Few systematic efforts have been made to characterize the prevalence of HIV types, HIV-1 groups, and HIV-1 group M subtypes within a specified geographic area, and few US studies like the one by Sides et al. [1] in this issue of the Journal of Infectious Diseases have been published. Their findings are important: they demonstrate a 95% prevalence of non-B HIV-1 subtypes; a predominance of subtypes C, A, and CRF02_AG/A1; and a substantial diversity of subtypes among the 87 HIV-infected African-born individuals in the targeted surveillance portion of their Minnesota study. African-born individuals contribute 20% of new HIV reports in Minnesota, resulting in a genetically diverse HIV epidemic. These findings, from a state where African-born individuals make up <1% of the population, suggest that it may be time to consider HIV genetic diversity surveillance in the United States