HIV screening in dental settings: Challenges, opportunities, and a call to action

Abstract

HIV is responsible for tremendous suffering and loss around the world, but many advances in HIV screening, diagnosis, treatment, and prevention provide hope for an end to the HIV epidemic. Global and national campaigns facilitate access to these HIV advances, but some individuals and communities still lack access, particularly in developing countries. To reach those who remain under‐served, campaigns encourage greater integration of HIV services with non‐HIV services. As members of the healthcare team with a clinical stake in HIV, dental care providers have a unique contribution to make. Much research on the role of dental care providers in HIV has focused on HIV screening in the dental setting, and researchers have identified possible ways forward but also daunting challenges. Approaches for screening, brief intervention, and referral to treatment used in primary care and dental care settings for other health risks may help overcome challenges related to provider scope of practice and need for training. Approaches to managing distress and uncertainty in other clinical contexts may help overcome challenges related to patient acceptability, equipping providers to manage sensitive topics and emotional aspects of HIV screening. While not panaceas, these approaches may be useful to dental care providers interested in answering the global “call to action” for contributing to ending the HIV epidemic.

Perceptions of mental health screening and referral to treatment in National Dental‐Practice Based Research Network practices: A qualitative study

“…The strong relationship with patients underscores the desire to contribute to the overall health of their patients beyond oral care, including utilizing active methods for identifying and responding to mental health concerns. This aligns with prior research findings that dentists exhibit the willingness to engage in screening endeavors for healthcare concerns, provided they are equipped with appropriate training, support, and resources, ensuring effective implementation within a suitable timeframe [20–23, 39, 40, 45–48].…”

“…Factors such as time constraints, costs, patient willingness, training, beliefs about job scope, perceptions of risk, and reimbursement issues provide potential obstacles to the execution of such protocols [20–23, 39–44]. To address these challenges, various facilitators have been identified, including continuing education (CE) and training, prior knowledge, training during professional schooling, supportive follow‐up practices, and approaches like screening, brief intervention, and referral to treatment [20–22, 42, 43, 45]. The effectiveness of these facilitators in mitigating the challenges has led to increased calls for integrated care, where different aspects of healthcare are interconnected and coordinated [46–48].…”

Research Agenda from the 8th World Workshop on Oral Health and Disease in HIV AIDS

“…• Research on improving referral rates by dental professionals for full HIV evaluation while taking into consideration patient values and preferences (Riddle, 2020).…”