Abstract
An accurate and comprehensive HIV surveillance system is critical to understanding the burden of HIV infection. Reliable estimates into the surveillance system serve as the cornerstone for HIV prevention and treatment programs. PURPOSE OF REVIEW: In this article, we review the current structure and function of the HIV surveillance system in the US, identify gaps in reporting, and propose multiple potential interventions to augment the HIV surveillance system. RECENT FINDINGS: Recent literature demonstrate that substantial gaps in reporting to health departments from clinical providers exist. These gaps include stigma, knowledge of HIV reporting requirements, inaccurate direct testing estimates, reporting errors, and lack of community engagement. All of these gaps place a substantial burden on health departments, hinder responses, and effect funding. Leveraging community partnerships, technologic advances, and emerging methodologies may fill some of these gaps. Advancements in HIV self-testing, broad community HIV testing, indirect statistical methods, and machine learning bolstered by broad community engagement and oversight could modernize the HIV surveillance system to achieve the Ending the HIV Epidemic goals.