"Attention to the person who prepared the questionnaire": Queer men's survey marginalia in HIV behavioural surveillance.

Survey marginalia are the unsolicited annotations left by participants in the margins of questionnaires. Marginalia can offer valuable insight into how participants perceive study instruments and researchers, the meanings behind their responses, and add nuance to lived experiences that are otherwise obscured or unaccounted for in survey design. This paper presents a qualitative analysis of survey marginalia left by participants of a pen-and-paper HIV behavioural surveillance survey administered in person to sexual minority men at 2S/LGBTQ+ pride events across Canada. Using interpretive description and reflexive thematic analysis, we analyzed 671 unique data items contributed by 404 participants, representing 12% of the survey sample. Our analysis identified three overarching themes characterizing how participants engaged with the survey through marginalia: (1) Answer Unasked Questions, in which participants used marginalia to introduce identities and experiences that the survey otherwise did not account for; (2) Avoid Misclassification, in which participants provided contextual information to prevent misclassification of "risk behaviours"; and (3) Talk Back, in which participants engaged in critical dialogue with researchers, challenging assumptions, questioning the validity of survey items, and offering direct feedback. Drawing on queer theory and community-based research principles, we interpret these findings as evidence that participants actively resisted classificatory logics and asserted authority over how their lives and identities should be represented. We argue that survey marginalia are not methodological noise but a substantive resource for reflexivity and the co-production of knowledge in public health research. Practical recommendations for the design and administration of HIV behavioural surveillance surveys and research with queer people are offered.