title: Evaluation of the National Human Immunodeficiency Virus Surveillance System for the 2011 diagnosis year.
abstract: BACKGROUND
  In 2009, the Centers for Disease Control and Prevention completed migration of all 59 surveillance project areas (PAs) from the case-based HIV/AIDS Reporting System to the document-based Enhanced HIV/AIDS Reporting System.
  
  
  OBJECTIVE
  We conducted a PA-level assessment of Enhanced HIV/AIDS Reporting System process and outcome standards for HIV infection cases.
  
  
  METHODS
  Process standards were reported by PAs and outcome standards were calculated using standardized Centers for Disease Control and Prevention SAS code.
  
  
  METHODS
  A total of 59 PAs including 50 US states, the District of Columbia, 6 separately funded cities (Chicago, Houston, Los Angeles County, New York City, Philadelphia, and San Francisco), and 2 territories (Puerto Rico and the Virgin Islands).
  
  
  METHODS
  Cases diagnosed or reported to the PA surveillance system between January 1, 2011, and December 31, 2011, using data collected through December 2012.
  
  
  METHODS
  Process standards for death ascertainment and intra- and interstate case de-duplication; outcome standards for completeness and timeliness of case reporting, data quality, intrastate duplication rate, risk factor ascertainment, and completeness of initial CD4 and viral load reporting.
  
  
  RESULTS
  Fifty-five of 59 PAs (93%) reported linking cases to state vital records death certificates during 2012, 76% to the Social Security Death Master File, and 59% to the National Death Index. Seventy percent completed monthly intrastate, and 63% completed semiannual interstate de-duplication. Eighty-three percent met the 85% or more case ascertainment standard, and 92% met the 66% or more timeliness standard; 75% met the 97% or more data quality standard; all PAs met the 5% or less intrastate duplication rate; 41% met the 85% or more risk factor ascertainment standard; 90% met the 50% or more standard for initial CD4; and 93% met the same standard for viral load reporting. Overall, 7% of PAs met all 11 process and outcome standards.
  
  
  CONCLUSIONS
  Findings support the need for continued improvement in HIV surveillance activities and monitoring of system outcomes.
authors.affiliation: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (Dr Karch and Ms Chen), and ICF International, Inc (Ms Tang), Atlanta, Georgia.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Karch
authors.forename: Mi
authors.initials: M
authors.lastname: Chen
authors.forename: Tian
authors.initials: T
authors.lastname: Tang
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards*; D002641:Chicago / Q000453:epidemiology; D018563:Disease Notification / Q000592:standards*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015143:Philadelphia / Q000453:epidemiology; D011159:Population Surveillance; D011647:Puerto Rico / Q000453:epidemiology; D012495:San Francisco / Q000453:epidemiology; D014481:United States; D014767:United States Virgin Islands / Q000453:epidemiology; D055815:Young Adult