164C. SPRAINS, DISLOCATIONS, BLISTERING
M164C. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M164D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M164D. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M164E. PERMANENT INJURY OR DISFIGUREMENT
M164E. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M165. How many times has as a parent or any adult relative choked, smothered, tr
PV2B:M165. How many times has as a parent or any adult relative choked, smothered, tried to drown you, burned or scalded you intentionally: once, a few times, many times?
ONCE [1] -> M171DON'T KNOW/DECLINED [99] -> M171
0
0
M166. How old were you the last time this happened?
PV2B: MOST RECENT TIMEM166. How old were you the last time this happened?
0
0
M167. What was your relationship to the relative who did this to you this last t
M167. What was your relationship to the relative who did this to you this last time?
0
0
M167. Other (Specify)
M167. Other (Specify)
0
0
M168. Did this relative live within the same household as you when this last eve
M168. Did this relative live within the same household as you when this most recent event occurred?
0
0
M169. Did this happen in the last 12 months?
M169. Did this happen in the last 12 months?
0
0
M170A. FEAR OR ANXIETY
M170A. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
M170B. CUTS, SCRATCHES, BRUISES
M170B. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M170C. SPRAINS, DISLOCATIONS, BLISTERING
M170C. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M170D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M170D. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M170E. PERMANENT INJURY OR DISFIGUREMENT
M170E. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M171. How old were you the first time this happened?
PV2B: FIRST TIMEM171. How old were you the first time this happened?
0
0
M172. What was your relationship to the relative who did this to you the first t
M172. What was your relationship to the relative who did this to you the first time?
0
0
M172. Other (Specify)
M172. Other (Specify)
0
0
M173. Did this relative live within the same household as you when this firts ev
M173. Did this parent or adult relative live within the same household as you when this first event occurred?
0
0
M174. Did this happen in the last 12 months?
M174. Did this happen in the last 12 months?
0
0
M175A. FEAR OR ANXIETY
M175A. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
M175B. CUTS, SCRATCHES, BRUISES
M175B. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M175C. SPRAINS, DISLOCATIONS, BLISTERING
M175C. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M175D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M175D. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M175E. PERMANENT INJURY OR DISFIGUREMENT
M175E. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M176. How many times has a parent or other adult relative used or threatened to
PV2C:M176. How many times has a parent or other adult relative used or threatened to use a knife or other weapon against you: once, a few times, many times?
ONCE [1] -> M182DON'T KNOW/DECLINED [99] -> M182
0
0
M177. How old were you the most recent time this happened?
PV2C: MOST RECENT TIMEM177. How old were you the most recent time this happened?
0
0
M178. What was your relationship to the relative who did this to you this last t
M178. What was your relationship to the relative who did this to you this last time?
0
0
M178. Other (Specify)
M178. Other (Specify)
0
0
M179. Did this relative live within the same household as you when this last eve
M179. Did this relative live within the same household as you when this last event occurred?
0
0
M180. Did this happen in the last 12 months?
M180. Did this happen in the last 12 months?
0
0
M181A. FEAR OR ANXIETY
M181A. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M181B. CUTS, SCRATCHES, BRUISES
M181B. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M181C. SPRAINS, DISLOCATIONS, BLISTERING
M181C. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M181D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M181D. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M181E. PERMANENT INJURY OR DISFIGUREMENT
M181E. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M182. How old were you the first time this happened?
PV2C: FIRST TIMEM182. How old were you the first time this happened?
0
0
M183. What was your relationship to the relative who did this to you the first t
M183. What was your relationship to the relative who did this to you the first time?
0
0
M183. Other (Specify)
M183. Other (Specify)
0
0
M184. Did this relative live within the same household as you when this first ev
M184. Did this relative live within the same household as you when this first event occurred?
0
0
M185. Did this happen in the last 12 months?
M185. Did this happen in the last 12 months?
0
0
M186A. FEAR OR ANXIETY
M186A. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M186B. CUTS, SCRATCHES, BRUISES
M186B. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M186C. SPRAINS, DISLOCATIONS, BLISTERING
M186C. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M186D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M186D. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M186E. PERMANENT INJURY OR DISFIGUREMENT
M186E. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M187A. Has other people who are in your community punched, kicked, whipped, or b
PV3: PEOPLE LIVING IN THE COMMUNITYThe next questions are about other people who are in your [insert culturally appropriate term for COMMUNITY]. This includes such people as teachers, police, religious or community leaders, friends, classmates or even strangers.
0
0
M187B. Has other people who are in your community choked, smothered, tried to dr
M187B. Have other people who are in your community choked, smothered, tried to drown you, or burned you intentionally?
0
0
M187C. Has other people who are in your community used or threatened you with a
M187C. Have other people who are in your community used or threatened you with a knife or other weapon?
IF M187A=1 AND M187B=2/99 AND M187C =2/99 -> M188 IF M187A=2/99 AND M187B=1 AND M187C =2/99 -> M201 IF M187A=2/99 AND M187B=2/99 AND M187C =1 -> M214
0
0
M188. How many times have you been punched you, kicked, whipped, or beat with an
PV3A:M188. How many times have you been punched you, kicked, whipped, or beat with an object by someone in your [insert culturally appropriate term for COMMUNITY]: once, a few times, or many times?
ONCE [1] -> M195DON'T KNOW/DECLINED [99] -> M195
0
0
M189. How old were you the last time this happened?
PV3A: MOST RECENT TIMEM189. How old were you the last time this happened?
0
0
M190. What was your relationship to the person who did this to you this last tim
M190. What was your relationship to the person who did this to you this last time?
0
0
M190. Other (Specify)
M190. Other (Specify)
0
0
M191. Was this person older than you, younger than you, or about the same age?
M191. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M193ABOUT SAME AGE [3] -> M193DON’T KNOW/DECLINED [99] -> M193
0
0
M192. Would you say this person was more than 10 years older than you, 5-10 year
M192. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M193. Did this happen in the last 12 months?
M193. Did this happen in the last 12 months?
0
0
M194A. FEAR OR ANXIETY
M194A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
M194B. CUTS, SCRATCHES, BRUISES
M194B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M194C. SPRAINS, DISLOCATIONS, BLISTERING
M194C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M194D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M194D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M194E. PERMANENT INJURY OR DISFIGUREMENT
M194E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M195. How old were you the first time this happened?
PV3A: FIRST TIMEM195. How old were you the first time this happened?
0
0
M196. What was your relationship to the person who did this to you this first ti
M196. What was your relationship to the person who did this to you this first time?
0
0
M196. Other (Specify)
M196. Other (Specify)
0
0
M197. Was this person older than you, younger than you, or about the same age?
M197. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M199ABOUT SAME AGE [3] -> M199DON’T KNOW/DECLINED [99] -> M199
0
0
M198. Would you say this person was more than 10 years older than you, 5-10 year
M198. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M199. Did this happen in the last 12 months?
M199. Did this happen in the last 12 months?
0
0
M200A. FEAR OR ANXIETY
M200A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
M200B. CUTS, SCRATCHES, BRUISES
M200B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M200C. SPRAINS, DISLOCATIONS, BLISTERING
M200C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M200D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M200D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M200E. PERMANENT INJURY OR DISFIGUREMENT
M200E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M201. How many times has someone in your community choked, smothered, tried to d
PV3B:M201. How many times has someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally: once, a few times, or many times?
ONCE [1] -> M208DON'T KNOW/DECLINED [99] -> M208
0
0
M202. How old were you the last time this happened?
PV3B: MOST RECENT TIMEM202. How old were you the last time this happened?
0
0
M203. What was your relationship to the person who did this to you this last tim
M203. What was your relationship to the person who did this to you this last time?
0
0
M203. Other (Specify)
M203. Other (Specify)
0
0
M204. Was this person older than you, younger than you, or about the same age?
M204. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M206ABOUT SAME AGE [3] -> M206DON’T KNOW/DECLINED [99] -> M206
0
0
M205. Would you say this person was more than 10 years older than you, 5-10 year
M205. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M206. Did this happen in the last 12 months?
M206. Did this happen in the last 12 months?
0
0
M207A. FEAR OR ANXIETY
M207A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
M207B. CUTS, SCRATCHES, BRUISES
M207B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M207C. SPRAINS, DISLOCATIONS, BLISTERING
M207C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M207D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M207D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M207E. PERMANENT INJURY OR DISFIGUREMENT
M207E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M208. How old were you the first time this happened?
PV3B: FIRST TIMEM208. How old were you the first time this happened?
0
0
M209. What was your relationship to the person who did this to you this first ti
M209. What was your relationship to the person who did this to you this first time?
0
0
M209. Other (Specify)
M209. Other (Specify)
0
0
M210. Was this person older than you, younger than you, or about the same age?
M210. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M212ABOUT SAME AGE [3] -> M212DON’T KNOW/DECLINED [99] -> M212
0
0
M211. Would you say this person was more than 10 years older than you, 5-10 year
M211. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M212. Did this happen in the last 12 months?
M212. Did this happen in the last 12 months?
0
0
M213A. FEAR OR ANXIETY
M213A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
M213B. CUTS, SCRATCHES, BRUISES
M213B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M223C. SPRAINS, DISLOCATIONS, BLISTERING
M223C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M213D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M213D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M213E. PERMANENT INJURY OR DISFIGUREMENT
M213E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M214. How many times has someone in your community used or threatened to use a k
PV3C:M214. How many times has someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a knife or other weapon against you: once, a few times, or many times?
ONCE [1] -> M221DON'T KNOW/DECLINED [99] -> M221
0
0
M215. How old were you the last time this happened?
PV3C: MOST RECENT TIMEM215. How old were you the last time this happened?
0
0
M216. What was your relationship to the person who did this to you this last tim
M216. What was your relationship to the person who did this to you this last time?
0
0
M216. Other (Specify)
M216. Other (Specify)
0
0
M217. Was this person older than you, younger than you, or about the same age?
M217. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M219ABOUT SAME AGE [3] -> M219DON’T KNOW/DECLINED [99] -> M219
0
0
M218. Would you say this person was more than 10 years older than you, 5-10 year
M218. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M219. Did this happen in the last 12 months?
M219. Did this happen in the last 12 months?
0
0
M220A. FEAR OR ANXIETY
M220A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M220B. CUTS, SCRATCHES, BRUISES
M220B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M220C. SPRAINS, DISLOCATIONS, BLISTERING
M220C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M220D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M220D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M220E. PERMANENT INJURY OR DISFIGUREMENT
M220E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M221. How old were you the first time this happened?
M221. How old were you the first time this happened?
0
0
M222. What was your relationship to the person who did this to you this first ti
M222. What was your relationship to the person who did this to you this first time?
0
0
M222. Other (Specify)
M222. Other (Specify)
0
0
M223. Was this person older than you, younger than you, or about the same age?
M223. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M225ABOUT SAME AGE [3] -> M225DON’T KNOW/DECLINED [99] -> M225
0
0
M224. Would you say this person was more than 10 years older than you, 5-10 year
M224. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M225. Did this happen in the last 12 months?
M225. Did this happen in the last 12 months?
0
0
M226A. FEAR OR ANXIETY
M226A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
M226B. CUTS, SCRATCHES, BRUISES
M226B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
M226C. SPRAINS, DISLOCATIONS, BLISTERING
M226C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
M226D. DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
M226D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
M226E. PERMANENT INJURY OR DISFIGUREMENT
M226E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
M227. Thinking about all your experiences with physical violence, have you ever
PV SERVICESM227. Thinking about all your experiences with physical violence, have you ever sought help for any of these experiences?
NO [2] -> M229DON'T KNOW/DECLINED [99] -> M229
0
0
M228. From whom have you sought help?
M228. From whom have you sought help? Anyone else?
RECORD ALL MENTIONED
0
0
M228A. OWN FAMILY
M228A. OWN FAMILY
-> M300
0
0
M228B. WIFE’S/PARTNER’S FAMILY
M228B. WIFE’S/PARTNER’S FAMILY
-> M300
0
0
M228C. CURRENT/FORMER WIFE PARTNER
M228C. CURRENT/FORMER WIFE PARTNER
-> M300
0
0
M228D. CURRENT/FORMER GIRLFRIEND
M228D. CURRENT/FORMER GIRLFRIEND
-> M300
0
0
M228E. FRIEND
M228E. FRIEND
-> M300
0
0
M228F. NEIGHBOR
M228F. NEIGHBOR
-> M300
0
0
M228G. RELIGIOUS LEADER
M228G. RELIGIOUS LEADER
-> M300
0
0
M228H. DOCTOR/MEDICAL PERSONNEL
M228H. DOCTOR/MEDICAL PERSONNEL
-> M300
0
0
M228I. POLICE
M228I. POLICE
-> M300
0
0
M228J. LAWYER
M228J. LAWYER
-> M300
0
0
M228K. SOCIAL SERVICE ORGANIZATION
M228K. SOCIAL SERVICE ORGANIZATION
-> M300
0
0
M228X. OTHER
M228X. OTHER
-> M300
0
0
M228Z. DON’T KNOW/DECLINED
M228Z. DON’T KNOW/DECLINED
-> M300
0
0
M228. Other (Specify)
M228. Other (Specify)
-> M300
0
0
M229. What was the main reason you did not seek help?
M229. What was the main reason you did not seek help?
-> M300
0
0
M229. Other (Specify)
M229. Other (Specify)
-> M300
0
0
M230. Have you ever told anyone about these experiences?
M230. Have you ever told anyone about these experiences?
NO [2] -> M300DON'T KNOW/DECLINED [99] -> M300
0
0
M231. From whom have you sought help?
M231. Who else did you speak to regarding any physical violence experiences that happened?
RECORD ALL MENTIONED
0
0
M231A. OWN FAMILY
M231A. OWN FAMILY
0
0
M231B. WIFE’S/PARTNER’S FAMILY
M231B. WIFE’S/PARTNER’S FAMILY
0
0
M231C. CURRENT/FORMER WIFE PARTNER
M231C. CURRENT/FORMER WIFE PARTNER
0
0
M231D. CURRENT/FORMER GIRLFRIEND
M231D. CURRENT/FORMER GIRLFRIEND
0
0
M231E. FRIEND
M231E. FRIEND
0
0
M231F. NEIGHBOR
M231F. NEIGHBOR
0
0
M231G. RELIGIOUS LEADER
M231G. RELIGIOUS LEADER
0
0
M231H. DOCTOR/MEDICAL PERSONNEL
M231H. DOCTOR/MEDICAL PERSONNEL
0
0
M231I. POLICE
M231I. POLICE
0
0
M231J. LAWYER
M231J. LAWYER
0
0
M231K. SOCIAL SERVICE ORGANIZATION
M231K. SOCIAL SERVICE ORGANIZATION
0
0
M231X. OTHER
M231X. OTHER
0
0
M231Z. DON’T KNOW/DECLINED
M231Z. DON’T KNOW/DECLINED
0
0
M231. Other (Specify)
M231. Other (Specify)
0
0
M300A. Has a parent or someone like a parent ever: told you that you were not lo
M300A. Has a parent or someone like a parent ever: told you that you were not loved, or did not deserve to be loved?
0
0
M300B. said they wished you had never been born or were dead?
M300B. Has a parent or someone like a parent ever: said they wished you had never been born or were dead?
0
0
M300C. ever ridiculed you or put you down (for example say that you were stupid
M300C. Has a parent or someone like a parent ever: ever ridiculed you or put you down (for example say that you were stupid or useless)?
IF M300A =1 OR M300B=1 OR M300C =1 -> M301 IF M300A=2/99 AND M300B=2/99 AND M300C =2/99 -> M400
0
0
M301. How many times has/did a parent or someone like a parent ever said or done
EV1M301. How many times has/did a parent or someone like a parent ever said or done these things: once, a few times, or many times?
ONCE [1] -> M305DON'T KNOW/DECLINED [99] -> M305
0
0
M302. How old were you the most recent time this happened?
EV1: MOST RECENT TIMEM302. How old were you the most recent time this happened?
0
0
M303. What was your relationship to the parent or primary caregiver who did this
M303. What was your relationship to this person who did this to you this most recent time?
0
0
M303. Other (Specify)
M303. Other (Specify)
0
0
M304. Did this happen in the last 12 months?
M304. Did this happen in the last 12 months?
0
0
M305. How old were you the first time this happened?
M305. How old were you the first time this happened?
0
0
M306. What was your relationship to this person who did this to you the first ti
M306. What was your relationship to this person who did this to you the first time?
0
0
M306. Other (Specify)
M306. Other (Specify)
0
0
M307. Did this happen in the last 12 months?
M307. Did this happen in the last 12 months?
0
0
M400. Have you ever had sexual intercourse whether this was something you wanted
SEXUAL BEHAVIOR: The next questions are about sexual activity.
NO [2] -> M500DON'T KNOW/DECLINED [99] -> M500
0
0
M401. How old were you when you had sexual intercourse for the very first time?
M401. How old were you when you had sexual intercourse for the very first time?
0
0
M402. The first time you had sexual intercourse, was it because you wanted to or
M402. The first time you had sexual intercourse, was it because you wanted to or because you were made to have it without your permission?
0
0
M403. In your life, how many sexual partners have you ever had?
SEX HISTORY AND RISK TAKING:For these next questions, a sexual partner is any person with whom you have had sexual intercourse. A sexual partner could be a girlfriend, romantic partner, or wife, or someone you met just that day.
0 IS NOT AN ACCEPTABLE ANSWER FOR THIS QUESTION, IF RESPONDENT SAYS 0 THEN REFER BACK TO M400 AND CORRECT IF NECESSARY.
0
0
M404. Have you had sexual intercourse in the past 12 months?
M404. Have you had sexual intercourse in the past 12 months?
NO [2] -> M500DON'T KNOW/DECLINED [99] -> M500
0
0
M405. How many partners have you had sexual intercourse with in the past 12 mont
M405. How many partners have you had sexual intercourse with in the past 12 months?
0
0
M406. What is/was your relationship to the most recent person with whom you had
I am going to ask you some questions about your sexual partners in the last 12 months.PARTNER 1 MOST RECENT
0
0
M406. Other (Specify)
M406. Other (Specify) PARTNER 1
0
0
M407. In the past 12 months, how often did you or this partner use a condom duri
M407. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? PARTNER 1
CHECK NUMBER OF PARTNERS REPORTED IN M405IF M405=1 -> M500
0
0
M406. What is/was your relationship to the SECOND MOST recent person with whom y
PARTNER 2 SECOND MOST RECENT Now think back to the partner you had sexual intercourse with before the partner we just talked about.
0
0
M406. Other (Specify)
M406. Other (Specify) PARTNER 2
0
0
M407. In the past 12 months, how often did you or this partner use a condom duri
M407. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? SECOND PARTNER
IF M405=2 -> M500 IF M405>2 -> M406 PARTNER 3
0
0
M406. What is/was your relationship to the THIRD MOST recent person with whom yo
PARTNER 3 THIRD MOST RECENT Now think back to the partner you had sexual intercourse with before the partner we just talked about.
GO TO M500
0
0
M406. Other (Specify)
M406. Other (Specify) PARTNER 3
0
0
M407. In the past 12 months, how often did you or this partner use a condom duri
M407. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? THIRD PARTNER
0
0
M500. Has anyone ever given you money, food, gifts, or any favors to have sexual
SEXUAL VIOLENCE: MONEY, GOODS OR FAVORS EXCHANGED FOR SEX/EXPLOITATION I’d like to ask you about some experiences you may have had with sex. Remember that everything you say will be confidential, and you can skip any questions that you don’t feel comfortable answering.
NO [2] -> M600DON'T KNOW/DECLINED [99] -> M600
0
0
M501. How old were you when you were first given money, food, gifts, or any favo
M501. How old were you when you were first given money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts?
0
0
M502. Was this person older than you, younger than you, or about the same age?
M502. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> M504ABOUT SAME AGE [3] -> M504DON’T KNOW/DECLINED [99] -> M504
0
0
M503. Would you say this person was more than 10 years older than you, 5-10 year
M503. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M504. In the last 12 months, how many sexual partners gave you money, food, gift
M504. In the last 12 months, how many sexual partners gave you money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts with them?
0
0
M505. What was your relationship to the people who did this to you?
Now think back to all experiences when you were given money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts with someone. What was your relationship to the people who did this to you?M505. What was your relationship to the people who did this to you?
Circle all mentioned
0
0
M505A. MALE FRIEND OR ACQUIANTANCE
M505A. MALE FRIEND OR ACQUAINTANCE
0
0
M505B. MALE TEACHER
M505B. MALE TEACHER
0
0
M505C. MALE COMMUNITY LEADER
M505C. MALE COMMUNITY LEADER
0
0
M505D. MALE RELIGIOUS LEADER
M505D. MALE RELIGIOUS LEADER
0
0
M505E. MALE EMPLOYER
M505E. MALE EMPLOYER
0
0
M505F. MALE CLASSMATE/ SCHOOLMATE
M505F. MALE CLASSMATE/ SCHOOLMATE
0
0
M505G. MALE NEIGHBOR
M505G. MALE NEIGHBOR
0
0
M505H. MALE POLICE
M505H. MALE POLICE
0
0
M505I. MALE SOLDIER
M505I. MALE SOLDIER
0
0
M505J. MALE TRUCK DRIVER
M505J. MALE TRUCK DRIVER
0
0
M505K. MALE TOURIST OR NON-NATIONAL
M505K. MALE TOURIST OR NON-NATIONAL
0
0
M505L. MALE I DON’T KNOW/ STRANGER
M505L. MALE I DON’T KNOW/ STRANGER
0
0
M505X. OTHER MALE
M505X. OTHER MALE
0
0
M505M. FEMALE FRIEND OR ACQUIANTANCE
M505M. FEMALE FRIEND OR ACQUIANTANCE
0
0
M505N. FEMALE TEACHER
M505N. FEMALE TEACHER
0
0
M505O. FEMALE COMMUNITY LEADER
M505O. FEMALE COMMUNITY LEADER
0
0
M505P. FEMALE RELIGIOUS LEADER
M505P. FEMALE RELIGIOUS LEADER
0
0
M505Q. FEMALE EMPLOYER
M505Q. FEMALE EMPLOYER
0
0
M505R. FEMALE CLASSMATE/ SCHOOLMATE
M505R. FEMALE CLASSMATE/ SCHOOLMATE
0
0
M505S. FEMALE NEIGHBOR
M505S. FEMALE NEIGHBOR
0
0
M505T. FEMALE POLICE/ SOLDIER
M505T. FEMALE POLICE/ SOLDIER
0
0
M505U. FEMALE SOLDIER
M505U. FEMALE SOLDIER
0
0
M505V. FEMALE TRUCK DRIVER
M505V. FEMALE TRUCK DRIVER
0
0
M505W. FEMALE TOURIST OR NON-NATIONAL
M505W. FEMALE TOURIST OR NON-NATIONAL
0
0
M505AA. FEMALE I DON’T KNOW/STRANGER
M505AA. FEMALE I DON’T KNOW/STRANGER
0
0
M505Y. OTHER FEMALE
M505Y. OTHER FEMALE
0
0
M505Z. DON’T KNOW/DECLINED
M505Z. DON’T KNOW/DECLINED
0
0
M505X. Other Male
M505X. Other Male
0
0
M505Y. Other Female
M505Y. Other Female
0
0
M600A. Has anyone ever made you upset by speaking to you in a sexual way or writ
SEXUAL VIOLENCE : NON-CONTACT SEXUAL VIOLENCE/EXPLOITATION M600A. Has anyone ever made you upset by speaking to you in a sexual way or writing sexual things about you?
IF M600A=1 AND M600B=2/99 AND M600C =2/99 -> M601IF M600A=2/99 AND M600B=1 AND M600C =2/99 -> M602IF M600A=2/99 AND M600B=2/99 AND M600C =1 -> M603
0
0
M600B. Has anyone ever forced you to watch sex photos or sex videos against your
M600B. Has anyone ever forced you to watch sex photos or sex videos against your will?
0
0
M600C. Has anyone ever forced you to be in a sex photo or video against your wil
M600C. Has anyone ever forced you to be in a sex photo or video against your will?
0
0
M601A. How many times has someone made you upset by speaking to you in a sexual
M601A. How many times has someone made you upset by speaking to you in a sexual way or writing sexual things about you: once, a few times or many times?
ONCE [1] -> M601CDK/DTA [99] -> CK, M600B and M600C
0
0
M601B. How old were you when this first happened?
M601B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
M601C. How old were you the most recent time this happened?
M601C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
M601D. Did this happen in the last 12 months?
M601D. Did this happen in the last 12 months?
0
0
M602A. How many times has someone forced you to watch sex photos or sex videos a
M602A. How many times has someone forced you to watch sex photos or sex videos against your will?
ONCE [1] -> M602CDK/DTA [99] -> CK, M600C
0
0
M602B. How old were you when this first happened?
M602B. How old were you when this first happened?
0
0
M602C. How old were you the most recent time this happened?
M602C. How old were you the most recent time this happened?
0
0
M602D. Did this happen in the last 12 months?
M602D. Did this happen in the last 12 months?
0
0
M603A. How many times has someone forced you to be in a sex photo or video again
M603A. How many times has someone forced you to be in a sex photo or video against your will: once, a few times or many times?
ONCE [1] -> M603CDK/DTA [99] -> M700
0
0
M603B. How old were you when this first happened?
M603B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
M603C. How old were you the most recent time this happened?
M603C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
M603D. Did this happen in the last 12 months?
M603D. Did this happen in the last 12 months?
0
0
M700. Has anyone, male or female, ever touched you in a sexual way without your
SEXUAL VIOLENCE: SEXUAL ABUSEBoys and men may experience unwanted sexual contact by people they know well, such as a romantic partner, family member or friend, or by strangers. Your answers are confidential and you can skip any questions that you don’t feel comfortable answering.
0
0
M800. Has anyone ever tried to make you have sexual intercourse of any kind with
M800. Has anyone ever tried to make you have sexual intercourse of any kind without your permission, but did not succeed?This includes someone penetrating your anus with their penis, hands, fingers, mouth, or any other objects, or penetrating your mouth with their penis. It can also include someone forcing your penis into their mouth, vagina or anus.
0
0
M900. Has anyone ever physically forced you to have sexual intercourse of any ki
M900. Has anyone ever physically forced you to have sexual intercourse of any kind regardless of whether you did or did not fight back?By physical force, we mean things like being pinned or held down or use of violence like pulling your hair, pushing, shoving, punching, using or threatening to use a weapon, or threatening to physically harm you or a loved one. Please include experiences when you may or may not have fought back.
0
0
M1000. Has anyone ever pressured you in a nonphysical way, to have sexual interc
M1000. Has anyone ever pressured you in a nonphysical way, to have sexual intercourse of any kind when you did not want to and sex happened?When someone pressures you into sex, it could involve things like threats, harassment, luring you, or tricking you into having sex.
IF M700=1 MOVE TO M701IF M800=1 MOVE TO M801IF M900=1 MOVE TO M901
0
0
M701. How many times in your life has anyone touched you in a sexual way without
SV1: TOUCHING WITHOUT PERMISSION- LIFETIMEThese questions ask you about a time when anyone, male or female, touched you in a sexual way without your permission, but the person did not try and force you to have sex.
1 [1] -> M174WRITE NUMBER IF 2 TIMES OR MORE: __ -> M702DON’T KNOW/DECLINED [99] -> M714
0
0
M702. How old were you the most recent time this happened?
SV1A: TOUCHING – MOST RECENTNow think about the most recent time anyone touched you in a sexual way without your permission but did not try to force you to have sex.
0
0
M703. This most recent time, did more than one person touch you in a sexual way
M703. This most recent time, did more than one person touch you in a sexual way without your permission?
NO, ONE PERSON ONLY [2] -> M706DON’T' KNOW/DECLINED [99] -> M706
0
0
M704. This most recent time, how many people touched you in a sexual way without
M704. This most recent time, how many people touched you in a sexual way without
0
0
M706. What was your relationship to the person who did this to you?
Of these people who touched you in a sexual way without your permission this most recent time, think of the person you know the best for the following questions:M706. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M706. Other (Specify)
M706. Other (Specify)
0
0
M707. Was the person older than you, younger than you, or about the same age?
M707. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M709ABOUT SAME AGE [3] -> M709DON’T KNOW/DECLINED [99] -> M709
0
0
M708. Would you say this person was more than 10 years older than you, 5-10 year
M708. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
ON A ROAD/STREET [4] -> M712MARKET/SHOP [5] -> M712SCHOOL [6] -> M712
0
0
M709. Where were you when this happened to you?
M709. Where were you when this happened to you?
0
0
M709. Other (Specify)
M709. Other (Specify)
0
0
M710. Was anyone else at home at the time?
M710. Was anyone else at home at the time?
NO [2] -> M712DON'T KNOW/DECLINED [99] -> M712
0
0
M711. Who else was at home at the time?
M711. Who else was at home at the time?
Circle all mentioned
0
0
M711A. PARENT
M711A. PARENT
0
0
M711B. SIBLING
M711B. SIBLING
0
0
M711C. OTHER RELATIVE
M711C. OTHER RELATIVE
0
0
M711D. FRIEND
M711D. FRIEND
0
0
M711X. OTHER
M711X. OTHER
0
0
M711Z. DON'T KNOW/DECLINED
M711Z. DON'T KNOW/DECLINED
0
0
M711X. Other (Specify)
M711X. Other (Specify)
0
0
M712. About what time of day did this happen?
M712. About what time of day did this happen?
0
0
M713. Did this happen to you within the past 12 months?
M713. Did this happen to you within the past 12 months?
0
0
M714. How old were you the first time this happened?
SV1B: TOUCHING – FIRST TIMENow think about the first time anyone touched you in a sexual way without your permission but did not try to force you to have sex of any kind.
DON'T KNOW/DECLINED [99] -> M800 - M1000
0
0
M715. This first time, did more than one person touch you in a sexual way withou
M715. This first time, did more than one person touch you in a sexual way without your permission?
NO, ONE PERSON ONLY [2] -> M718DON’T' KNOW/DECLINED [99] -> M718
0
0
M716. This first time, how many people touched you in a sexual way without your
M716. This first time, how many people touched you in a sexual way without your permission?
0
0
M718. What was your relationship to the person who did this to you?
Of these people who touched you in a sexual way without your permission this first time, think of the person you know the best for the following questions:M718. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M718. Other (Specify)
M718. Other (Specify)
0
0
M719. Was the person older than you, younger than you, or about the same age?
M719. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M721ABOUT SAME AGE [3] -> M721DON’T KNOW/DECLINED [99] -> M721
0
0
M720. Would you say this person was more than 10 years older than you, 5-10 year
M720. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M721. Where were you when this happened to you?
M721. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M724MARKET/SHOP [5] -> M724SCHOOL [6] -> M724
0
0
M721. Other (Specify)
M721. Other (Specify)
0
0
M722. Was anyone else at home at the time?
M722. Was anyone else at home at the time?
NO [2] -> M724DON'T KNOW/DECLINED [99] -> M724
0
0
M723. Who else was at home at the time?
M723. Who else was at home at the time?
Circle all mentioned
0
0
M723A. PARENT
M723A. PARENT
0
0
M723B. SIBLING
M723B. SIBLING
0
0
M723C. OTHER RELATIVE
M723C. OTHER RELATIVE
0
0
M723D. FRIEND
M723D. FRIEND
0
0
M723X. OTHER
M723X. OTHER
0
0
M723Z. DON'T KNOW/DECLINED
M723Z. DON'T KNOW/DECLINED
0
0
M723X. Other (Specify)
M723X. Other (Specify)
0
0
M724. About what time of day did this happen?
M724. About what time of day did this happen?
0
0
M725. Did this happen to you within the past 12 months?
M725. Did this happen to you within the past 12 months?
REFER TO M800 M900 M1000 FOR ROUTING TO NEXT SECTIONIF M800=1 MOVE TO M801
0
0
M801. How many times in your life has anyone tried to make you have sexual inter
SV2: ATTEMPTED SEX- LIFETIMEM801. How many times in your life has anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed?
1 [1] -> M814WRITE NUMBER IF 2 TIMES OR MORE: __ -> M802DON'T KNOW/DECLINED [99] -> M814
0
0
M802. How old were you the most recent time this happened?
SV2A: ATTEMPTED SEX – MOST RECENTNow think about the most recent time anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed.
0
0
M803. This most recent time, did more than one person try to make you have sexua
M803. This most recent time, did more than one person try to make you have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> M806DON’T' KNOW/DECLINED [99] -> M806
0
0
M804. This most recent time, how many people tried to make you have sexual inter
M804. This most recent time, how many people tried to make you have sexual intercourse of any kind without your permission?
0
0
M806. What was your relationship to the person who did this to you?
Of these people who attempted to have sex with you without your permission this most recent time, think of the person you know the best for the following questions:M806. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M806. Other (Specify)
M806. Other (Specify)
0
0
M807. Was the person older than you, younger than you, or about the same age?
M807. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M809ABOUT SAME AGE [3] -> M809DON’T KNOW/DECLINED [99] -> M809
0
0
M808. Would you say this person was more than 10 years older than you, 5-10 year
M808. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M809. Where were you when this happened to you?
M809. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M812MARKET/SHOP [5] -> M812SCHOOL [6] -> M812
0
0
M809. Other (Specify)
M809. Other (Specify)
0
0
M810. Was anyone else at home at the time?
M810. Was anyone else at home at the time?
NO [2] -> M812DON'T KNOW/DECLINED [99] -> M812
0
0
M811. Who else was at home at the time?
M811. Who else was at home at the time?
0
0
M811A. PARENT
M811A. PARENT
0
0
M811B. SIBLING
M811B. SIBLING
0
0
M811C. OTHER RELATIVE
M811C. OTHER RELATIVE
0
0
M811D. FRIEND
M811D. FRIEND
0
0
M811X. OTHER
M811X. OTHER
0
0
M811Z. DON'T KNOW/DECLINED
M811Z. DON'T KNOW/DECLINED
0
0
M811X. Other (Specify)
M811X. Other (Specify)
0
0
M812. About what time of day did this happen?
M812. About what time of day did this happen?
0
0
M813. Did this happen to you within the past 12 months?
M813. Did this happen to you within the past 12 months?
0
0
M814. How old were you the first time this happened?
SV2B: ATTEMPTED SEX - FIRST TIMENow think about the first time anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed.
DON'T KNOW/DECLINED [99] -> Section based on M900 and M1000
0
0
M815. This first time, did more than one person try to make you have sexual inte
M815. This first time, did more than one person try to make you have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> M818DON’T' KNOW/DECLINED [99] -> M818
0
0
M816. This first time, how many people tried to make you have sexual intercourse
M816. This first time, how many people tried to make you have sexual intercourse of any kind without your permission?
0
0
M818. What was your relationship to the person who did this to you?
Of these people who attempted to have sex with you without your permission this first time, think of the person you know the best for the following questions:M818. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M818. Other (Specify)
M818. Other (Specify)
0
0
M819. Was the person older than you, younger than you, or about the same age?
M819. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M821ABOUT SAME AGE [3] -> M821DON’T KNOW/DECLINED [99] -> M821
0
0
M820. Would you say this person was more than 10 years older than you, 5-10 year
M820. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M821. Where were you when this happened to you?
M821. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M824MARKET/SHOP [5] -> M824SCHOOL [6] -> M824
0
0
M821. Other (Specify)
M821. Other (Specify)
0
0
M822. Was anyone else at home at the time?
M822. Was anyone else at home at the time?
NO [2] -> M824DON'T KNOW/DECLINED [99] -> M824
0
0
M823. Who else was at home at the time?
M823. Who else was at home at the time?
Circle all mentioned
0
0
M823A. PARENT
M823A. PARENT
0
0
M823B. SIBLING
M823B. SIBLING
0
0
M823C. OTHER RELATIVE
M823C. OTHER RELATIVE
0
0
M823D. FRIEND
M823D. FRIEND
0
0
M823X. OTHER
M823X. OTHER
0
0
M823Z. DON'T KNOW/DECLINED
M823Z. DON'T KNOW/DECLINED
0
0
M823X. Other (Specify)
M823X. Other (Specify)
0
0
M824. About what time of day did this happen?
M824. About what time of day did this happen?
0
0
M825. Did this happen to you within the past 12 months?
M825. Did this happen to you within the past 12 months?
REFER TO M900 M1000 FOR ROUTING TO NEXT SECTIONIF M900=1 MOVE TO M901IF M1000=1 MOVE TO M1001
0
0
M901. How many times in your life have you been physically forced to have sexual
SV3: PHYSICALLY FORCED SEX- LIFETIMEM901. How many times in your life have you been physically forced to have sexual intercourse of any kind regardless of whether you did or did not fight back?
1 [1] -> M915WRITE NUMBER IF 2 TIMES OR MORE: __ -> M902DON'T KNOW/DECLINED [99] -> M915
0
0
M902. How old were you the most recent time this ever happened?
SV3A: PHYSICALLY FORCED SEX – MOST RECENTNow think about the most recent time anyone physically forced you to have sexual intercourse of any kind without your permission.
NO, ONE PERSON ONLY [2] -> M906DON’T' KNOW/DECLINED [99] -> M906
0
0
M903. This most recent time, did more than one person physically force you to ha
M903. This most recent time, did more than one person physically force you to have sexual intercourse of any kind without your permission?
0
0
M904. This most recent time, how many people physically forced you to have sexua
M904. This most recent time, how many people physically forced you to have sexual intercourse of any kind without your permission?
0
0
M906. What was your relationship to the person who did this to you?
Of these people who physically forced you to have sex of any kind without your permission this most recent time, think of the person you know best for the following questions:M906. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M906. Other (Specify)
M906. Other (Specify)
0
0
M907. Was the person older than you, younger than you, or about the same age?
M907. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M821ABOUT SAME AGE [3] -> M821DON’T KNOW/DECLINED [99] -> M821
0
0
M908. Would you say this person was more than 10 years older than you, 5-10 year
M908. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M909. Did the person who did this to you this most recent time use a weapon such
M909. Did the person who did this to you this most recent time use a weapon such as a gun, knife or machete?
0
0
M910. Where were you when this happened to you?
M910. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M913MARKET/SHOP [5] -> M913SCHOOL [6] -> M913
0
0
M910. Other (Specify)
M910. Other (Specify)
0
0
M911. Was anyone else at home at the time?
M911. Was anyone else at home at the time?
NO [2] -> M913DON'T KNOW/DECLINED [99] -> M913
0
0
M912. Who else was at home at the time?
M912. Who else was at home at the time?
Circle all mentioned
0
0
M912A. PARENT
M912A. PARENT
0
0
M912B. SIBLING
M912B. SIBLING
0
0
M912C. OTHER RELATIVE
M912C. OTHER RELATIVE
0
0
M912D. FRIEND
M912D. FRIEND
0
0
M912X. OTHER
M912X. OTHER
0
0
M912Z. DON'T KNOW/DECLINED
M912Z. DON'T KNOW/DECLINED
0
0
M912X. Other (Specify)
M912X. Other (Specify)
0
0
M913. About what time of day did this happen?
M913. About what time of day did this happen?
0
0
M914. Did this most recent experience of being physically forced to have sex of
M914. Did this most recent experience of being physically forced to have sex of any kind happen to you within the past 12 months?
0
0
M915. How old were you the first time this happened?
SV3B: PHYSICALLY FORCED SEX – FIRST TIMENow think about the first time anyone physically forced you to have sexual intercourse of any kind without your permission.
DON'T KNOW/DECLINED [99] -> Section based on M1000
0
0
M916. This first time, did more than one person physically force you to have sex
M916. This first time, did more than one person physically force you to have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> M919DON’T' KNOW/DECLINED [99] -> M919
0
0
M917. This first time, how many people physically forced you to have sexual inte
M917. This first time, how many people physically forced you to have sexual intercourse of any kind without your permission?
0
0
M919. What was your relationship to the person who did this to you?
Of these people who physically forced you to have sex of any kind without your permission the first time, think of the person you know best for the following questions:M919. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M919. Other (Specify)
M919. Other (Specify)
0
0
M920. Did the person who did this to you the first time use a weapon such as a g
M920. Did the person who did this to you the first time use a weapon such as a gun, knife or machete?
0
0
M921. Was the person older than you, younger than you, or about the same age?
M921. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M923ABOUT SAME AGE [3] -> M923DON’T KNOW/DECLINED [99] -> M923
0
0
M922. Would you say this person was more than 10 years older than you, 5-10 year
M922. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M923. Where were you when this happened to you?
M923. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M926MARKET/SHOP [5] -> M926SCHOOL [6] -> M926
0
0
M923. Other (Specify)
M923. Other (Specify)
0
0
M924. Was anyone else at home at the time?
M924. Was anyone else at home at the time?
NO [2] -> M926DON'T KNOW/DECLINED [99] -> M926
0
0
M925. Who else was at home at the time?
M925. Who else was at home at the time?
Circle all mentioned
0
0
M925A. PARENT
M925A. PARENT
0
0
M925B. SIBLING
M925B. SIBLING
0
0
M925C. OTHER RELATIVE
M925C. OTHER RELATIVE
0
0
M925D. FRIEND
M925D. FRIEND
0
0
M925X. OTHER
M925X. OTHER
0
0
M925Z. DON'T KNOW/DECLINED
M925Z. DON'T KNOW/DECLINED
0
0
M925X. Other (Specify)
M925X. Other (Specify)
0
0
M926. About what time of day did this happen?
M926. About what time of day did this happen?
0
0
M927. Did this first experience when someone physically forced you to have sexua
M927. Did this first experience when someone physically forced you to have sexual intercourse of any kind happen to you within the past 12 months?
REFER TO M1000 FOR ROUTING TO NEXT SECTIONIF M1000=1 MOVE TO M1001IF M1000 =2/99 MOVE TO SVCS M1100
0
0
M1001. How many times in your life has someone pressured you in a nonphysical wa
SV4: PRESSURED SEX- LIFETIMEM1001. How many times in your life has someone pressured you in a nonphysical way, to have sexual intercourse of any kind when you did not want to and sex happened?
1 [1] -> M1014WRITE NUMBER IF 2 TIMES OR MORE: __ -> M1002DON'T KNOW/DECLINED [99] -> M1014
0
0
M1002. How old were you the most recent time this happened?
SV4A: PRESSURED INTO SEX – MOST RECENTNow think about the most recent time anyone pressured you, in a nonphysical way, to have sexual intercourse of any kind when you did not want to, and sex happened.
0
0
M1003. This most recent time, did more than one person pressure you, in a nonphy
M1003. This most recent time, did more than one person pressure you, in a nonphysical way, to have sexual intercourse of any kind when you did not want to?
NO, ONE PERSON ONLY [2] -> M1006DON’T' KNOW/DECLINED [99] -> M1006
0
0
M1004. This most recent time, how many people pressured you in a nonphysical way
M1004. This most recent time, how many people pressured you in a nonphysical way to have sexual intercourse of any kind, when you did not want to?
0
0
M1006. What was your relationship to the person who did this to you?
Of the people who pressured in a nonphysical way to have sexual intercourse of any kind when you did not want to this most recent time, think of the person you know the best for the following questions:M1006. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M1006. Other (Specify)
M1006. Other (Specify)
0
0
M1007. Was the person older than you, younger than you, or about the same age?
M1007. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M1009ABOUT SAME AGE [3] -> M1009DON’T KNOW/DECLINED [99] -> M1009
0
0
M1008. Would you say this person was more than 10 years older than you, 5-10 yea
M1008. Would you say this person was more than 10 years older than you, 5-10 years older, or less than 5 years older?
0
0
M1009. Where were you when this happened to you?
M1009. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M1012MARKET/SHOP [5] -> M1012SCHOOL [6] -> M1012
0
0
M1009. Other (Specify)
M1009. Other (Specify)
0
0
M1010. Was anyone else at home at the time?
M1010. Was anyone else at home at the time?
NO [2] -> M1012DON'T KNOW/DECLINED [99] -> M1012
0
0
M1011. Who else was at home at the time?
M1011. Who else was at home at the time?
Circle all mentioned
0
0
M1011A. PARENT
M1011A. PARENT
0
0
M1011B. SIBLING
M1011B. SIBLING
0
0
M1011C. OTHER RELATIVE
M1011C. OTHER RELATIVE
0
0
M1011D. FRIEND
M1011D. FRIEND
0
0
M1011X. OTHER
M1011X. OTHER
0
0
M1011Z. DON'T KNOW/DECLINED
M1011Z. DON'T KNOW/DECLINED
0
0
M1011X. Other (Specify)
M1011X. Other (Specify)
0
0
M1012. About what time of day did this happen?
M1012. About what time of day did this happen?
0
0
M1013. Did this most recent experience of being pressured in a nonphysical way t
M1013. Did this most recent experience of being pressured in a nonphysical way to have sex of any kind happen to you within the past 12 months?
0
0
M1014. How old were you the first time this happened?
SV4B: PRESSURED INTO SEX – FIRST TIMENow think about the first time anyone pressured you, in a nonphysical way, to have sex of any kind when you did not want to, and sex happened.
DON'T KNOW/DECLINED [99] -> M1100
0
0
M1015. This first time, did more than one person pressure you, in a nonphysical way, to have sex of any kind when you did not want to?
NO, ONE PERSON ONLY [2] -> M1018DON’T' KNOW/DECLINED [99] -> M1018
0
0
M1016. This first time, how many people pressured you in a nonphysical way to have sex of any kind, when you did not want to?
0
0
M1018. What was your relationship to the person who did this to you?
Of these people who pressured you in a nonphysical way to have sex of any kind without your permission this first time, think of the person you know the best for the following questions:M1018. What was your relationship to the person who did this to you? This could be a girlfriend, wife, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
M1018. Other (Specify)
M1018. Other (Specify)
0
0
M1019. Was the person older than you, younger than you, or about the same age?
M1019. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> M1021ABOUT SAME AGE [3] -> M1021DON’T KNOW/DECLINED [99] -> M1021
0
0
M1020. Would you say this person was more than 10 years older than you, 5-10 yea
M1020. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
M1021. Where were you when this happened to you?
M1021. Where were you when this happened to you?
ON A ROAD/STREET [4] -> M1024MARKET/SHOP [5] -> M1024SCHOOL [6] -> M1024
0
0
M1021. Other (Specify)
M1021. Other (Specify)
0
0
M1022. Was anyone else at home at the time?
M1022. Was anyone else at home at the time?
NO [2] -> M1024DON'T KNOW/DECLINED [99] -> M1024
0
0
M1023. Who else was at home at the time?
M1023. Who else was at home at the time?
Circle all mentioned
0
0
M1023A. PARENT
M1023A. PARENT
0
0
M1023B. SIBLING
M1023B. SIBLING
0
0
M1023C. OTHER RELATIVE
M1023C. OTHER RELATIVE
0
0
M1023D. FRIEND
M1023D. FRIEND
0
0
M1023X. OTHER
M1023X. OTHER
0
0
M1023Z. DON'T KNOW/DECLINED
M1023Z. DON'T KNOW/DECLINED
0
0
M1023X. Other (Specify)
M1023X. Other (Specify)
0
0
M1024. About what time of day did this happen?
M1024. About what time of day did this happen?
0
0
M1025. Did this first experience of being pressured in a nonphysical way to have
M1025. Did this first experience of being pressured in a nonphysical way to have sex of any kind happen to you within the past 12 months?
0
0
M1100. Thinking about all of the sexual experiences that happened without your p
SV SERVICESM1100. Thinking about all of the sexual experiences that happened without your permission, have you ever sought help for these experiences?
NO [2] -> M1102DON'T KNOW/DECLINED [99] -> M1102
0
0
M1101. From whom have you sought help?
M1101. From whom have you sought help? Anyone else?
RECORD ALL MENTIONED
0
0
M1101A. OWN FAMILY
M1101A. OWN FAMILY
-> M1200 (PERPETRATION)
0
0
M1101B. WIFE’S/PARTNER’S FAMILY
M1101B. WIFE’S/PARTNER’S FAMILY
-> M1200 (PERPETRATION)
0
0
M1101C. CURRENT/FORMER WIFE PARTNER
M1101C. CURRENT/FORMER WIFE PARTNER
-> M1200 (PERPETRATION)
0
0
M1101D. CURRENT/FORMER GIRLFRIEND
M1101D. CURRENT/FORMER GIRLFRIEND
-> M1200 (PERPETRATION)
0
0
M1101E. FRIEND
M1101E. FRIEND
-> M1200 (PERPETRATION)
0
0
M1101F. NEIGHBOR
M1101F. NEIGHBOR
-> M1200 (PERPETRATION)
0
0
M1101G. RELIGIOUS LEADER
M1101G. RELIGIOUS LEADER
-> M1200 (PERPETRATION)
0
0
M1101H. DOCTOR/MEDICAL PERSONNEL
M1101H. DOCTOR/MEDICAL PERSONNEL
-> M1200 (PERPETRATION)
0
0
M1101I. POLICE
M1101I. POLICE
-> M1200 (PERPETRATION)
0
0
M1101J. LAWYER
M1101J. LAWYER
-> M1200 (PERPETRATION)
0
0
M1101K. SOCIAL SERVICE ORGANIZATION
M1101K. SOCIAL SERVICE ORGANIZATION
-> M1200 (PERPETRATION)
0
0
M1101X. OTHER
M1101X. OTHER
-> M1200 (PERPETRATION)
0
0
M1101Z. DON’T KNOW/DECLINED
M1101Z. DON’T KNOW/DECLINED
-> M1200 (PERPETRATION)
0
0
M1101. Other (Specify)
M1101. Other (Specify)
0
0
M1102. What was the main reason you did not seek help?
M1102. What was the main reason you did not seek help?
0
0
M1102. Other (Specify)
M1102. Other (Specify)
0
0
M1103. Have you ever told anyone about these experiences?
M1103. Have you ever told anyone about these experiences?
NO [2] -> M1200DON'T KNOW/DECLINED [99] -> M1200
0
0
M1104. From whom have you sought help?
M1104. Who else did you speak to regarding any of these sexual experiences that happened without your permission?
RECORD ALL MENTIONED
0
0
M1104A. OWN FAMILY
M1104A. OWN FAMILY
0
0
M1104B. WIFE’S/PARTNER’S FAMILY
M1104B. WIFE’S/PARTNER’S FAMILY
0
0
M1104C. CURRENT/FORMER WIFE PARTNER
M1104C. CURRENT/FORMER WIFE PARTNER
0
0
M1104D. CURRENT/FORMER GIRLFRIEND
M1104D. CURRENT/FORMER GIRLFRIEND
0
0
M1104E. FRIEND
M1104E. FRIEND
0
0
M1104F. NEIGHBOR
M1104F. NEIGHBOR
0
0
M1104G. RELIGIOUS LEADER
M1104G. RELIGIOUS LEADER
0
0
M1104H. DOCTOR/MEDICAL PERSONNEL
M1104H. DOCTOR/MEDICAL PERSONNEL
0
0
M1104I. POLICE
M1104I. POLICE
0
0
M1104J. LAWYER
M1104J. LAWYER
0
0
M1104K. SOCIAL SERVICE ORGANIZATION
M1104K. SOCIAL SERVICE ORGANIZATION
0
0
M1104X. OTHER
M1104X. OTHER
0
0
M1104Z. DON’T KNOW/DECLINED
M1104Z. DON’T KNOW/DECLINED
0
0
M1104. Other (Specify)
M1104. Other (Specify)
0
0
M1200. Have you slapped or pushed a current or previous partner/wife?
PERPETRATION M1200. Have you slapped or pushed a current or previous partner/wife: never, once, a few times, many times? By partner I mean a girlfriend, romantic partner, fiancé, live-in partner, or wife.
0
0
M1201. Have you punched, kicked, whipped, or beat with an object a current or pr
M1201. Have you punched, kicked, whipped, or beat with an object a current or previous partner/wife: never, once, a few times, many times?
0
0
M1202. Have you choked, smothered, tried to drown, or intentionally burned or sc
M1202. Have you choked, smothered, tried to drown, or intentionally burned or scalded a current or previous partner/wife: never, once, a few times, many times?
0
0
M1203. Have you used or threatened to use a knife or other weapon against a curr
M1203. Have you used or threatened to use a knife or other weapon against a current or previous partner/wife: never, once, a few times, many times?
0
0
M1204. Have you forced a current or previous partner/wife to have sexual interco
M1204. Have you forced a current or previous partner/wife to have sexual intercourse or perform any other sex acts with you when they did not want to: never, once, a few times, many times?
0
0
M1205. Have you ever had sexual intercourse with someone who is not your wife?
M1205. Have you ever had sexual intercourse with someone who is not your wife or partner?
NO [2] -> M1300DON'T KNOW/DECLINED [99] -> M1300
0
0
M1206. Did you force them or did they force you?
M1206. Did you force them or did they force you?
0
0
M1300. In the past 30 days, have you used drugs such as marijuana, pills, ecstas
SUBSTANCE ABUSE: M1300. In the past 30 days, have you used drugs such as marijuana, pills, ecstasy, yama or sniffed any chemical such as petrol or glue?
0
0
M1301. In the past 30 days, on how many days did you drink alcohol to the point
M1301. In the past 30 days, on how many days did you drink alcohol to the point that you became drunk?
0
0
M1302. During the past 30 days, did you smoke cigarettes daily, occasionally, or
M1302. During the past 30 days, did you smoke cigarettes daily, occasionally, or not at all?
0
0
M1303A. NERVOUS
During the past 30 days, how often did you feel the following ways: (Read categories below)M1303A. All the time, most of the time, some of the time, a little of the time, or none of the time NERVOUS?
0
0
M1303B. HOPELESS
M1303B. All the time, most of the time, some of the time, a little of the time, or none of the time HOPELESS?
0
0
M1303C. RESTLESS
M1303C. All the time, most of the time, some of the time, a little of the time, or none of the time RESTLESS?
0
0
M1303D. SO DEPRESSED THAT NOTHING COULD CHEER YOU UP
M1303D. All the time, most of the time, some of the time, a little of the time, or none of the time SO DEPRESSED THAT NOTHING COULD CHEER YOU UP?
0
0
M1303E. THAT EVERYTHING WAS AN EFFORT
M1303E. All the time, most of the time, some of the time, a little of the time, or none of the time THAT EVERYTHING WAS AN EFFORT?
0
0
M1303F. WORTHLESS
M1303F. All the time, most of the time, some of the time, a little of the time, or none of the time WORTHLESS?
0
0
M1304. Have you ever intentionally hurt yourself in any way?
M1304. Have you ever intentionally hurt yourself in any way?
0
0
M1305. Have you ever thought about killing yourself?
M1305. Have you ever thought about killing yourself?
-> M1307
0
0
M1306. Have you ever tried to kill yourself?
M1306. Have you ever tried to kill yourself?
0
0
M1307. Do you know what HIV is?
HIV/AIDS - STIs: The next few questions ask you to think about HIV/AIDS. Remember that everything you say will be confidential, and you can skip any questions that you don’t feel comfortable answering.
0
0
M1308. Do you know any place where people could go for HIV testing?
M1308. Do you know any place where people could go for HIV testing?
0
0
M1309. Have you ever been tested for HIV?
M1309. Have you ever been tested for HIV?
YES [1] -> M1311DON'T KNOW/DECLINED [99] -> M1313
0
0
M1310. What is the main reason you have never been tested?
M1310. What is the main reason you have never been tested?
-> M1313
0
0
M1310. Other (Specify)
M1310. Other (Specify)
0
0
M1311. When was the most recent time you were tested for HIV?
M1311. When was the most recent time you were tested for HIV: less than 12 months ago, 1-2 years ago, or more than 2 years ago?
0
0
M1312. This most recent time you were tested for HIV, did you get the results of
M1312. This most recent time you were tested for HIV, did you get the results of your test?
0
0
M1313. Have you ever had an abnormal discharge from your penis?
M1313. Sometimes boys and men experience an abnormal discharge from their penis. Have you ever had an abnormal discharge from your penis?
0
0
M1314. Have you ever had a sore or ulcer near your penis?
M1314. Sometimes men have a sore or ulcer near their penis. Have you ever had a sore or ulcer near your penis?
0
0
M1400. Do you feel that the time you took to answer these questions was worthwhi
RESPONSES TO SENSITVE QUESTIONSM1400. Do you feel that the time you took to answer these questions was worthwhile for you?
0
0
0
0
M1401. At any point during the interview, were you afraid that someone might hea
M1401. At any point during the interview, were you afraid that someone might hear your answers and hurt you in any way because of what they heard?
0
0
0
0
M1402. Did my asking you any of these questions about violence make you feel ups
M1402. Did my asking you any of these questions about violence make you feel upset because the violence reminded you of a past experience?
0
0
0
0
M1403. Did you find it upsetting or stressful to answer any of these questions?
M1403. Did you find it upsetting or stressful to answer any of these questions?
NO [2] -> M1406DON'T KNOW/DECLINED [99] -> M1406
0
0
0
0
M1404. Which questions did you find upsetting or stressful to answer?
M1404. Which questions did you find upsetting or stressful to answer? The questions on physical violence, emotional violence, sexual violence, or other questions?
RECORD ALL MENTIONED
0
0
0
0
M1404A. PARENT
M1404A. PARENT
0
0
0
0
M1404B. SIBLING
M1404B. SIBLING
0
0
0
0
M1404C. OTHER RELATIVE
M1404C. OTHER RELATIVE
0
0
0
0
M1404X. OTHER
M1404X. OTHER
0
0
0
0
M1404Z. DON'T KNOW/DECLINED
M1404Z. DON'T KNOW/DECLINED
0
0
0
0
M1404. Other (Specify)
M1404. Other (Specify)
0
0
0
0
M1405. Why did you find it upsetting or stressful to answer these questions?
M1405. Why did you find it upsetting or stressful to answer these questions?
0
0
M1406. I have asked you about many difficult things. How has talking about these things made you feel?
0
0
M1407.Do you have any comments, or is there anything else you would like to add?
M1407. We have now finished the interview. Do you have any comments, or is there anything else you would like to add?
0
0
TIME INTERVIEW ENDED -HOUR
TIME INTERVIEW ENDED -HOUR
0
0
TIME INTERVIEW ENDED -MINUTE
TIME INTERVIEW ENDED -MINUTE
0
0
DID RESPONDENT TELL YOU ABOUT/DISCLOSE ANY VIOLENCE IN THE PAST?
Did respondent tell you about/disclose any violence in the past?
0
0
DID THE RESPONDENT SHOW ANY SIGNS OF BEING UPSET AT ANY POINT DURING THE INTERVI
Did the respondent show any signs of being upset at any point during the interview e.g. being tearful, angry, sad, shaking body, difficulty in breathing, etc.?
0
0
DID THE RESPODENT TELL YOU ABOUT FEELING UNSAFE IN CURRENT LIVING SITUATION AT A
Did the respondent tell you about feeling unsafe in current living situation or asks for help with current or past experiences of violence at any point during the interview?
0
0
Do you have any questions you would like to ask me?
Do you have any questions you would like to ask me?
0
0
Do you think that you would like to talk to one of our social workers/arrange fo
Do you think that you would like to talk to one of our social workers/arrange for a social worker from a local NGO to speak with you?
0
0
Do you have any questions you would like to ask me?
Do you have any questions you would like to ask me?
0
0
INTERVIEWER QC CODE
Interviewer QC initials
0
0
SUPERVISOR TEAM CODE
Supervisor team code
0
0
URBAN/RURAL
Urban/Rural
0
0
CLUSTER NUMBER
Cluster number
0
0
Cluster number(1)
0
0
Province_Code
Province code
0
0
Province_Name
Province name
0
0
District_Code
District code
0
0
District_Name
District name
0
0
Commune_Code
Commune code
0
0
Commune_Name
Commune name
0
0
Village_Name
Village name
0
0
ExpectedHits
Expected hits
0
0
EA_Gender
EA gender
0
0
Primary sampling unit
0
0
Final weight
0
0
Identification
Identification
0
0
Identification Number
Identification Number
0
0
EA Identification
EA Identification
0
0
Province
Province
0
0
District
District
0
0
Commune
Commune
0
0
EA
EA
0
0
Household
Household
0
0
Interviewer Code
Interviewer Code
0
0
Cluster Type
Cluster Type
0
0
Final Visit Number
Final Visit Number
0
0
Final Visit Date
Final Visit Date
0
0
Final Visit Date - Year
Final Visit Date - Year
0
0
Final Visit Date - Month
Final Visit Date - Month
0
0
Final Visit Date - Day
Final Visit Date - Day
0
0
Final Household Listing Result
Final Household Listing Result
0
0
Final Household Questionnaire Result
Final Household Questionnaire Result
0
0
Final Respondent Questionnaire Result
Final Respondent Questionnaire Result
0
0
Visit Number Aux. 1
Visit Number Aux. 1
0
0
Visit Date - Year Aux. 1
Visit Date - Year Aux. 1
0
0
Visit Date - Month Aux. 1
Visit Date - Month Aux. 1
0
0
Visit Date - Day Aux. 1
Visit Date - Day Aux. 1
0
0
Household Listing Result Aux. 1
Household Listing Result Aux. 1
0
0
Visit Number Aux. 2
Visit Number Aux. 2
0
0
Visit Date - Year Aux. 2
Visit Date - Year Aux. 2
0
0
Visit Date - Month Aux. 2
Visit Date - Month Aux. 2
0
0
Visit Date - Day Aux. 2
Visit Date - Day Aux. 2
0
0
Household Listing Result Aux. 2
Household Listing Result Aux. 2
0
0
Visit Number Aux. 3
Visit Number Aux. 3
0
0
Visit Date - Year Aux. 3
Visit Date - Year Aux. 3
0
0
Visit Date - Month Aux. 3
Visit Date - Month Aux. 3
0
0
Visit Date - Day Aux. 3
Visit Date - Day Aux. 3
0
0
Household Listing Result Aux. 3
Household Listing Result Aux. 3
0
0
Visit Number(1)
Visit Number(1)
0
0
Visit Number(2)
Visit Number(2)
0
0
Visit Number(3)
Visit Number(3)
0
0
Visit Date - Year(1)
Visit Date - Year(1)
0
0
Visit Date - Year(2)
Visit Date - Year(2)
0
0
Visit Date - Year(3)
Visit Date - Year(3)
0
0
Visit Date - Month(1)
Visit Date - Month(1)
0
0
Visit Date - Month(2)
Visit Date - Month(2)
0
0
Visit Date - Month(3)
Visit Date - Month(3)
0
0
Visit Date - Day(1)
Visit Date - Day(1)
0
0
Visit Date - Day(2)
Visit Date - Day(2)
0
0
Visit Date - Day(3)
Visit Date - Day(3)
0
0
Household Listing Result(1)
Household Listing Result(1)
0
0
Household Listing Result(2)
Household Listing Result(2)
0
0
Household Listing Result(3)
Household Listing Result(3)
0
0
Household Questionnaire Result(1)
Household Questionnaire Result(1)
0
0
Household Questionnaire Result(2)
Household Questionnaire Result(2)
0
0
Household Questionnaire Result(3)
Household Questionnaire Result(3)
0
0
Respondent Questionnaire Result(1)
Respondent Questionnaire Result(1)
0
0
Respondent Questionnaire Result(2)
Respondent Questionnaire Result(2)
0
0
Respondent Questionnaire Result(3)
Respondent Questionnaire Result(3)
0
0
Number of People living in this Household
Number of People Living In This Household
0
0
Number of Females in this Household
Number of Females in this Household
0
0
Line Number of Selected ER
Line Number of Selected ER
0
0
Line of ER Selected from HH Listing Form
Line of ER Selected From Hh Listing Form
0
0
Head of Household Available
Head of Household Available
0
0
Household Member Line(1)
Household Member Line(1)
0
0
Household Member Line(2)
Household Member Line(2)
0
0
Household Member Line(3)
Household Member Line(3)
0
0
Household Member Line(4)
Household Member Line(4)
0
0
Household Member Line(5)
Household Member Line(5)
0
0
Household Member Line(6)
Household Member Line(6)
0
0
Household Member Line(7)
Household Member Line(7)
0
0
Household Member Line(8)
Household Member Line(8)
0
0
Household Member Line(9)
Household Member Line(9)
0
0
Household Member Line(10)
Household Member Line(10)
0
0
Household Member Line(11)
Household Member Line(11)
0
0
Household Member Line(12)
Household Member Line(12)
0
0
Household Member Line(13)
Household Member Line(13)
0
0
Household Member Line(14)
Household Member Line(14)
0
0
Household Member Line(15)
Household Member Line(15)
0
0
Household Member Line(16)
Household Member Line(16)
0
0
Household Member Line(17)
Household Member Line(17)
0
0
Household Member Line(18)
Household Member Line(18)
0
0
Household Member Line(19)
Household Member Line(19)
0
0
Age of Household Member(1)
Age of Household Member(1)
0
0
Age of Household Member(2)
Age of Household Member(2)
0
0
Age of Household Member(3)
Age of Household Member(3)
0
0
Age of Household Member(4)
Age of Household Member(4)
0
0
Age of Household Member(5)
Age of Household Member(5)
0
0
Age of Household Member(6)
Age of Household Member(6)
0
0
Age of Household Member(7)
Age of Household Member(7)
0
0
Age of Household Member(8)
Age of Household Member(8)
0
0
Age of Household Member(9)
Age of Household Member(9)
0
0
Age of Household Member(10)
Age of Household Member(10)
0
0
Age of Household Member(11)
Age of Household Member(11)
0
0
Age of Household Member(12)
Age of Household Member(12)
0
0
Age of Household Member(13)
Age of Household Member(13)
0
0
Age of Household Member(14)
Age of Household Member(14)
0
0
Age of Household Member(15)
Age of Household Member(15)
0
0
Age of Household Member(16)
Age of Household Member(16)
0
0
Age of Household Member(17)
Age of Household Member(17)
0
0
Age of Household Member(18)
Age of Household Member(18)
0
0
Age of Household Member(19)
Age of Household Member(19)
0
0
Date of Birth(1)
Date of Birth(1)
0
0
Date of Birth(2)
Date of Birth(2)
0
0
Date of Birth(3)
Date of Birth(3)
0
0
Date of Birth(4)
Date of Birth(4)
0
0
Date of Birth(5)
Date of Birth(5)
0
0
Date of Birth(6)
Date of Birth(6)
0
0
Date of Birth(7)
Date of Birth(7)
0
0
Date of Birth(8)
Date of Birth(8)
0
0
Date of Birth(9)
Date of Birth(9)
0
0
Date of Birth(10)
Date of Birth(10)
0
0
Date of Birth(11)
Date of Birth(11)
0
0
Date of Birth(12)
Date of Birth(12)
0
0
Date of Birth(13)
Date of Birth(13)
0
0
Date of Birth(14)
Date of Birth(14)
0
0
Date of Birth(15)
Date of Birth(15)
0
0
Date of Birth(16)
Date of Birth(16)
0
0
Date of Birth(17)
Date of Birth(17)
0
0
Date of Birth(18)
Date of Birth(18)
0
0
Date of Birth(19)
Date of Birth(19)
0
0
Date of Birth - Year(1)
Date of Birth - Year(1)
0
0
Date of Birth - Year(2)
Date of Birth - Year(2)
0
0
Date of Birth - Year(3)
Date of Birth - Year(3)
0
0
Date of Birth - Year(4)
Date of Birth - Year(4)
0
0
Date of Birth - Year(5)
Date of Birth - Year(5)
0
0
Date of Birth - Year(6)
Date of Birth - Year(6)
0
0
Date of Birth - Year(7)
Date of Birth - Year(7)
0
0
Date of Birth - Year(8)
Date of Birth - Year(8)
0
0
Date of Birth - Year(9)
Date of Birth - Year(9)
0
0
Date of Birth - Year(10)
Date of Birth - Year(10)
0
0
Date of Birth - Year(11)
Date of Birth - Year(11)
0
0
Date of Birth - Year(12)
Date of Birth - Year(12)
0
0
Date of Birth - Year(13)
Date of Birth - Year(13)
0
0
Date of Birth - Year(14)
Date of Birth - Year(14)
0
0
Date of Birth - Year(15)
Date of Birth - Year(15)
0
0
Date of Birth - Year(16)
Date of Birth - Year(16)
0
0
Date of Birth - Year(17)
Date of Birth - Year(17)
0
0
Date of Birth - Year(18)
Date of Birth - Year(18)
0
0
Date of Birth - Year(19)
Date of Birth - Year(19)
0
0
Date of Birth - Month(1)
Date of Birth - Month(1)
0
0
Date of Birth - Month(2)
Date of Birth - Month(2)
0
0
Date of Birth - Month(3)
Date of Birth - Month(3)
0
0
Date of Birth - Month(4)
Date of Birth - Month(4)
0
0
Date of Birth - Month(5)
Date of Birth - Month(5)
0
0
Date of Birth - Month(6)
Date of Birth - Month(6)
0
0
Date of Birth - Month(7)
Date of Birth - Month(7)
0
0
Date of Birth - Month(8)
Date of Birth - Month(8)
0
0
Date of Birth - Month(9)
Date of Birth - Month(9)
0
0
Date of Birth - Month(10)
Date of Birth - Month(10)
0
0
Date of Birth - Month(11)
Date of Birth - Month(11)
0
0
Date of Birth - Month(12)
Date of Birth - Month(12)
0
0
Date of Birth - Month(13)
Date of Birth - Month(13)
0
0
Date of Birth - Month(14)
Date of Birth - Month(14)
0
0
Date of Birth - Month(15)
Date of Birth - Month(15)
0
0
Date of Birth - Month(16)
Date of Birth - Month(16)
0
0
Date of Birth - Month(17)
Date of Birth - Month(17)
0
0
Date of Birth - Month(18)
Date of Birth - Month(18)
0
0
Date of Birth - Month(19)
Date of Birth - Month(19)
0
0
Date of Birth - Day(1)
Date of Birth - Day(1)
0
0
Date of Birth - Day(2)
Date of Birth - Day(2)
0
0
Date of Birth - Day(3)
Date of Birth - Day(3)
0
0
Date of Birth - Day(4)
Date of Birth - Day(4)
0
0
Date of Birth - Day(5)
Date of Birth - Day(5)
0
0
Date of Birth - Day(6)
Date of Birth - Day(6)
0
0
Date of Birth - Day(7)
Date of Birth - Day(7)
0
0
Date of Birth - Day(8)
Date of Birth - Day(8)
0
0
Date of Birth - Day(9)
Date of Birth - Day(9)
0
0
Date of Birth - Day(10)
Date of Birth - Day(10)
0
0
Date of Birth - Day(11)
Date of Birth - Day(11)
0
0
Date of Birth - Day(12)
Date of Birth - Day(12)
0
0
Date of Birth - Day(13)
Date of Birth - Day(13)
0
0
Date of Birth - Day(14)
Date of Birth - Day(14)
0
0
Date of Birth - Day(15)
Date of Birth - Day(15)
0
0
Date of Birth - Day(16)
Date of Birth - Day(16)
0
0
Date of Birth - Day(17)
Date of Birth - Day(17)
0
0
Date of Birth - Day(18)
Date of Birth - Day(18)
0
0
Date of Birth - Day(19)
Date of Birth - Day(19)
0
0
Sex of Household Member(1)
Sex of Household Member(1)
0
0
Sex of Household Member(2)
Sex of Household Member(2)
0
0
Sex of Household Member(3)
Sex of Household Member(3)
0
0
Sex of Household Member(4)
Sex of Household Member(4)
0
0
Sex of Household Member(5)
Sex of Household Member(5)
0
0
Sex of Household Member(6)
Sex of Household Member(6)
0
0
Sex of Household Member(7)
Sex of Household Member(7)
0
0
Sex of Household Member(8)
Sex of Household Member(8)
0
0
Sex of Household Member(9)
Sex of Household Member(9)
0
0
Sex of Household Member(10)
Sex of Household Member(10)
0
0
Sex of Household Member(11)
Sex of Household Member(11)
0
0
Sex of Household Member(12)
Sex of Household Member(12)
0
0
Sex of Household Member(13)
Sex of Household Member(13)
0
0
Sex of Household Member(14)
Sex of Household Member(14)
0
0
Sex of Household Member(15)
Sex of Household Member(15)
0
0
Sex of Household Member(16)
Sex of Household Member(16)
0
0
Sex of Household Member(17)
Sex of Household Member(17)
0
0
Sex of Household Member(18)
Sex of Household Member(18)
0
0
Sex of Household Member(19)
Sex of Household Member(19)
0
0
Household Member live in this House(1)
Household Member live in this House(1)
0
0
Household Member live in this House(2)
Household Member live in this House(2)
0
0
Household Member live in this House(3)
Household Member live in this House(3)
0
0
Household Member live in this House(4)
Household Member live in this House(4)
0
0
Household Member live in this House(5)
Household Member live in this House(5)
0
0
Household Member live in this House(6)
Household Member live in this House(6)
0
0
Household Member live in this House(7)
Household Member live in this House(7)
0
0
Household Member live in this House(8)
Household Member live in this House(8)
0
0
Household Member live in this House(9)
Household Member live in this House(9)
0
0
Household Member live in this House(10)
Household Member live in this House(10)
0
0
Household Member live in this House(11)
Household Member live in this House(11)
0
0
Household Member live in this House(12)
Household Member live in this House(12)
0
0
Household Member live in this House(13)
Household Member live in this House(13)
0
0
Household Member live in this House(14)
Household Member live in this House(14)
0
0
Household Member live in this House(15)
Household Member live in this House(15)
0
0
Household Member live in this House(16)
Household Member live in this House(16)
0
0
Household Member live in this House(17)
Household Member live in this House(17)
0
0
Household Member live in this House(18)
Household Member live in this House(18)
0
0
Household Member live in this House(19)
Household Member live in this House(19)
0
0
Eligible Household Member(1)
Eligible Household Member(1)
0
0
Eligible Household Member(2)
Eligible Household Member(2)
0
0
Eligible Household Member(3)
Eligible Household Member(3)
0
0
Eligible Household Member(4)
Eligible Household Member(4)
0
0
Eligible Household Member(5)
Eligible Household Member(5)
0
0
Eligible Household Member(6)
Eligible Household Member(6)
0
0
Eligible Household Member(7)
Eligible Household Member(7)
0
0
Eligible Household Member(8)
Eligible Household Member(8)
0
0
Eligible Household Member(9)
Eligible Household Member(9)
0
0
Eligible Household Member(10)
Eligible Household Member(10)
0
0
Eligible Household Member(11)
Eligible Household Member(11)
0
0
Eligible Household Member(12)
Eligible Household Member(12)
0
0
Eligible Household Member(13)
Eligible Household Member(13)
0
0
Eligible Household Member(14)
Eligible Household Member(14)
0
0
Eligible Household Member(15)
Eligible Household Member(15)
0
0
Eligible Household Member(16)
Eligible Household Member(16)
0
0
Eligible Household Member(17)
Eligible Household Member(17)
0
0
Eligible Household Member(18)
Eligible Household Member(18)
0
0
Eligible Household Member(19)
Eligible Household Member(19)
0
0
Age of Elegible Respondement(1)
Age of Elegible Respondement(1)
0
0
Age of Elegible Respondement(2)
Age of Elegible Respondement(2)
0
0
Age of Elegible Respondement(3)
Age of Elegible Respondement(3)
0
0
Age of Elegible Respondement(4)
Age of Elegible Respondement(4)
0
0
Age of Elegible Respondement(5)
Age of Elegible Respondement(5)
0
0
Age of Elegible Respondement(6)
Age of Elegible Respondement(6)
0
0
Age of Elegible Respondement(7)
Age of Elegible Respondement(7)
0
0
Age of Elegible Respondement(8)
Age of Elegible Respondement(8)
0
0
Date of Birth of ER - Day(1)
Date of Birth of ER - Day(1)
0
0
Date of Birth of ER - Day(2)
Date of Birth of ER - Day(2)
0
0
Date of Birth of ER - Day(3)
Date of Birth of ER - Day(3)
0
0
Date of Birth of ER - Day(4)
Date of Birth of ER - Day(4)
0
0
Date of Birth of ER - Day(5)
Date of Birth of ER - Day(5)
0
0
Date of Birth of ER - Day(6)
Date of Birth of ER - Day(6)
0
0
Date of Birth of ER - Day(7)
Date of Birth of ER - Day(7)
0
0
Date of Birth of ER - Day(8)
Date of Birth of ER - Day(8)
0
0
Date of Birth of ER - Month(1)
Date of Birth of ER - Month(1)
0
0
Date of Birth of ER - Month(2)
Date of Birth of ER - Month(2)
0
0
Date of Birth of ER - Month(3)
Date of Birth of ER - Month(3)
0
0
Date of Birth of ER - Month(4)
Date of Birth of ER - Month(4)
0
0
Date of Birth of ER - Month(5)
Date of Birth of ER - Month(5)
0
0
Date of Birth of ER - Month(6)
Date of Birth of ER - Month(6)
0
0
Date of Birth of ER - Month(7)
Date of Birth of ER - Month(7)
0
0
Date of Birth of ER - Month(8)
Date of Birth of ER - Month(8)
0
0
Date of Birth of ER - Year(1)
Date of Birth of ER - Year(1)
0
0
Date of Birth of ER - Year(2)
Date of Birth of ER - Year(2)
0
0
Date of Birth of ER - Year(3)
Date of Birth of ER - Year(3)
0
0
Date of Birth of ER - Year(4)
Date of Birth of ER - Year(4)
0
0
Date of Birth of ER - Year(5)
Date of Birth of ER - Year(5)
0
0
Date of Birth of ER - Year(6)
Date of Birth of ER - Year(6)
0
0
Date of Birth of ER - Year(7)
Date of Birth of ER - Year(7)
0
0
Date of Birth of ER - Year(8)
Date of Birth of ER - Year(8)
0
0
Line of ER from the HH Listing Form(1)
Line of ER from the HH Listing Form(1)
0
0
Line of ER from the HH Listing Form(2)
Line of ER from the HH Listing Form(2)
0
0
Line of ER from the HH Listing Form(3)
Line of ER from the HH Listing Form(3)
0
0
Line of ER from the HH Listing Form(4)
Line of ER from the HH Listing Form(4)
0
0
Line of ER from the HH Listing Form(5)
Line of ER from the HH Listing Form(5)
0
0
Line of ER from the HH Listing Form(6)
Line of ER from the HH Listing Form(6)
0
0
Line of ER from the HH Listing Form(7)
Line of ER from the HH Listing Form(7)
0
0
Line of ER from the HH Listing Form(8)
Line of ER from the HH Listing Form(8)
0
0
Continue household questionnaire?
Continue household questionnaire?
0
0
H1. Record the time the Interview Began - Hour
H1. Record the time the Interview Began - Hour
0
0
H1. Record the time the Interview Began - Min
H1. Record the time the Interview Began - Min
0
0
Sex of hhld head
H2. Sex of the head of household
0
0
Age of hhld head
H3. Age of the head of the household
0
0
Relationship to selected respondent
H4. How is the selected respondent related to you?
0
0
Relationship to selected respondent, other
H4. Other (Specify)
0
0
Main source of drinking water
H5. What is the main source of drinking water for members of your household?
0
0
Main source of drinking water, other
H5. Other (Specify)
0
0
Main source of water for other purposes
H6. What is the main source of water used by your household for other purposes such as cooking and hand washing?
0
0
Main source of water for other purposes, other
H6. Other (Specify)
0
0
Kind of toilet facility
H7. What kind of toilet facility do members of your household usually use?
IF “FLUSH” OR “POUR FLUSH”, PROBE:Where does it flush to?
0
0
Kind of toilet facility, other
H7. Other (Specify)
0
0
Share toilet facility with others
H8. Do you share this facility with other households?
0
0
Electricity
H9A. Does your household have: Electricity?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Radio
H9B. Does your household have: Radio?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Television
H9C. Does your household have: Television?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Mobile Telephone
H9D. Does your household have: Mobile Telephone?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Non-Mobile Telephone
H9E. Does your household have: Non-Mobile Telephone?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Refrigerator
H9F. Does your household have: Refrigerator?
PLEASE CIRCLE THE APPROPRIATE RESPONSE FOR QUESTION A THROUGH F.
0
0
Table
H10A. Does your household have the following furniture: Table?
0
0
Chair
H10B. Does your household have the following furniture: Chair?
0
0
Sofa
H10C. Does your household have the following furniture: Sofa?
0
0
Bed
H10D. Does your household have the following furniture: Bed?
0
0
Wardrobe
H10E. Does your household have the following furniture: Wardrobe?
0
0
Kitchen Cabinet
H10F. Does your household have the following furniture: Kitchen Cabinet?
0
0
Fuel for cooking
H11. What type of fuel does your household mainly use for cooking?
0
0
Fuel for cooking, other
H11. Other (Specify)
0
0
Floor material
Interviewer
H12. Main material of the dwelling floor
Observation only
0
0
Floor material, other
H12. Other (Specify)
0
0
Roof material
Interviewer
H13. Main material of the roof
Observation only
0
0
Roof material, other
H13. Other (Specify)
0
0
Wall material
Interviewer
H14. Main material of the walls
Observation only
0
0
Wall material, other
H14. Other (Specify)
0
0
Number of rooms
H15. How many rooms are there in this household?
This excludes bathroom, kitchen, garage and rice storage.
0
0
Number of rooms for sleeping
H16. How many rooms in this household are used for sleeping?
0
0
Watch
H17A. Does any member of your household own: Watch?
0
0
Bicycle
H17B. Does any member of your household own: Bicycle?
0
0
Motorcycle or scooter
H17C. Does any member of your household own: Motorcycle or scooter?
0
0
Animal drawn-cart
H17D. Does any member of your household own: Animal drawn-cart?
0
0
Car or van
H17E. Does any member of your household own: Car or van?
0
0
Boat without a motor?
H17F. Does any member of your household own: Boat without a motor?
0
0
Boat with a motor
H17G. Does any member of your household own: Boat with a motor?
0
0
Tractor
H17H. Does any member of your household own: Tractor?
0
0
Hand Tractor
H17I. Does any member of your household own: Hand Tractor?
0
0
Own land for agriculture
H18. Does any member of this household have any land that can be used for agricultural purposes?
0
0
Own livestock, herds, etc.
H19. Does this household own any livestock, herds, or farm animals?
0
0
Bank account
H20. Does any member of this household have a bank account?
0
0
Continue respondent qsnaire
Continue respondent questionnaire?
0
0
Time of interview - start - hour
The question should be ask member of family above 13 and above.
0
0
Time of interview - start - min
0
0
Age
Eligible respondent
the question ask only female respondent between 13 and 24 years old .
0
0
How old are you?
Education - Attended school
Eligible respondent
F8
DON'T KNOW/DECLINED [99] -> F8]]>
the question ask only female respondent between 13 and 24 years old .
0
0
Education - Attending school
Eligible respondent
YES [1] -> F6DON'T KNOW/DECLINED [99] -> F8
Age
the question ask only female respondent between 13 and 24 years old .
0
0
Age
Education - Highest level of education
Eligible respondent
LESS THAN PRIMARY [1] -> F8PRIMARY [2] -> F8SECONDARY [3] -> F8
the question ask only female respondent between 13 and 24 years old .
0
0
Education - Current level
Eligible respondent
the question ask only female respondent between 13 and 24 years old .
0
0
Education - Connection with other students
Eligible respondent
the question ask only female respondent between 13 and 24 years old .
0
0
Friendship - Talk to friends
Eligible respondent
the question ask only female respondent between 13 and 24 years old .
0
0
Work - Ever worked for money
Eligible respondent
NO [2] -> F11DON'T KNOW/DECLINED [99] -> F11
the question ask only female respondent between 13 and 24 years old .
0
0
Work - Currently working
Eligible respondent
0
0
Parents - Living with mother
NO [2] -> F16DON'T KNOW/DECLINED [99] -> F16
0
0
Parents - Age last lived with mother
0
0
Parents - Reason for not living with mother
MOTHER DIED [1] -> F15
0
0
Parents - Reason for not living with mother, other
0
0
Parents - Mother still alive
YES [1] -> F16DON'T KNOW/DECLINED [99] -> F16
0
0
Parents - Age when mother died
if her mother die, Asking about age of her monther.
0
0
Parents - How close to mother
0
0
Parents - Living with father
0
0
Parents - Age last lived with father
0
0
Parents - Reason for not living with father
MOTHER DIED [1] -> F21
0
0
Parents - Reason for not living with father, other
0
0
Parents - Father still alive
YES [1] -> F22DON'T KNOW/DECLINED [99] -> F22
0
0
Parents - Age when father died
0
0
Parents - How close to father
0
0
This question ask about relationship between her father with her, How close do you/did you feel to your biological father? Would you say very close, close, not close, or never had a relationship with her?
Marriage - Ever been married
Eligible respondent
YES [1] -> F27DON'T KNOW/DECLINED [99] -> F27
0
0
Marriage - Age at first marriage
Eligible respondent
0
0
Marriage - Marital status
Eligible respondent
WIDOWED [2] -> F27DIVORCED [3] -> F27SEPARATED [4] -> F27
0
0
Marriage - Living with spouse
Eligible respondent
YES [1] -> F31DON'T KNOW/DECLINED [99] -> F31
0
0
Partner - Ever lived together with someone
Eligible respondent
DON'T KNOW/DECLINED [99] -> F30
0
0
Partner - Age at first live in
Eligible respondent
0
0
Partner - Living with someone
Eligible respondent
YES [1] -> F31DON'T KNOW/DECLINED [99] -> F31
0
0
Are you currently living with that person now?
Partner - Ever had boyfriend
Eligible respondent
0
0
Have you ever had a boyfriend or romantic partner?
GA - Beat - goes out without telling husband
Eligible respondent
Read categories below.
0
0
GA - Beat - neglects children
Eligible respondent
Read categories below.
0
0
GA - Beat - argues with husband
Eligible respondent
Read categories below.
0
0
GA - Beat - refuses to have sex
Eligible respondent
F31D. Do you believe it is right for a man to hit or beat his wife: if she refuses to have sex with him?
Read categories below.
0
0
GA - Beat - makes bad food
Eligible respondent
F31E. Do you believe it is right for a man to hit or beat his wife: if she makes bad food?
Read categories below.
0
0
GA - Men decide when to have sex
Eligible respondent
F32A. Do you believe: men decide when to have sex?
Read categories below.
0
0
GA - Men need more sex
Eligible respondent
F32B. Do you believe: men need more sex?
Read categories below.
0
0
GA - Men need other women
Eligible respondent
F32C. Do you believe: men need other women?
Read categories below.
0
0
GA - Women who carry condoms have sex with a lot of men
Eligible respondent
F32D. Do you believe: women who carry condoms have sex with a lot of men?
Read categories below.
0
0
GA - Women should tolerate violence
Eligible respondent
F32E. Do you believe: women should tolerate violence?
Read categories below.
0
0
GA - Safety - trust people in community
Eligible respondent
Read categories below.
0
0
GA - Safety - feel safe in community
Eligible respondent
Read categories below.
0
0
PV - witness to physical violence
Eligible respondent
NEVER [1] -> F37AONCE [2] -> F36CDK/DTA [99] -> F37A
0
0
PV - witness - first time - age
Eligible respondent
0
0
How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
PV - witness - recent - age
Eligible respondent
0
0
PV - witness - recent - happened in last 12 months
Eligible respondent
0
0
Did this happen in the last 12 months?
PV - Slap - witness
Eligible respondent
0
0
Did the slapping, punching or kicking occur once, a few times or many times?
PV - Used knife - witness
Eligible respondent
IF F37A=1 AND M37B=2/99 -> F38IF F37A=1 AND F37B=1 -> F38 FOLLOWED BY F39IF F37A =2/99 AND F37B=1 -> F39
0
0
Have you ever seen an adult hurt or scare another adult by using or threatening to use a knife, gun, stick, rock or other similar weapon?
PV - Slap - witness - number of times occurred
Eligible respondent
NEVER [1] -> F38CDK/DTA [99] -> F39 OR F100
0
0
Did the slapping, punching or kicking occur once, a few times or many time?
PV - Slap - witness - first - age
Eligible respondent
0
0
How old were you when this first happened? ( the slapping, punching or kicking occur )
PV - Slap - witness - recent - age
Eligible respondent
0
0
How old were you the most recent time this happened?
PV - Slap - witness - happened in last 12 months
Eligible respondent
0
0
Did this happen in the last 12 months?
PV - Used knife - witness - number of times occurred
Eligible respondent
NEVER [1] -> F39CDK/DTA [99] -> F100
0
0
Have you ever seen an adult hurt or scare another adult by using or threatening to use a knife, gun, stick, rock or similar weapon occur once, a few times or many times?
PV - Used knife - witness - first - age
Eligible respondent
0
0
How old were you when this first happened?
PV - Used knife - witness - recent - age
Eligible respondent
0
0
How old were you the most recent time this happened?
PV - Used knife - witness - happened in last 12 months
Eligible respondent
0
0
Did this happen in the last 12 months?
PV1A - Ever been slapped by partner
Eligible respondent
0
0
PV1B - Ever been punched by partner
Eligible respondent
0
0
PV1C - Ever been choked by partner
Eligible respondent
0
0
PV1D - Ever been threatened with use of knife by partner
Eligible respondent
IF F100A =1 AND F100B=2/99 AND F100C=2/99 AND F100D=2/99 -> F101 IF F100A =2/99 AND F100B=1 AND F100C=2/99 AND F100D=2/99 -> F114 IF F100A =2/99 AND F100B=2/99 AND F100C=1 AND F100D=2/99 -> F127
0
0
PV1A - Slap - number of times
Eligible respondent
ONCE [1] -> F108DON'T KNOW/DECLINED [99] -> F108
the question ask only respondent between 13 and 24 years old.
0
0
PV1A - Slap - recent - age
Eligible respondent
Asking about most recent time that respondent has a romantic partner, boyfriend or husband ever punched, kicked, whipped, or beat you with an object.
0
0
Asking about MOST RECENT TIME
PV1A - Slap - recent - relationship to person
Eligible respondent
0
0
Was this partner who did this to you the last time your boyfriend, romantic partner, husband?
PV1A - Slap - recent - relative age
Eligible respondent
YOUNGER [2] -> F106ABOUT SAME AGE [3] -> F106DON’T KNOW/DECLINED [99] -> F106
0
0
Was this partner older than you, younger than you, or about the same age?
PV1A - Slap - recent - estimated age
Eligible respondent
0
0
PV1A - Slap - recent - happened in last 12 months
Eligible respondent
0
0
PV1A - Slap - recent - fear
Eligible respondent
0
0
PV1A - Slap - recent - cuts
Eligible respondent
0
0
PV1A - Slap - recent - sprains
Eligible respondent
0
0
PV1A - Slap - recent - deep wounds
Eligible respondent
0
0
PV1A - Slap - recent - miscarriage
Eligible respondent
0
0
PV1A - Slap - recent - permanent injury
Eligible respondent
0
0
PV1A - Slap - first time - age
Eligible respondent
Asking about first time that respondent has a romantic partner, boyfriend or husband ever slapped or pushed.
0
0
PV1A - Slap - first time - relationship to person
Eligible respondent
0
0
PV1A - Slap - first time - relative age
Eligible respondent
YOUNGER [2] -> F112ABOUT SAME AGE [3] -> F112DON’T KNOW/DECLINED [99] -> F112
0
0
PV1A - Slap - first time - estimated age
Eligible respondent
Asking about age of repondent partner that has violence on her .
0
0
PV1A - Slap - first time - happened in last 12 months
0
0
PV1A - Slap - first time - fear
Eligible respondent
As a result of the last time when your partner slapped/pushed you, did you experience?
0
0
Asking about her feeling when she met violence .
PV1A - Slap - first time - cuts
Eligible respondent
0
0
PV1A - Slap - first time - sprains
Eligible respondent
0
0
PV1A - Slap - first time - deep wounds
Eligible respondent
0
0
PV1A - Slap - first time - miscarriage
Eligible respondent
0
0
PV1A - Slap - first time - permanent injury
Eligible respondent
0
0
PV1B - Punch - number of times
Eligible respondent
ONCE [1] -> F121DON'T KNOW/DECLINED [99] -> F121
0
0
PV1B - Punch - recent - age
Eligible respondent
0
0
PV1B - Punch - recent - relationship to person
Eligible respondent
Asking about the most recent time when she met violence.
0
0
PV1B - Punch - recent - relative age
Eligible respondent
YOUNGER [2] -> F119ABOUT SAME AGE [3] -> F119DON’T KNOW/DECLINED [99] -> F119
Was this partner older than you, younger than you, or about the same age?
0
0
PV1B - Punch - recent - estimated age
Eligible respondent
Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV1B - Punch - recent - happened in last 12 months
Eligible respondent
Did this happen in the last 12 months?
0
0
PV1B - Punch - recent - fear
Eligible respondent
As a result of the last time when your partner slapped/pushed you, did you experience?
0
0
PV1B - Punch - recent - cuts
Eligible respondent
F120B. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience CUTS, SCRATCHES, BRUISES?
CUTS, SCRATCHES, BRUISES
0
0
PV1B - Punch - recent - sprains
F120C. As a result of the last time when your partner punched, kicked, whipped, or beat you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
SPRAINS, DISLOCATIONS, BLISTERING
0
0
PV1B - Punch - recent - deep wounds
DEEP WOUNDS, BROKEN BONES, CHARRED SKIN
0
0
PV1B - Punch - recent - miscarriage
MISCARRIAGE
0
0
PV1B - Punch - recent - permanent injury
0
0
PV1B - Punch - first time - age
0
0
PV1B - Punch - first time - relationship to person
0
0
PV1B - Punch - first time - relative age
YOUNGER [2] -> F125ABOUT SAME AGE [3] -> F125DON’T KNOW/DECLINED [99] -> F125
0
0
PV1B - Punch - first time - estimated age
0
0
PV1B - Punch - first time - happened in last 12 months
0
0
PV1B - Punch - first time - fear
0
0
PV1B - Punch - first time - cuts
0
0
PV1B - Punch - first time - sprains
0
0
PV1B - Punch - first time - deep wounds
0
0
PV1B - Punch - first time - miscarriage
0
0
PV1B - Punch - first time - permanent injury
0
0
PV1C - Choke - number of times
ONCE [1] -> F134DON'T KNOW/DECLINED [99] -> F134
0
0
PV1C - Choke - recent - age
0
0
PV1C - Choke - recent - relationship to person
0
0
PV1C - Choke - recent - relative age
YOUNGER [2] -> F132ABOUT SAME AGE [3] -> F132DON’T KNOW/DECLINED [99] -> F132
0
0
PV1C - Choke - recent - estimated age
0
0
PV1C - Choke - recent - happened in last 12 months
0
0
PV1C - Choke - recent - fear
F133A. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV1C - Choke - recent - cuts
F133B. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV1C - Choke - recent - sprains
F133C. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV1C - Choke - recent - deep wounds
F133D. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV1C - Choke - recent - miscarriage
F133E. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience A MISCARRIAGE?
0
0
PV1C - Choke - recent - permanent injury
F133F. As a result of this last time when your partner choked, smothered, tried to drown you, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV1C - Choke - first time - age
0
0
PV1C - Choke - first time - relationship to person
F135. Was this partner who did this to you this first time your boyfriend, romantic partner, husband?
0
0
PV1C - Choke - first time - relative age
F136. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> F138ABOUT SAME AGE [3] -> F138DON’T KNOW/DECLINED [99] -> F138
0
0
PV1C - Choke - first time - estimated age
F137. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV1C - Choke - first time - happened in last 12 months
0
0
PV1C - Choke - first time - fear
F139A. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV1C - Choke - first time - cuts
F139B. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV1C - Choke - first time - sprains
F139C. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV1C - Choke - first time - deep wounds
F139D. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV1C - Choke - first time - miscarriage
F139E. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience A MISCARRIAGE?
0
0
PV1C - Choke - first time - permanent injury
F139F. As a result of the first time when your partner choked, smothered, tried to drown, burned or scaled you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV1D - Used knife - number of times
PV1D:F140. How many times has a romantic partner/husband used or threatened to use a knife or other weapon against you: once, a few times, many times?
ONCE [1] -> F147DON'T KNOW/DECLINED [99] -> F147
0
0
PV1D - Used knife - recent - age
F141. How old were you the last time this happened?
0
0
PV1D - Used knife - recent - relationship to person
F142. Was this partner who did this to you this last time your boyfriend, romantic partner, husband?
0
0
PV1D - Used knife - recent - relative age
F143. Was this partner older than you, younger than you, or about the same age?
YOUNGER [2] -> F145ABOUT SAME AGE [3] -> F145DON’T KNOW/DECLINED [99] -> F145
0
0
PV1D - Used knife - recent - estimated age
F144. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV1D - Used knife - recent - happened in last 12 months
F145. Did this happen in the last 12 months?
0
0
PV1D - Used knife - recent - fear
F146A. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV1D - Used knife - recent - cuts
F146B. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV1D - Used knife - recent - sprains
F146C. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV1D - Used knife - recent - deep wounds
F146D. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV1D - Used knife - recent - miscarriage
F146E. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience A MISCARRIAGE?
0
0
PV1D - Used knife - recent - permanent injury
F146F. As a result of this last time when a partner used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV1D - Used knife - first time - age
PV1D: FIRST TIMEF147. How old were you the first time this happened?
0
0
PV1D - Used knife - first time - relationship to person
F148. Was this partner who did this to you this first time your boyfriend, romantic partner, husband?
0
0
PV1D - Used knife - first time - relative age
F149. Was this partner older than you, younger than you, or about the same age?
0
0
PV1D - Used knife - first time - estimated age
F150. Would you say this partner was more than 10 years older than you, 5-10 years older or less than 5 years older?
YOUNGER [2] -> F151ABOUT SAME AGE [3] -> F151DON’T KNOW/DECLINED [99] -> F151
0
0
PV1D - Used knife - first time - happened in last 12 months
F151. Did this happen in the last 12 months?
0
0
PV1D - Used knife - first time - fear
F152A. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV1D - Used knife - first time - cuts
F152B. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV1D - Used knife - first time - sprains
F152C. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV1D - Used knife - first time - deep wounds
F152D. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV1D - Used knife - first time - miscarriage
F152E. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience A MISCARRIAGE?
0
0
PV1D - Used knife - first time - permanent injury
F152F. As a result of this first time when a partner used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2A - Ever been punched by parent
PV2: PARENTS AND OTHER ADULT RELATIVESThe next questions are about parents or other adult relatives. Remember, you can ask to skip any question that you do not want to answer.
0
0
PV2B - Ever been choked by parent
F153B. Has a parent or other adult relative ever: choked, smothered, tried to drown you, or burned you intentionally?
0
0
PV2C - Ever been threatened with use of knife by parent
F153C. Has a parent or other adult relative ever: used or threatened you with a knife or other weapon?
IF F153A=1 AND F153B=2/99 AND F153C =2/99 -> F154 IF F153A=2/99 AND F153B=1 AND F153C =2/99 -> F165 IF F153A=2/99 AND F153B=2/99 AND F153C =1 -> F176
0
0
PV2A - Punch - number of times
PV2A:F154. How many times has a parent or other adult relative punched, kicked, whipped, or beat you with an object: once, a few times, many times?
ONCE [1] -> F160DON'T KNOW/DECLINED [99] -> F160
0
0
PV2A - Punch - recent - age
PV2A: MOST RECENT TIMEF155. How old were you the last time this happened?
0
0
PV2A - Punch - recent - relationship to person
F156. What was your relationship to the relative who did this to you this last time?
0
0
PV2A - Punch - recent - relative age
F156. Other (Specify)
0
0
PV2A - Punch - recent - estimated age
F157. Did this relative live within the same household as you when this last event occurred?
0
0
PV2A - Punch - recent - happened in last 12 months
F158. Did this happen in the last 12 months?
0
0
PV2A - Punch - recent - fear
F159A. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
PV2A - Punch - recent - cuts
F159B. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2A - Punch - recent - sprains
F159C. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2A - Punch - recent - deep wounds
F159D. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2A - Punch - recent - miscarriage
F159E. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience A MISCARRIAGE?
0
0
PV2A - Punch - recent - permanent injury
F159F. As a result of this last time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2A - Punch - first time - age
F160. How old were you the first time this happened?
0
0
PV2A - Punch - first time - relationship to person
F161. What was your relationship to the relative who did this to you the first time?
0
0
PV2A - Punch - first time - relative age
F161. Other (Specify)
0
0
PV2A - Punch - first time - estimated age
F162. Did this relative live within the same household as you when this first event occurred?
0
0
PV2A - Punch - first time - happened in last 12 months
F163. Did this happen in the last 12 months?
0
0
PV2A - Punch - first time - fear
F164A. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
PV2A - Punch - first time - cuts
F164B. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2A - Punch - first time - sprains
F164C. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2A - Punch - first time - deep wounds
F164D. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2A - Punch - first time - miscarriage
F164E. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience A MISCARRIAGE?
0
0
PV2A - Punch - first time - permanent injury
F164F. As a result of this first time when a parent or adult relative punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2B - Choke - number of times
PV2B:F165. How many times has as a parent or any adult relative choked, smothered, tried to drown you, burned or scalded you intentionally: once, a few times, many times?
ONCE [1] -> F171DON'T KNOW/DECLINED [99] -> F171
0
0
PV2B - Choke - recent - age
PV2B: MOST RECENT TIMEF166. How old were you the last time this happened?
0
0
PV2B - Choke - recent - relationship to person
F167. What was your relationship to the relative who did this to you this last time?
0
0
PV2B - Choke - recent - relative age
F167. Other (Specify)
0
0
PV2B - Choke - recent - estimated age
F168. Did this relative live within the same household as you when this most recent event occurred?
0
0
PV2B - Choke - recent - happened in last 12 months
F169. Did this happen in the last 12 months?
0
0
PV2B - Choke - recent - fear
F170A. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV2B - Choke - recent - cuts
F170B. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2B - Choke - recent - sprains
F170C. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2B - Choke - recent - deep wounds
F170D. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2B - Choke - recent - miscarriage
F170E. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience A MISCARRIAGE?
0
0
PV2B - Choke - recent - permanent injury
F170F. As a result of this last time when a parent or adult relative choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2B - Choke - first time - age
PV2B: FIRST TIMEF171. How old were you the first time this happened?
0
0
PV2B - Choke - first time - relationship to person
F172. What was your relationship to the relative who did this to you the first time?
0
0
PV2B - Choke - first time - relative age
F172. Other (Specify)
0
0
PV2B - Choke - first time - estimated age
F173. Did this parent or adult relative live within the same household as you when this first event occurred?
0
0
PV2B - Choke - first time - happened in last 12 months
F174. Did this happen in the last 12 months?
0
0
PV2B - Choke - first time - fear
F175A. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV2B - Choke - first time - cuts
F175B. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2B - Choke - first time - sprains
F175C. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2B - Choke - first time - deep wounds
F175D. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2B - Choke - first time - miscarriage
F175E. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience A MISCARRIAGE?
0
0
PV2B - Choke - first time - permanent injury
F175F. As a result of the first time when a parent or adult relative choked, smothered, tried to drown, or burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2C - Used knife - number of times
PV2C:F176. How many times has a parent or other adult relative used or threatened to use a knife or other weapon against you: once, a few times, many times?
ONCE [1] -> F182DON'T KNOW/DECLINED [99] -> F182
0
0
PV2C - Used knife - recent - age
PV2C: MOST RECENT TIMEF177. How old were you the most recent time this happened?
0
0
PV2C - Used knife - recent - relationship to person
F178. What was your relationship to the relative who did this to you this last time?
0
0
PV2C - Used knife - recent - relative age
F178. Other (Specify)
0
0
PV2C - Used knife - recent - estimated age
F179. Did this relative live within the same household as you when this last event occurred?
0
0
PV2C - Used knife - recent - happened in last 12 months
F180. Did this happen in the last 12 months?
0
0
PV2C - Used knife - recent - fear
F181A. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV2C - Used knife - recent - cuts
F181B. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2C - Used knife - recent - sprains
F181C. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2C - Used knife - recent - deep wounds
F181D. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2C - Used knife - recent - miscarriage
F181E. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experienceA MISCARRIAGE?
0
0
PV2C - Used knife - recent - permanent injury
F181F. As a result of this last time when a parent or adult relative used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV2C - Used knife - first time - age
PV2C: FIRST TIMEF182. How old were you the first time this happened?
0
0
PV2C - Used knife - first time - relationship to person
F183. What was your relationship to the relative who did this to you the first time?
0
0
PV2C - Used knife - first time - relative age
F183. Other (Specify)
0
0
PV2C - Used knife - first time - estimated age
F184. Did this relative live within the same household as you when this first event occurred?
0
0
PV2C - Used knife - first time - happened in last 12 months
F185. Did this happen in the last 12 months?
0
0
PV2C - Used knife - first time - fear
F186A. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV2C - Used knife - first time - cuts
F186B. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV2C - Used knife - first time - sprains
F186C. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV2C - Used knife - first time - deep wounds
F186D. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV2C - Used knife - first time - miscarriage
F186E. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience A MISCARRIAGE?
0
0
PV2C - Used knife - first time - permanent injury
F186F. As a result of the first time when a parent or adult relative used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3A - Ever been punched by people in community
PV3: PEOPLE LIVING IN THE COMMUNITYThe next questions are about other people who are in your [insert culturally appropriate term for COMMUNITY]. This includes such people as teachers, police, religious or community leaders, friends, classmates or even strangers.
0
0
PV3B - Ever been choked by people in community
F187B. Have other people who are in your community choked, smothered, tried to drown you, or burned you intentionally?
0
0
PV3C - Ever been threatened with use of knife by people in community
F187C. Have other people who are in your community used or threatened you with a knife or other weapon?
IF F187A=1 AND F187B=2/99 AND F187C =2/99 -> F188 IF F187A=2/99 AND F187B=1 AND F187C =2/99 -> F201 IF F187A=2/99 AND F187B=2/99 AND F187C =1 -> F214
0
0
PV3A - Punch - number of times
PV3A:F188. How many times have you been punched you, kicked, whipped, or beat with an object by someone in your [insert culturally appropriate term for COMMUNITY]: once, a few times, or many times?
ONCE [1] -> F195DON'T KNOW/DECLINED [99] -> F195
0
0
PV3A - Punch - recent - age
PV3A: MOST RECENT TIMEF189. How old were you the last time this happened?
0
0
PV3A - Punch - recent - relationship to person
F190. What was your relationship to the person who did this to you this last time?
0
0
PV3A - Punch - recent - relationship to person, other
F190. Other (Specify)
0
0
PV3A - Punch - recent - relative age of person
F191. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F193ABOUT SAME AGE [3] -> F193DON’T KNOW/DECLINED [99] -> F193
0
0
PV3A - Punch - recent - estimated age of person
F192. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3A - Punch - recent - happened in last 12 months
F193. Did this happen in the last 12 months?
0
0
PV3A - Punch - recent - fear
F194A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
PV3A - Punch - recent - cuts
F194B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3A - Punch - recent - sprains
F194C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3A - Punch - recent - deep wounds
F194D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3A - Punch - recent - miscarriage
F194E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience A MISCARRIAGE?
0
0
PV3A - Punch - recent - permanent injury
F194F. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3A - Punch - first time - age
PV3A: FIRST TIMEF195. How old were you the first time this happened?
0
0
PV3A - Punch - first time - relationship to person
F196. What was your relationship to the person who did this to you this first time?
0
0
PV3A - Punch - first time - relationship to person, other
F196. Other (Specify)
0
0
PV3A - Punch - first time - relative age of person
F197. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F199ABOUT SAME AGE [3] -> F199DON’T KNOW/DECLINED [99] -> F199
0
0
PV3A - Punch - first time - estimated age of person
F198. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3A - Punch - first time - happened in last 12 months
F199. Did this happen in the last 12 months?
0
0
PV3A - Punch - first time - fear
F200A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience FEAR OR ANXIETY?
0
0
PV3A - Punch - first time - cuts
F200B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3A - Punch - first time - sprains
F200C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3A - Punch - first time - deep wounds
F200D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3A - Punch - first time - miscarriage
F200E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience A MISCARRIAGE?
0
0
PV3A - Punch - first time - permanent injury
F200F. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] punched, kicked, whipped, or beat you with an object, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3B - Choke - number of times
PV3B:F201. How many times has someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally: once, a few times, or many times?
ONCE [1] -> F208DON'T KNOW/DECLINED [99] -> F208
0
0
PV3B - Choke - recent - age
PV3B: MOST RECENT TIMEF202. How old were you the last time this happened?
0
0
PV3B - Choke - recent - relationship to person
F203. What was your relationship to the person who did this to you this last time?
0
0
PV3B - Choke - recent - relationship to person, other
F203. Other (Specify)
0
0
PV3B - Choke - recent - relative age of person
F204. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F206ABOUT SAME AGE [3] -> F206DON’T KNOW/DECLINED [99] -> F206
0
0
PV3B - Choke - recent - estimated age of person
F205. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3B - Choke - recent - happened in last 12 months
F206. Did this happen in the last 12 months?
0
0
PV3B - Choke - recent - fear
F207A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV3B - Choke - recent - cuts
F207B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3B - Choke - recent - sprains
F207C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3B - Choke - recent - deep wounds
F207D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3B - Choke - recent - miscarriage
F207E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience A MISCARRIAGE?
0
0
PV3B - Choke - recent - permanent injury
F207F. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3B - Choke - first time - age
PV3B: FIRST TIMEF208. How old were you the first time this happened?
0
0
PV3B - Choke - first time - relationship to person
F209. What was your relationship to the person who did this to you this first time?
0
0
PV3B - Choke - first time - relationship to person, other
F209. Other (Specify)
0
0
PV3B - Choke - first time - relative age of person
F210. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F212ABOUT SAME AGE [3] -> F212DON’T KNOW/DECLINED [99] -> F212
0
0
PV3B - Choke - first time - estimated age of person
F211. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3B - Choke - first time - happened in last 12 months
F212. Did this happen in the last 12 months?
0
0
PV3B - Choke - first time - fear
F213A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience FEAR OR ANXIETY?
0
0
PV3B - Choke - first time - cuts
F213B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3B - Choke - first time - sprains
F213C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3B - Choke - first time - deep wounds
F213D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3B - Choke - first time - miscarriage
F213E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience A MISCARRIAGE?
0
0
PV3B - Choke - first time - permanent injury
F213F. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] choked, smothered, tried to drown, burned or scalded you intentionally, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3C - Used knife - number of times
PV3C:F214. How many times has someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a knife or other weapon against you: once, a few times, or many times?
ONCE [1] -> F221DON'T KNOW/DECLINED [99] -> F221
0
0
PV3C - Used knife - recent - age
PV3C: MOST RECENT TIMEF215. How old were you the last time this happened?
0
0
PV3C - Used knife - recent - relationship to person
F216. What was your relationship to the person who did this to you this last time?
0
0
PV3C - Used knife - recent - relationship to person, other
F216. Other (Specify)
0
0
PV3C - Used knife - recent - relative age of person
F217. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F219ABOUT SAME AGE [3] -> F219DON’T KNOW/DECLINED [99] -> F219
0
0
PV3C - Used knife - recent - estimated age of person
F218. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3C - Used knife - recent - happened in last 12 months
F219. Did this happen in the last 12 months?
0
0
PV3C - Used knife - recent - fear
F220A. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV3C - Used knife - recent - cuts
F220B. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3C - Used knife - recent - sprains
F220C. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3C - Used knife - recent - deep wounds
F220D. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3C - Used knife - recent - miscarriage
F220E. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience A MISCARRIAGE?
0
0
PV3C - Used knife - recent - permanent injury
F220F. As a result of this last time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV3C - Used knife - first time - age
F221. How old were you the first time this happened?
0
0
PV3C - Used knife - first time - relationship to person
F222. What was your relationship to the person who did this to you this first time?
0
0
PV3C - Used knife - first time - relationship to person, other
F222. Other (Specify)
0
0
PV3C - Used knife - first time - relative age of person
F223. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F225ABOUT SAME AGE [3] -> F225DON’T KNOW/DECLINED [99] -> F225
0
0
PV3C - Used knife - first time - estimated age of person
F224. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
PV3C - Used knife - first time - happened in last 12 months
F225. Did this happen in the last 12 months?
0
0
PV3C - Used knife - first time - fear
F226A. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience FEAR OR ANXIETY?
0
0
PV3C - Used knife - first time - cuts
F226B. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience CUTS, SCRATCHES, BRUISES?
0
0
PV3C - Used knife - first time - sprains
F226C. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience SPRAINS, DISLOCATIONS, BLISTERING?
0
0
PV3C - Used knife - first time - deep wounds
F226D. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience DEEP WOUNDS, BROKEN BONES, CHARRED SKIN?
0
0
PV3C - Used knife - first time - miscarriage
F226E. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience A MISCARRIAGE?
0
0
PV3C - Used knife - first time - permanent injury
F226F. As a result of the first time when someone in your [insert culturally appropriate term for COMMUNITY] used or threatened to use a weapon against you, did you experience PERMANENT INJURY OR DISFIGUREMENT?
0
0
PV - Thought of seeking help
PV SERVICESF227. Thinking about all your experiences with physical violence, have you ever sought help for any of these experiences?
NO [2] -> F229DON'T KNOW/DECLINED [99] -> F229
0
0
PV - Sought help
F228. From whom have you sought help? Anyone else?
RECORD ALL MENTIONED
0
0
PV - Sought help - own family
F228A. OWN FAMILY
-> F300
0
0
PV - Sought help - husband's family
F228B. HUSBAND’S/PARTNER’S FAMILY
-> F300
0
0
PV - Sought help - current husband
F228C. CURRENT/FORMER HUSBAND/PARTNER
-> F300
0
0
PV - Sought help - current partner
F228D. CURRENT/FORMER BOYFRIEND
-> F300
0
0
PV - Sought help - friend
F228E. FRIEND
-> F300
0
0
PV - Sought help - neighbor
F228F. NEIGHBOR
-> F300
0
0
PV - Sought help - religious leader
F228G. RELIGIOUS LEADER
-> F300
0
0
PV - Sought help - doctor
F228H. DOCTOR/MEDICAL PERSONNEL
-> F300
0
0
PV - Sought help - police
F228I. POLICE
-> F300
0
0
PV - Sought help - lawyer
F228J. LAWYER
-> F300
0
0
PV - Sought help - social service organization
F228K. SOCIAL SERVICE ORGANIZATION
-> F300
0
0
PV - Sought help - other
F228X. OTHER
-> F300
0
0
PV - Sought help - don't know
F228Z. DON’T KNOW/DECLINED
-> F300
0
0
PV - Sought help - other
F228. Other (Specify)
-> F300
0
0
PV - Reason why not seek help
F229. What was the main reason you did not seek help?
-> F300
0
0
PV - Reason why not seek help - other
F229. Other (Specify)
-> F300
0
0
PV - Told anyone
F230. Have you ever told anyone about these experiences?
NO [2] -> F300DON'T KNOW/DECLINED [99] -> F300
0
0
PV - Spoken with someone
F231. Who else did you speak to regarding any physical violence experiences that happened?
RECORD ALL MENTIONED
0
0
PV - Spoke to - own family
F231A. OWN FAMILY
0
0
PV - Spoke to - husband's family
F231B. HUSBAND’S/PARTNER’S FAMILY
0
0
PV - Spoke to - current husband
F231C. CURRENT/FORMER HUSBAND/PARTNER
0
0
PV - Spoke to - current partnet
F231D. CURRENT/FORMER BOYFRIEND
0
0
PV - Spoke to - friend
F231E. FRIEND
0
0
PV - Spoke to - neighbor
F231F. NEIGHBOR
0
0
PV - Spoke to - religious leader
F231G. RELIGIOUS LEADER
0
0
PV - Spoke to - doctor
F231H. DOCTOR/MEDICAL PERSONNEL
0
0
PV - Spoke to - police
F231I. POLICE
0
0
PV - Spoke to - lawyer
F231J. LAWYER
0
0
PV - Spoke to - social service organization
F231K. SOCIAL SERVICE ORGANIZATION
0
0
PV - Spoke to - other
F231X. OTHER
0
0
PV - Spoke to - don't know
F231Z. DON’T KNOW/DECLINED
0
0
PV - Spoke to - other
F231. Other (Specify)
0
0
EV - Ever told not loved by parent
F300A. Has a parent or someone like a parent ever: told you that you were not loved, or did not deserve to be loved?
0
0
EV - Ever told wished never born by parent
F300B. Has a parent or someone like a parent ever: said they wished you had never been born or were dead?
0
0
EV - Ever been ridiculed by parent
F300C. Has a parent or someone like a parent ever: ever ridiculed you or put you down (for example say that you were stupid or useless)?
IF F300A =1 OR F300B=1 OR F300C =1 -> F301 IF F300A=2/99 AND F300B=2/99 AND F300C =2/99 -> F400
0
0
EV1 - Not loved - number of times
EV1F301. How many times has/did a parent or someone like a parent ever said or done these things: once, a few times, or many times?
ONCE [1] -> F305DON'T KNOW/DECLINED [99] -> F305
0
0
EV1 - Not loved - recent - age
EV1: MOST RECENT TIMEF302. How old were you the most recent time this happened?
0
0
EV1 - Not loved - recent - relationship to person
F303. What was your relationship to this person who did this to you this most recent time?
0
0
EV1 - Not loved - recent - relationship to person, other
F303. Other (Specify)
0
0
EV1 - Not loved - recent - happened in last 12 months
F304. Did this happen in the last 12 months?
0
0
EV1 - Not loved - first time - age
F305. How old were you the first time this happened?
0
0
EV1 - Not loved - first time - relationship to person
F306. What was your relationship to this person who did this to you the first time?
0
0
EV1 - Not loved - first time - relationship to person, other
F306. Other (Specify)
0
0
EV1 - Not loved - first time - happened in last 12 months
F307. Did this happen in the last 12 months?
0
0
SB - Ever had sex
SEXUAL BEHAVIOR: The next questions are about sexual activity.
NO [2] -> F500DON'T KNOW/DECLINED [99] -> F500
0
0
SB - Age at first sex
F401. How old were you when you had sexual intercourse for the very first time?
0
0
SB - Wanted/ unwanted first sex
F402. The first time you had sexual intercourse, was it because you wanted to or because you were made to have it without your permission?
0
0
Pregnancy - Ever been pregnant
PREGNANCY:The next questions are about pregnancy.
NO [2] -> F406DON'T KNOW/DECLINED [99] -> F406
0
0
Pregnancy - Age at first pregnancy
F404. How old were you the first time that you got pregnant?
0
0
Pregnancy - Ever had stillborn
F405. Have you ever had a pregnancy that did not end in a live birth?
0
0
SH - Number of sexual partners
SEX HISTORY AND RISK TAKING:For these next questions, a sexual partner is any person with whom you have had sexual intercourse. A sexual partner could be a boyfriend, romantic partner, or husband, or someone you met just that day.
0 IS NOT AN ACCEPTABLE ANSWER FOR THIS QUESTION, IF RESPONDENT SAYS 0 THEN REFER BACK TO F400 AND CORRECT IF NECESSARY.
0
0
SH - Had sex in past 12 months
F407. Have you had sexual intercourse in the past 12 months?
NO [2] -> F500DON'T KNOW/DECLINED [99] -> F500
0
0
SH - Number of partners - past 12 months
F408. How many partners have you had sexual intercourse with in the past 12 months?
0
0
SH - Most recent partner - relationship
I am going to ask you some questions about your sexual partners in the last 12 months.PARTNER 1 MOST RECENT
0
0
SH - Most recent partner - relationship, other
F409. Other (Specify) PARTNER 1
0
0
SH - Most recent partner - condom use freq - past 12 months
F410. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? PARTNER 1
CHECK NUMBER OF PARTNERS REPORTED IN F408IF F408=1 -> F500
0
0
SH - 2nd most recent partner - relationship
PARTNER 2 SECOND MOST RECENT Now think back to the partner you had sexual intercourse with before the partner we just talked about.
0
0
SH - 2nd most recent partner - relationship, other
F409. Other (Specify) PARTNER 2
0
0
SH - 2nd most recent partner - condom use freq - past 12 months
M410. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? SECOND PARTNER
IF F408=1 -> F500 IF F408>1 -> F409 PARTNER 3
0
0
SH - 3rd most recent partner - relationship
PARTNER 3 THIRD MOST RECENT Now think back to the partner you had sexual intercourse with before the partner we just talked about.
GO TO F500
0
0
SH - 3rd most recent partner - relationship, other
F409. Other (Specify) PARTNER 3
0
0
SH - 3rd most recent partner - condom use freq - past 12 months
M410. In the past 12 months, how often did you or this partner use a condom during sexual intercourse? Would you say always, sometimes, or never? THIRD PARTNER
0
0
SV - Ever been bribed for sex
SEXUAL VIOLENCE: MONEY, GOODS OR FAVORS EXCHANGED FOR SEX/EXPLOITATION I’d like to ask you about some experiences you may have had with sex. Remember that everything you say will be confidential, and you can skip any questions that you don’t feel comfortable answering.
NO [2] -> F600DON'T KNOW/DECLINED [99] -> F600
0
0
SV - Bribed for sex - age
F501. How old were you when you were first given money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts?
0
0
SV - Bribed for sex - relative age of person
F502. Was this person older than you, younger than you, or about the same age?
YOUNGER [2] -> F504ABOUT SAME AGE [3] -> F504DON’T KNOW/DECLINED [99] -> F504
0
0
SV - Bribed for sex - estimated age of person
F503. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV - Bribed for sex - number of partners - past 12 months
F504. In the last 12 months, how many sexual partners gave you money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts with them?
0
0
SV - Bribed for sex - relationship to person
Now think back to all experiences when you were given money, food, gifts, or any favors to have sexual intercourse or perform any other sexual acts with someone. What was your relationship to the people who did this to you?F505. What was your relationship to the people who did this to you?
Circle all mentioned
0
0
SV - Bribed for sex - male - friend
M505A. MALE FRIEND OR ACQUAINTANCE
0
0
SV - Bribed for sex - male - teacher
M505B. MALE TEACHER
0
0
SV - Bribed for sex - male community leader
M505C. MALE COMMUNITY LEADER
0
0
SV - Bribed for sex - male - religious leader
M505D. MALE RELIGIOUS LEADER
0
0
SV - Bribed for sex - male - employer
M505E. MALE EMPLOYER
0
0
SV - Bribed for sex - male - classmate/ schoolmate
M505F. MALE CLASSMATE/ SCHOOLMATE
0
0
SV - Bribed for sex - male - neighbor
M505G. MALE NEIGHBOR
0
0
SV - Bribed for sex - male - police
M505H. MALE POLICE
0
0
SV - Bribed for sex - male - soldier
M505I. MALE SOLDIER
0
0
SV - Bribed for sex - male - truck driver
M505J. MALE TRUCK DRIVER
0
0
SV - Bribed for sex - male - tourist or non-national
M505K. MALE TOURIST OR NON-NATIONAL
0
0
SV - Bribed for sex - male - i don't know/ stranger
M505L. MALE I DON’T KNOW/ STRANGER
0
0
SV - Bribed for sex - other male,1
M505X. OTHER MALE
0
0
SV - Bribed for sex - female - friend
M505M. FEMALE FRIEND OR ACQUIANTANCE
0
0
SV - Bribed for sex - female - teacher
M505N. FEMALE TEACHER
0
0
SV - Bribed for sex - female - community leader
M505O. FEMALE COMMUNITY LEADER
0
0
SV - Bribed for sex - female - religious leader
M505P. FEMALE RELIGIOUS LEADER
0
0
SV - Bribed for sex - female - employer
M505Q. FEMALE EMPLOYER
0
0
SV - Bribed for sex - female - classmate/ schoolmate
M505R. FEMALE CLASSMATE/ SCHOOLMATE
0
0
SV - Bribed for sex - female - neighbor
M505S. FEMALE NEIGHBOR
0
0
SV - Bribed for sex - female - police
M505T. FEMALE POLICE/ SOLDIER
0
0
SV - Bribed for sex - female - soldier
M505U. FEMALE SOLDIER
0
0
SV - Bribed for sex - female - truck driver
M505V. FEMALE TRUCK DRIVER
0
0
SV - Bribed for sex - female - tourist or non-national
M505W. FEMALE TOURIST OR NON-NATIONAL
0
0
M505AA. FEMALE I DON’T KNOW/STRANGER
0
0
SV - Bribed for sex - other female,1
M505Y. OTHER FEMALE
0
0
SV - Bribed for sex - don't know/declined
M505Z. DON’T KNOW/DECLINED
0
0
SV - Bribed for sex - other male,2
M505X. Other Male
0
0
SV - Bribed for sex - other female,2
M505Y. Other Female
0
0
SV - Non-contact sex - verbal/ written words
SEXUAL VIOLENCE : NON-CONTACT SEXUAL VIOLENCE/EXPLOITATION F600A. Has anyone ever made you upset by speaking to you in a sexual way or writing sexual things about you?
IF F600A=1 AND F600B=2/99 AND F600C =2/99 -> F601IF F600A=2/99 AND F600B=1 AND F600C =2/99 -> F602IF F600A=2/99 AND F600B=2/99 AND F600C =1 -> F603
0
0
SV - Non-contact sex - forced to watch sex photo/ video
F600B. Has anyone ever forced you to watch sex photos or sex videos against your will?
0
0
SV - Non-contact sex - forced to be in sex photo/ video
F600C. Has anyone ever forced you to be in a sex photo or video against your will?
0
0
SV - Non-contact sex - Verbal/ written sex - number of times
F601A. How many times has someone made you upset by speaking to you in a sexual way or writing sexual things about you: once, a few times or many times?
ONCE [1] -> F601CDK/DTA [99] -> CK, F600B and F600C
0
0
SV - Non-contact sex - Verbal/ written sex - first time - age
F601B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
SV - Non-contact sex - Verbal/ written sex - recent - age
F601C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
SV - Non-contact sex - Verbal/ written sex - happened in last 12 months
F601D. Did this happen in the last 12 months?
0
0
SV - Non-contact sex - Watch sex photo/ video - number of times
F602A. How many times has someone forced you to watch sex photos or sex videos against your will?
ONCE [1] -> F602CDK/DTA [99] -> CK, F600C
0
0
SV - Non-contact sex - Watch sex photo/ video - first time - age
F602B. How old were you when this first happened?
0
0
SV - Non-contact sex - Watch sex photo/ video - recent - age
F602C. How old were you the most recent time this happened?
0
0
SV - Non-contact sex - Watch sex photo/ video - happened in last 12 months
F602D. Did this happen in the last 12 months?
0
0
SV - Non-contact sex - Be in sex photo/ video - number of times
F603A. How many times has someone forced you to be in a sex photo or video against your will: once, a few times or many times?
ONCE [1] -> F603CDK/DTA [99] -> F700
0
0
SV - Non-contact sex - Be in sex photo/ video - first time - age
F603B. How old were you when this first happened: 0-5, 6-11, 12-17, 18 or older?
0
0
SV - Non-contact sex - Be in sex photo/ video - recent - age
F603C. How old were you: ONCE: when this happened?FEW OR MANY: the most recent time this happened?
0
0
SV - Non-contact sex - Be in sex photo/ video - happened in last 12 months
F603D. Did this happen in the last 12 months?
0
0
SV1 - Ever been touched without permission
SEXUAL VIOLENCE: SEXUAL ABUSEGirls and women may experience unwanted sexual contact by people they know well, such as a romantic partner, family member or friend, or by strangers. Your answers are confidential and you can skip any questions that you don’t feel comfortable answering.
0
0
SV2 - Ever been attempted to have sex without permission
F800. Has anyone ever tried to make you have sexual intercourse of any kind without your permission, but did not succeed?This includes someone penetrating your vagina or anus with their penis, hands, fingers, mouth, or any other objects, or penetrating your mouth with their penis.
0
0
SV3 - Ever forced to have sex without permission
F900. Has anyone ever physically forced you to have sexual intercourse of any kind regardless of whether you did or did not fight back?By physical force, we mean things like being pinned or held down or use of violence like pulling your hair, pushing, shoving, punching, using or threatening to use a weapon, or threatening to physically harm you or a loved one. Please include experiences when you may or may not have fought back.
0
0
SV4 - Ever pressured to have sex without permission
F1000. Has anyone ever pressured you in a nonphysical way, to have sexual intercourse of any kind when you did not want to and sex happened?When someone pressures you into sex, it could involve things like threats, harassment, luring you, or tricking you into having sex.
IF F700=1 FOVE TO F701IF F800=1 FOVE TO F801IF F900=1 FOVE TO F901
0
0
SV1 - Touching - number of times
SV1: TOUCHING WITHOUT PERMISSION- LIFETIMEThese questions ask you about a time when anyone, male or female, touched you in a sexual way without your permission, but the person did not try and force you to have sex.
1 [1] -> F174WRITE NUMBER IF 2 TIMES OR MORE: __ -> F702DON’T KNOW/DECLINED [99] -> F714
0
0
SV1A - Touching - recent - age
SV1A: TOUCHING – MOST RECENTNow think about the most recent time anyone touched you in a sexual way without your permission but did not try to force you to have sex.
0
0
SV1A - Touching - recent - more than 1 person
F703. This most recent time, did more than one person touch you in a sexual way without your permission?
NO, ONE PERSON ONLY [2] -> F706DON’T' KNOW/DECLINED [99] -> F706
0
0
SV1A - Touching - recent - number of persons
F704. This most recent time, how many people touched you in a sexual way without
0
0
SV1A - Touching - recent - relationship to person
Of these people who touched you in a sexual way without your permission this most recent time, think of the person you know the best for the following questions:F706. What was your relationship to the person who did this to you?
0
0
SV1A - Touching - recent - relationship to person, other
F706. Other (Specify)
0
0
SV1A - Touching - recent - relative age of person
F707. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F709ABOUT SAME AGE [3] -> F709DON’T KNOW/DECLINED [99] -> F709
0
0
SV1A - Touching - recent - estimated age of person
F708. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
ON A ROAD/STREET [4] -> F712MARKET/SHOP [5] -> F712SCHOOL [6] -> F712
0
0
SV1A - Touching - recent - place
F709. Where were you when this happened to you?
0
0
SV1A - Touching - recent - place, other
F709. Other (Specify)
0
0
SV1A - Touching - recent - anyone else at home
F710. Was anyone else at home at the time?
NO [2] -> F712DON'T KNOW/DECLINED [99] -> F712
0
0
SV1A - Touching - recent - who else at home
F711. Who else was at home at the time?
Circle all mentioned
0
0
SV1A - Touching - recent - at home - parent
F711A. PARENT
0
0
SV1A - Touching - recent - at home - sibling
F711B. SIBLING
0
0
SV1A - Touching - recent - at home - other relative
F711C. OTHER RELATIVE
0
0
SV1A - Touching - recent - at home - friend
F711D. FRIEND
0
0
SV1A - Touching - recent - at home - other
F711X. OTHER
0
0
SV1A - Touching - recent - at home - don't know/declined
F711Z. DON'T KNOW/DECLINED
0
0
SV1A - Touching - recent - at home - other (specify)
F711X. Other (Specify)
0
0
SV1A - Touching - recent - time of incident
F712. About what time of day did this happen?
0
0
SV1A - Touching - recent - happened in last 12 months
F713. Did this happen to you within the past 12 months?
0
0
SV1B - Touching - first time - age
SV1B: TOUCHING – FIRST TIMENow think about the first time anyone touched you in a sexual way without your permission but did not try to force you to have sex of any kind.
DON'T KNOW/DECLINED [99] -> F800 - F1000
0
0
SV1B - Touching - first time - more than 1 person
F715. This first time, did more than one person touch you in a sexual way without your permission?
NO, ONE PERSON ONLY [2] -> F718DON’T' KNOW/DECLINED [99] -> F718
0
0
SV1B - Touching - first time - number of persons
F716. This first time, how many people touched you in a sexual way without your permission?
0
0
SV1B - Touching - first time - relationship to person
Of these people who touched you in a sexual way without your permission this first time, think of the person you know the best for the following questions:F718. What was your relationship to the person who did this to you?
0
0
SV1B - Touching - first time - relationship to person, other
F718. Other (Specify)
0
0
SV1B - Touching - first time - relative age of person
F719. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F721ABOUT SAME AGE [3] -> F721DON’T KNOW/DECLINED [99] -> F721
0
0
SV1B - Touching - first time - estimated age of person
F720. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV1B - Touching - first time - place
F721. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F724MARKET/SHOP [5] -> F724SCHOOL [6] -> F724
0
0
SV1B - Touching - first time - place, other
F721. Other (Specify)
0
0
SV1B - Touching - first time - anyone else at home
F722. Was anyone else at home at the time?
NO [2] -> F724DON'T KNOW/DECLINED [99] -> F724
0
0
SV1B - Touching - first time - who else at home
F723. Who else was at home at the time?
Circle all mentioned
0
0
SV1B - Touching - first time - at home - parent
F723A. PARENT
0
0
SV1B - Touching - first time - at home - sibling
F723B. SIBLING
0
0
SV1B - Touching - first time - at home - other relative
F723C. OTHER RELATIVE
0
0
SV1B - Touching - first time - at home - friend
F723D. FRIEND
0
0
SV1B - Touching - first time - at home - other
F723X. OTHER
0
0
SV1B - Touching - first time - at home - don't know/declined
F723Z. DON'T KNOW/DECLINED
0
0
SV1B - Touching - first time - at home - other (specify)
F723X. Other (Specify)
0
0
SV1B - Touching - first time - time of incident
F724. About what time of day did this happen?
0
0
SV1B - Touching - first time - happened in last 12 months
F725. Did this happen to you within the past 12 months?
REFER TO F800 F900 F1000 FOR ROUTING TO NEXT SECTIONIF F800=1 FOVE TO F801
0
0
SV2 - Attempted sex - number of times
SV2: ATTEMPTED SEX- LIFETIMEF801. How many times in your life has anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed?
1 [1] -> F814WRITE NUMBER IF 2 TIMES OR MORE: __ -> F802DON'T KNOW/DECLINED [99] -> F814
0
0
SV2A - Attempted sex - recent - age
SV2A: ATTEMPTED SEX – MOST RECENTNow think about the most recent time anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed.
0
0
SV2A - Attempted sex - recent - more than 1 person
F803. This most recent time, did more than one person try to make you have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> F806DON’T' KNOW/DECLINED [99] -> F806
0
0
SV2A - Attempted sex - recent - number of persons
F804. This most recent time, how many people tried to make you have sexual intercourse of any kind without your permission?
0
0
SV2A - Attempted sex - recent - relationship to person
Of these people who attempted to have sex with you without your permission this most recent time, think of the person you know the best for the following questions:F806. What was your relationship to the person who did this to you?
0
0
SV2A - Attempted sex - recent - relationship to person, other
F806. Other (Specify)
0
0
SV2A - Attempted sex - recent - relative age of person
F807. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F809ABOUT SAME AGE [3] -> F809DON’T KNOW/DECLINED [99] -> F809
0
0
SV2A - Attempted sex - recent - estimated age of person
F808. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV2A - Attempted sex - recent - place
F809. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F812MARKET/SHOP [5] -> F812SCHOOL [6] -> F812
0
0
SV2A - Attempted sex - recent - place, other
F809. Other (Specify)
0
0
SV2A - Attempted sex - recent - anyone else at home
F810. Was anyone else at home at the time?
NO [2] -> F812DON'T KNOW/DECLINED [99] -> F812
0
0
SV2A - Attempted sex - recent - who else at home
F811. Who else was at home at the time?
0
0
SV2A - Attempted sex - recent - at home - parent
F811A. PARENT
0
0
SV2A - Attempted sex - recent - at home - sibling
F811B. SIBLING
0
0
SV2A - Attempted sex - recent - at home - other relative
F811C. OTHER RELATIVE
0
0
SV2A - Attempted sex - recent - at home - friend
F811D. FRIEND
0
0
SV2A - Attempted sex - recent - at home - other
F811X. OTHER
0
0
SV2A - Attempted sex - recent - at home - don't know/declined
F811Z. DON'T KNOW/DECLINED
0
0
SV2A - Attempted sex - recent - at home - other (specify)
F811X. Other (Specify)
0
0
SV2A - Attempted sex - recent - time of incident
F812. About what time of day did this happen?
0
0
SV2A - Attempted sex - recent - happened in last 12 months
F813. Did this happen to you within the past 12 months?
0
0
SV2B - Attempted sex - first time - age
SV2B: ATTEMPTED SEX - FIRST TIMENow think about the first time anyone tried to make you have sexual intercourse of any kind without your permission, but did not succeed.
DON'T KNOW/DECLINED [99] -> Section based on F900 and F1000
0
0
SV2B - Attempted sex - first time - more than 1 person
F815. This first time, did more than one person try to make you have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> F818DON’T' KNOW/DECLINED [99] -> F818
0
0
SV2B - Attempted sex - first time - number of persons
F816. This first time, how many people tried to make you have sexual intercourse of any kind without your permission?
0
0
SV2B - Attempted sex - first time - relationship to person
Of these people who attempted to have sex with you without your permission this first time, think of the person you know the best for the following questions:F818. What was your relationship to the person who did this to you?
0
0
SV2B - Attempted sex - first time - relationship to person, other
F818. Other (Specify)
0
0
SV2B - Attempted sex - first time - relative age of person
F819. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F821ABOUT SAME AGE [3] -> F821DON’T KNOW/DECLINED [99] -> F821
0
0
SV2B - Attempted sex - first time - estimated age of person
F820. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV2B - Attempted sex - first time - place
F821. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F824MARKET/SHOP [5] -> F824SCHOOL [6] -> F824
0
0
SV2B - Attempted sex - first time - place, other
F821. Other (Specify)
0
0
SV2B - Attempted sex - first time - anyone else at home
F822. Was anyone else at home at the time?
NO [2] -> F824DON'T KNOW/DECLINED [99] -> F824
0
0
SV2B - Attempted sex - first time - who else at home
F823. Who else was at home at the time?
Circle all mentioned
0
0
SV2B - Attempted sex - first time - at home - parent
F823A. PARENT
0
0
SV2B - Attempted sex - first time - at home - sibling
F823B. SIBLING
0
0
SV2B - Attempted sex - first time - at home - other relative
F823C. OTHER RELATIVE
0
0
SV2B - Attempted sex - first time - at home - friend
F823D. FRIEND
0
0
SV2B - Attempted sex - first time - at home - other
F823X. OTHER
0
0
SV2B - Attempted sex - first time - at home - don't know/declined
F823Z. DON'T KNOW/DECLINED
0
0
SV2B - Attempted sex - first time - at home - other (specify)
F823X. Other (Specify)
0
0
SV2B - Attempted sex - first time - time of incident
F824. About what time of day did this happen?
0
0
SV2B - Attempted sex - first time - happened in last 12 months
F825. Did this happen to you within the past 12 months?
REFER TO F900 F1000 FOR ROUTING TO NEXT SECTIONIF F900=1 MOVE TO F901IF F1000=1 MOVE TO F1001
0
0
SV3 - Forced sex - number of times
SV3: PHYSICALLY FORCED SEX- LIFETIMEF901. How many times in your life have you been physically forced to have sexual intercourse of any kind regardless of whether you did or did not fight back?
1 [1] -> F917WRITE NUMBER IF 2 TIMES OR MORE: __ -> F902DON'T KNOW/DECLINED [99] -> F917
0
0
SV3A - Forced sex - recent - age
SV3A: PHYSICALLY FORCED SEX – MOST RECENTNow think about the most recent time anyone physically forced you to have sexual intercourse of any kind without your permission.
NO, ONE PERSON ONLY [2] -> F906DON’T' KNOW/DECLINED [99] -> F906
0
0
SV3A - Forced sex - recent - more than 1 person
F903. This most recent time, did more than one person physically force you to have sexual intercourse of any kind without your permission?
0
0
SV3A - Forced sex - recent - number of persons
F904. This most recent time, how many people physically forced you to have sexual intercourse of any kind without your permission?
0
0
SV3A - Forced sex - recent - relationship to person
Of these people who physically forced you to have sex of any kind without your permission this most recent time, think of the person you know best for the following questions:F906. What was your relationship to the person who did this to you?
0
0
SV3A - Forced sex - recent - relationship to person, other
F906. Other (Specify)
0
0
SV3A - Forced sex - recent - relative age of person
F907. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F909ABOUT SAME AGE [3] -> F909DON’T KNOW/DECLINED [99] -> F909
0
0
SV3A - Forced sex - recent - estimated age of person
F908. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV3A - Forced sex - recent - used weapon
F909. Did the person who did this to you this most recent time use a weapon such as a gun, knife or machete?
0
0
SV3A - Forced sex - recent - place
F910. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F913MARKET/SHOP [5] -> F913SCHOOL [6] -> F913
0
0
SV3A - Forced sex - recent - place, other
F910. Other (Specify)
0
0
SV3A - Forced sex - recent - anyone else at home
F911. Was anyone else at home at the time?
NO [2] -> F913DON'T KNOW/DECLINED [99] -> F913
0
0
SV3A - Forced sex - recent - who else at home
F912. Who else was at home at the time?
Circle all mentioned
0
0
SV3A - Forced sex - recent - at home - parent
F912A. PARENT
0
0
SV3A - Forced sex - recent - at home - parent
F912B. SIBLING
0
0
SV3A - Forced sex - recent - at home - sibling
F912C. OTHER RELATIVE
0
0
SV3A - Forced sex - recent - at home - other relative
F912D. FRIEND
0
0
SV3A - Forced sex - recent - at home - friend
F912X. OTHER
0
0
SV3A - Forced sex - recent - at home - other
F912Z. DON'T KNOW/DECLINED
0
0
SV3A - Forced sex - recent - at home - don't know/declined
F912X. Other (Specify)
0
0
SV3A - Forced sex - recent - time of incident
F913. About what time of day did this happen?
0
0
SV3A - Forced sex - recent - got pregnant
F914. This most recent time, do you think that you got pregnant as a result of being physically forced to have sex?
NO [2] -> F916DON'T KNOW [99] -> F916
0
0
SV3A - Forced sex - recent - deliver baby
F915. Did you deliver the baby?
0
0
SV3A - Forced sex - recent - happened in last 12 months
F916. Did this most recent experience of being physically forced to have sex of any kind happen to you within the past 12 months?
0
0
SV3B - Forced sex - first time - age
SV3B: PHYSICALLY FORCED SEX – FIRST TIMENow think about the first time anyone physically forced you to have sexual intercourse of any kind without your permission.
DON'T KNOW/DECLINED [99] -> Section based on F1000
0
0
SV3B - Forced sex - first time - more than 1 person
F918. This first time, did more than one person physically force you to have sexual intercourse of any kind without your permission?
NO, ONE PERSON ONLY [2] -> F921DON’T' KNOW/DECLINED [99] -> F921
0
0
SV3B - Forced sex - first time - number of persons
F919. This first time, how many people physically forced you to have sexual intercourse of any kind without your permission?
0
0
SV3B - Forced sex - first time - relationship to person
Of these people who physically forced you to have sex of any kind without your permission the first time, think of the person you know best for the following questions:F921. What was your relationship to the person who did this to you? This could be a boyfriend, husband, parent or other relative, neighbor, teacher, police, other security personnel, or anyone else.
0
0
SV3B - Forced sex - first time - relationship to person, other
F921. Other (Specify)
0
0
SV3B - Forced sex - first time - relative age of person
F922. Did the person who did this to you the first time use a weapon such as a gun, knife or machete?
0
0
SV3B - Forced sex - first time - estimated age of person
F923. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F925ABOUT SAME AGE [3] -> F925DON’T KNOW/DECLINED [99] -> F925
0
0
SV3B - Forced sex - first time - used weapon
F924. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV3B - Forced sex - first time - place
F925. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F928MARKET/SHOP [5] -> F928SCHOOL [6] -> F928
0
0
SV3B - Forced sex - first time - place, other
F925. Other (Specify)
0
0
SV3B - Forced sex - first time - anyone else at home
F926. Was anyone else at home at the time?
NO [2] -> F928DON'T KNOW/DECLINED [99] -> F928
0
0
SV3B - Forced sex - first time - who else at home
F926. Who else was at home at the time?
Circle all mentioned
0
0
SV3B - Forced sex - first time - at home - parent
F927A. PARENT
0
0
SV3B - Forced sex - first time - at home - parent
F927B. SIBLING
0
0
SV3B - Forced sex - first time - at home - sibling
F927C. OTHER RELATIVE
0
0
SV3B - Forced sex - first time - at home - other relative
F927D. FRIEND
0
0
SV3B - Forced sex - first time - at home - friend
F927X. OTHER
0
0
SV3B - Forced sex - first time - at home - other
F927Z. DON'T KNOW/DECLINED
0
0
SV3B - Forced sex - first time - at home - don't know/declined
F927X. Other (Specify)
0
0
SV3B - Forced sex - first time - time of incident
F928. About what time of day did this happen?
0
0
SV3B - Forced sex - first time - got pregnant
F929. After this first experience, do you think that you got pregnant as a result of being physically forced to have sex?
0
0
SV3B - Forced sex - first time - deliver baby
F930. Did you deliver the baby?
0
0
SV3B - Forced sex - first time - happened in last 12 months
F931. Did this first experience when someone physically forced you to have sexual intercourse of any kind happen to you within the past 12 months?
REFER TO F1000 FOR ROUTING TO NEXT SECTIONIF F1000=1 MOVE TO F1001IF F1000 =2/99 MOVE TO SVCS F1100
0
0
SV4 - Pressured sex - number of times
SV4: PRESSURED SEX- LIFETIMEF1001. How many times in your life has someone pressured you in a nonphysical way, to have sexual intercourse of any kind when you did not want to and sex happened?
1 [1] -> F1016WRITE NUMBER IF 2 TIMES OR MORE: __ -> F1002DON'T KNOW/DECLINED [99] -> F1016
0
0
SV4A - Forced sex - recent - age
SV4A: PRESSURED INTO SEX – MOST RECENTNow think about the most recent time anyone pressured you, in a nonphysical way, to have sexual intercourse of any kind when you did not want to, and sex happened.
0
0
SV4A - Forced sex - recent - more than 1 person
F1003. This most recent time, did more than one person pressure you, in a nonphysical way, to have sexual intercourse of any kind when you did not want to?
NO, ONE PERSON ONLY [2] -> F1006DON’T' KNOW/DECLINED [99] -> F1006
0
0
SV4A - Forced sex - recent - number of persons
F1004. This most recent time, how many people pressured you in a nonphysical way to have sexual intercourse of any kind, when you did not want to?
0
0
SV4A - Forced sex - recent - relationship to person
Of the people who pressured in a nonphysical way to have sexual intercourse of any kind when you did not want to this most recent time, think of the person you know the best for the following questions:F1006. What was your relationship to the person who did this to you?
0
0
SV4A - Forced sex - recent - relationship to person, other
F1006. Other (Specify)
0
0
SV4A - Forced sex - recent - relative age of person
F1007. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F1009ABOUT SAME AGE [3] -> F1009DON’T KNOW/DECLINED [99] -> F1009
0
0
SV4A - Forced sex - recent - estimated age of person
F1008. Would you say this person was more than 10 years older than you, 5-10 years older, or less than 5 years older?
0
0
SV4A - Forced sex - recent - place
F1009. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F1012MARKET/SHOP [5] -> F1012SCHOOL [6] -> F1012
0
0
SV4A - Forced sex - recent - place, other
F1009. Other (Specify)
0
0
SV4A - Forced sex - recent - anyone else at home
F1010. Was anyone else at home at the time?
NO [2] -> F1012DON'T KNOW/DECLINED [99] -> F1012
0
0
SV4A - Forced sex - recent - who else at home
F1011. Who else was at home at the time?
Circle all mentioned
0
0
SV4A - Forced sex - recent - at home - parent
F1011A. PARENT
0
0
F1011B. SIBLING
0
0
F1011C. OTHER RELATIVE
0
0
F1011D. FRIEND
0
0
F1011X. OTHER
0
0
F1011Z. DON'T KNOW/DECLINED
0
0
F1011X. Other (Specify)
0
0
SV4A - Forced sex - recent - time of incident
F1012. About what time of day did this happen?
0
0
SV4A - Forced sex - recent - got pregnant
F1013. After this most recent experience, do you think that yu got pregnant as a result?
NO [2] -> F1015DON'T KNOW/DECLINED [99] -> F1015
0
0
SV4A - Forced sex - recent - deliver baby
F1014. Did you deliver the baby?
0
0
SV4A - Forced sex - recent - happened in last 12 months
F1015. Did this most recent experience of being pressured in a nonphysical way to have sex of any kind happen to you within the past 12 months?
0
0
SV4B - Forced sex - first time - age
SV4B: PRESSURED INTO SEX – FIRST TIMENow think about the first time anyone pressured you, in a nonphysical way, to have sex of any kind when you did not want to, and sex happened.
DON'T KNOW/DECLINED [99] -> F1100
0
0
SV4B - Forced sex - first time - more than 1 person
F1017. This first time, did more than one person pressure you, in a nonphysical way, to have sex of any kind when you did not want to?
NO, ONE PERSON ONLY [2] -> F1020DON’T' KNOW/DECLINED [99] -> F1020
0
0
SV4B - Forced sex - first time - number of persons
F1018. This first time, how many people pressured you in a nonphysical way to have sex of any kind, when you did not want to?
0
0
SV4B - Forced sex - first time - relationship to person
Of these people who pressured you in a nonphysical way to have sex of any kind without your permission this first time, think of the person you know the best for the following questions:F1020. What was your relationship to the person who did this to you?
0
0
SV4B - Forced sex - first time - relationship to person, other
F1020. Other (Specify)
0
0
SV4B - Forced sex - first time - relative age of person
F1021. Was the person older than you, younger than you, or about the same age?
YOUNGER [2] -> F1023ABOUT SAME AGE [3] -> F1023DON’T KNOW/DECLINED [99] -> F1023
0
0
SV4B - Forced sex - first time - estimated age of person
F1022. Would you say this person was more than 10 years older than you, 5-10 years older or less than 5 years older?
0
0
SV4B - Forced sex - first time - place
F1023. Where were you when this happened to you?
ON A ROAD/STREET [4] -> F1026MARKET/SHOP [5] -> F1026SCHOOL [6] -> F1026
0
0
SV4B - Forced sex - first time - place, other
F1023. Other (Specify)
0
0
SV4B - Forced sex - first time - anyone else at home
F1024. Was anyone else at home at the time?
NO [2] -> F1026DON'T KNOW/DECLINED [99] -> F1026
0
0
SV4B - Forced sex - first time - who else at home
F1025. Who else was at home at the time?
Circle all mentioned
0
0
SV4B - Forced sex - first time - at home - parent
F1025A. PARENT
0
0
SV4B - Forced sex - first time - at home - sibling
F1025B. SIBLING
0
0
F1025C. OTHER RELATIVE
0
0
F1025D. FRIEND
0
0
F1025X. OTHER
0
0
F1025Z. DON'T KNOW/DECLINED
0
0
F1025X. Other (Specify)
0
0
SV4B - Forced sex - first time - time of incident
F1026. About what time of day did this happen?
0
0
SV4B - Forced sex - first time - got pregnant
F1027. After this most recent experience, do you think that you got pregnant as a result?
0
0
SV4B - Forced sex - first time - deliver baby
F1028. Did you deliver the baby?
0
0
SV4B - Forced sex - first time - happened in last 12 months
F1029. Did this first experience of being pressured in a nonphysical way to have sex of any kind happen to you within the past 12 months?
0
0
SV - Thought of seeking help
SV SERVICESF1100. Thinking about all of the sexual experiences that happened without your permission, have you ever sought help for these experiences?
NO [2] -> F1102DON'T KNOW/DECLINED [99] -> F1102
0
0
SV - Sought help
F1101. From whom have you sought help? Anyone else?
RECORD ALL MENTIONED
0
0
SV - Sought help - own family
F1101A. OWN FAMILY
-> F1200 (PERPETRATION)
0
0
SV - Sought help - husband's family
F1101B. HUSBAND’S/PARTNER’S FAMILY
-> F1200 (PERPETRATION)
0
0
SV - Sought help - current husband
F1101C. CURRENT/FORMER HUSBAND/PARTNER
-> F1200 (PERPETRATION)
0
0
SV - Sought help - current partner
F1101D. CURRENT/FORMER BOYFRIEND
-> F1200 (PERPETRATION)
0
0
SV - Sought help - friend
F1101E. FRIEND
-> F1200 (PERPETRATION)
0
0
SV - Sought help - neighbor
F1101F. NEIGHBOR
-> F1200 (PERPETRATION)
0
0
SV - Sought help - religious leader
F1101G. RELIGIOUS LEADER
-> F1200 (PERPETRATION)
0
0
SV - Sought help - doctor
F1101H. DOCTOR/MEDICAL PERSONNEL
-> F1200 (PERPETRATION)
0
0
SV - Sought help - police
F1101I. POLICE
-> F1200 (PERPETRATION)
0
0
SV - Sought help - lawyer
F1101J. LAWYER
-> F1200 (PERPETRATION)
0
0
SV - Sought help - social service organization
F1101K. SOCIAL SERVICE ORGANIZATION
-> F1200 (PERPETRATION)
0
0
SV - Sought help - other
F1101X. OTHER
-> F1200 (PERPETRATION)
0
0
SV - Sought help - don't know
F1101Z. DON’T KNOW/DECLINED
-> F1200 (PERPETRATION)
0
0
SV - Sought help - other
F1101. Other (Specify)
0
0
SV - Reason why not seek help
F1102. What was the main reason you did not seek help?
0
0
SV - Reason why not seek help - other
F1102. Other (Specify)
0
0
SV - Told anyone
F1103. Have you ever told anyone about these experiences?
NO [2] -> F1200DON'T KNOW/DECLINED [99] -> F1200
0
0
SV - Spoken with someone
F1104. Who else did you speak to regarding any of these sexual experiences that happened without your permission?
RECORD ALL MENTIONED
0
0
SV - Spoke to - own family
F1104A. OWN FAMILY
0
0
SV - Spoke to - husband's family
F1104B. HUSBAND’S/PARTNER’S FAMILY
0
0
SV - Spoke to - current husband
F1104C. CURRENT/FORMER HUSBAND/PARTNER
0
0
SV - Spoke to - current partnet
F1104D. CURRENT/FORMER BOYFRIEND
0
0
SV - Spoke to - friend
F1104E. FRIEND
0
0
SV - Spoke to - neighbor
F1104F. NEIGHBOR
0
0
SV - Spoke to - religious leader
F1104G. RELIGIOUS LEADER
0
0
SV - Spoke to - doctor
F1104H. DOCTOR/MEDICAL PERSONNEL
0
0
SV - Spoke to - police
F1104I. POLICE
0
0
SV - Spoke to - lawyer
F1104J. LAWYER
0
0
SV - Spoke to - social service organization
F1104K. SOCIAL SERVICE ORGANIZATION
0
0
SV - Spoke to - other
F1104X. OTHER
0
0
SV - Spoke to - don't know
F1104Z. DON’T KNOW/DECLINED
0
0
SV - Spoke to - other
F1104. Other (Specify)
0
0
Perpetration - Ever slapped husband
0
0
Perpetration - Ever punched husband
0
0
Perpetration - Ever choked husband
F1202. Have you choked, smothered, tried to drown, or intentionally burned or scalded a current or previous partner/husband: never, once, a few times, many times?
0
0
Perpetration - Ever threatened husband with use of knife
F1203. Have you used or threatened to use a knife or other weapon against a current or previous partner/husband: never, once, a few times, many times?
0
0
Perpetration - Ever forced sex with husband
F1204. Have you forced a current or previous partner/husband to have sexual intercourse or perform any other sex acts with you when they did not want to: never, once, a few times, many times?
0
0
Perpetration - Ever had sex with someone not husband
F1205. Have you ever had sexual intercourse with someone who is not your husband ?
NO [2] -> F1300DON'T KNOW/DECLINED [99] -> F1300
0
0
Perpetration - Forced someone/ was forced by someone to have sex
F1206. Did you force them or did they force you?
0
0
Substance abuse - Used drugs - past 30 days
SUBSTANCE ABUSE: F1300. In the past 30 days, have you used drugs such as marijuana, pills, ecstasy, yama or sniffed any chemical such as petrol or glue?
0
0
Substance abuse - Days drunk alcohol - past 30 days
F1301. In the past 30 days, on how many days did you drink alcohol to the point that you became drunk?
0
0
Substance abuse - Smoke cigarettes freq - past 30 days
F1302. During the past 30 days, did you smoke cigarettes daily, occasionally, or not at all?
0
0
Mental health - nervous - past 30 days
During the past 30 days, how often did you feel the following ways: (Read categories below)F1303A. All the time, most of the time, some of the time, a little of the time, or none of the time NERVOUS?
0
0
Mental health - hopeless - past 30 days
F1303B. All the time, most of the time, some of the time, a little of the time, or none of the time HOPELESS?
0
0
Mental health - restless - past 30 days
F1303C. All the time, most of the time, some of the time, a little of the time, or none of the time RESTLESS?
0
0
Mental health - depressed - past 30 days
F1303D. All the time, most of the time, some of the time, a little of the time, or none of the time SO DEPRESSED THAT NOTHING COULD CHEER YOU UP?
0
0
Mental health - everything an effort - past 30 days
F1303E. All the time, most of the time, some of the time, a little of the time, or none of the time THAT EVERYTHING WAS AN EFFORT?
0
0
Mental health - worthless - past 30 days
F1303F. All the time, most of the time, some of the time, a little of the time, or none of the time WORTHLESS?
0
0
Mental health - intentionally hurt self
F1304. Have you ever intentionally hurt yourself in any way?
0
0
Mental health - thought of killing self
F1305. Have you ever thought about killing yourself?
NO [2] -> F1307DON'T KNOW/DECLINED [99] -> F1307
0
0
Mental health - tried killing self
F1306. Have you ever tried to kill yourself?
0
0
HIV - HIV aware
HIV/AIDS - STIs: The next few questions ask you to think about HIV/AIDS. Remember that everything you say will be confidential, and you can skip any questions that you don’t feel comfortable answering.
0
0
HIV - know place for HIV test
F1308. Do you know any place where people could go for HIV testing?
0
0
HIV - ever been tested for HIV
F1309. Have you ever been tested for HIV?
YES [1] -> F1311DON'T KNOW/DECLINED [99] -> F1313
0
0
HIV - reason never been tested
F1310. What is the main reason you have never been tested?
-> F1313
0
0
HIV - reason never been tested, other
F1310. Other (Specify)
0
0
HIV - HIV test - recent
F1311. When was the most recent time you were tested for HIV: less than 12 months ago, 1-2 years ago, or more than 2 years ago?
0
0
HIV - HIV test - recent - got results
F1312. This most recent time you were tested for HIV, did you get the results of your test?
0
0
HIV - unusual discharge from vagina
F1313. Sometimes boys and men experience an abnormal discharge from their penis. Have you ever had an abnormal discharge from your penis?
0
0
HIV - ever had genital sore
F1314. Sometimes men have a sore or ulcer near their penis. Have you ever had a sore or ulcer near your penis?
0
0
Time to answer questions worthwhile
RESPONSES TO SENSITVE QUESTIONSF1400. Do you feel that the time you took to answer these questions was worthwhile for you?
0
0
Afraid someone might hear
F1401. At any point during the interview, were you afraid that someone might hear your answers and hurt you in any way because of what they heard?
0
0
Questions on violence upsetting due to memory of past experience
F1402. Did my asking you any of these questions about violence make you feel upset because the violence reminded you of a past experience?
0
0
Upsetting to answer questions
F1403. Did you find it upsetting or stressful to answer any of these questions?
NO [2] -> F1406DON'T KNOW/DECLINED [99] -> F1406
0
0
Upset questions
F1404. Which questions did you find upsetting or stressful to answer? The questions on physical violence, emotional violence, sexual violence, or other questions?
RECORD ALL MENTIONED
0
0
Upset questions - physical violence
F1404A. PARENT
0
0
Upset questions - emotional violence
F1404B. SIBLING
0
0
Upset questions - sexual violence
F1404C. OTHER RELATIVE
0
0
Upset questions - other
F1404X. OTHER
0
0
Upset questions - don't know
F1404Z. DON'T KNOW/DECLINED
0
0
Upset questions - specify
F1404. Other (Specify)
0
0
Reason why questions are upsetting
F1405. Why did you find it upsetting or stressful to answer these questions?
0
0
Feelings towards talking about difficult things
F1406. I have asked you about many difficult things. How has talking about these things made you feel?
0
0
Comments
F1407. We have now finished the interview. Do you have any comments, or is there anything else you would like to add?
0
0
Time of interview - end - hour
TIME INTERVIEW ENDED -HOUR
0
0
Time of interview - end - min
TIME INTERVIEW ENDED -MINUTE
0
0
Respondent disclosed violence in the past
Did respondent tell you about/disclose any violence in the past?
0
0
Respondent showed signs of being upset
Did the respondent show any signs of being upset at any point during the interview e.g. being tearful, angry, sad, shaking body, difficulty in breathing, etc.?
0
0
Respondent felt unsafe in current situation
Did the respondent tell you about feeling unsafe in current living situation or asks for help with current or past experiences of violence at any point during the interview?
0
0
FO1 - Have questions
Do you have any questions you would like to ask me?
0
0
FO2 - Would like to talk to social worker
Do you think that you would like to talk to one of our social workers/arrange for a social worker from a local NGO to speak with you?
0
0
FO2 - Have questions
Do you have any questions you would like to ask me?
0
0
Interviewer QC initials
Interviewer QC initials
0
0
Supervisor team code
Supervisor team code
0
0
Urban/Rural
Urban/Rural
0
0
Cluster number
Cluster number
0
0
Cluster number(1)
Cluster number(1)
0
0
Province code
Province code
0
0
Province name
Province name
0
0
District code
District code
0
0
District name
District name
0
0
Commune code
Commune code
0
0
Commune name
Commune name
0
0
Village name
Village name
0
0
Expected hits
Expected hits
0
0
EA gender
EA gender
0
0
Primary sampling unit
Primary sampling unit
0
0
Final weight
Final weight
0
0