Dental News - People living with HIV struggle to access oral health services

Dental Tribune International

Thu. 1. August 2019

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VANCOUVER, British Columbia, Canada: Researchers from the University of British Columbia have recently conducted an environmental scan and categorized the scope of medical and oral health care services for people living with HIV (PLWHIV) across the province of British Columbia (BC). The findings revealed a mismatch between the number and scope of services available for PLWHIV and the distribution of HIV infection across BC.

According to the World Health Organization, nearly 37 million people were living with HIV globally in 2017. In Canada, 84,409 cases of HIV have been reported since 1985. The province of Ontario accounted for the most HIV cases reported in 2016 (37%), followed by Quebec (25%) and Alberta (12%). According to a report published in 2017, there were 2,344 new diagnoses of HIV infection reported in Canada in 2016. Another report identified a total of 2,402 new HIV diagnoses in 2017. PLWHIV are at high risk for oral lesions caused by immunosuppression resulting from uncontrolled HIV infection. These infections continue to impact their overall well-being and quality of life.

In the study, the researchers collected data using online search engines and the websites of health services agencies and community/not-for-profit organizations in BC. They then conducted informal telephone conversations to confirm the findings from the online scan.

The researchers identified 104 organizations that were providing services exclusively for PLWHIV. These organizations were unevenly distributed across 40 out of 51 cities in BC. Of all the services offered at these organizations, 59% were preventive and educational in nature, 15% were related to treatment services for HIV-related conditions and 38% entailed support services. Only 3% of the 104 organizations offered basic dental care.

More than 75% of the participants reported untreated dental conditions such as dental caries, gingivitis and tooth sensitivity. On investigating the main factors preventing people from seeking dental care, the researchers discovered that 46% of the participants had experienced discrimination by dental professionals, 66% feared going to the dentist, 50% did not have dental insurance and 62% were experiencing difficulty affording housing, transportation and food.

The findings show the need for more training for dental care providers on how to better serve PLWHIV. The authors also suggest that, since many HIV patients may be struggling with poverty, homelessness, drug use or lack of social support, the next generation of dental professionals should receive robust training in cultural sensitivity and trauma-informed care in order to be able to make PLWHIV feel safe and welcome in their dental offices.

The study, titled “Availability of medical and oral health services for people living with HIV in British Columbia, Canada,” was published online on Jan. 15, 2019, in the Journal of the Canadian Dental Association.

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