Abstract
BackgroundHIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors.MethodsDental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview.ResultsA total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8).ConclusionDisparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.
Highlights
Human Immunodeficiency Virus (HIV) infected patients should be expected in the Sudanese dental health care services with an increasing frequency
Enabling- and need related factors by hospital of attendance Table 2 depicts the percentage distribution of sum scores of enabling and need related factors (DMFT, perceived general and oral health) based on hospital of attendance
In light of previous studies suggesting that fear of contracting HIV tend to decrease with increasing level of education [24], the present results suggest that social resources related to HIV and Acquired Immune Deficiency Syndrome (AIDS) seem to be influenced by factors other than people's educational level
Summary
HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (sociodemographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. With the exception of the Sudan the HIV epidemics in the Middle East and North Africa is comparatively small [2] This is so in Sub-Saharan Africa where an estimated 22 million people were living with HIV and Acquired Immune Deficiency Syndrome (AIDS) towards the end of 2007 and where access to dental health care services is commonly very limited [3,4]. HIV infected patients should continue to be expected in the Sudanese dental health care services with an increasing frequency
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