Information Collection

Sexual risk-taking among young black men who have sex with men: exploring the social and situational contexts of HIV risk, prevention and treatment

IC 193928 under ICR 200910-0920-004 · OMB 0920-0840.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Screener Sexual risk-taking among young black men who have sex with men: exploring the social and situational contexts of HIV risk, prevention and treatment Form
ACASI survey Sexual risk-taking among young black men who have sex with men: exploring the social and situational contexts of HIV risk, prevention and treatment Form
Web-based sex diary Sexual risk-taking among young black men who have sex with men: exploring the social and situational contexts of HIV risk, prevention and treatment Form
In-depth interview Sexual risk-taking among young black men who have sex with men: exploring the social and situational contexts of HIV risk, prevention and treatment Form
Screener
Attachment 1a_Screening and Contact Info Forms.06262010.docx
Form
ACASI survey
Attachment 1b_ACASI Survey.06262010.docx
Form
Web-based sex diary
Attachment 1c_Web-based Sex Diary.06262010.docx
Form
In-depth interview
Attachment 1d_In-depth Interviews.docx
Form
SS Part A.06262010.docx
Supporting statement A
IC Document
SS Part B.docx
Supporting statement B
IC Document
Attachment 2_Consent Forms.06262010.docx
Attachment 2 - Consent forms
IC Document
Attachment 4_Recruitment Materials and Website Screenshots.06262010.docx
Attachment 4 - Recruitment materials
IC Document
Attachment 3a_local IRBapproval.April 2011.pdf
Attachment 3 - IRB approval
IC Document
Attachment 5_Certificate of Confidentiality.pdf
Attachment 5 - Certificate of confidentiality
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable
Form none Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,780 0 0 0 0 0
Annual IC Time Burden (Hours) 745 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Supporting statement A 07/14/2010
Supporting statement B 07/14/2010
Attachment 2 - Consent forms 07/14/2010
Attachment 4 - Recruitment materials 07/14/2010
Attachment 3 - IRB approval 07/14/2010
Attachment 5 - Certificate of confidentiality 07/14/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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