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

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 can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
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

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

OMB Details

Eligibility Consent

Federal Enterprise Architecture: Health - Illness Prevention

Form 0920-

Eligibility Consent

Fillable Fileable

Form and instruction

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