Barriers and facilitators to dental care among HIV-Infected adults.
Oral health problems can significantly compromise HIV-infected individuals' general health and well-being, yet many of them experience an unmet need for oral care. The barriers and facilitators of obtaining dental care in a sample of HIV-infected adults, all of whom were eligible for Ryan White Part A funding for their treatment, were investigated through qualitative interviews with HIV-positive individuals who had not received dental services in the prior 12 months (n = 44). Identified barriers were as follows: (1) dental anxiety and fear, (2) cumbersome administrative procedures, (3) long waits at the dental office, (4) problem focused care-seeking behavior, (5) transportation difficulties, (6) dentists' reluctance to treat people like them, and (7) psychological issues. Identified facilitating factors were as follows: (1) coverage for dental care, (2) being treated with respect and acceptance, and (3) having an assigned case manager or social worker. Many of the barriers uncovered in this qualitative study can be addressed and overcome by case management services, but other approaches are needed to address the additional psychological and stigma-related factors that are impeding access to oral healthcare in this population.
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
Carrigan
C
Parish
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
Karolynn
K
Siegel
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.|Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami.
Margaret
M
Pereyra
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.|Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami.
Terri
T
Liguori
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.|Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Coral Gables, Miami.
Lisa
L
Metsch
D000328:Adult; D000368:Aged; D019090:Case Management; D017742:Dental Care for Chronically Ill; D005260:Female; D005431:Florida; D015658:HIV Infections / Q000150:complications*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000209:etiology* / Q000628:therapy*
HIV/AIDS; access/barriers to care; dental utilization; oral health