Underreporting of AIDS cases in South Carolina, 1986 and 1987

An evaluation of the completeness and accuracy of case reporting of the acquired immunodeficiency syndrome (AIDS) for the 18-month period from January 1, 1986, through June 30, 1987, was conducted for South Carolina. A total of 596,585 hospital discharge billing records were searched by computer for conditions defining AIDS. The resulting 1513 records were manually reviewed. Of these, 349 discharges for 163 individuals were classified as being definitely AIDS related, the clinical features of these cases meeting Centers for Disease Control criteria for AIDS diagnosis. Of these cases, 153 were reportable to the South Carolina AIDS registry at the time of their diagnosis. Comparison of this case list with registry records revealed that only 91 (59.5%) had been reported. Reporting was significantly poorer for cases among blacks (53.1%) than for cases among whites (71.6%). These findings may have important implications for the interpretation of AIDS surveillance data and for planning activities in which awareness of complete case counts may be critical.