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American Journal of Public Health logoLink to American Journal of Public Health
. 1999 Jun;89(6):834–839. doi: 10.2105/ajph.89.6.834

Dental care access and use among HIV-infected women.

C H Shiboski 1, H Palacio 1, J M Neuhaus 1, R M Greenblatt 1
PMCID: PMC1508645  PMID: 10358671

Abstract

OBJECTIVES: This study sought to identify predictors of dental care use in HIV-infected women. METHODS: In a cross-sectional survey of HIV-infected women enrolled in the northern California site of the Women's Interagency HIV Study, dental care use and unmet need were assessed in relation to selected variables. RESULTS: Among 213 respondents, who were predominantly Black and younger than 45 years, 43% had not seen a dentist and 53% (among dentate women) reported no dental cleaning in more than a year (although 67% had dental insurance coverage, mainly state Medicaid). Nine percent were edentulous. Among nonusers of dental care, 78% reported that they wanted care but failed to get it. Barriers included fear of and discomfort with dentists, not getting around to making an appointment, and not knowing which dentist to visit. Multivariate analysis showed that lack of past-year dental care was associated mainly with unemployment, a perception of poor oral health, and edentulism. CONCLUSIONS: HIV-positive women appear to be underusing dental care services. Fear and lack of information regarding available resources, in addition to unemployment and perception of poor oral health, may be important barriers.

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Selected References

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  1. Aday L. A., Forthofer R. N. A profile of black and Hispanic subgroups' access to dental care: findings from the National Health Interview Survey. J Public Health Dent. 1992 Summer;52(4):210–215. doi: 10.1111/j.1752-7325.1992.tb02275.x. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Andersen R. M. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995 Mar;36(1):1–10. [PubMed] [Google Scholar]
  4. 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]
  5. Capilouto E. I., Piette J., White B. A., Fleishman J. Perceived need for dental care among persons living with acquired immunodeficiency syndrome. Med Care. 1991 Aug;29(8):745–754. doi: 10.1097/00005650-199108000-00007. [DOI] [PubMed] [Google Scholar]
  6. Centers for Disease Control and Prevention (CDC) Dental service use and dental insurance coverage--United States, Behavioral Risk Factor Surveillance System, 1995. MMWR Morb Mortal Wkly Rep. 1997 Dec 19;46(50):1199–1203. [PubMed] [Google Scholar]
  7. Elter J. R., Strauss R. P., Beck J. D. Assessing dental anxiety, dental care use and oral status in older adults. J Am Dent Assoc. 1997 May;128(5):591–597. doi: 10.14219/jada.archive.1997.0258. [DOI] [PubMed] [Google Scholar]
  8. Gielen A. C., Faden R. R., O'Campo P., Kass N., Anderson J. Women's protective sexual behaviors: a test of the health belief model. AIDS Educ Prev. 1994 Feb;6(1):1–11. [PubMed] [Google Scholar]
  9. Gisselsson H., Birkhed D., Björn A. L. Effect of a 3-year professional flossing program with chlorhexidine gel on approximal caries and cost of treatment in preschool children. Caries Res. 1994;28(5):394–399. doi: 10.1159/000262008. [DOI] [PubMed] [Google Scholar]
  10. Greene V. A., Chu S. Y., Diaz T., Schable B. Oral health problems and use of dental services among HIV-infected adults. Supplement to HIV/AIDS Surveillance Project Group. J Am Dent Assoc. 1997 Oct;128(10):1417–1422. doi: 10.14219/jada.archive.1997.0061. [DOI] [PubMed] [Google Scholar]
  11. Grembowski D., Andersen R. M., Chen M. A public health model of the dental care process. Med Care Rev. 1989 Winter;46(4):439–496. doi: 10.1177/107755878904600405. [DOI] [PubMed] [Google Scholar]
  12. Hayward R. A., Meetz H. K., Shapiro M. F., Freeman H. E. Utilization of dental services: 1986 patterns and trends. J Public Health Dent. 1989 Summer;49(3):147–152. doi: 10.1111/j.1752-7325.1989.tb02051.x. [DOI] [PubMed] [Google Scholar]
  13. Holloway P. J., Clarkson J. E. Cost: benefit of prevention in practice. Int Dent J. 1994 Aug;44(4):317–322. [PubMed] [Google Scholar]
  14. Kedes D. H., Ganem D., Ameli N., Bacchetti P., Greenblatt R. The prevalence of serum antibody to human herpesvirus 8 (Kaposi sarcoma-associated herpesvirus) among HIV-seropositive and high-risk HIV-seronegative women. JAMA. 1997 Feb 12;277(6):478–481. [PubMed] [Google Scholar]
  15. Kronenfeld J. Access to dental care: a comparison of medicine/dentistry and the role of a regular source. Med Care. 1979 Oct;17(10):1000–1011. [PubMed] [Google Scholar]
  16. Lemeshow S., Hosmer D. W., Jr A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol. 1982 Jan;115(1):92–106. doi: 10.1093/oxfordjournals.aje.a113284. [DOI] [PubMed] [Google Scholar]
  17. 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]
  18. Manski R. J., Goldfarb M. M. Dental utilisation for older Americans aged 55-75. Gerodontology. 1996 Jul;13(1):49–55. doi: 10.1111/j.1741-2358.1996.tb00150.x. [DOI] [PubMed] [Google Scholar]
  19. Milgrom P., Fiset L., Melnick S., Weinstein P. The prevalence and practice management consequences of dental fear in a major US city. J Am Dent Assoc. 1988 May;116(6):641–647. doi: 10.14219/jada.archive.1988.0030. [DOI] [PubMed] [Google Scholar]
  20. Newman J. F., Gift H. C. Regular pattern of preventive dental services--a measure of access. Soc Sci Med. 1992 Oct;35(8):997–1001. doi: 10.1016/0277-9536(92)90239-m. [DOI] [PubMed] [Google Scholar]
  21. Schneider D. A., Hardwick K. S., Marconi K. M., Niemcryk S. J., Bowen G. S. Delivery of oral health care through the Ryan White CARE Act to people infected with HIV. J Public Health Dent. 1993 Fall;53(4):258–264. doi: 10.1111/j.1752-7325.1993.tb02714.x. [DOI] [PubMed] [Google Scholar]

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