HIV-positive patients' discussion of oral health with their HIV primary care providers in Miami, Florida

Abstract

Over 90% of HIV-positive persons will have at least one oral manifestation of HIV disease during the course of infection. Clinical guidelines suggest that examination of the oral cavity should be included in initial and interim physical examinations of all HIV-infected patients by their HIV care providers. Clinically significant manifestations of oral disease may impact prescribed treatment regimens. The objective of this analysis was to describe HIV-positive patients' discussion of oral health and dental health with their HIV primary care providers and the correlates of this discussion. We used cross-sectional data from the baseline of a randomized trial testing the efficacy of a risk reduction intervention. Participants were HIV-positive male and female patients attending five HIV primary care clinics in Miami-Dade County, Florida, USA. Overall, 37% of patients did not discuss oral health with their provider. After controlling for age, gender, education, and clinic, odds of discussion of oral health for respondents with five or more primary care visits in the past year were half the odds of those with fewer visits (odds ratio (OR)=0.525, 95% confidence interval (CI): 0.336, 0.821). Odds of discussion for men reporting illicit drug use were 35% of that for non-drug using men (OR=0.353, 95% CI: 0.186, 0.671). Odds of discussion were 1.4 times greater for each additional health topic discussed (e.g., nutrition and smoking) (95% CI: 1.317, 1.544). Given that more than one-third of patients reported no discussion of oral health with HIV primary care providers in the past year, there is a need to increase the focus on oral health in the HIV primary care setting.