The completeness of AIDS surveillance.

AIDS surveillance data are widely used in setting HIV intervention policies, and the effectiveness of these data depend on their completeness. We reviewed studies conducted by state and local health departments on the completeness of AIDS reporting. These studies identified AIDS cases through alternate data sources, such as death certificates, hospital discharge records, disease registries, or medication records. In most instances greater than 80% of AIDS cases detected through these studies had been reported, although lower levels of reporting were found in some outpatient settings. A comparison of vital records and AIDS surveillance confirmed that AIDS surveillance is identifying 70-90% of all HIV-related deaths in men 25-44 years of age. Historically, AIDS surveillance has emphasized reporting from hospitals. Efforts to maintain current levels of reporting, or to improve reporting, are challenged by the growth of the epidemic and by the increasing role of outpatient diagnosis of AIDS.