HIV/AIDS surveillance systems in Australia.

We review the HIV/AIDS reporting protocols in Australia, and describe the technical components of surveillance and its guiding principles, including a strict adherence to confidentiality at all levels. The majority of AIDS diagnoses in Australia have occurred in men who acquired HIV infection through male-to-male sex. The annual incidence of AIDS peaked in 1994, and then declined sharply over the subsequent 4 years. Advances in treatment effectiveness have focused attention on ensuring that people with HIV infection have access to optimal therapy, and emphasized the role of AIDS case reports as indicators of treatment failure. Analyses of the date of HIV diagnosis in people with AIDS have been used as indicators and predictors of undiagnosed HIV infection in the population. Australia's linkage of program funding to AIDS case counts provides an incentive for both health departments and community-based organizations to actively support AIDS surveillance activities. The challenge for surveillance is to maintain vigilance for shifts in HIV infection rates, or in behavior patterns that may be related to transmission.