Oral health care: The forgotten need for HIV-positive populations in the continuum of care

Background: Many people living with HIV (PLWHA) experience oral manifestations of HIV disease that can lead to poor health status. Yet, studies have shown that unmet need for dental care for PLWHA is greater than medical care. We examined the factors associated with unmet need for dental care among underserved, hard to reach PLWHA enrolled in interventions to engage them in HIV care. Methods: A longitudinal survey was conducted among PLWHA at risk for not engaging in HIV medical care from ten urban community and clinic-based sites. Measures included socio-demographics, drug use, mental health status, health care utilization, and unmet needs for dental care and support services. Bivariate and multivariate analyses were conducted to examine the factors associated with unmet need for dental care. McNemar chi-square test was conducted to assess the changes in unmet need for dental care. Results: Dental care (70%) was the most frequently reported service need compared to transportation, mental health treatment, financial assistance, food and benefits. Factors significantly associated with unmet need for dental care included being uninsured and poor mental health status. Conclusions: Dental care is a significant need among hard to reach, underserved PLWHA. However, this need is less likely to be addressed compared to other support services and medical care needs. This study highlights the importance of promoting strategies to improve access to dental care among underserved PLWHA within the continuum of HIV care.