National HIV Behavioral Surveillance System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0770 Behavioral Assessment for HET (Spanish)	Form and Instruction	Modified	Available
Form 0920-0770 Behavioral Assessment for HET (English)	Form and Instruction	Modified	Available
Form 0920-0770 Behavioral Assessment for IDU (Spanish)	Form and Instruction	Modified	Available
Form 0920-0770 Behavioral Assessment for IDU (English)	Form and Instruction	Modified	Available
Form 0920-0770 Recruiter Debriefing (Spanish)	Form and Instruction	Modified	Available
Form 0920-0770 Recruiter Debriefing (English)	Form and Instruction	Modified	Available
Form 0920-0770 Behavioral Assessment for MSM (Spanish)	Form and Instruction	Modified	Available
Form 0920-0770 Behavioral Assessment for MSM (English)	Form and Instruction	Modified	Available
Form 0920-0770 Eligibility Screener (Spanish)	Form and Instruction	Modified	Available
Form 0920-0770 Eligibility Screener (English)	Form and Instruction	Modified	Available
Att 18_Auth to Operate for DCC.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 17_References.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 16_Response rate calculations.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 14_Model recruitment coupon.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 13_Summary of Changes to Data Collection.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 12_Sample analysis tables.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 11_CDC IRB determination.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 10_Model Consent Form.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 9_Consultants.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 8_NHBS cycle overview.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 7_Agreement to abide by restrictions.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 6b_PIA Form NHBS.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 6a_Assurance of Confidentiality.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 5_NHBS Publications.docx	Supplementary Document	Uploaded 2019-09-27	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Att 1_PHSA.pdf	Supplementary Document	Uploaded 2019-09-27	Available
Supporting Statement B final.docx	Supporting Statement B	Uploaded 2019-09-27	Repair queued
Supporting Statement A final.docx	Supporting Statement A	Uploaded 2019-09-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
196958	NHBS Behavioral Assessment Survey (HET)	Form and Instruction	Modified	Behavioral Assessment for HET (Spanish)
196958	NHBS Behavioral Assessment Survey (HET)	Form and Instruction	Modified	Behavioral Assessment for HET (English)
196957	NHBS Behavioral Assessment (IDU)	Form and Instruction	Modified	Behavioral Assessment for IDU (Spanish)
196957	NHBS Behavioral Assessment (IDU)	Form and Instruction	Modified	Behavioral Assessment for IDU (English)
196956	NHBS Recruiter Debriefing	Form and Instruction	Modified	Recruiter Debriefing (Spanish)
196956	NHBS Recruiter Debriefing	Form and Instruction	Modified	Recruiter Debriefing (English)
182203	NHBS Behavioral Assessment (MSM)	Form and Instruction	Modified	Behavioral Assessment for MSM (Spanish)
182203	NHBS Behavioral Assessment (MSM)	Form and Instruction	Modified	Behavioral Assessment for MSM (English)
182201	NHBS Screening (All Respondent Groups)	Form and Instruction	Modified	Eligibility Screener (Spanish)
182201	NHBS Screening (All Respondent Groups)	Form and Instruction	Modified	Eligibility Screener (English)

ICR Details

OMB Control No: 0920-0770	ICR Reference No: 201909-0920-001
Status: Historical Active	Previous ICR Reference No: 201609-0920-008
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 with change	Conclusion Date: 01/24/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/30/2019
Terms of Clearance: Approved with the understanding that NHBS will continue to consult with CDC/NCHS, as well as with other major surveillance systems within CDC and SAMHSA, in the development and adaptation of questions related to illicit behaviors and drug use.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2023	36 Months From Approved	05/31/2020
Responses	31,668	0	29,136
Time Burden (Hours)	8,195	0	9,138
Cost Burden (Dollars)	0	0	0

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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. The revisions include adding respondents, modifying instruments, and lowering the overall burden.

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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:
	84 FR 32184	07/05/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 51586	09/30/2019
Did the Agency receive public comments on this ICR? No

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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	Behavioral Assessment for IDU (English) ,   Behavioral Assessment for IDU (Spanish)
NHBS Behavioral Assessment (MSM)	0920-0770, 0920-0770	Behavioral Assessment for MSM (English) ,   Behavioral Assessment for MSM (Spanish)
NHBS Behavioral Assessment Survey (HET)	0920-0770, 0920-0770	Behavioral Assessment for HET (English) ,   Behavioral Assessment for HET (Spanish)
NHBS Recruiter Debriefing	0920-0770, 0920-0770	Recruiter Debriefing (English) ,   Recruiter Debriefing (Spanish)
NHBS Screening (All Respondent Groups)	0920-0770, 0920-0770	Eligibility Screener (English) ,   Eligibility Screener (Spanish)

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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	29,136	0	2,532	0	0
Annual Time Burden (Hours)	8,195	9,138	0	-943	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Two sites were added however the overall burden decreased due to lower estimations of burden time for some of the instruments.

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Annual Cost to Federal Government: $12,058,565

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

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: 09/30/2019

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