OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

"Cohort Study of HIV, STIs and Preventive Interventions among Young MSM in Thailand

ICR 201610-0920-014 · OMB 0920-1191 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Att 17 Mahidol University Approval Letter.pdf Supplementary Document Uploaded 2016-10-31 Available
Att 16 Thai EC Approval Letter.pdf Supplementary Document Uploaded 2016-10-31 Available
Att 15 CDC IRB Approval Letter.pdf Supplementary Document Uploaded 2016-10-31 Available
Att 2 60 Day FRN.pdf Supplementary Document Uploaded 2016-10-31 Available
Att 1_Sect 301 PHSA.pdf Supplementary Document Uploaded 2016-10-31 Available
Supporting Statement B.docx Supporting Statement B Uploaded 2016-10-31 Available
Supporting Statement A.docx Supporting Statement A Uploaded 2016-10-31 Available
IC Document Collections
IC IDCollectionTypeStatusForm
224251 HIV CASI Cohort Other-WORD/Screenshots New
224250 YMSM Clinical Form Other-WORD New
224249 Follow-up CASI Other-WORD/Screenshots New
224248 Enrollment Consent Assent Other-WORD/Screenshots New
224247 HIV CASI Other-WORD/Screenshots New
224246 Screening CASI Other-WORD/Screenshots New
224245 Screening Consent Assent Other-word New
224244 Screening Checklist Other-WORD New
224243 Key Iinformant Interview Other-WORD New
224242 Key Informant Interview (KII) Consent Assent Other-WORD New
224241 Focus Group Discussion Guide Other-WORD New
224240 Focus Group Discussion (FGD) Consent Assent (English/Siamese) Other-WORD New
ICR Details
0920-1191 201610-0920-014
Historical Active
HHS/CDC 0920-16JD
"Cohort Study of HIV, STIs and Preventive Interventions among Young MSM in Thailand
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/14/2017
Retrieve Notice of Action (NOA) 11/08/2016
  Inventory as of this Action Requested Previously Approved
07/31/2020 36 Months From Approved
2,675 0 0
814 0 0
0 0 0
The goal of the Young MSM Study Thailand is to evaluate risk factors for HIV and sexually transmitted infections (STI), and describe incidence and prevalence in young men who have sex with men (MSM) and transgender women (TGW) in Thailand.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  81 FR 1952 01/14/2016
81 FR 76944 11/04/2016
Yes
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,675 0 0 2,675 0 0
Annual Time Burden (Hours) 814 0 0 814 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New collection request for a new OMB Control Number.
$2,350,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Thelma Sims 4046394771
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/08/2016