Document
Data Variable Options
ICR 202605-0920-005 · OMB 0920-0696 · Object 169126700.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Data Variable Options |
| Author | Heitgerd, Janet (CDC/OID/NCHHSTP) |
| Last Modified By | Writer |
| File Modified | 2018-08-20 |
| File Created | 2026-06-04 |
| Conversion State | complete |
Extracted Text
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 A01 Agency Name A01a Agency ID A02 Jurisdiction A27 CBO Agency Name A28 CBO Agency ID Site S01 Site ID S04 Site Type S08 Site – County S09 Site – State S10 Site - Zip Code S03 Site Name CDC CDC06 CDC Variable 6 CDC07 CDC Variable 7 CDC08 CDC Variable 8 CDC09 CDC Variable 9 CDC10 CDC Variable 10 Client G101 Date Client Demographic Data Collected G103 Local Client ID G112 Date of Birth - Year G114 Ethnicity G116 Race G120 State/Territory of Residence G123 Assigned Sex at Birth G124 Current Gender Identity G124a Specify Current Gender Identity G132 Client – County G134 Client - Zip Code G200 Date Client Risk Collected G200_1 Client Behavioral Risk Profile G204 Previous HIV Test G205 Self-Reported HIV Test Result G209 Pregnant (Only If Female) G210 In Prenatal Care (Only if Pregnant) G211_01 Injection Drug Use G211_08 Share Drug Injection Equipment G212 Additional Client Risk Factors G216a Vaginal or Anal Sex with a Male G216b Vaginal or Anal Sex with a Female G216c Vaginal or Anal Sex with a Transgender Person G217a Vaginal or Anal Sex without a Condom with a Male G217b Vaginal or Anal Sex without a Condom with a Female G217c Vaginal or Anal Sex without a Condom with a Transgender Person G218a Vaginal or Anal Sex with a Male IDU G218b Vaginal or Anal Sex with a Female IDU G218c Vaginal or Anal Sex with a Transgender IDU G219a Vaginal or Anal Sex with HIV-Positive Male G219b Vaginal or Anal Sex with HIV-Positive Female G219c Vaginal or Anal Sex with HIV-Positive Transgender Person G220 Vaginal or Anal Sex with MSM (female only) G222 Vaginal or Anal Sex without a Condom (PS only) G223 Vaginal or Anal Sex with an IDU (PS only) G205a Previous HIV Test Result G400 In the past 5 years, has the client/patient had sex with a male? G401 In the past 5 years, has the client/patient had sex with a female? G402 In the past 5 years, has the client/patient injected drugs that were not prescribed to him/her by a medical care provider? G403 In the past 5 years, has the client/patient had sex with a transgender person? New Testing 1 H04a Test Form ID H06 Session Date H800 Has the client/patient ever heard of PrEP, the medicine taken daily to reduce the risk for getting HIV? H802 Has the client/patient used PrEP anytime in the last 12 months? H04c eHARS State Number H04d eHARS City/County Number Partner Services PCR101 Case Number PCR103 Case Open Date PCR104 Case Close Date PCR108 Date of Report PCR109 Reported to Surveillance PCR200 Date Collected PCR202a Local PS ID PCR207 Partner Type PCR209 Notification Plan PCR104a Care Status at Case Close Date Testing 2 X103 Test Technology X104 HIV Test Election X104a HIV Test Election X105 Sample Date X110 Test Result X111 Result Provided X115 If Result Not Provided, Why X124 Basis of Final Determination X125 HIV Test Result, Final Determination X126 Preliminary Positive point-of-care rapid test X126a Specimen Collection Date of Preliminary Positive point-of-care rapid test X127 Tests for co-infections X127a Syphilis Test X127b Gonorrhea X127c Chlamydial infection X127d Hepatitis C X135 Worker ID X136 In Surveillance System or Records X137 Program Announcement or Program Strategy X137-1 Specify Program Announcement/Strategy X138 Client HIV Status X150 Has the client/patient ever had a positive HIV test? X150a If yes, date of first positive HIV test X224 Stage of infection X302 Attempt to Locate Outcome X303 Reason for Unsuccessful Attempt X303a Specify Reason for Unsuccessful Attempt X306 Enrollment Status X502 Time Period for Recall (in months) X503 Total number of claimed sex and/or needle-sharing partners within the last 12 months X511 Total number of named sex and/or needle sharing partners within the last 12 months (with enough information to locate) X511a Total Number of Named Male Partners X511b Total Number of Named Female Partners X511c Total Number of Named Transgender Partners X600 Partner Notifiability X601 Actual Notification Method X602 Previous HIV Test X603 Self-Reported HIV Test Result X604 Date of Last HIV Test X702 Referral Date X702a Reason Client Not Referred to HIV Medical Care X703_01 Referred To HIV Testing X703_10 Referred To Medical Care X703_14 Referred To Partner Services X703_17 Referred To HIV Prevention Services X706 Referral Outcome X706b First HIV Medical Care Appointment within 90 Days of HIV Test X706c HIV Medical Care Linkage X706d First HJV Medical Appointment Date X712 HIV Test Performed X712a Coinfection Screen (Partner Services) X712b Co-infection Result (Partner Services) X713 HIV Test Result X714a HIV Test Results Provided X724 Client Received Prevention Services X725 Partner Service Interview X725a Was the PS Interview within 30 Days of Receiving a Positive HIV Test Result X725b Care Status at Time of the PS Interview X730a Housing status in past 12 months - revised X731 PrEP Status X731a Partner referred to PrEP Provider (Partner Services) X740 Seen a Medical Care Provider in past 6 months X741 Attend HIV medical care appointment X741a Appointment Date X742 Individualized behavioral risk-reduction counseling X743 Information provided for partner services X744 Interviewed for partner services X744a Date of partner services interview X745 Screened for perinatal HIV service coordination needs X746 Perinatal HIV service coordination needs identified X747 Referred for HIV perinatal service coordination X748 Screened for PrEP eligibility X749 Eligible for PrEP referral X750 Referred to a PrEP Provider X751 Assistance with linkage to a PrEP provider X752a Navigation services for linkage to HIV medical care – screened for need X752b Navigation services for linkage to HIV medical care – need identified X752c Navigation services for linkage to HIV medical care – provided or referred for service X752e Linkage services to HIV medical care – screened for need X752f Linkage services to HIV medical care – need identified X752g Linkage services to HIV medical care – provided or referred for service X753a Health benefits navigation and enrollment – screened for need X753b Health benefits navigation and enrollment – need identified X753c Health benefits navigation and enrollment – provided or referred to service X754a Medication adherence support – screened for need X754b Medication adherence support – need identified X754c Medication adherence support – provided or referred to service X755a Evidence-based risk reduction intervention – screened for need X755b Evidence-based risk reduction intervention – need identified X755c Evidence-based risk reduction intervention – provided or referred to service X756a Behavioral health services – screened for need X756b Behavioral health services – need identified X756c Behavioral health services – provided or referred to service X758a Social services – screened for need X758b Social services – need identified X758c Social services – provided or referred to service Aggregate ME201a Category A total PS18-1801-funded aggregate test events ME201b Category A total reimbursed aggregate test events ME202a Category A PS18-1801-funded aggregate newly diagnosed HIV-positive test events ME202b Category A reimbursed aggregate newly diagnosed HIV-positive testing events CBO CBOCL003 Client Record Number CBOTEST001 Target Population(s) CBOTEST002 High-Risk Client CBOTEST003 HIV Medical Care at the time of this positive test CBOTEST004 Navigation and prevention and essential support services, HIV Testing CBOTEST004SP Other recommended support services, HIV testing CBOTEST005 Date client attended first medical care appointment Data Upload Z03c Schema Version Number Z06 Data Type in File Budget Health Department PS18-1802 Only BASTRAT10a1P Percent Allocated - Monitoring and Evaluation - Prevention New BASTRAT10a1S Percent Allocated - Monitoring and Evaluation - Surveillance New BASTRAT11a1P Percent Allocated - Capacity Building and TA - Prevention New BASTRAT11a1S Percent Allocated - Capacity Building and TA - Surveillance New BASTRAT11a2P Percent Allocated - Geocoding - Prevention New BASTRAT11a2S Percent Allocated - Geocoding - Surveillance New BASTRAT1a1S Percent Allocated – Data Activities - Surveillance New BASTRAT1a2P Percent Allocated – Data Activities - Prevention New BASTRAT2a1P Percent allocated - Routine HIV testing, Healthcare -Prevention 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 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