title: Retention of people living with HIV/AIDS in oral health care.
abstract: OBJECTIVE
  We identified factors associated with retention in oral health care for people living with HIV/AIDS (PLWHA) and the impact of care retention on oral health-related outcomes.
  
  
  METHODS
  We collected interview, laboratory value, clinic visit, and service utilization data from 1,237 HIV-positive patients entering dental care from May 2007 to August 2009, with at least an 18-month observation period. Retention in care was defined as two or more dental visits at least 12 months apart. We conducted multivariate regression using generalized estimating equations to explore factors associated with retention in care.
  
  
  RESULTS
  In multivariate analysis, patients who received oral health education were 5.91 times as likely (95% confidence interval 3.73, 9.39) as those who did not receive this education to be retained in oral health care. Other factors associated with care retention included older age, taking antiretroviral medications, better physical health status, and having had a dental visit in the past two years. Patients retained in care were more likely to complete their treatment plans and attend a recall visit. Those retained in care experienced fewer oral health symptoms and less pain, and better overall health of teeth and gums.
  
  
  CONCLUSIONS
  Retention in oral health care was associated with positive oral health outcomes for this sample of PLWHA. The strongest predictor of retention was the receipt of oral health education, suggesting that training in oral health education is an important factor when considering competencies for new dental professionals, and that patient education is central to the development of dental homes, which are designed to engage and retain people in oral health care over the long term.
authors.affiliation: Health & Disability Working Group, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA. tcarol@bu.edu
authors.forename: Carol R
authors.initials: CR
authors.lastname: Tobias
authors.forename: Jane E
authors.initials: JE
authors.lastname: Fox
authors.forename: Angela W
authors.initials: AW
authors.lastname: Walter
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Lemay
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Abel
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D017742:Dental Care for Chronically Ill / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006267:Health Education, Dental; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data; D012959:Socioeconomic Factors