Dental care and HIV-infected individuals: are they equally treated?
OBJECTIVE
To investigate the problems in seeking dental care faced by HIV-positive individuals in Italy.


METHODS
A multicenter observational study was performed by distributing an anonymous self-administered questionnaire to patients of six public healthcare facilities specialized in the treatment of individuals with HIV infection. The questions concerned personal data potentially correlated with discrimination, the patient-dentist relationship before and after HIV diagnosis, and the reasons for seeking dental care in public facilities. We also evaluated the patients' discomfort in the patient-dentist relationship after HIV diagnosis, performing univariate and multivariate analyses.


RESULTS
Of the 1,500 questionnaires distributed; 883 were filled-out completely. A total of 630 persons received dental care after HIV diagnosis: 209 (33.2%) did not tell the dentist that they were seropositive. Of those who did, 56 were refused care. For patients treated by a private dentist, having been treated by the same dentist before diagnosis was a risk factor for great discomfort in the patient-dentist relationship (P < 0.002). Being treated in public facilities was associated with having received dental care after HIV diagnosis (P < 0.001) and a primary school education (P < 0.001).


CONCLUSIONS
There exist episodes of discrimination on the part of some dentists, and a relatively high proportion of HIV-positive persons do not disclose their seropositivity to the dentist. Dentists should be provided with training for promoting both ethically acceptable practices and suitable clinical management of HIV-positive persons.
Giuliani
Michele
M
Istituto di Clinica Odontoiatrica, Università Cattolica, Rome, Italy. michele.giuliani@rm.unicatt.it
Lajolo
Carlo
C
Rezza
Giovanni
G
Arici
Claudio
C
Babudieri
Sergio
S
Grima
Pierfrancesco
P
Martinelli
Canio
C
Tamburrini
Enrica
E
Vecchiet
Jacopo
J
Mura
Maria Stella
MS
Cauda
Roberto
R
Mario
Tumbarello
T
D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D017742:Dental Care for Chronically Ill / Q000523:psychology / Q000706:statistics & numerical data*; D003812:Dentist-Patient Relations; D005260:Female; D015658:HIV Infections; D006297:Health Services Accessibility; D006801:Humans; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D011287:Prejudice; D011331:Private Practice; D011636:Public Health Dentistry; D016079:Refusal to Treat; D011795:Surveys and Questionnaires; D014342:Truth Disclosure