OMB control number

Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services

OMB 0920-1284 · HHS/CDC.

OMB 0920-1284

The goal of this study is to evaluate the effectiveness of mailing out rapid HIV home-testing kits and additional testing promotion components to increase HIV testing among black/African American and Hispanic/Latino MSM. The findings from this research will assist local and state health departments and community-based organizations in making decisions on how to improve HIV testing and linkage to HIV prevention services for black/African American and Hispanic/Latino MSM in the United States. We are requesting non-substantive modifications to this previously approved ICR. No changes are requested to survey/data collection instruments and there are no changes to the burden hours calculated for the study.

The latest form for Web-based Approaches to Reach Black or African American and Hispanic/Latino MSM for HIV Testing and Prevention Services expires 2023-02-28 and is listed under ICR 202003-0920-013.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 0920- Guest HIV Test Result Survey	Form and Instruction
Form 0920- Guest Consent Form	Form and Instruction
Form 0920- Product Ordering	Form and Instruction
Form 0920- Final HIV Test Result Survey (completion)	Form and Instruction
Form 0920- Follow-up	Form and Instruction
Form 0920- Initial HIV Test Result Survey	Form and Instruction
Form 0920- Baseline Survey	Form and Instruction
Form 0920- Registration Contact Information	Form and Instruction
Form 0920- Study Consent	Form and Instruction
Form 0920- Eligibility Screener	Form and Instruction
Form 0920- Eligibility Consent	Form and Instruction
Summary of Proposed Changes in the ICR for Web.docx	Justification for No Material/Nonsubstantive Change
SS A FINAL 03FEB2020.docx	Supplementary Document
Att 6_Screenshots.docx	Supplementary Document
Att 5c_Data Sharing Agreement.doc	Supplementary Document
Att 3b_Registration contact info.docx	Supplementary Document
Att 2a_Public Comment_Whitman_Walker Comments _ Docket No. CDC_2018_0102.pdf	Supplementary Document
Att 5b_PIA_Form_iSTAMP approved (03-04-2019).pdf	Supplementary Document
Att 5a_Emory IRB Approval.pdf	Supplementary Document
Att 2_60 Day FRN.pdf	Supplementary Document
Att 1_Authorizing Legislation.docx	Supplementary Document
SS B final.docx	Supporting Statement B
SS A final.docx	Supporting Statement A
Guest HIV Test Result Survey	Form and Instruction
Guest Consent Form	Form and Instruction
Product Ordering	Form and Instruction
Final HIV Test Result Survey (completion)	Form and Instruction
Follow-up	Form and Instruction
Initial HIV Test Result Survey	Form and Instruction
Baseline Survey	Form and Instruction
Registration Contact Information	Form and Instruction
Study Consent	Form and Instruction
Eligibility Screener	Form and Instruction
Eligibility Consent	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202003-0920-013	No material or nonsubstantive change to a currently approved collection	2020-03-19		Approved without change
201907-0920-005	New collection (Request for a new OMB Control Number)	2019-07-25		Approved with change

OMB Details

Eligibility Consent

Federal Enterprise Architecture: Health - Illness Prevention

Information collection instruments
Form	Name	Electronic access	Type
Form 0920-	Eligibility Consent	Fillable Fileable	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.