title: Correlates of unmet dental care need among HIV-positive people since being diagnosed with HIV.
abstract: OBJECTIVE
  We analyzed the characteristics of people living with HIV/AIDS (PLWHA) who reported unmet oral health needs since testing positive and compared those characteristics with people reporting no unmet health needs. We also identified barriers to accessing oral health care for PLWHA.
  
  
  METHODS
  We collected data from 2,469 HIV-positive patients who had not received oral health care in the previous 12 months and who had accessed care at Health Resources and Service Administration-funded Special Projects of National Significance Innovations in Oral Health Care Initiative demonstration sites. The outcome of interest was prior unmet oral health needs. We explore barriers to receiving oral health care, including cost, access, logistics, and personal factors. Bivariate tests of significance and generalized estimating equations were used in analyses.
  
  
  RESULTS
  Nearly half of the study participants reported unmet dental care needs since their HIV diagnosis. People reporting unmet needs were more likely to be non-Hispanic white, U.S.-born, and HIV-positive for more than one year, and to have ever used crack cocaine or crystal methamphetamine. The top three reported barriers to oral care were cost, access to dental care, and fear of dental care. Additional reported barriers were indifference to dental care and logistical issues.
  
  
  CONCLUSIONS
  Innovative strategies are needed to increase access to and retention in oral health care for PLWHA. Key areas for action include developing strategies to reduce costs, increase access, and reduce personal barriers to receiving dental care, particularly considering the impact of poor oral health in this population.
authors.affiliation: Miller School of Medicine, Department of Epidemiology and Public Health, University of Miami, 1125 NW 14th St., Miami, FL 33136, USA. yjeanty@med.miami.edu
authors.forename: Yves
authors.initials: Y
authors.lastname: Jeanty
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cardenas
authors.forename: Jane E
authors.initials: JE
authors.lastname: Fox
authors.forename: Margaret
authors.initials: M
authors.lastname: Pereyra
authors.forename: Chanelle
authors.initials: C
authors.lastname: Diaz
authors.forename: Helene
authors.initials: H
authors.lastname: Bednarsh
authors.forename: David A
authors.initials: DA
authors.lastname: Reznik
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Abel
authors.forename: Sara S
authors.initials: SS
authors.lastname: Bachman
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection; D003729:Dental Care / Q000706:statistics & numerical data*; D017742:Dental Care for Chronically Ill; D005260:Female; D006678:HIV; D006679:HIV Seropositivity; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult