Since its discovery more than 30 years ago, HIV continues to be a public health problem, with an estimated 1.1 million people living with HIV alone 'in the United States (5). Although the annual number of new diagnoses over the past decade has remained stable (around 50,000), the number of new infections among young people, particularly young people and black men, has increased (1, 2, 5). . Most worrying is the fact that an estimated 180,000 people (of the 1.1 million people living with HIV) are unaware that they are infected (4). Many of those who are unaware of their infection are not diagnosed until they develop AIDS-related illnesses (11). Additionally, only 37% of the population aged 18 to 64 report having ever been tested for HIV, an estimate that varies by state from 23.4% to 66.3% (3). Reporting of HIV cases is mandatory in all states in the United States. Each state is responsible for collecting HIV/AIDS surveillance data based on recommendations from the Centers for Disease Control and Prevention (CDC) and reporting these data to the CDC. All states, Washington DC and five dependent regions of the United States were using confidential nominative reports in April 2008 (9). The accuracy and completeness of reporting varies from state to state, despite following recommended guidelines. Accurate collection and reporting of HIV surveillance data is a vitally important public health initiative. The allocation of federal funds, such as those from the Ryan White Care Act, relies largely on surveillance data (6). This in turn affects the availability and ease of access to testing and treatment, particularly in rural areas. Underreporting is more likely to occur in rural areas where HIV incidence is lower due to ineffective surveillance infrastructure that includes availability of testing and treatment. , 277-282.10. McCoy, S.I. (2010). Variability in HIV diagnosis date: comparison of self-report, medical record, and HIV/AIDS surveillance data. Annals of Epidemiology, 20(10), 734-742. Retrieved February 2014.11 Burke, RC, Sepkowitz, KA, Bernstein, KT, Karpati, AM, Myers, JE, Tsoi, BW, & Begier, EM (2007). Why don't doctors test for HIV? A review of American literature. Aids, 21(12), 1617-1624. doi: 10.1097/QAD.0b013e32823f91ff12. Penner M, Leone PA. Integrating screening, prevention and access to treatment for HIV infection: national and local perspectives. Clin InfectDis 2007; 45: S281 to S286.13. Ohl, ME and Perencevitch, E. (2011). Frequency of human immunodeficiency virus (HIV) testing in urban and rural areas of the United States: Results from a nationally representative sample. Bmc Public Health, 11.