BACKGROUND: Despite the risk of oral health problems in HIV-infected patients, many patients who receive regular medical care for HIV do not get the dental care they need. Access to dental care for people living with HIV (PLWH) is essential for early diagnosis, prevention and treatment of oral diseases. We assessed the role of sociodemographic, behavioral and clinical factors as determinants of unmet dental care needs of HIV Patients receiving Medical Care in Houston/Harris County from 2009-2013.
METHODS: Data used for this study was obtained from the Medical Monitoring Project (MMP) survey conducted in Houston/Harris County, Texas between 2009 and 2013. The data comprised of 941 records of persons who received HIV medical care and consented to either face-to-face or telephone interview by trained interviewers during the period. The survey assessed dental care met and unmet need of PLWH in relation to selected patients’ sociodemographic, behavioral and clinical characteristics. The data obtained were subjected to complex survey analysis using the SAS software version 9.4 (SAS Institute Inc., Cary, North Carolina, USA).
RESULTS: Met and unmet dental care needs in the HIV-infected population were 66.1% (95% CI: 62.5-69.8) and 33.9% (95%CI: 30.2-37.5). Unmet dental care needs were more common (p<0.0001) among African Americans (64.2%) and Hispanics (23.6%) than Whites (10.4%). Similarly, the dental care needs were more pronounced among those at or below poverty level compared to those above poverty level (33.5%). PLWH who had higher than high school education had more met dental care needs than those with high school education or below. However, when all factors considered were taken into account and adjusted for, only poverty level and alcohol abuse were the significant determinants of unmet dental care needs compare to met dental care needs, where race/ethnicity, education, health insurance, poverty level, sexual orientation were significant (p< 0.05) predictors. The top five barriers to unmet dental care needs identified include: “in process of getting the service” (28.3%), “not knowing where to go or whom to call” (21.8%), waiting list too long (9.1%), transportation problems (7.8%) and lack of insurance/service cost (4.9%).
CONCLUSIONS:
Collaborative intervention strategies are needed to improve dental care needs for PLWH by addressing key barriers and establishing preventive dental care programs for behavioral change, especially African Americans and Hispanics. Our study underscores the need for increased allocation of resources to fill gaps in dental care needs, considering the impact of poor oral health on the general health of PLWH.