Oral health needs of persons living in the community with advanced HIV/AIDS

Background: HIV/AIDS is increasingly affecting populations who have traditionally experienced barriers accessing health care -- the uninsured, homeless, substance abusers, and incarcerated. Although treatment advances have transformed HIV/AIDS from a rapidly fatal illness to a chronic disease, it is remains an important cause of morbidity and mortality and attention to palliative care is an essential aspect of clinical services for those with advanced disease. Methods: A NINR-funded longitudinal investigation of care management of community residents living with advanced HIV/AIDS (n=104) was conducted. The diverse adult patient sample was recruited from a major urban medical center -- 46% Hispanic, 43% black non-Hispanic, 8% white non-Hispanic. A multi-modal data collection (in-depth interviews, questionnaires, medical records) was conducted in English/Spanish. Results: Patients living with advanced HIV/AIDS continue to experience a large number of symptoms. A high prevalence of oral health symptoms were among those reported – 53% dry mouth, 27% change in way food tastes, 14% difficulty swallowing, and 12% mouth sores. Nearly all patients, 95%, reported needing at least one medical service and nine in ten reported need for some type of practical assistance/social services. Among the medical needs that patients reported, 52% of the patients reported oral health needs of which 39% were unmet. Conclusion: A substantial number of patients living with advanced HIV/AIDS experience oral health symptoms and report unmet oral health needs, suggesting that oral health care is an important component to include in palliative care programs.