HIV Case Control Study

The Prevalence and Incidence of HIV Molecular Variants and Their Correlation with Risk Behaviors and HIV Treatment in Brazilian Blood Donors (NHLBI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0597 can be found here:

Documents and Forms

Document Name Document Type
Form 1 HIV Case Control Study Form and Instruction
1 survey Attachment 1_English Questionnaire .RTF Form and Instruction
Attachment 2_English Consent .doc Attachment 2_English Consent IC Document

Information Collection (IC) Details

IC Title:	HIV Case Control Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	survey	Attachment 1_English Questionnaire .RTF		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	800	800
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 2_English Consent	Attachment 2_English Consent .doc	10/08/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.