Oral health care and smoking cessation practices of homecare providers for patients with HIV

Background: The unmet need for oral health services among patients with HIV has been well documented and is fueled by patient, provider, socioeconomic, and systems factors. Individuals with HIV/AIDS are at risk for many oral health problems, particularly those in advanced stages of disease and those who smoke tobacco. The integration of dental services into health care settings for patients with HIV has been suggested to address this unmet need. The study presented here examined the oral health assessment and smoking cessation counseling by nurses and other HIV home care providers for their patients with HIV. Methods: A random sample of 85 HIV care providers in a large urban home care agency completed a brief pen and paper survey assessing attitudes, beliefs and practices regarding oral health assessment and smoking cessation counseling for their patients with HIV. Data were entered into SPSS for descriptive analysis. Results: 84 caregivers (nurses 46%, home health aides 36%, social workers 14%, nutritionists 4%) completed the survey. Attitudes, beliefs, and self-efficacy for providing oral health care and smoking cessation were high among all providers, however 47% rarely or never assessed oral health or referred patients for dental care, and only 35% refer their patients for smoking cessation. 72% of nurses would like to receive additional training in comprehensive oral health assessment. Conclusions: Home care settings provide a unique opportunity to enhance the oral health of patients with HIV and decrease smoking among this vulnerable population. Additional training in oral health and smoking cessation is needed.