Online Program

Factors associated with use of oral health care in an underserved HIV positive population

Monday, November 4, 2013

Angela Walter, PhD, MPH, MSW, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA
Sara Bachman, Ph.D., School of Social Work, Boston University, Boston, MA
Amarachi Umez-Eronini, M.P.H., TIMI Study Group, Brigham and Women's Hospital Teaching Affiliate of Harvard Medical School, Boston, MA
Background: Research suggests that individuals with chronic illness have unmet need for and limited access to oral health care. Further research demonstrates that there is a higher unmet need for oral health care among people who are HIV positive. For people living with HIV/AIDS, unmet oral health needs could negatively impact adherence to HIV treatment, nutritional status, and have a detrimental effect on overall health.

Methods: This research examined data from fifteen sites of the U.S. Health Resources and Services Administration (HRSA) Special Projects of National Significance HIV Oral Health Initiative (N=2,469). Multivariate logistic regression techniques were used to identify differences between individuals who had been out of dental care five years or more, and those who had not received care in one to five years. The study was informed by the Institute of Medicine's (IOM) conceptual model of access to health care services.

Results: Poor access to oral health care is associated with personal factors: low education, poor immune system and oral health status; structural factors: not having a regular source of dental care and using a dentist's office for care; and the financial factor of not having medical insurance.

Conclusion: Participants have characteristics that reflect a disenfranchised population that faces numerous barriers to accessing oral health care. Results suggest that it is possible to engage HIV positive individuals into oral health care, despite being out of care for so long. Findings underscore the need to expand access to oral health care for people living with HIV/AIDS.

Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify factors associated with use of oral health care in an underserved HIV positive population Describe how individual and contextual factors are associated with access to oral health care among people living with HIV/AIDS Analyze public health implications for expanding access to oral health care for people living with HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working as a researcher in the area of HIV/AIDS for over ten years. On this particular project, I was the graduate research assistant working under the directrion of the co-principal investigator, Sara S. Bachman,Ph.D. My research interests have focused on addressing racial and ethnic disparities in marginalized populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.