Access to oral health care for people living with HIV/AIDS attending a community-based program.

Objective: People living with HIV/AIDS (PLWHA) have difficulty accessing oral health services primarily due to HIV-related stigma and discrimination. In 2011, the University of British Columbia (UBC) Dental Hygiene Degree Program implemented a preventive oral health services program at the Positive Living Society of British Columbia (PLSBC), a non-profit organization supporting PLWHA. This study aims to assess the perception of how this type of service delivery influenced access to oral health care for members of PLSBC. Methods: Personal interviews with 10 members and one focus group comprising 12 staff were conducted. Audiorecordings were transcribed verbatim and coded thematically. Emerging themes were identified using the interpretative phenomenology approach following Penchansky and Thomas' theory of access. Results: The program helped members maximize their dental coverage to receive other types of dental services. Members who were influenced by past traumatic experiences appreciated that services were delivered in a safe manner and in a stigma-free setting. Members valued the opportunity to educate future dental professionals to reduce HIV-related stigma. However, dental needs that could not be addressed by the program remained untreated for some members who continued to face barriers to care at referral clinics. Conclusion: This community-based preventive dental program provided affordable dental care, a stigma-free setting, care delivered in a safe manner, an educational opportunity, and accessible location, which all seemed to have a positive influence on access to oral health care for members of PLSBC. However, the limited availability of the program prevented many members from accessing comprehensive oral health care and is a factor that should be addressed.

Objectif: Les gens qui vivent avec le VIH/SIDA (GVAVS) ont de la difficulté à accéder à des services de santé buccodentaire, principalement en raison de la stigmatisation et de la discrimination associées au VIH. En 2011, le Programme de baccalauréat en hygiène dentaire de l'Université de la Colombie-Britannique (UBC) a mis en place un programme de services de santé buccodentaire préventifs à la Positive Living Society of British Columbia (PLSBC), un organisme sans but lucratif soutenant les GVAVS. La présente étude vise à évaluer la perception de la façon dont ce type de prestation de service a influencé l'accès aux soins de santé buccodentaire pour les membres de la PLSBC. Méthodologie: Des entrevues personnelles ont été menées avec 10 membres et un groupe de discussion comprenant 12 membres du personnel. Les enregistrements sonores ont été transcrits mot à mot et codés par thème. Des thèmes émergents ont été ciblés au moyen de l'approche phénoménologique et interprétative, fondée sur la théorie sur l'accès de Penchansky et Thomas. Résultats: Le programme a aidé les membres à maximiser leur couverture dentaire afin de pouvoir recevoir d'autres types de services dentaires. Les membres qui ont été influencés par des expériences traumatiques précédentes ont été reconnaissants que les services aient été fournis de façon sécuritaire et dans un milieu exempt de stigmatisation. Les membres ont aimé avoir l'occasion d'éduquer les futurs professionnels dentaires en vue de réduire la stigmatisation liée au VIH. Cependant, les besoins dentaires qui ne pouvaient pas être satisfaits par le programme sont demeurés non traités pour certains membres qui ont continué à faire face à des obstacles en matière de soins aux cliniques de renvois. Conclusion: Ce programme dentaire préventif offert en milieu communautaire fournit des soins dentaires à prix abordables, un milieu libre de stigmatisation, des soins offerts de manière sécuritaire, une occasion de formation et un emplacement accessible, qui semblent tous avoir une influence positive sur l'accès aux soins de santé buccodentaire des membres de la PLSBC. Cependant, l'accessibilité limitée du programme a empêché plusieurs membres d'avoir accès à des soins de santé buccodentaire complets et cela est un élément qui doit être abordé.

Evaluating Point-of-Care HIV Screening in Dental Hygiene Education Settings: Patient, Faculty, and Student Perspectives.

Although HIV screening is needed at a wider range of sites, dentists have shown reluctance to incorporate screening in their practices, but dental hygiene settings may be better suited for such screenings. The aim of this mixed-methods study was to determine the feasibility and acceptability of point-of-care (POC) HIV screening in dental hygiene education community settings from the patient, faculty, and student perspectives. After training, dental hygiene students and faculty at a Canadian dental school offered POC HIV screening to patients as part of routine dental hygiene care over 36 weeks at four sites in 2015-16. Of the 199 patients offered screening, 78 agreed; no positive results were found. Of the 199 patients, 97 completed an 11-item survey (49% response rate), with 80 (82%) agreeing HIV screening was within the scope of practice of a dental professional. Of the 57 patients who were screened, 48 (84%) agreed POC HIV screening should be part of regular dental check-ups, and 52 (91%) perceived dental settings were appropriate sites for screening. The main reasons for patients' agreeing to screening were that it was free and convenient and the results were delivered quickly. Those who refused screening had been tested recently or did not perceive themselves at risk for HIV. In two focus groups with 12 dental hygiene students, one focus group with five faculty members, and individual interviews with five other faculty members, participants agreed on the importance of offering POC HIV screening in the dental setting as a public health service. Faculty members thought students were well prepared and increased in confidence with testing. Students expressed a desire to offer screening throughout their careers and to educate patients about the importance of HIV testing.