Oral Health-related Quality of Life in HIV: A Systematic Review.

AIM: To systematically evaluate the literature evidence related to oral health and quality of life (QoL) among HIV-positive adults. BACKGROUND: The oral health-related quality of life (OHRQoL) is an essential entity to be measured for understanding the domains affected due to oral health problems. HIV comes with an array of complexities in the oral cavity and is also reflection of the systemic illness of the oral cavity. Hence, it is essential to know the area affected and also the lesions that contribute the most to decrease the QoL in this aspect. A systematic review was carried out in relation to studies across PubMed and Google Scholar regarding HIV and OHRQoL from January 1970 to May 2019. Of the 1,374 articles screened, 11 studies were filtered for the final review. REVIEW RESULTS: The physical domain followed by the psychological domain is the most affected in the HIV-positive patients. The maximum effect is due to dental caries and periodontitis. No studies report about oral substance abuse and its effect. CONCLUSION: Studies are further needed on a larger sample size and on similar scales and parameters to ensure greater evidence for intervention related to areas that should be focused upon for improving the QoL of HIV-positive patients. CLINICAL SIGNIFICANCE: There is a greater need to include quality-based assessment while treating HIV-positive people. Also not just physical indicators like pain or dental caries, even social indicators like mental and social dimensions of a patient's life should be included while deciding the treatment approach.

Stigma and Discrimination faced by HIV-infected Adults on Antiretroviral Therapy for more than 1 Year in Raichur Taluk, Karnataka, India.

AIM: The aim of this study was to evaluate the stress and discrimination faced by human immunodeficiency virus (HIV)-affected adult patients on antiretroviral therapy (ART) for more than 1 year. MATERIALS AND METHODS: A cross-sectional study was carried out among 170 adults on ART, reporting to the ART center of the District Civil Hospital, for more than 1 year in Raichur Taluk, Karnataka, India. Convenience sampling technique was followed. Descriptive statistics was performed (Chi-square test) using Statistical Package for the Social Sciences version 16.0. RESULTS: A total of 156 (91.8%) patients' families had knowledge about their seropositive status. Seventeen (10.9%) HIV-positive patients reported of change in the attitude of their family members. The main reasons for not revealing the HIV status were the internalized stigma and fear of rejection. Women faced greater discrimination from family, friends, and neighbors than men. CONCLUSION: It is necessary to not undermine the effect of rejection due to HIV. It is the only infection that has so many associated social and psychological norms which we need to tend at the earnest. Till date, there is an existence of condescendence toward treatment approach. CLINICAL SIGNIFICANCE: The presence of stigma and the fear of being discriminated could be a major hurdle in the rehabilitation of these patients into the mainstream society. Furthermore, it serves as an existing challenge to ascertain these individuals to achieve overall health.