National acquired immunodeficiency syndrome surveillance commenced with the beginning of the human immunodeficiency virus (HIV) epidemic in the United States in 1981, and by 2003 all states had implemented HIV surveillance. This information, used for prevention interventions, and the allocation of resources, must be accurate to determine trends in HIV transmission and the number of persons living with HIV. Standards for data accuracy were developed through a national consensus approach and integrated into a framework for local and national program evaluation. The evaluation framework allows for continual quality improvement by providing information for training and technical assistance efforts. These tools allow comprehensive assessments of whether reported HIV case data are adequate, reliable, and sufficiently accurate for determining the resources needed for HIV prevention and care.