Effect of delayed access to oral health care on people living with HIV

Background

Dental care is a critical service for people living with HIV (PLWHIV), but access to care is problematic and reported as a major unmet need. Fifteen dental clinics nationally expanded services to PLWHIV with limited access to care. This study examines the chief oral health complaints of PLWHIV who entered care for the first time in over a year.

Methods

Interviewers obtained patient information on demographics, oral health symptoms and health status. Population characteristics and chief complaints were analyzed using descriptive statistics. Multivariable analysis was conducted to determine socio-demographic and health status characteristics associated with the chief complaints.

Results

Over 1400 people entered dental care and 56% reported coming in to resolve a dental problem, rather than for a cleaning or check-up. Prevalent symptoms included loose teeth (26%), bleeding gums (41%), toothache (54%), and sensitivity (57%). In multivariable analysis controlling for age, gender, race, insurance status and length of time positive, the following factors were associated with dental problems at time of care entry: site of care (urban and stationary programs), IDU transmission, health status and needing care but not receiving it in the past (F:56.6; df: 5, 1111; R2=.203).

Discussion

PLWHIV of all races, ages and genders who have not accessed dental care report many symptoms that may impact their ability to obtain proper nutrition or take medications. The inability to receive care in the past is strongly associated with current problems, suggesting the need for programs that offer affordable dental care to PLWHIV before problems arise.