15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

IS BEING HIV-INFECTED A BARRIER TO ACCESSING DENTAL CARE?

HIV Med 2009 Apr 1-3 (Suppl 1);15:17 (abstract no. P11)

NM Steedman¹ and CJ Cunningham^2
1Countess of Chester Hospital NHS Foundation Trust, Chester, UK, ²Lothian Salaried Primary Care Dental Service, Edinburgh, UK

BACKGROUND: The Medical Foundation for AIDS and Sexual Health (MedFASH) recommended standards for NHS HIV services include the provision of timely dental care for those living with HIV. In addition, the UK General Dental Council (GDC) policy states that it is unethical for a dentist to refuse to treat a patient solely on the grounds that the person has a blood-borne virus. We therefore undertook a prospective, questionnaire-based study to ascertain the current dental care arrangements and experiences of accessing dental care in a cohort of HIV- positive patients and a control population who were not known to be HIV-infected.

METHODS: In total 100 questionnaires were distributed to HIV-positive patients and 100 to control patients with return rates of 59% and 92% respectively.

RESULTS: Only 56% of HIV-positive patients surveyed were currently registered with a dentist compared with 80% of control patients (P<0.005) and HIV-positive patients were more likely to have experienced difficulties accessing dental care (P<0.05). HIV-positive patients were significantly less likely to have most recently been seen by an NHS dentist (18/59 patients compared with 58/92 controls, P<0.0005) and were more likely to have last been seen at an emergency dental service (7/59 compared with 0/92 controls, P<0.005). Overall, one quarter of HIV- positive patients surveyed (15/59) expressed concerns about disclosing their HIV-status to a dentist and 18% (6/33) of HIV-positive patients currently registered with a dentist had not disclosed their HIV status to their regular dentist. Five patients in the survey felt they had been refused dental treatment as a result of their HIV status. The majority of HIV-positive patients (39/59, 66%) stated that they would utilize a dedicated dental unit specifically for HIV patients if provided.

CONCLUSIONS: Despite MedFASH and GDC guidance HIV-positive individuals still experience significant barriers to accessing dental treatment and many patients remain reluctant to disclose their HIV status. Continued efforts to reduce HIV-associated stigma are essential in order to improve dental care for people living with HIV.

2009-04-01
P11

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