Crystal Meth Belief and Behavior Questionnaire

Please fill out this survey only once. If you have done so in the past do not fill out a second time. THANKS!

Please only fill out the survey if you are a resident of the Chicago area.

Click to select one response as it relates to your beliefs regarding crystal meth. The survey is anonymous; you will not be asked for your name or any other identifying information.
 
    Strongly Agree   Neutral   Strongly
Disagree
    5 4 3 2 1
1. Crystal meth is a significant substance use problem in the gay community
2. Crystal is currently the most commonly used substance in gay community
3. Crystal is commonly used within my friendship circle
4. Crystal meth is easier to obtain than any other illegal street drug
5. Crystal is most popular among gay men between the ages of 18-25
6. Gay men use crystal mainly to prolong and/or increase sexual enjoyment
7. Crystal users are more likely to put themselves at risk for HIV and other STD infections
8. Crystal can never be used safely on an occasional recreational basis
9. Local media have given appropriate coverage to the crystal problem in the gay community
10. The Chicago gay community has responded appropriately to the crystal problem
11. The crystal problem will get worse before it gets better
 
12. Have you ever tried crystal meth? Yes
No
If no please skip to question 32 below
If yes please continue the survey
 
13. How often do use crystal?
 
14. Which way do you most commonly use it?
 
15. I have used crystal with complete strangers Yes No Don't Know
16. I have used crystal to feel accepted by peers Yes No Don't Know
17. I have used it before going out to a bar Yes No Don't Know
18. I have used crystal to be more sexually adventurous Yes No Don't Know
19. I have had unprotected sex while on crystal Yes No Don't Know
20. I have used crystal before or while at a bathhouse Yes No Don't Know
21. I have contracted an STD while on crystal Yes No Don't Know
22. I contracted HIV while on crystal Yes No Don't Know
23. I have used crystal to forget about my HIV status Yes No Don't Know
24. I have experienced withdrawal after stopping crystal Yes No Don't Know
25. I have used crystal continually for over 24 hours Yes No Don't Know
26. I have experienced legal complications due to crystal Yes No Don't Know
27. I have sought treatment to help stop using crystal Yes No Don't Know
28. I believe in abstinence only programs for crystal Yes No Don't Know
29. I have stopped using crystal completely on my own without help from others Yes No Don't Know
30. I have "relapsed" on crystal more than once Yes No Don't Know
31. I have made a commitment to never use crystal again Yes No Don't Know
 
32. At what zip code do you currently reside?
 
33. What is the year of your birth?
 
34. How do you describe your ethnic/racial background?

if Other, please specify:  
 
35. How do you identify your sexual orientation?
 
36. With whom have you had sex in the past 12 months?