National HIV Behavioral Surveillance System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0770 Attachment 3d Behavioral Assessment (HET) Spanish version	Form and Instruction	New	Available
Form 0920-0770 Attachment 2d Behavioral Assessment (HET) English version	Form and Instruction	New	Available
Form 0920-0770 Attachment 2c Behavioral Assessment (IDU) English version	Form and Instruction	New	Available
Form 0920-0770 Attachment 3c Behavioral Assessment (IDU) Spanish version	Form and Instruction	New	Available
Form 0920-0770 Attachment 3e Recruiter Debrief Spanish version	Form and Instruction	New	Available
Form 0920-0770 Attachment 2e Recruiter Debriefing English version	Form and Instruction	New	Available
NHBS for HET	Form and Instruction	Removed	Available
Form 0920-0770 Attachment 3b Behavioral Assessment (MSM) Spanish version	Form and Instruction	Modified	Available
Form 0920-0770 Attachment 2b	Form and Instruction	Modified	Available
NHBS Survey for IDU	Form and Instruction	Removed	Available
Form 0920-0770 Attachment 2A	Form and Instruction	Modified	Available
Form 0920-0770 Attachment 3a	Form and Instruction	Modified	Available
0920-0770 Supporting Statement B.doc	Supporting Statement B	Uploaded 2011-03-08	Available
0920-0770_Att 17_References.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 16_Response rate calculations.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 13_Sample analysis tables.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 12_Summary of Changes to Data Collection Instruments.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 11_CDC IRB determination (2).pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 10_Model Consent Form.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 9 Consultants.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 7_NHBS cycle overview.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 6_Agreement to abide by restrictions.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 5_Assurance of confidentiality.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 4_NHBS Publications.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 1b_Authorization to Operate for DCC.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 1a PHSA.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 8b_response to FRN comment.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 15_Recruiter Training Script.pdf	Supplementary Document	Uploaded 2011-03-08	Available
0920-0770_Att 3b_Behavioral Assessment_MSM_Spanish.pdf	Supplementary Document	Uploaded 2011-03-04	Available
0920-0770 Supporting Statement A.doc	Supporting Statement A	Uploaded 2011-03-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
196958	NHBS Behavioral Assessment Survey (HET)	Form and Instruction	New	Attachment 3d Behavioral Assessment (HET) Spanish version
196958	NHBS Behavioral Assessment Survey (HET)	Form and Instruction	New	Attachment 2d Behavioral Assessment (HET) English version
196957	NHBS Behavioral Assessment (IDU)	Form and Instruction	New	Attachment 2c Behavioral Assessment (IDU) English version
196957	NHBS Behavioral Assessment (IDU)	Form and Instruction	New	Attachment 3c Behavioral Assessment (IDU) Spanish version
196956	NHBS Recruiter Debriefing	Form and Instruction	New	Attachment 3e Recruiter Debrief Spanish version
196956	NHBS Recruiter Debriefing	Form and Instruction	New	Attachment 2e Recruiter Debriefing English version
182204	NHBS Survey (HET)	Form and Instruction	Removed	NHBS for HET
182203	NHBS Behavioral Assessment (MSM)	Form and Instruction	Modified	Attachment 3b Behavioral Assessment (MSM) Spanish version
182203	NHBS Behavioral Assessment (MSM)	Form and Instruction	Modified	Attachment 2b
182202	NHBS Survey (IDU)	Form and Instruction	Removed	NHBS Survey for IDU
182201	NHBS Screening (All Respondent Groups)	Form and Instruction	Modified	Attachment 2A
182201	NHBS Screening (All Respondent Groups)	Form and Instruction	Modified	Attachment 3a

ICR Details

OMB Control No: 0920-0770	ICR Reference No: 201103-0920-003
Status: Historical Active	Previous ICR Reference No: 200710-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National HIV Behavioral Surveillance System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/31/2011
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/16/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	36 Months From Approved	05/31/2011
Responses	31,668	0	82,500
Time Burden (Hours)	9,932	0	29,791
Cost Burden (Dollars)	0	0	0

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Abstract: The National HIV Behavioral Surveillance System (NHBS) was designed to address the need for a national behavioral surveillance system for persons at risk for HIV infection, as articulated in CDC's HIV Prevention Strategic Plan. The primary objective of NHBS is to conduct behavioral surveillance among persons at high risk for HIV infection in the United States in order to assess prevalence of and trends in: 1) risk behaviors for HIV infection, 2) HIV testing behaviors, 3) HIV seroprevalence and incidence, and 4) exposure to, use of, and impact of HIV prevention services. Through NHBS, CDC works with state and local health departments to obtain HIV-related behavioral data through anonymous interviews with three groups at highest risk for infection: men who have sex with men, injecting drug users, and heterosexuals at increased risk. NHBS addresses the goal of strengthening the capacity nationwide to monitor the epidemic to better direct and evaluate prevention efforts.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   US Code: 42 USC 306 Name of Law: Public Health Service Act
  

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:
	75 FR 76470	12/08/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 12359	03/07/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
NHBS Behavioral Assessment (IDU)	0920-0770, 0920-0770	Attachment 3c Behavioral Assessment (IDU) Spanish version ,   Attachment 2c Behavioral Assessment (IDU) English version
NHBS Behavioral Assessment (MSM)	0920-0770, 0920-0770	Attachment 2b ,   Attachment 3b Behavioral Assessment (MSM) Spanish version
NHBS Behavioral Assessment Survey (HET)	0920-0770, 0920-0770	Attachment 2d Behavioral Assessment (HET) English version ,   Attachment 3d Behavioral Assessment (HET) Spanish version
NHBS Recruiter Debriefing	0920-0770, 0920-0770	Attachment 2e Recruiter Debriefing English version ,   Attachment 3e Recruiter Debrief Spanish version
NHBS Screening (All Respondent Groups)	0920-0770, 0920-0770	Attachment 3a ,   Attachment 2A
NHBS Survey (HET)	None	NHBS for HET
NHBS Survey (IDU)	None	NHBS Survey for IDU

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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	31,668	82,500	0	-20,832	-30,000	0
Annual Time Burden (Hours)	9,932	29,791	0	-17,359	-2,500	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: Yes

Burden Reduction Due to: Changing Forms

Short Statement: Modifying eligibility criteria for the men who have sex with men (MSM) cycle. It was determined that changing the eligibility criteria would reduce the burden on non-MSM who would no longer be eligible for the behavioral assessment. Renumbering the eligibility screener and behavioral assessment. Revision of the eligibility screener some questions were revised in order to improve respondents' understanding of the questions. Adding an instrument to be used to debrief peer recruiters by asking questions to assess coupon distribution and coupon refusal. This information will help assess non-response bias.

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Annual Cost to Federal Government: $12,710,009

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 03/16/2011

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