National HIV Behavioral Surveillance System

Forms and Documents

Document Name	Status
NHBS Behavioral Assessment Survey (HET) Form and Instruction	Modified
NHBS Behavioral Assessment (IDU) Form and Instruction	Modified
NHBS Recruiter Debriefing Form and Instruction	Modified
NHBS Behavioral Assessment (MSM) Form and Instruction	Modified
NHBS Screening (All Respondent Groups) Form and Instruction	Modified
Att 18_Auth to Operate for DCC.pdf Supplementary Document	2016-12-08
Att 17_References.docx Supplementary Document	2016-12-08
Att 16_Response rate calculations.docx Supplementary Document	2016-12-08
Att 14_Model recruitment coupon.docx Supplementary Document	2016-12-08
Att 13_Summary of Changes to Data Collection_11 29 16.docx Supplementary Document	2016-12-08
Att 12_Sample analysis tables.pdf Supplementary Document	2016-12-08
Att 11_CDC IRB determination.pdf Supplementary Document	2016-12-08
Att 10_Model Consent Form.doc Supplementary Document	2016-12-08
Att 9_Consultants.pdf Supplementary Document	2016-12-08
Att 8_NHBS cycle overview.pdf Supplementary Document	2016-12-08
Att 7_Agreement to abide by restrictions.docx Supplementary Document	2016-12-08
Att 6_Assurance of Confidentiality.pdf Supplementary Document	2016-12-08
Att 5_NHBS Publications.doc Supplementary Document	2016-12-08
Att 2a Public Comment.docx Supplementary Document	2016-12-08
Att 2_60 Day_FRN.pdf Supplementary Document	2016-12-08
Att 1_PHSA.pdf Supplementary Document	2016-12-08
Supporting Statement B_03 14 17.docx Supporting Statement B	2017-03-15
Supporting Statement A_03 14 17.docx Supporting Statement A	2017-03-15

IC Document Collections

IC ID	Document Title	Status
196958	NHBS Behavioral Assessment Survey (HET) Form and Instruction	Modified
196957	NHBS Behavioral Assessment (IDU) Form and Instruction	Modified
196956	NHBS Recruiter Debriefing Form and Instruction	Modified
182203	NHBS Behavioral Assessment (MSM) Form and Instruction	Modified
182201	NHBS Screening (All Respondent Groups) Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0770	ICR Reference No: 201609-0920-008
Status: Historical Active	Previous ICR Reference No: 201410-0920-028
Agency/Subagency: HHS/CDC	Agency Tracking No: 07AG
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: 05/30/2017
	Date Received in OIRA: 12/12/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2017
Responses	29,136	0	31,668
Time Burden (Hours)	9,138	0	9,932
Cost Burden (Dollars)	0	0	0

---

Abstract: The NHBS was designed to address the need for a national behavioral surveillance system for persons at risk for HIV infection. The primary objective is to conduct behavioral surveillance among persons at high-rsk for HIV in the US to assess prevalence of and trends in 1) risk behaviors, 2) HIV testing behaviors, 3) HIV seroprevalence and incidence, and 4) exposure to, use of, and impact of HIV prevention services. CDC works with state and local health depts. to collect data through anonymous interviews with men who have sex with men, injecting drug users, and heterosexuals at increased risk. NHBS addresses the goal of strengthening the capacity to monitor the epidemic to better direct and evaluate prevention efforts.

---

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

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 36544	06/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 88684	12/08/2016
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
NHBS Behavioral Assessment (MSM)	N/A, N/A	Behavioral Assessment for MSM (English) ,   Behavioral Assessment for MSM (Spanish)
NHBS Screening (All Respondent Groups)	N/A, N/A	Eligibility Screener (English) ,   Eligibility Screener (Spanish)
NHBS Recruiter Debriefing	N/A, N/A	Recruiter Debriefing (English) ,   Recruiter Debriefing (Spanish)
NHBS Behavioral Assessment (IDU)	N/A, N/A	Behavioral Assessment for IDU (English) ,   Behavioral Assessment for IDU (Spanish)
NHBS Behavioral Assessment Survey (HET)	N/A, N/A	Behavioral Assessment for HET (English) ,   Behavioral Assessment for HET (Spanish)

---

ICR Summary 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	29,136	31,668	0	-2,532	0	0
Annual Time Burden (Hours)	9,138	9,932	0	-794	0	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: Miscellaneous Actions

Short Statement: The previously approved estimates were based on 25 awardees. The revised estimates are based on 22 current awardees. There is no change in the estimated number of interviews to be conducted per awardee. If there is a change in the number of funded awardees, CDC will submit a Change Request to make the appropriate adjustment.

---

Annual Cost to Federal Government: $11,938,505

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

---

Common Form ICR:  No

---

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: 12/12/2016

---