160308 Onsite dental care is needed for HIV positive patients in Miami, FL

Wednesday, November 7, 2007: 3:00 PM

Wei Zhao, MD MS , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Lisa R. Metsch, PhD , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Margaret R. Pereyra, DrPH , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Yves Jeanty, MPH , Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Scott L. Tomar, DMD, DrPH , Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL
Gordon Dickinson, MD , Medicine, Miller School of Medicine, University of Miami, Miami, FL
Stuart Kline, DDS , Miller School of Medicine, University of Miami, Miami, FL
Henry Boza , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Marvin Shika , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Faye Yeomans , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
Yolanda Camacho , Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL
OBJECTIVE: An estimated 90% of HIV+ people have at least one oral manifestation of the disease. Many HIV health care facilities do not include dental services, and people living with HIV frequently report unmet dental care needs. This study examined barriers to accessing dental care, comparing HIV health facilities that provide dental care onsite with those that do not. METHODS: Structured interviews were conducted with 297 HIV+ patients receiving HIV care but not dental care in the preceding 12 months. Participants were recruited in 2005 from HIV clinics with or without onsite dental care. Bivariate and multiple regression analyses were conducted. RESULTS: Participants at sites with onsite dental clinics were less likely to report unmet dental care needs in the preceding 12 months (45% vs. 72%). Compared with participants at sites without dental services, participants at sites with dental clinics were less likely to report these reasons for not receiving needed dental care: could not afford care (39% vs. 69%), could not find a dentist that treats HIV patients (9% vs. 28%), did not know where to find care (13% vs. 31%), did not want to tell dentist they were HIV+ (4% vs. 17%). Multiple regression showed that onsite participants reported fewer barriers than offsite participants (=-1.40) after adjusting for age, gender, race, years since HIV diagnosis, drug used in past four weeks and currently in HIV medication. CONCLUSIONS: Onsite dental care as a part of HIV care programs may enhance access to dental care for people living with HIV.

Learning Objectives:
1. List five important barriers which deter HIV+ people to access dental care. 2. Report and discuss those barriers to HIV/AIDS care and public health policymakers. 3. Develop more onsite dental care in HIV care facilities.

Keywords: HIV/AIDS, Access to Care

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.