Barriers and facilitators to dental care among HIV‐Infected adults

Abstract

Oral health problems can significantly compromise HIV-infected individuals’ general health and well-being, yet many of them experience an unmet need for oral care. The barriers and facilitators of obtaining dental care in a sample of HIV-infected adults, all of whom were eligible for Ryan White Part A funding for their treatment, were investigated through qualitative interviews with HIV-positive individuals who had not received dental services in the prior 12 months (n = 44). Identified barriers were as follows: (1) dental anxiety and fear, (2) cumbersome administrative procedures, (3) long waits at the dental office, (4) problem focused care-seeking behavior, (5) transportation difficulties, (6) dentists’ reluctance to treat people like them, and (7) psychological issues. Identified facilitating factors were as follows: (1) coverage for dental care, (2) being treated with respect and acceptance, and (3) having an assigned case manager or social worker. Many of the barriers uncovered in this qualitative study can be addressed and overcome by case management services, but other approaches are needed to address the additional psychological and stigma-related factors that are impeding access to oral healthcare in this population.

Human immunodeficiency virus related discrimination in general dentistry

“…In our study population, the total HIV-related discrimination rate was 67.4%. Human immunodeficiency virus stigma affects patients’ health, and PLWH are known to have unmet oral care needs 9,19. Oral problems reported by HIV patients include difficulties in eating, sleeping, and maintaining good oral hygiene 20.…”

“…Also, a correlation has been found between the age and duration of HIV involvement with the overall dental health status of the participants 10. Barriers that PLWH face in dental settings include complicated administrative work, long waiting times, unwillingness to provide treatment, difficulty to find treating dentists, and having previous psychological problems related to the dental experience 9. Moreover, in a study done to investigate HIV-related discrimination in dental settings, a low percentage of stigma and discrimination was observed.…”

“…Therefore, their need for oral care is increasing accordingly 8. However, care seeking behavior leads PLWH to visit the dental office only when having active symptoms 9. In a study carried out to investigate the dental status of HIV-positive patients, the overall dental health was poor.…”

Living with HIV in regional Queensland: social ties, care and support in managing a long-term complex chronic illness

“…These include psychosocial health needs [8], prevention and treatment of other chronic conditions, and dental care [59] 9…”

“…Dental care is a key element for healthy living with HIV. Unattended dental health in positive people contributes to opportunistic infections and prevents proper swallowing of ART [59], in addition to impacting on a person's psychosocial health. Positive people's needs around dental care are therefore greater than those in the general population [59].…”