Comment on AN20-Proposed Rule-Sheldon T Brown

The attached detailed comments were unanimously agreed to by the officers of the Veterans Administration Society of Practitioners of Infectious Disease (VASPID). Recommendations in these comments include: The officers of VASPID (Veterans Administration Society of Practitioners of Infectious Disease) strongly support the planned revision to 38 CFR Part 17 that will remove the requirement that HIV testing in patients receiving care in Veterans Administration (VA) facilities can only be done if the patients first provide written informed consent. This action is consistent with the recent passage of Public Law 110-387 (section 407) by the 2008 Congress and signed by the President which revokes the relevant provisions in Section 124 of Public Law 100–322 (1988). Furthermore this planned revision to 38 CFR Part 17 is consistent with the recommendations for HIV testing that have been issued by the Centers for Disease Control and Prevention. This action will facilitate the earlier diagnosis and more effective treatment of HIV-infected patients receiving care in VA facilities. This will be of great benefit to the population served by the VA. To further improve the environment of HIV testing in the VA, we recommend that the clauses below be deleted from the final language of the Department of Veterans Affairs rules on HIV testing, as published in the Federal Register December 29, 2008. "Providers would be required to give patients written educational materials that include an explanation of HIV infection and the meaning of positive and negative test results." "The educational materials will be made available in the languages of the most commonly encountered populations within the service area." "As is the case for other tests performed in the VA, providers would be required to document the patient's informed consent in the patient's electronic health record."