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AIDS 2012: Three Out of Five Dentists Agree…To Offer HIV Testing!

, by Reilly O'Neal

DentistApptCROPA survey reported Tuesday at AIDS 2012 showed that 63% of U.S. dentists would be willing to offer rapid oral HIV testing at their dental practice or clinic. As presenter Lisa Metsch of Columbia University pointed out, expanding HIV testing to dental care settings could help reach people who are not getting tested elsewhere.

In fact, a 2010 article coauthored by Metsch observed that 70% of the 3.5 million U.S. adults who have never had an HIV test and who report engaging in behaviors that put them at risk for HIV have had recent contact with a dental provider.

Testing for HIV wouldn’t be beyond the pale for dental care settings, Metsch said, noting that many of the 1,802 dentists who replied to the survey already offer hypertension screening using a blood pressure cuff. “Why not take on HIV testing?” she asked. Indeed, among survey respondents who already offer screening for oral cancer during dental visits, 75% were willing to add rapid HIV testing to their menu of services.

Metsch acknowledged that further investigation is needed into dentists’ and dental patients’ willingness to pursue HIV testing in this particular health care setting, and into the potential cost-effectiveness of such programs.

Still, she concluded, dental visits represent an untapped opportunity to increase HIV status awareness, link newly-diagnosed people with care and treatment, and normalize HIV testing.

Dentist’s willingness to offer oral HIV rapid testing: results from a nationally representative survey

Metsch, L. and others

Background: Identification of undiagnosed persons with HIV infection is a public health challenge. The 2006 CDC guidelines recommend wide spread screening in a variety of health care settings. Prior research highlights the potential of the dental care setting as a promising venue for HIV screening of otherwise untested individuals.

Methods: We performed a nationally representative survey of general dentists which examined barriers and facilitators to offering oral HIV rapid testing at chair side (n=1802, 70% response rate). Sixty-three percent of dentists indicated they were somewhat or very willing to rapid testing in the next year. We examined dentists´ willingness to perform such testing using multivariable logistic regression controlling for potential confounders (age, gender, and race/ethnicity).

Results: Dentists´ willingness to offer rapid testing in the next year was positively associated with dentists´ positive attitude regarding patient acceptance of testing (AOR=3.5; CI: 2.7, 4.3). Agreement with the statement “my colleagues´ perception of me as a health care provider would improve” was also positively associated with willingness to offer testing (AOR=2.7 for each unit increase in 4-point agreement scale; CI: 2.2, 3.2). Finally, dentists´ agreement with the importance for all persons at high risk to get tested for HIV annually was positively associated with willingness to offer testing (AOR=1.7 for each unit increase in 4-point agreement scale; CI: 1.4, 2.0).

Conclusions: Dentists appear potentially willing to perform HIV screening within general practice settings. Patients´ and colleagues´ perceptions appear important in shaping dentists´ attitudes and likely behavior concerning this service. These findings may inform the targeting of patient and provider behavior change interventions.

Reilly O’Neal is the editor of BETA.

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