Information Collection Request

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

ICR 202503-0920-034 · OMB 0920-1398 · Received in OIRA

Forms and Documents

Document Name	Status
Qualitative Interviews Form and Instruction	Modified
Qualitative Eligibility Screener Form and Instruction	Unchanged
Quantitative Population-specific Questions Form and Instruction	Unchanged
Quantitative Core Survey Form and Instruction	Unchanged
Quantitative Population Eligibility Screener Form and Instruction	Modified
Quantitative Base Eligibility Screener Form and Instruction	Unchanged
Justification Memo.docx Justification for No Material/Nonsubstantive Change	2025-03-27
Att 11_Summary of NHBS-BHBA Data Collection_clean.docx Supplementary Document	2025-03-27
Att 11_Summary of NHBS-BHBA Data Collection_20230524_clean.docx Supplementary Document	2023-06-01
0920-1398_NHBS-BHBA_Change Request_20230524.docx Justification for No Material/Nonsubstantive Change	2023-06-01
SSA HIV Behavioral Surveillance BHBA_09302022.docx Supporting Statement A	2022-09-30
Att 11_Summary of NHBS-BHBA Data Collection_clean.docx Supplementary Document	2022-09-29
Att 10_Analysis Tables.docx Supplementary Document	2022-09-29
Att 9_Project Determination.pdf Supplementary Document	2022-09-29
Att 8d_Model Qualitative FG Consent Form.docx Supplementary Document	2022-09-29
Att 8c_Model Qualitative CKI Consent Form.docx Supplementary Document	2022-09-29
Att 8b_Model Qualitative PKI Consent Form.docx Supplementary Document	2022-09-29
Att 8a_Model Survey Consent Form.pdf Supplementary Document	2022-11-09
Att 7_BHBA cycle overview.docx Supplementary Document	2022-09-29
Att 6_Agreement to Abide by Restrictions_rev.docx Supplementary Document	2022-09-29
Att 5b_BHBA_PIA Form.pdf Supplementary Document	2022-09-29
Att 5a_Assurance of Confidentiality.docx Supplementary Document	2022-09-29
Att 2b_Memo in response to public comment on NHBS 60-day FRN 20220513.pdf Supplementary Document	2022-09-29
Att 2a_Public comments.pdf Supplementary Document	2022-09-29
Att 2_60 Day FRN.pdf Supplementary Document	2022-09-29
Att 1_PHSA.pdf Supplementary Document	2022-09-29
BHBA_Supporting Statement B.docx Supporting Statement B	2022-09-29

IC Document Collections

IC ID	Document Title	Status
255848	Qualitative Interviews Form and Instruction	Modified
255847	Qualitative Eligibility Screener Form and Instruction	Unchanged
255846	Quantitative Population-specific Questions Form and Instruction	Unchanged
255845	Quantitative Core Survey Form and Instruction	Unchanged
255844	Quantitative Population Eligibility Screener Form and Instruction	Modified
255843	Quantitative Base Eligibility Screener Form and Instruction	Unchanged

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1398
Type of Information Collection	No material or nonsubstantive change to a currently approved collection
Previous ICR Reference No	202305-0920-014
Agency Tracking No	0920-1398-25-0075
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31