Access to oral health services in PLWHA in rural South Carolina: A coordinated care model

There is an unmet need of oral health services for the general population (especially in rural America), due to many factors. This need is further pronounced in persons living with HIV/AIDS (PLWHA). Untreated oral conditions can lead to systemic complications which may advance the problems experienced by a doubly vulnerable population. This study identified organizational characteristics within a coordinated model that facilitated or prevented continuous patient engagement in oral health services.

This program utilized a fully staffed mobile dental unit to provide services to PLWHA within a medical service organization in rural South Carolina. African American patient participants in this evaluation were concurrently engaged in regular medical care where they sought dental services; this population has been reported to seek routine dental care less frequently as other subpopulations.

Case study analysis format was used, where data was collected using qualitative interviews and demographic surveys (8 staff members, 16 patients). Interviews were transcribed and analyzed using QSR NVivo; demographic information was summarized in Microsoft Excel. Patients were concurrently engaged in regular medical care where they sought dental services. Twenty-six organization-level themes were identified that influenced patient engagement. Themes were categorized as systemic, service, clinical staff/non-clinical staff, or reinforcing.

Recommendations to reduce or eliminate the organizational barriers have been made; additionally, an expansion of existing policies and programs to provide financial coverage for dental services is recommended. The findings of this study can be used to develop and implement organization-wide strategies that will encourage continued engagement of PLWHA in oral health services.