title: Methamphetamine use and dental problems among adults enrolled in a program to increase access to oral health services for people living with HIV/AIDS.
abstract: OBJECTIVE
  We examined the association between methamphetamine (meth) use and dental problems in a large sample of HIV-positive adults.
  
  
  METHODS
  We gathered data from 2,178 interviews across 14 sites of the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance Innovations in Oral Health Care Initiative from May 2007 to August 2010. We used multivariate generalized estimating equations to test the association between meth use and dental problems, adjusting for potential confounders.
  
  
  RESULTS
  Past and current meth use was significantly associated with more dental problems. The study also found that poor self-reported mental health status, fewer years since testing positive for HIV, a history of forgoing dental care, less frequent teeth brushing, poor self-reported oral health status, oral pain, grinding or clenching teeth, some alcohol use, more years of education, and self-reported men-who-have-sex-with-men HIV risk exposure (compared with other exposure routes) were significantly associated with dental problems.
  
  
  CONCLUSIONS
  Individuals who are HIV-positive with a history of meth use experience access barriers to oral health care and more dental problems. Our study demonstrated that it is possible to recruit this population into dental care. Findings suggest that predisposing, enabling, and need factors can serve as demographic, clinical, and behavioral markers for recruiting people living with HIV/AIDS into oral health programs that can mitigate dental problems.
authors.affiliation: The Heller School for Social Policy and Management, Brandeis University, 415 South St., Waltham, MA 02454, USA. awalter@brandeis.edu
authors.forename: Angela W
authors.initials: AW
authors.lastname: Walter
authors.forename: Sara S
authors.initials: SS
authors.lastname: Bachman
authors.forename: David A
authors.initials: DA
authors.lastname: Reznik
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.forename: Amarachi
authors.initials: A
authors.lastname: Umez-Eronini
authors.forename: Avantika
authors.initials: A
authors.lastname: Nath
authors.forename: Minnjuan W
authors.initials: MW
authors.lastname: Flournoy
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Young
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000209:etiology*; D003625:Data Collection; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D009909:Oral Health; D012737:Sex Factors; D012959:Socioeconomic Factors; D009057:Stomatognathic Diseases / Q000209:etiology*
chemical_list: D008694:Methamphetamine