Attachment 5B. National HIV Prevention Program Monitoring and Evaluation (NHM&E) Data Variable Options (OMB 0920-0696, Exp. 02/28/2019)
Option 1 is available through December 31, 2018 for health departments funded under PS18-1802. However, additional time may be granted to those health departments unable to transition to Option 2 by that date. Option 1 is required for community based organizations funded under PS15-1502 through the last year of current funding (June 30, 2020) and those funded under PS17-1704 through March 31, 2019.
Option 2 is available to health departments beginning July 1, 2018 and required for all health departments on January 1, 2019. Option 2 will be required for any new CBO NOFO. New Variables will be available following OMB approval.
Variable Number |
Variable Name |
Option 1: NHM&E Requirements |
Option 2: NHM&E Requirements |
Status |
Agency |
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A01 |
Agency Name |
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A01a |
Agency ID |
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A02 |
Jurisdiction |
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A27 |
CBO Agency Name |
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A28 |
CBO Agency ID |
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Site |
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S01 |
Site ID |
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S04 |
Site Type |
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S08 |
Site – County |
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S09 |
Site – State |
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S10 |
Site - Zip Code |
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S03 |
Site Name |
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CDC |
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CDC06 |
CDC Variable 6 |
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CDC07 |
CDC Variable 7 |
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CDC08 |
CDC Variable 8 |
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CDC09 |
CDC Variable 9 |
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CDC10 |
CDC Variable 10 |
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Client |
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G101 |
Date Client Demographic Data Collected |
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G103 |
Local Client ID |
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G112 |
Date of Birth - Year |
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G114 |
Ethnicity |
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G116 |
Race |
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G120 |
State/Territory of Residence |
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G123 |
Assigned Sex at Birth |
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G124 |
Current Gender Identity |
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G124a |
Specify Current Gender Identity |
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G132 |
Client – County |
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G134 |
Client - Zip Code |
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G200 |
Date Client Risk Collected |
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G200_1 |
Client Behavioral Risk Profile |
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G204 |
Previous HIV Test |
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G205 |
Self-Reported HIV Test Result |
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G209 |
Pregnant (Only If Female) |
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G210 |
In Prenatal Care (Only if Pregnant) |
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G211_01 |
Injection Drug Use |
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G211_08 |
Share Drug Injection Equipment |
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G212 |
Additional Client Risk Factors |
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G216a |
Vaginal or Anal Sex with a Male |
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G216b |
Vaginal or Anal Sex with a Female |
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G216c |
Vaginal or Anal Sex with a Transgender Person |
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G217a |
Vaginal or Anal Sex without a Condom with a Male |
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G217b |
Vaginal or Anal Sex without a Condom with a Female |
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G217c |
Vaginal or Anal Sex without a Condom with a Transgender Person |
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G218a |
Vaginal or Anal Sex with a Male IDU |
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G218b |
Vaginal or Anal Sex with a Female IDU |
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G218c |
Vaginal or Anal Sex with a Transgender IDU |
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G219a |
Vaginal or Anal Sex with HIV-Positive Male |
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G219b |
Vaginal or Anal Sex with HIV-Positive Female |
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G219c |
Vaginal or Anal Sex with HIV-Positive Transgender Person |
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G220 |
Vaginal or Anal Sex with MSM (female only) |
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G222 |
Vaginal or Anal Sex without a Condom (PS only) |
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G223 |
Vaginal or Anal Sex with an IDU (PS only) |
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G205a |
Previous HIV Test Result |
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G400 |
In the past 5 years, has the client/patient had sex with a male? |
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G401 |
In the past 5 years, has the client/patient had sex with a female? |
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G402 |
In the past 5 years, has the client/patient injected drugs that were not prescribed to him/her by a medical care provider? |
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G403 |
In the past 5 years, has the client/patient had sex with a transgender person? |
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New |
Testing 1 |
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H04a |
Test Form ID |
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H06 |
Session Date |
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H800 |
Has the client/patient ever heard of PrEP, the medicine taken daily to reduce the risk for getting HIV? |
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H802 |
Has the client/patient used PrEP anytime in the last 12 months? |
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H04c |
eHARS State Number |
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H04d |
eHARS City/County Number |
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Partner Services |
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PCR101 |
Case Number |
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PCR103 |
Case Open Date |
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PCR104 |
Case Close Date |
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PCR108 |
Date of Report |
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PCR109 |
Reported to Surveillance |
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PCR200 |
Date Collected |
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PCR202a |
Local PS ID |
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PCR207 |
Partner Type |
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PCR209 |
Notification Plan |
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PCR104a |
Care Status at Case Close Date |
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Testing 2 |
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X103 |
Test Technology |
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X104 |
HIV Test Election |
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X104a |
HIV Test Election |
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X105 |
Sample Date |
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X110 |
Test Result |
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X111 |
Result Provided |
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X115 |
If Result Not Provided, Why |
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X124 |
Basis of Final Determination |
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X125 |
HIV Test Result, Final Determination |
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X126 |
Preliminary Positive point-of-care rapid test |
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X126a |
Specimen Collection Date of Preliminary Positive point-of-care rapid test |
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X127 |
Tests for co-infections |
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X127a |
Syphilis Test |
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X127b |
Gonorrhea |
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X127c |
Chlamydial infection |
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X127d |
Hepatitis C |
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X135 |
Worker ID |
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X136 |
In Surveillance System or Records |
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X137 |
Program Announcement or Program Strategy |
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X137-1 |
Specify Program Announcement/Strategy |
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X138 |
Client HIV Status |
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X150 |
Has the client/patient ever had a positive HIV test? |
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X150a |
If yes, date of first positive HIV test |
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X224 |
Stage of infection |
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X302 |
Attempt to Locate Outcome |
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X303 |
Reason for Unsuccessful Attempt |
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X303a |
Specify Reason for Unsuccessful Attempt |
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X306 |
Enrollment Status |
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X502 |
Time Period for Recall (in months) |
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X503 |
Total number of claimed sex and/or needle-sharing partners within the last 12 months |
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X511 |
Total number of named sex and/or needle sharing partners within the last 12 months (with enough information to locate) |
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X511a |
Total Number of Named Male Partners |
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X511b |
Total Number of Named Female Partners |
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X511c |
Total Number of Named Transgender Partners |
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X600 |
Partner Notifiability |
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X601 |
Actual Notification Method |
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X602 |
Previous HIV Test |
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X603 |
Self-Reported HIV Test Result |
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X604 |
Date of Last HIV Test |
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X702 |
Referral Date |
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X702a |
Reason Client Not Referred to HIV Medical Care |
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X703_01 |
Referred To HIV Testing |
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X703_10 |
Referred To Medical Care |
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X703_14 |
Referred To Partner Services |
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X703_17 |
Referred To HIV Prevention Services |
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X706 |
Referral Outcome |
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X706b |
First HIV Medical Care Appointment within 90 Days of HIV Test |
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X706c |
HIV Medical Care Linkage |
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X706d |
First HJV Medical Appointment Date |
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X712 |
HIV Test Performed |
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X712a |
Coinfection Screen (Partner Services) |
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X712b |
Co-infection Result (Partner Services) |
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X713 |
HIV Test Result |
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X714a |
HIV Test Results Provided |
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X724 |
Client Received Prevention Services |
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X725 |
Partner Service Interview |
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X725a |
Was the PS Interview within 30 Days of Receiving a Positive HIV Test Result |
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X725b |
Care Status at Time of the PS Interview |
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X730a |
Housing status in past 12 months - revised |
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X731 |
PrEP Status |
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X731a |
Partner referred to PrEP Provider (Partner Services) |
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X740 |
Seen a Medical Care Provider in past 6 months |
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X741 |
Attend HIV medical care appointment |
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X741a |
Appointment Date |
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X742 |
Individualized behavioral risk-reduction counseling |
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X743 |
Information provided for partner services |
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X744 |
Interviewed for partner services |
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X744a |
Date of partner services interview |
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X745 |
Screened for perinatal HIV service coordination needs |
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X746 |
Perinatal HIV service coordination needs identified |
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X747 |
Referred for HIV perinatal service coordination |
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X748 |
Screened for PrEP eligibility |
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X749 |
Eligible for PrEP referral |
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X750 |
Referred to a PrEP Provider |
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X751 |
Assistance with linkage to a PrEP provider |
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X752a |
Navigation services for linkage to HIV medical care – screened for need |
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X752b |
Navigation services for linkage to HIV medical care – need identified |
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X752c |
Navigation services for linkage to HIV medical care – provided or referred for service |
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X752e |
Linkage services to HIV medical care – screened for need |
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X752f |
Linkage services to HIV medical care – need identified |
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X752g |
Linkage services to HIV medical care – provided or referred for service |
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X753a |
Health benefits navigation and enrollment – screened for need |
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X753b |
Health benefits navigation and enrollment – need identified |
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X753c |
Health benefits navigation and enrollment – provided or referred to service |
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X754a |
Medication adherence support – screened for need |
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X754b |
Medication adherence support – need identified |
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X754c |
Medication adherence support – provided or referred to service |
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X755a |
Evidence-based risk reduction intervention – screened for need |
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X755b |
Evidence-based risk reduction intervention – need identified |
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X755c |
Evidence-based risk reduction intervention – provided or referred to service |
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X756a |
Behavioral health services – screened for need |
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X756b |
Behavioral health services – need identified |
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X756c |
Behavioral health services – provided or referred to service |
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X758a |
Social services – screened for need |
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X758b |
Social services – need identified |
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X758c |
Social services – provided or referred to service |
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Aggregate |
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ME201a |
Category A total PS18-1801-funded aggregate test events |
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ME201b |
Category A total reimbursed aggregate test events |
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ME202a |
Category A PS18-1801-funded aggregate newly diagnosed HIV-positive test events |
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ME202b |
Category A reimbursed aggregate newly diagnosed HIV-positive testing events |
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CBO |
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CBOCL003 |
Client Record Number |
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CBOTEST001 |
Target Population(s) |
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CBOTEST002 |
High-Risk Client |
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CBOTEST003 |
HIV Medical Care at the time of this positive test |
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CBOTEST004 |
Navigation and prevention and essential support services, HIV Testing |
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CBOTEST004SP |
Other recommended support services, HIV testing |
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CBOTEST005 |
Date client attended first medical care appointment |
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|
Data Upload |
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Z03c |
Schema Version Number |
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Z06 |
Data Type in File |
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Budget |
Health Department PS18-1802 Only |
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BASTRAT10a1P |
Percent Allocated - Monitoring and Evaluation - Prevention |
|
|
New |
BASTRAT10a1S |
Percent Allocated - Monitoring and Evaluation - Surveillance |
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New |
BASTRAT11a1P |
Percent Allocated - Capacity Building and TA - Prevention |
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New |
BASTRAT11a1S |
Percent Allocated - Capacity Building and TA - Surveillance |
|
|
New |
BASTRAT11a2P |
Percent Allocated - Geocoding - Prevention |
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New |
BASTRAT11a2S |
Percent Allocated - Geocoding - Surveillance |
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New |
BASTRAT1a1S |
Percent Allocated – Data Activities - Surveillance |
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New |
BASTRAT1a2P |
Percent Allocated – Data Activities - Prevention |
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New |
BASTRAT2a1P |
Percent allocated - Routine HIV testing, Healthcare -Prevention |
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New |
BASTRAT2a2P |
Percent allocated - Targeted HIV testing, non-Healthcare - Prevention |
|
|
New |
BASTRAT2a3P |
Percent allocated - HIV Partner Services - Prevention |
|
|
New |
BASTRAT2a4P |
Percent allocated - D2C - Prevention |
|
|
New |
BASTRAT2a4S |
Percent expended - D2C - Surveillance |
|
|
New |
BASTRAT3a1P |
Percent Allocated - HIV Transmission Clusters and Outbreaks - Prevention |
|
|
New |
BASTRAT3a1S |
Percent Allocated - HIV Transmission Clusters and Outbreaks - Surveillance |
|
|
New |
BASTRAT4a1P |
Percent Allocated - CPP, Continuum of Care - Prevention |
|
|
New |
BASTRAT4a2P |
Percent Allocated - CPP, Risk Reduction Interventions - Prevention |
|
|
New |
BASTRAT4a3P |
Percent Allocated - Other CPP - Prevention |
|
|
New |
BASTRAT5a1P |
Percent Allocated - Prevention with HIV-negative persons - Prevention |
|
|
New |
BASTRAT5a2P |
Percent Allocated - PrEP Access and Support - Prevention |
|
|
New |
BASTRAT5a3P |
Percent Allocated - PEP Access and Support - Prevention |
|
|
New |
BASTRAT6a1P |
Percent Allocated - Perinatal HIV Exposure Reporting - Prevention |
|
|
New |
BASTRAT6a1S |
Percent Allocated - Perinatal HIV Exposure Reporting - Surveillance |
|
|
New |
BASTRAT6a2P |
Percent Allocated - Perinatal HIV Surveillance Coordination - Prevention |
|
|
New |
BASTRAT6a2S |
Percent Allocated - Perinatal HIV Surveillance Coordination - Surveillance |
|
|
New |
BASTRAT7a1P |
Percent Allocated - Community-level Prevention Activities - Prevention |
|
|
New |
BASTRAT7a2P |
Percent Allocated - SSP - Prevention |
|
|
New |
BASTRAT7a3P |
Percent Allocated - Condom Distribution - Prevention |
|
|
New |
BASTRAT8a1P |
Percent Allocated - HIV Planning - Prevention |
|
|
New |
BASTRAT8a1S |
Percent Allocated - HIV Planning - Surveillance |
|
|
New |
BASTRAT9a1P |
Percent Allocated - Health Information Infrastructure - Prevention |
|
|
New |
BASTRAT9a1S |
Percent Allocated - Health Information Infrastructure -Surveillance |
|
|
New |
BASTRAT9a2P |
Percent Allocated - Data Security and Confidentiality - Prevention |
|
|
New |
BASTRAT9a2S |
Percent Allocated - Data Security and Confidentiality - Surveillance |
|
|
New |
BASTRAT9a3P |
Percent Allocated - Policies and Protocols - Prevention |
|
|
New |
BASTRAT9a3S |
Percent Allocated - Policies and Protocols - Surveillance |
|
|
New |
BESTRAT10a1P |
Percent Expended - Monitoring and Evaluation - Prevention |
|
|
New |
BESTRAT10a1S |
Percent Expended - Monitoring and Evaluation - Surveillance |
|
|
New |
BESTRAT11a1P |
Percent Expended - Capacity Building and TA - Prevention |
|
|
New |
BESTRAT11a1S |
Percent Expended - Capacity Building and TA - Surveillance |
|
|
New |
BESTRAT11a2P |
Percent Expended - Geocoding - Prevention |
|
|
New |
BESTRAT11a2S |
Percent Expended - Geocoding - Surveillance |
|
|
New |
BESTRAT1a1S |
Percent Expended – Data Activities - Surveillance |
|
|
New |
BESTRAT1a2P |
Percent expended - NHME |
|
|
New |
BESTRAT2a1P |
Percent expended - Routine HIV testing, Healthcare - Prevention |
|
|
New |
BESTRAT2a2P |
Percent expended - Targeted HIV testing, non-Healthcare - Prevention |
|
|
New |
BESTRAT2a3P |
Percent expended - HIV Partner Services - Prevention |
|
|
New |
BESTRAT2a4P |
Percent expended - D2C - Prevention |
|
|
New |
BESTRAT2a4S |
Percent expended - D2C - Surveillance |
|
|
New |
BESTRAT3a1P |
Percent Expended - HIV Transmission Clusters and Outbreaks - Prevention |
|
|
New |
BESTRAT3a1S |
Percent Expended - HIV Transmission Clusters and Outbreaks - Surveillance |
|
|
New |
BESTRAT4a1P |
Percent Expended - CPP, Continuum of Care - Prevention |
|
|
New |
BESTRAT4a2P |
Percent Expended - CPP, Risk Reduction Interventions - Prevention |
|
|
New |
BESTRAT4a3P |
Percent Expended - Other CPP - Prevention |
|
|
New |
BESTRAT5a1P |
Percent Expended - Prevention with HIV-negative persons - Prevention |
|
|
New |
BESTRAT5a2P |
Percent Expended - PrEP Access and Support - Prevention |
|
|
New |
BESTRAT5a3P |
Percent Expended - PEP Access and Support - Prevention |
|
|
New |
BESTRAT6a1P |
Percent Expended - Perinatal HIV Exposure Reporting - Prevention |
|
|
New |
BESTRAT6a1S |
Percent Expended - Perinatal HIV Exposure Reporting - Surveillance |
|
|
New |
BESTRAT6a2P |
Percent Expended - Perinatal HIV Surveillance Coordination - Prevention |
|
|
New |
BESTRAT6a2S |
Percent Expended - Perinatal HIV Surveillance Coordination - Surveillance |
|
|
New |
BESTRAT7a1P |
Percent Expended - Community-level Prevention Activities - Prevention |
|
|
New |
BESTRAT7a2P |
Percent Expended - SSP - Prevention |
|
|
New |
BESTRAT7a3P |
Percent Expended - Condom Distribution - Prevention |
|
|
New |
BESTRAT8a1P |
Percent Expended - HIV Planning - Prevention |
|
|
New |
BESTRAT8a1S |
Percent Expended - HIV Planning - Surveillance |
|
|
New |
BESTRAT9a1P |
Percent Expended - Health Information Infrastructure - Prevention |
|
|
New |
BESTRAT9a1S |
Percent Expended - Health Information Infrastructure - Surveillance |
|
|
New |
BESTRAT9a2P |
Percent Expended - Data Security and Confidentiality - Prevention |
|
|
New |
BESTRAT9a2S |
Percent Expended - Data Security and Confidentiality - Surveillance |
|
|
New |
BESTRAT9a3P |
Percent Expended - Policies and Protocols - Prevention |
|
|
New |
BESTRAT9a3S |
Percent Expended - Policies and Protocols - Surveillance |
|
|
New |
CSTRATEGY1 |
Comments - Strategy 1 |
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New |
CSTRATEGY10 |
Comments - Strategy 10 |
|
|
New |
CSTRATEGY11 |
Comments - Strategy 11 |
|
|
New |
CSTRATEGY2 |
Comments - Strategy 2 |
|
|
New |
CSTRATEGY3 |
Comments - Strategy 3 |
|
|
New |
CSTRATEGY4 |
Comments - Strategy 4 |
|
|
New |
CSTRATEGY5 |
Comments - Strategy 5 |
|
|
New |
CSTRATEGY6 |
Comments - Strategy 6 |
|
|
New |
CSTRATEGY7 |
Comments - Strategy 7 |
|
|
New |
CSTRATEGY8 |
Comments - Strategy 8 |
|
|
New |
CSTRATEGY9 |
Comments - Strategy 9 |
|
|
New |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Heitgerd, Janet (CDC/OID/NCHHSTP) |
File Modified | 0000-00-00 |
File Created | 2021-05-17 |