Feasibility and acceptability of HIV screening in the dental care setting among national AIDS directors

BACKGROUND: One-fifth of approximately 1 million Americans living with HIV are undiagnosed and unaware of their infected status. In 2006, the CDC issued recommendations to incorporate routine HIV screening in all healthcare settings, including dental clinics. Increasing the number of individuals who know their serostatus could decrease HIV incidence and reduce morbidity and mortality. METHODS: During April 2010, the National Alliance of State and Territorial AIDS Directors (NASTAD), an organization composed of the highest ranking state HIV/AIDS officials, completed a quantitative survey regarding the feasibility and acceptability of incorporating HIV screening in dental settings (n=54). We used descriptive analyses to describe how state directors view the dental setting as a venue for HIV screening and key barriers towards implementation. RESULTS: While 19% of health departments (n=10) currently support HIV testing in dental settings, nearly one-half indicated no plans to support implementation and only 9% are currently discussing it. Lack of funding to support implementation was the most important barrier identified by NASTAD officials (60%), followed by insufficient data justifying HIV screening (38%) and dentists lack of interest in HIV testing (38%). CONCLUSIONS: HIV testing continues to be an important tool to facilitate earlier diagnosis and treatment; however, it is underutilized in dental settings. The current movement in the dental profession towards offering oral diagnostics provides a unique opportunity to expand screening efforts to include HIV testing. Future research is needed to identify methods to increase willingness to test or expand testing and decrease structural barriers identified by key stakeholders.