Acceptability of oral rapid HIV testing at dental clinics in communities with high HIV prevalence in South Florida

Abstract

BackgroundExpanding HIV screening for populations at risk necessitates testing in nontraditional settings. We assessed HIV testing in dental clinics in South Florida, an urban area with the highest rates of HIV diagnoses in the United States in 2015.AimsWe explored patients’ acceptance of oral HIV rapid tests administered by dental providers and identified reasons for accepting or declining HIV testing.MethodsDuring 2014 and 2015, dentists and hygienists at two federally qualified health center (FQHC) dental clinics who serve racial/ethnic minority patient populations in South Florida were trained to administer oral HIV rapid tests as a part of a routine dental visit. Patients presenting for dental services were offered a rapid HIV test and brief survey regarding their demographics, HIV testing history and behaviors.ResultsWe enrolled 600 patients (median age = 43 years; IQR: 29–56 years), 45% non-Hispanic black and 35% Hispanic/Latino, 83% graduated high school, and 50% unemployed. Most (85%) accepted oral HIV rapid testing (none tested HIV-positive); 14% had never been tested for HIV. The most common reasons for testing were a desire to know HIV status (56%) and free testing (54%). Among 93 (15%) patients who declined testing, 58% were tested recently and 31% felt confident that they were HIV-negative; however, 74 (80%) who declined testing said they would feel comfortable discussing HIV prevention with their dentist. Additionally, 290 of 600 patients (48%) reported condomless vaginal or anal sex in the past 6 months. Further, among 119 patients who had condomless sex with an HIV-positive partner and/or one whose HIV status was unknown, 98 (82%) accepted the oral HIV test.ConclusionDental clinics may provide expanded opportunities for oral HIV rapid testing and conversations about HIV prevention in high HIV prevalence communities.

HIV screening in dental settings: Challenges, opportunities, and a call to action

“…Research has addressed some of the concerns raised by dental care providers. Regarding concerns about offending patients by addressing HIV, one study surveyed a national‐representative sample of 600 dental patients at urban clinics where free HIV screening was offered (Bradley, Vidot, Gaul, Vidot, Gaul, Sutton, & Pereyra, 2018). Among patients surveyed, 85% evaluated HIV screening in the dental setting as acceptable, citing the main reasons for screening as wanting to know their status, and having a free HIV test available.…”

HIV screening in the dental setting in New York State

“…The 26-month project found one new confirmed HIV positive diagnosis among 9,057 tests performed, resulting in a 0.011% rate. This rate was higher than that of Bradley et al (2018) [27] and Nassry et al (2012), [29] which found no HIV positive persons, whereas this rate was lower than 0.31% in Suarez-Durall et al (2019), [26] 0.53% in Blackstock et al (2010) [28] or 0.13% in Leung et al (2016). [30] It is noteworthy that these studies found almost all of the HIV positive individuals in high-risk areas such as Los Angeles and New York City, and that the estimated percentage of people with undiagnosed HIV (among the adult population) was much higher in New York City (0.081%) than the rest of the state (0.037%) in 2017.…”

“…319 patients (out of 811) accepted the offer; and one was confirmed HIV positive. In a study by Bradley et al (2018), [27] dentists and hygienists administered rapid oral HIV screening as part of routine care at two dental clinics in South Florida in 2015. A large majority of patients (507 out of 600 patients) accepted HIV screening, but none tested reactive.…”

Voluntary Counselling and Testing for HIV in the dental setting: Knowledge, attitudes and practices of oral health care workers in eThekwini district, KwaZulu-Natal

“…6 The reported benefits of rapid HIV testing in the dental workplace, highlights a significant positive impact on patients visiting the dental sector. 8,9,10 These reports reiterate the value and role of oral health care workers as an integral component in early HIV recognition and management. 4,11,12 Studies examining oral health care workers' knowledge, attitudes, perceptions and practice regarding VCT at the dental workplace, suggested that oral health care workers were generally supportive of extending HIV testing services to the dental setting.…”