Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CBO Needs Assessment for Preparedness and Resources for Support of Biomedical HIV Prevention New 895 323 0 Other-Pre-test Telephone Interview Script
Form None Biomedical HIV Prevention Organizational Assessment Web-based Survey Screenshots
Form none Consent Form
DSTP Assessment of STD Clinic Users New 4400 733 0 Other-Consent
Form none DSTDP Assessment of STD Clinic Users
Development of CDC's Act Against AIDS Social Marketing Campaigns Targeting Consumers New 5038 2061 0 Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Other-WORD
Development of a Motion Comic for HIV/STI Prevention Among Young People Ages 15-24 Phase 2 New 540 275 0 Form none Motion Comic Pre Test Survey
Form none Motion Comic Focus Group Guide 2
Form none Motion Comic Screener
Form none Motion Comic Post Test Survey
Form none Motion Comic Focus Group Guide 1
Evaluating HIV/AIDS Focused Video Game for Young People New 700 129 0 Form none Enrollment Day Survey
Form none Experimental Group Survey
Form none 30 Day Post Survey
Form none Demographic Screener
Evaluation of HIV Self-Testing Among MSM in High Prevalence Cities (eSTAMP) New 14360 1830 0 Form none Eligibility Screener
Form none Registration
Form none Baseline Survey
Form none Reporting of Self-Test Results
Form none Follow-up Survey
Other-Screenshots
Feasibility of HIV Behavioral Surveillance for Young MSM New 5446 1715 0 Form and Instruction 0920-0840 Attachment 4_Recruitment Debriefing
Form and Instruction 0920-0840 Attachment 5_Eligibility Screener
Form and Instruction 0920-0840 Attachment 6_Behavioral Assessment
Form and Instruction 0920-0840 Attachment 7_Key informant interview
Form and Instruction 0920-0840 Attachment 8_Focus Group Interview
Form and Instruction 0920-0840 Attachment 9_Enumeration Interview
Form and Instruction 0920-0840 Attachment 10_Landing Page and Banner Ad
Formative Research and Tool Development: Survey of HIV Medical Care Providers to Guide the Medical Monitoring Project New 5400 1300 0 Form none MMP Provider Survey
Form none MMP Provider Survey Web-based Application Screenshots
Formative Research to Develop Social Marketing Campaigns: Prevention Is Care (PIC) New 480 154 0 Form and Instruction None Provider Screening Instrument
Form None Paper and Pencil Survey
Form None Informed Consent Form
Form and Instruction None Provider Screening Instrument
Form None Review Material-Envelope
Form None Review Material Folder
Form None Review Material Brouchure and Folding Instructions
Form None Review Material Patient Baseline Screen
Form None Review Material Patient Adherence Brochure
Form None Review Material Adherence Wall Poster
Form None Review Material Risk Reduction MD Brochure
Form None Review Material Patient Action Plan
Form None Review Material Patient Risk Reduction Brochure
Form None Review Material Retention Brochure MD
Form None Review Material Patient Record Form
Form None Review Material Retention Brochure Patient
Form None Review Material Retention Poster
Form None Review Material Gardner Study Reprint
Form None Review Material Adherence Brochure MD
Form None CME Promotion Card
Form None Review Material Risk Reduction Poster Option
Informing the Development of Mobile Apps for HIV Prevention, Treatment & Care New 692 206 0 Form none Screener
Form none Screener High Risk
Form none Screener HIV Providers
Form none PLWH Guide
Form none PLWH Guide Spanish
Form none High Risk Guide
Form form High Risk Guide Spanish
Form none HC Providers Guide
Form none Focus Group Assessment
Form none Focus Group Assessment Spanish
Form none End User Survey
Form none Consent PLWH & High Risk
Form none Consent PLWH & High Risk Spanish
Form none Assent PLWH & High Risk
Form none Consent HC Providers
Form none Usability Consent
Form none Usability Assent
Injection Behaviors Among Young Persons in Rural/Suburban Settings New 2400 394 0 Form none Formative Research Study
Form none Screener
Form none Consent
Local Effectiveness Assessment Project (LEAP): A Case Study of a Local Jurisdiction Providing HIV Services to MSM New 60 33 0 Form and Instruction None Interview Guide - Public Policy Stakeholders
Form and Instruction None Interview Guide - Community Leaders
Form and Instruction None Interview Guide - Individual/Network
Form and Instruction None Key Participant Information Sheet and Consent Form
Pilot Test Study for the HIV Risk Reduction Educational Tool (HRRET) New 12000 1750 0 Form and Instruction None Pilot Study HRRET Screener Survey
Form and Instruction None Pilot Test HRRET PRETEST Web-based Survey
Form and Instruction None Pilot Test HRRET POSTTEST Web-based Survey
Other-HRRET Website Content
Testing Brief Messages for Black and Latino MSM New 3780 1455 0 Form none Eligibility Screener - English
Form none Eligibility Screener -Spanish
Form none Messages and Outcomes
Form none Messages and Outcomes - Spanish
Form none Assessment - English
Form none Assessment - Spanish
Testing Messages for Black and Latino MSM New 270 150 0 Form and Instruction none Eligibility Screener
Form and Instruction none Eligibility Screener - Spanish Version
Form and Instruction none Focus Group/Interview Guide
Form and Instruction none Focus Group/Interview Guide - Spanish Version
Testing Solutions for Sampling Challenges for MMP New 2850 983 0 Form none 2a - Interview questionnaire - English
Form none 2b - interview questionnaire - Spanish
Understanding Barriers and Facilitators to HIV Prevention, Care, and Treatment New 590 167 0 Form none Provider Demographic Questionnaire
Form and Instruction none Provider interview guide
Form none Study screener - English
Form none Study screener - Spanish
Form none Discordant partners screeners - English
Form none Discordant partners screener - Spanish
Form none Contact Information - English
Form none Contact Information - Spanish
Form none Discordant partners contact info - English
Form none Discordant partners contact info - Spanish
Form and Instruction none PLWH interview guide - English
Form and Instruction none PLWH interview guide - Spanish
Form and Instruction none Discordant partners interview guide - English
Form and Instruction none Discordant partners interview guide - Spanish
Form and Instruction none Provider info sheet and consent
Form and Instruction none PLWH consent
Form and Instruction none PLWH consent - Spanish
Form and Instruction none Discordant partner consent - English
Form and Instruction none Discordant partner consent - Spanish
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 59901 13658 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title