Letter of Support: HHS/CDC/NCHHSTP/Division of HIV Prevention

NSFG OMB Attachment E8 OMB No. 0920-0314

March 25, 2021

Anjani Chandra, PhD

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 Prevention (DHP) at the Centers for Disease Control and Prevention (CDC) is responsible for funding HIV prevention activities in the United States and evaluating those efforts. Although much of what we know about HIV infection has come from HIV case surveillance data and from behavioral surveillance studies of groups at increased risk for acquiring HIV or people living with HIV, data from national probability samples such as the NSFG are also critical to our ability to monitor HIV in the United States.

The NSFG is a source of several important indicators we use to monitor progress toward national goals. These include indicators of sexual risk such as multiple sex partners, sex with persons who inject drugs 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. The NSFG also provides important information about behaviors that can reduce HIV acquisition or transmission in the U.S. population, such as condom use and HIV testing. HIV testing data provided by NSFG help evaluate the uptake of 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.

DHP also uses data from NSFG to monitor indicators in populations at high risk for HIV, such as men who have sex with men (MSM), a population that accounted for 69% of all new diagnoses in 2018. DHP has frequently relied on NSFG data to analyze and disseminate information about HIV testing and risk behaviors among MSM as well as other populations at increased risk (see references below). Furthermore, NSFG data were instrumental in enabling DHP to produce national population size estimates for populations at risk for HIV, including MSM (Purcell 2011), persons who inject drugs (Lansky 2013), and heterosexuals at risk (Lansky 2015), which have improved our estimation of HIV rates in these populations.

The NSFG is one of only a few nationally representative surveys that collect 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 DHP.

We look forward to continued success of the NSFG.

Sincerely,

Marc Pitasi, MPH

Epidemiologist

Special Studies and Diagnostics Team

Behavioral and Clinical Surveillance Branch

Division of HIV Prevention

Centers for Disease Control and Prevention

1600 Clifton Rd. NE, MS-E46

Atlanta, GA 30333

Phone: 404 639 6361

Email: mpitasi@cdc.gov

cc: Joseph Prejean, PhD, Chief, Behavioral and Clinical Surveillance Branch

Kevin Delaney, PhD, MPH, Team Leader, Special Studies and Diagnostics Team

References

Abara WE, Oraka E, Jeffries WL 4th, Chavez P, Nasrullah M, et al. (2017) Prevalence and Correlates of Condom Use Among Sexually Active Men Who Have Sex with Men in the United States: Findings from the National Survey of Family Growth, 2002, 2006–10 and 2011–13. Sex Health 14(4): 363-71

Aholou TM, McCree DH, Oraka E, Jeffries WL 4th, Rose CE, et al. (2017) Sexual Risk and Protective Behaviors Among Reproductive-Aged Women in the United States. J Womens Health (Larchmt) 26(11): 1150-60

Balaji AB, Oraka E, Fasula AM, Jayne PE, Carry MG, et al. (2017) Association Between Parent-Adolescent Communication About Sex-Related Topics and HIV Testing, United States. 2006–2013. AIDS Care 29(3): 344-9

Evans ME, Tao G, Porter SE, Gray SC, Huang YA, Hoover KW. (2018) Low HIV Testing Rates Among US Women Who Report Anal Sex and Other HIV Sexual Risk Behaviors, 2011–2015. Am J Obstet Gynecol 219(4): 383.e1-383.e7

Fasula AM, Oraka E, Jeffries WL 4th, Carry M, Banez Ocfemia MC, et al. (2016) Young Sexual Minority Males in the United States: Sociodemographic Characteristics and Sexual Attraction, Identity and Behavior. Perspect Sex Reprod Health 48(1): 3-8

Jeffries WL 4^th, Johnson OD. (2018) Internalized Homonegativity and Substance Use Among U.S. Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW). Subst Use Misuse 53(4): 559-64

Jeffries WL 4th, Johnson OD. (2015) Homonegative Attitudes and Risk Behaviors for HIV and Other Sexually Transmitted Infections Among Sexually Active Men in the United States. Am J Public Health 105(12): 2466-72

Lansky A, Johnson C, Oraka E, Sionean C, Joyce MP, et al. (2015) Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection. PLoS ONE 10(7): e0133543

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

McCree DH, Walker T, DiNenno E, Hoots B, Valverde E, Ocfemia MCB, et al. (2018) A Programmatic Approach to Address Increasing HIV Diagnoses Among Hispanic/Latino MSM, 2010-2014. Prev Med 114: 64-71.

Nasrullah M, Oraka E, Chavez P, Valverde E, DiNenno E. (2015) Nonvolitional Sex and HIV-related Sexual Risk Behaviours Among MSM in the United States. AIDS 29(13): 1673-80

Nasrullah M, Oraka E, Chavez PR, Johnson CH, DiNenno E. (2017) Factors Associated with Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006–2010 and 2011–2013. J Sex Med 14(4): 541-50

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

Van Handel M, Lyons B, Oraka E, Nasrullah M, DiNenno E, et al. (2015) Factors Associated with Time Since Last HIV Test Among Persons at High Risk for HIV Infection, National Survey of Family Growth, 2006–2010. AIDS Patient Care STDS 29(10): 533-40

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