HIV Incidence Surveillance Data Elements

Adult and Pediatric HIV/AIDS Confidential Case Reports for National HIV/AIDS Surveillance

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Document Name Document Type
0920-0573_Att 3(d) incidence data elem.doc Other-Incidence Data Elements
0920-0573_att 4(b)Technical_Guidance_HIV Incidence Surveillance.pdf HIV Incidence Surveillance Technical Guidance IC Document

Information Collection (IC) Details

IC Title:	HIV Incidence Surveillance Data Elements	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Incidence Data Elements			0920-0573_Att 3(d) incidence data elem.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC	FR Citation: 57 FR 62812

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	60,925	60,925
Annual IC Time Burden (Hours)	10,154	10,154
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
HIV Incidence Surveillance Technical Guidance	0920-0573_att 4(b)Technical_Guidance_HIV Incidence Surveillance.pdf	11/30/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.