HIV‐related stigma in the dental setting: a qualitative study

Abstract

Purpose To explore the experiences and expectations of HIV‐related stigma in dental settings. Methods This was a cross‐sectional study of 60 HIV+ adult volunteers. We conducted audio‐recorded interviews; responses to four open‐ended questions were analyzed qualitatively for theme and content. Results Twenty‐seven participants (45%) reported ever having anticipated being judged, stigmatized or treated with disrespect in a dental setting due to HIV status. Thematic response categories included concerns about: (i) receiving humane and respectful treatment, (ii) being judged or stereotyped and (iii) giving HIV to the dentist. Regarding hesitancy to visit the dentist, subjects equally endorsed fear of the dentist (35%) and concerns about confidentiality and receiving humane treatment (35%). Conclusion HIV+ individuals encounter many fears and concerns related to dental care; fear of the dentist and concerns about confidentiality and receiving humane treatment appear to be central issues. Dental providers should be aware of and better manage these issues.

Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada

“…Similar to previous reports on PLHIV, the present study identified the enabling predictors, mostly related to the financial affordability and resources (see Table 2), which are also key factors in dental care utilization by other Canadians (7,10,14,20,21). In fact, according to the A&N model, these enabling factors can play an essential role in increasing one's access to dental care (9).…”

“…Approximately one-third of the 185 participating PLHIV visited a dental professional within the last year, which is lower than for the average Canadians (10,14). For almost half of the participants, the main reason for the dental visit was an emergency, and almost half reported unmet dental treatment needs, a similar pattern was found by Fox et al (2012) when studying access to dental care in PLHIV, by Jessani et al (2016) when studying access to dental care by vulnerable pregnant women, and by Bedos et al (2003) when discussing the lack of access to dental care by those living on welfare assistance (7,11,15,16).…”

“…High levels of dental treatment needs and irregular visits to dental professionals were also reported by other studies . The factors most commonly associated with a lack of access to dental care are a low income, using illicit drugs, having Aboriginal status, and being unemployed, although stigma and discrimination from oral health service providers create another layer of complexity in accessing oral health services . The Andersen and Newman (A&N) model of health service utilization offers a comprehensive view of the various factors involved in accessing and utilizing care and categorizes them into predisposing factors, enabling resources, and need factors .…”

“…According to Marcus and colleagues in 2005, as many as 40 percent of PLHIV have unmet dental treatment needs, and less than half had visited a dental professional within the last year . High levels of dental treatment needs and irregular visits to dental professionals were also reported by other studies . The factors most commonly associated with a lack of access to dental care are a low income, using illicit drugs, having Aboriginal status, and being unemployed, although stigma and discrimination from oral health service providers create another layer of complexity in accessing oral health services .…”

Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting

“…A central strength of this approach is that it was developed for HIV+ adults at high risk for oral disease [45]; commonly, such patients had concomitant illnesses (i.e., were medically complex), and had some level of economic and/or psychosocial strain as well as concerns about stigma, confidentiality, and whether they would be treated with respect by their health care providers [96]. In many ways, such a population represents an ideal prototype—as individuals in this population can present with a concentration of health issues (that might otherwise be seen across several different people).…”