National HIV Behavioral Surveillance: Brief HIV Bio-behavioral Assessment (NHBS-BHBA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Qualitative Interviews	Form and Instruction	New	Repair queued
Qualitative Eligibility Screener	Form and Instruction	New	Repair queued
Quantitative Population-specific Questions	Form and Instruction	New	Repair queued
Quantitative Core Survey	Form and Instruction	New	Repair queued
Quantitative Population Eligibility Screener	Form and Instruction	New	Repair queued
Quantitative Base Eligibility Screener	Form and Instruction	New	Available
SSA HIV Behavioral Surveillance BHBA_09302022.docx	Supporting Statement A	Uploaded 2022-09-30	Repair queued
Att 11_Summary of NHBS-BHBA Data Collection_clean.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 10_Analysis Tables.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 9_Project Determination.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 8d_Model Qualitative FG Consent Form.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 8c_Model Qualitative CKI Consent Form.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 8b_Model Qualitative PKI Consent Form.docx	Supplementary Document	Uploaded 2022-09-29	Available
Att 8a_Model Survey Consent Form.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 7_BHBA cycle overview.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 6_Agreement to Abide by Restrictions_rev.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 5b_BHBA_PIA Form.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 5a_Assurance of Confidentiality.docx	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 2b_Memo in response to public comment on NHBS 60-day FRN 20220513.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 2a_Public comments.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 2_60 Day FRN.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
Att 1_PHSA.pdf	Supplementary Document	Uploaded 2022-09-29	Repair queued
BHBA_Supporting Statement B.docx	Supporting Statement B	Uploaded 2022-09-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
255848	Qualitative Interviews	Form and Instruction	New
255847	Qualitative Eligibility Screener	Form and Instruction	New
255846	Quantitative Population-specific Questions	Form and Instruction	New
255845	Quantitative Core Survey	Form and Instruction	New
255844	Quantitative Population Eligibility Screener	Form and Instruction	New
255843	Quantitative Base Eligibility Screener	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202209-0920-004
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-22FI
Title: National HIV Behavioral Surveillance: Brief HIV Bio-behavioral Assessment (NHBS-BHBA)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/30/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	4,718	0
Time Burden (Hours)	494	0
Cost Burden (Dollars)	0	0

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Abstract: The primary objective of NHBS-BHBA is to conduct mixed-methods behavioral surveillance among populations at high risk for HIV in selected geographic areas of interest to assess: 1) risk behaviors and social determinants of health for HIV infection, 2) HIV testing behaviors and treatment, 3) HIV seroprevalence and incidence, and 4) exposure to, use of, and impact of HIV prevention services. Through this project, funded state health departments for NHBS-BHBA will work with local entities to collect surveillance data to understand HIV risk, especially in areas or populations with limited information.

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Authorizing Statute(s): US Code: 42 USC 241 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:
	87 FR 29316	05/13/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 59430	09/30/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Qualitative Eligibility Screener	None, None	Qualitative Eligibility Screener (English) ,   Qualitative Eligibility Screener (Spanish)
Qualitative Interviews	None, None	Qualitative Interviews (English) ,   Qualitative Interviews (Spanish)
Quantitative Base Eligibility Screener	None, None	Quantitative Base Eligibility Screener (English) ,   Quantitative Base Eligibility Screener (Spanish)
Quantitative Core Survey	None, None	Quantitative Core Survey (English) ,   Quantitative Core Survey (Spanish)
Quantitative Population Eligibility Screener	None, None	Quantitative Population Eligibility Screener (English) ,   Quantitative Population Eligibility Screener (Spanish)
Quantitative Population-specific Questions	None, None	Quantitative Population-specific Questions (English) ,   Quantitative Population-specific Questions (Spanish)

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	4,718	0	0	4,718	0	0
Annual Time Burden (Hours)	494	0	0	494	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: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

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Annual Cost to Federal Government: $1,239,795

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? No

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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: 09/30/2022

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