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People Living with HIV Still Struggle to Access Oral Healthcare

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People with disabilities, chronic health conditions, and otherwise vulnerable persons have difficulty accessing oral care. And accessing care becomes even more difficult for patients living with highly stigmatised diseases like HIV/AIDS.

A recent research survey conducted in British Columbia, published in JCDA and looking at the availability of oral care (and medical) services for people living with HIV/AIDS (PLWHA), found many PLWHAs are not seeking dental care because of stigma and cost. The study also indicates that PLWHAs, facing unstable housing, problematic drug use, and food insecurity, were less likely to seek out dental and medical care.

Providing Dental Care to People Living with HIV

According to the American Dental Association, “prevention is important for HIV-positive patients who are more susceptible to oral disease. Dentists should continuously monitor dental and oral health for disease progression. If any oral manifestations of HIV are present, the first priority is to relieve pain and treat infections.” 

To help dentists deliver compassionate and effective oral healthcare to PLWHAs, The ADA has created a resource about HIV/AIDS and treating patients. Here, dentists can learn more about:

  • The HIV virus
  • Diagnostic testing
  • Infection control
  • Dental care
  • Dental patient management
  • Additional citations and resources

Creating a stigma-free Dental Office

The Alberta Dental Association and College has created the Guidelines for Excellence in Service Provision for People Living with HIV (adapted from the General Dental Council Standards for Dental Professionals) to support dentists and their team in creating safe, stigma-free spaces for HIV positive patients.

Barriers to Access

While drug therapies have improved the lives of people living with HIV/AIDS, many continue to struggle to access much-needed dental services. For PLWHAs who are not receiving medical treatment and drug therapies, or those with uncontrolled HIV-infection, the risk of opportunistic infections like oral lesions from immunosuppression is certainly existent. According to the Alberta Dental Association, “90% of people living with HIV will develop at least one oral condition. It is often the dentist who is the first to identify an oral manifestation of HIV, even in patients who are not known to be HIV positive.”

Three quarters of respondents in the BC survey reported having bleeding gums, tooth sensitivity and tooth decay. Further, significant numbers of respondents reported they had unmet dental treatment needs.

When accessing oral health and dental care, PLWHAs reported the following:

  • 66% experienced dental anxiety.
  • 50% did not have dental insurance. 
  • 62% were experiencing difficulties with housing, transportation, and food.
  • 46% experienced discrimination by dental professionals.

Understanding the U = U (Undetectable = Untransmittable) campaign

In December of 2018, Canada’s Minister of Health, the Honourable Ginette Petitpas Taylor, officially endorsed Undetectable = Untransmittable (U=U). This campaign supports and promotes scientific evidence, indicating that there is effectively no risk of sexual transmission when a person is being treated for HIV and maintains a suppressed or undetectable viral load.

U=U is part of a broader campaign to reduce stigma and affirm treatment as prevention models. Canada is the first government to sign on to this global campaign that will directly improve the lives of people living with HIV and reduce social, economic, and medical barriers while encouraging people living with HIV to access care services.

 

Resources

We always want to hear your thoughts and questions about this post and other topics. Leave a comment in the box below or send us your feedback by email or call us at 1-855-716-2747.

Until next time!

CDA Oasis Team

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