Questionnaire for women who have sex with men

to evaluate:
correlation between the frequency of receptive sex and
dyspareunia/discomfort/bleeding
correlation between either of the previous factors and HIV status
multivariate analysis of factors for dyspareunia (creation of an index for
dyspareunia possible for a specific set of the questions)

1. General Data:

Participant number/ID code: ______

Gender: m f transgender do not wish to specify

Age: ____

Weight: ______ kg Height: ______ cm

Education: primary
secondary
college or university graduation

2. Sexual history questions:

Are you sexually active? yes no

What was your age at first sex with a man? ___________

2.1 Which of the following do you use or have used on yourself for vaginal
insertion?

dildos
plugs
other toys or objects (specify:______________________________)
hands/fists, or arms
none of the above (proceed with question 2.3)

2.2 Is the maximum size (diameter/caliber/circumference) of the toys you

normally use...

below the size of this object?

about the size of this object?
above the size of this object?
[The participant is shown a cylindric object with a diameter of 4 cm.]

2.3 How many vaginal births have you had?

 0 1 2 3 4 5 6 7 8 9 10

2.4 In the last month, how many times did you have receptive vaginal
intercourse or use sex toys, plugs, dildos, or other objects on yourself
(vaginally) which had at least the diameter just shown?

0 1 2 3 4 5 6 7 8 9 10
11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 >30 times

2.5 How long (in days) were the longest time gaps between any instance of
vaginal intercourse or any vaginal insertion of toys, plugs, dildos, or
other objects which had at least the diameter just shown...

(a) ...in the last month?

1 day 2 3 4 5 6 7 8 9 10
11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 days
>30 days (or no vaginal intercourse/object insertion in last month)

(b) ...in your sexually active life?

1 day 2 3 4 5 6 7 8 9 10
11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 days
>30 days >60 days >90 days
attempted vaginal intercourse/object insertion only a few times in life
or never

2.6 Have you ever noticed blood on your vagina or your partner's penis
during vaginal intercourse or after vaginal sex that was not related to
menstruation?
never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.7 Have you ever noticed vaginal itching, burning, or soreness during or
after receptive vaginal intercourse?
never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.8 Over the past 4 weeks, how satisfied have you been with the amount of
emotional closeness during sexual activity between you and your
partner(s)?
No sexual activity
 Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

2.9 Over the past 4 weeks, how satisfied have you been with your sexual
relationship with your partner(s)?
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

2.10 Over the past 4 weeks, how satisfied have you been with your overall
sexual life?
Very satisfied
Moderately satisfied
About equally satisfied and dissatisfied
Moderately dissatisfied
Very dissatisfied

2.11 Over the past 4 weeks, how often did you experience discomfort or pain
during vaginal penetration?
Did not attempt intercourse
Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

2.12 Over the past 4 weeks, how often did you experience discomfort or pain
following vaginal penetration?
Did not attempt intercourse
Almost always or always
Most times (more than half the time)
Sometimes (about half the time)
A few times (less than half the time)
Almost never or never

2.13 Over the past 4 weeks, how would you rate your level (degree) of
discomfort or pain during or following vaginal penetration?
Did not attempt intercourse
Very high
High
Moderate
Low
Very low or none at all
2.14 Do you currently have a steady relationship?
yes no

2.15 Have you had steady relationships...?

rarely or none
some
through most of your youth and adult life
always

2.16 Do you use a water or silicone-based lubricant for receptive vaginal

intercourse?
never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.17 How long is receptive vaginal intercourse usually...?

seconds to a few minutes
about five minutes
about five to ten minutes
about ten to twenty minutes
about twenty to thirty minutes
longer than thirty minutes

2.18 Do you have finger stimulation or massage of the vagina before

intercourse?
never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.19 Do you have sex toys, plugs, or dildos inserted before vaginal
intercourse?
never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.20 How many sex partners for receptive vaginal intercourse have you had in
life?
0123 4 5 6 7 8 9 10
11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 >30

2.21 How many sex partners for vaginal intercourse have you had in the last
12 months?
 0 1 2 3 4 5 6 7 8 9 10
11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 >30

2.22 Have you been diagnosed with any of the following STIs?
Syphilis
Chlamydia
Gonorrhoea
Genital Herpes
Trichomoniasis
Hepatitis C
Genital or anal warts/HPV

2.23 For vaginal intercourse, do you use condoms...?

never
rarely (less than half the time)
sometimes (about half the time)
most times (more than half the time)
always

2.24 Do you engage in BDSM (bondage, discipline/domination, sado-

masochism) practices?
never
rarely
sometimes
regularly

2.25 If yes, do they involve blood?

never
rarely
sometimes
regularly

2.26 Do you take part in group sex?

never
rarely
sometimes
regularly

2.27 Do you have sexual intercourse with anonymous partners?

never
rarely
sometimes
regularly

2.28 Do you engage in dry sex practices or insert herbs, potions, powders or
cleaning agents in your vagina?
never
rarely
 sometimes
regularly

2.29 Do you use any of the following drugs in relation to sexual intercourse?
stimulants (methamphetamine, mephedrone, cocaine, crack, ecstasy,
etc.)
never
rarely
sometimes
regularly
inhaled nitrites (poppers)
never
rarely
sometimes
regularly
GHB (liquid G)
never
rarely
sometimes
regularly
PCP (Angel Dust)
never
rarely
sometimes
regularly
alcohol
never
rarely
sometimes
regularly

If you have experienced discomfort or pain during sex:

2.30 Do you feel that sexual discomfort or pain during vaginal intercourse
occurs less or more...

(a) with a steady partner than with casual sex partners?

less
no difference
more
cannot compare
(b) the more partners you already had receptive intercourse with?
less
no difference
more
cannot compare
(c) with a higher number of partners you have sex with at a time (as
in group sex, etc.)?
less
 no difference
more
cannot compare
(d) with higher age?
less
no difference
more
cannot compare
(e) with longer duration of intercourse?
less
no difference
more
cannot compare
(f) with higher regularity or frequency of vaginal intercourse and/or
object use?
less
no difference
more
cannot compare
(g) after foreplay or finger stimulation before intercourse?
less
no difference
more
cannot compare
(h) with lubrification or lubes and oils?
less
no difference
more
cannot compare
(i) with condoms?
less
no difference
more
cannot compare
(j) after object insertion immediately before intercourse?
less
no difference
more
cannot compare
(k) with certain sex drugs such as GHB, alcohol etc.?
less
no difference
more
cannot compare