ATT D8 DHAP Letter of Support

NSFG 2015-2018

OMB Attachment D8

OMB No. 0920-0314

October 9, 2014
Anjani Chandra, Ph.D.
Principal Investigator and Team Leader
National Survey of Family Growth
National Center for Health Statistics
3311 Toledo Road
Hyattsville, MD 20782
Dear Dr. Chandra,
I am writing in support of the National Survey of Family Growth (NSFG), and to
emphasize its importance in monitoring HIV prevention activities. The Division of
HIV/AIDS Prevention (DHAP) is responsible for funding HIV prevention activities in
the United States and evaluating those efforts. Much of what we know about HIV
infection has come from HIV/AIDS case surveillance data and from behavioral
surveillance studies of groups at increased risk for acquiring HIV as well as those
individuals living with HIV; however, data from national probability samples, such as the
NSFG, are also critical to our ability to monitor the HIV epidemic.
The NSFG is important to DHAP because the survey measures several important
indicators we use to monitor the epidemic in the United States. These include indicators
of sexual risk such as multiple sex partners, sex with injection drug users or HIV-infected
persons, and the exchange of sex for money or drugs. Each of these behaviors place
individuals at increased risk for HIV infection. There are also questions on condom use,
which is an important factor for preventing HIV acquisition and transmission. Questions
on HIV testing are pivotal to evaluate the uptake of Centers for Disease Control and
Prevention (CDC)’s recommendations on routine HIV testing in all healthcare settings
for patients between the ages of 13 through 64 as well as repeat screening every year for
patients at high risk for HIV infection. We have recently used data from NSFG to report
on national baseline HIV testing rates (CDC, 2013). NSFG also affords DHAP the ability
to monitor trends in sexual violence – which is related to increased HIV/AIDS risk –
because it collects information not only on HIV-related sexual risk behaviors but also on
sexual violence, perpetrators of violence and circumstances leading to sexual violence
(Nasrullah, under review).

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The Division of HIV/AIDS Prevention uses data from NSFG along with those from other
sources to monitor progress towards goals of our Division's and Center's strategic plans,
as well as goals of the National HIV/AIDS Strategy. One of the goals is to reduce HIVrelated disparities in the country. Men who have sex with men (MSM) are
disproportionately affected by HIV epidemic and accounted for 63% new HIV infections
in 2010 in the United States. We have used NSFG to conduct reports on HIV testing and
sexual risk behaviors among MSM; these manuscripts have been either submitted in
journals or in different phases of preparation or CDC clearance (see references below).
DHAP has also used NSFG data to produce national estimates of populations at-risk of
HIV in the United States; one on MSM (Purcell 2011) and one on IDU (Lansky 2013)
have been published and another on heterosexuals at risk of HIV infection is soon to be
submitted to CDC clearance.
The NSFG is one of a few nationally representative surveys of adults collecting data
related to HIV risk and prevention on a regular basis. It has a history of successfully
collecting sensitive information from respondents, and it continues to be an important
data source for DHAP.
We look forward to continued success of the NSFG.

Sincerely yours,

Muazzam Nasrullah, MD, MPH
Medical Epidemiologist
Special Studies and Diagnostics Team
Behavioral and Clinical Surveillance Branch
Division of HIV/AIDS Prevention
Centers for Disease Control and Prevention
1600 Clifton Rd. NE, MS-E46
Atlanta, GA 30333
Phone: 404 639 3271
Email: snasrullah@cdc.gov

cc:

Joseph Prejean, Chief, Behavioral and Clinical Surveillance Branch
Elizabeth DiNenno, Team Lead, Special Studies and Diagnostics Team
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References
Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, et al. (2012) Estimating the
population size of men who have sex with men in the United States to obtain HIV and
syphilis rates. Open AIDS J 6: 98–107
Lansky A, Finlayson T, Johnson C, Holtzman D, Wejnert C, et al. (2014) Estimating the
Number of Persons Who Inject Drugs in the United States by Meta-Analysis to Calculate
National Rates of HIV and Hepatitis C Virus Infections. PLoS ONE 9(5): e97596
HIV Testing in the United States, 2002-2006. Atlanta, GA: U.S. Department of Health
and Human Services, Centers for Disease Control and Prevention.
http://www.cdc.gov/hiv/resources/reports/pdf/AHITS_Baseline_Report.pdf .
Nasrullah M, Oraka E, Chavez P, Valverde E, DiNenno E. Sexual Violence and HIVrelated Risk Behaviors among Men Who Have Sex with Men in a Nationally
Representative Cross Sectional Survey of the United States. Clin Infect Dis (under
review)
Chavez P, Oraka E, Nasrullah M, DiNenno E. The Impact of Medical Encounters on
Reasons for HIV Testing among Men Who Have Sex with Men. (CDC clearance)
Dietz P, Lyons B, Van Handel M, Nasrullah M, Oraka E, DiNenno L. Factors Associated
with Being Tested in the Last 12 Months and More Than the Last 12 Months Compared
to Never Being Tested for HIV Among Men who are Engaged in Sexual Risk Behaviors
(under preparation)
Nasrullah M, Oraka E, Chavez P, Christopher Johnson, DiNenno E. Factors Associated
with Condom Use Among U.S. Adult Men and Women, National Survey of Family
Growth, 2006-2010 . (under preparation)
Nasrullah M, Oraka E, Chavez P, DiNenno E. Sexual Violence, an Important Indicator
for HIV-related Sexual Risk Behaviors for Men and Women—Evidence from the U.S.
National Survey of Family Growth. (under preparation)

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