Transgender HIV Behavioral Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OMBpassback_clean_Eligibility screener.doc	Supplementary Document	Uploaded 2008-12-23	Available
postpassback_clean_ survey revised.doc	Supplementary Document	Uploaded 2008-12-23	Available
CDC IRB approved protocol chapter requesting parental waiver.pdf	Supplementary Document	Uploaded 2008-12-23	Available
transgender survey revised.doc	Supplementary Document	Uploaded 2008-12-23	Available
092007BKTHBS SSsection PART B June 23 2008.doc	Supporting Statement B	Uploaded 2008-07-14	Available
092007BK Att 11 References.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 10 Process Indicator Reports.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 9 Recruiter training.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 8 Model coupon.doc	Supplementary Document	Uploaded 2008-07-14	Available
CDC IRB approved protocol chapter requesting parental waiver.pdf	Supplementary Document	Uploaded 2008-12-23	Available
092007BK Att 6 Model Consent Form June 2008.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 5 Assurance of Confidentiality.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 4 Consultants.doc	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 2 60 day FRN.pdf	Supplementary Document	Uploaded 2008-07-14	Available
092007BK Att 1 PHSA.pdf	Supplementary Document	Uploaded 2008-07-14	Available
Supporting Statement PART A.doc	Supporting Statement A	Uploaded 2008-08-11	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
186175	Eligibility Screener	Other-Eligibility screener	New
186174	Core Questionnaire	Other-Core questionnaire	New

ICR Details

OMB Control No: 0920-0794	ICR Reference No: 200808-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Transgender HIV Behavioral Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/24/2008
	Date Received in OIRA: 08/18/2008
Terms of Clearance: Subsequent request for clearance must include: (1) a discussion of the effectiveness of respondent-driven sampling in recruiting a generalizable sample of the target population, and (2) a discussion of response and non-response rates to behavioral questions and what strategies will be used to increase response rates to those questions in future iterations of the survey.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2010	24 Months From Approved
Responses	440	0	0
Time Burden (Hours)	170	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The proposed information collection addresses gaps in the knowledge about how to conduct an HIV-related behavioral survey among transgender persons. The Transgender HIV Behavioral Survey is a pilot survery of an eligibility screener, a behavioral questionnaire and sampling method for recruiting transgender persons. The goal is to assess the content of the questionnaire and the sampling and recruiting methods. Data will be collected through in-person and self interviews in 4 MSA in the United States. Data will provide estimates of HIV-related risk behaviors, prior HIV testing, and the use of HIV prevention services. Data will impact local, state, and national prevention program development.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: General Powers and Duties of Public Health Service
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 40298	07/24/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 43240	07/24/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Core Questionnaire
Eligibility Screener

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	440	0	0	0	440	0
Annual Time Burden (Hours)	170	0	0	0	170	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $360,270

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/18/2008

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