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. 2000 Jul;90(7):1059–1063. doi: 10.2105/ajph.90.7.1059

Perceived unmet need for oral treatment among a national population of HIV-positive medical patients: social and clinical correlates.

M Marcus 1, J R Freed 1, I D Coulter 1, C Der-Martirosian 1, W Cunningham 1, R Andersen 1, I Garcia 1, D A Schneider 1, W R Maas 1, S A Bozzette 1, M F Shapiro 1
PMCID: PMC1446293  PMID: 10897183

Abstract

OBJECTIVES: This study examines social, behavioral, and clinical correlates of perceived unmet need for oral health care for people with HIV infection. METHODS: Baseline in-person interviews with 2864 individuals were conducted with the HIV Cost and Services Utilization Study cohort, a nationally representative probability sample of HIV-infected persons in medical care. Bivariate and logistic regression analyses were conducted, with unmet need in the last 6 months as the dependent variable and demographic, social, behavioral, and disease characteristics as independent variables. RESULTS: We estimate that 19.3% of HIV-infected medical patients (n = 44,550) had a perceived unmet need for dental care in the last 6 months. The odds of having unmet dental needs were highest for those on Medicaid in states without dental benefits (odds ratio [OR] = 2.21), for others with no dental insurance (OR = 2.26), for those with incomes under $5000 (OR = 2.20), and for those with less than a high school education (OR = 1.83). Low CD4 count was not significant. CONCLUSIONS: Perceived unmet need was related more to social and economic factors than to stage of infection. An expansion of dental benefits for those on Medicaid might reduce unmet need for dental care.

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Selected References

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  1. Andersen R. M., Davidson P. L. Ethnicity, aging, and oral health outcomes: a conceptual framework. Adv Dent Res. 1997 May;11(2):203–209. doi: 10.1177/08959374970110020201. [DOI] [PubMed] [Google Scholar]
  2. Berk M. L., Schur C. L., Cantor J. C. Ability to obtain health care: recent estimates from the Robert Wood Johnson Foundation National Access to Care Survey. Health Aff (Millwood) 1995 Fall;14(3):139–146. doi: 10.1377/hlthaff.14.3.139. [DOI] [PubMed] [Google Scholar]
  3. Bonuck K. A., Arno P. S., Green J., Fleishman J., Bennett C. L., Fahs M. C., Maffeo C. Self-perceived unmet health care needs of persons enrolled in HIV care. J Community Health. 1996 Jun;21(3):183–198. doi: 10.1007/BF01557998. [DOI] [PubMed] [Google Scholar]
  4. Burgan S. W. The role of tobacco use in periodontal diseases: a literature review. Gen Dent. 1997 Sep-Oct;45(5):449–470. [PubMed] [Google Scholar]
  5. Fleishman J. A., Schneider D. A., Garcia I., Hardwick K. Dental service use among adults with human immunodeficiency virus infection. Med Care. 1997 Jan;35(1):77–85. doi: 10.1097/00005650-199701000-00007. [DOI] [PubMed] [Google Scholar]
  6. Frankel M. R., Shapiro M. F., Duan N., Morton S. C., Berry S. H., Brown J. A., Burnam M. A., Cohn S. E., Goldman D. P., McCaffrey D. F. National probability samples in studies of low-prevalence diseases. Part II: Designing and implementing the HIV cost and services utilization study sample. Health Serv Res. 1999 Dec;34(5 Pt 1):969–992. [PMC free article] [PubMed] [Google Scholar]
  7. Krall E. A., Garvey A. J., Garcia R. I. Alveolar bone loss and tooth loss in male cigar and pipe smokers. J Am Dent Assoc. 1999 Jan;130(1):57–64. doi: 10.14219/jada.archive.1999.0029. [DOI] [PubMed] [Google Scholar]
  8. Lenker S. L., Lubeck D. P., Vosler A. Planning community-wide services for persons with HIV infection in an area of moderate incidence. Public Health Rep. 1993 May-Jun;108(3):285–293. [PMC free article] [PubMed] [Google Scholar]
  9. Marx R., Katz M. H., Park M. S., Gurley R. J. Meeting the service needs of HIV-infected persons: is the Ryan White CARE Act succeeding? J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Jan 1;14(1):44–55. doi: 10.1097/00042560-199701010-00008. [DOI] [PubMed] [Google Scholar]
  10. Mueller C. D., Schur C. L., Paramore L. C. Access to dental care in the United States. J Am Dent Assoc. 1998 Apr;129(4):429–437. doi: 10.14219/jada.archive.1998.0241. [DOI] [PubMed] [Google Scholar]
  11. Shapiro M. F., Berk M. L., Berry S. H., Emmons C. A., Athey L. A., Hsia D. C., Leibowitz A. A., Maida C. A., Marcus M., Perlman J. F. National probability samples in studies of low-prevalence diseases. Part I: Perspectives and lessons from the HIV cost and services utilization study. Health Serv Res. 1999 Dec;34(5 Pt 1):951–968. [PMC free article] [PubMed] [Google Scholar]
  12. Shiboski C. H., Palacio H., Neuhaus J. M., Greenblatt R. M. Dental care access and use among HIV-infected women. Am J Public Health. 1999 Jun;89(6):834–839. doi: 10.2105/ajph.89.6.834. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Tonetti M. S. Cigarette smoking and periodontal diseases: etiology and management of disease. Ann Periodontol. 1998 Jul;3(1):88–101. doi: 10.1902/annals.1998.3.1.88. [DOI] [PubMed] [Google Scholar]

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