DENTAL CARE: Many HIV-Positive Women Go without Care Due to Fear, Other Barriers
"HIV-positive women appear to be underusing dental care services," according to a study published in the American Journal of Public Health. Of 213 HIV-positive California women surveyed, 43% had not seen a dentist and 53% had not had their teeth cleaned in the past year. Of those who did not receive any dental care, 78% said they wanted care but didn't get it. Fear of dentists, lack of information regarding available dental care, unemployment, injection drug use and a perception of poor oral health were identified as barriers to dental care services. Black women were more likely than white women to be nonusers of dental care. In addition, the study found that the "proportion of women who reported having had a dental cleaning in the previous year was no higher among Medi-Cal recipients than among women without coverage." As a result, the authors suggest that "some may not be aware of their eligibility to receive basic dental care." The findings, they conclude, suggest "the need to better inform HIV-infected populations, their primary care providers, and social workers about available benefits" (Shiboski et al., June 1999 issue).
An Idea with Teeth
Scouting out "oral health providers who are available and accessible to Medicaid recipients is a real struggle," said Dr. Georgina Zabos of Columbia University's School of Public Health. In an accompanying editorial, Zabos points to the study as evidence that dental providers should work to break down the barriers to care for HIV-positive women. "Expanded hours are essential, as are family-centered services where women and their families can be treated together," she says, noting that dental schools are beginning to do their part to educate their dentists about HIV. Challenging dentists to "prepare for the long haul," Zabos says dental "schools need to attract faculty role models interested in working with underserved HIV populations. ... If the oral health needs of poor women of color and their families are to be met, the dental profession must learn to redouble its efforts to educate and inspire dentists who will stay where they are needed" (Zabos, AJPH, June 1999 issue).