What are the self-reported unmet dental treatment needs of people living with HIV in British Columbia? A case of minority subpopulation in Canada

Abstract

Objectives: To identify associations of Andersen and Newman's (A&N) predisposing, enabling, and need factors with self-reported oral health status and self-reported unmet dental treatment needs in a sample of people living with HIV (PLHIV) in British Columbia (BC), Canada.

Methods: Participants responded anonymously to a 41-item online questionnaire with the following inclusion criteria: a) be at least 19 years old; b) self-identify as HIV-positive; c) be able to provide consent and be willing to voluntarily participate in the study; d) be residing in British Columbia; and e) be able to proficiently respond to the questions in English. Following the descriptive statistics, associations between A&N model factors and the main outcome variables (self-reported oral health status and self-reported dental treatment needs) were evaluated using bivariate inferential analyses.

Results: A total of 186 participants met the inclusion criteria. Approximately 40% (n = 74) of participants rated the health of their mouth as fair/poor and more than half (n = 112; 60.2%) reported having bleeding gums, tooth decay or tooth sensitivity. The bivariate analysis for the self-reported oral status as the outcome variable showed "having fair/poor general health" (P = 0.001), "unemployment" (P = 0.019), "avoiding dental treatment due to cost" (P = 0.005), and "not visiting a dental professional within the last year" (P < 0.001) as the strongest predictors. For the second outcome variable unmet dental treatment needs, the strongest predictors were "experience of being discriminated by dental professionals" (P = 0.001), "having fair/poor general health" (P = 0.006), and "suffering from past and current medical conditions due to HIV" (P < 0.001).

Conclusions: Several predisposing, enabling and need factors from the A&N model were associated with self-reported oral health status and unmet dental treatment needs of PLHIV. Results from this study highlight the needs of improving access to affordable dental care to address the unmet oral health needs of PLHIV.

Keywords: enabling factors; marginalized population; need factors; people living with HIV; predisposing factors; self-reported oral health; stigma and discrimination; unmet dental treatment needs.