Assessing patients’ attitudes to opt-out HIV rapid screening in community dental clinics: a cross-sectional Canadian experience

Abstract

BackgroundAs a public health initiative, provided-initiated HIV screening test in dental settings has long been available in the U.S.; it was only in 2011 that such setting was used in Canada. The objective of this paper was to assess patients’ response to, and attitudes towards, an opt-out rapid HIV screening test in a dental setting in Vancouver, Canada.MethodsA cross-sectional evaluation design using a self-complete survey questionnaire on self-perceived values and benefits of an opt-out rapid HIV screening was employed. An anonymous 10-item questionnaire was developed to explore reasons for accepting or declining the HIV rapid screening test, and barriers and facilitators for the HIV screening in dental settings. Eligible participants were male and female older than 19 years attending community dental clinics and who were offered the HIV screening test between June 2010 and February 2015.ResultsFrom the 1552 age-eligible patients, 519 completed the survey and 155 (10 %) accepted the HIV screening due to its convenience, and/or free cost, and/or instant results. From the 458 respondents who did not accept the screening, 362 (79 %) were between the ages of 25 and 45 years; 246 (53.7 %) had identifiable risk factors for contracting HIV; and 189 (41.3 %) reported having been tested within the last 3 months. Those tested in less than 3 months had 3.5 times higher odds to decline the HIV screening compared to those who have been tested between 3 months and 1 year.ConclusionsConvenience, cost-free and readily available results are factors influencing rapid HIV screening uptake. Although dental settings remain an alternative venue for HIV screening from the patients’ perspectives, dental hygiene settings might offer a better option.

Indian Dentist's Knowledge, Attitudes, and Willingness to Conduct HIV Testing: A Qualitative Study

“…A number of studies across the world have shown that dentists are willing to conduct HIV testing like in the cross-sectional study conducted in Canada 155 (10%) accepted the HIV screening due to its convenience, and/or free cost, and/or instant results [4] In another regional (Xi'an), cross-sectional survey conducted in China (N=477) the percentage of dentists willing to offer HIV testing was as high as 91.2% [5,6] followed by 89% amongst the Korean [7] dentists (N=475). Some of the other studies showed that 65.1% of the Australian [8] dentists (N=532) and 56.7% of the United States (US) dentists [9].…”

“…A number of barriers were posed in these studies which tend to limit the role of dentists in conducting HIV testing at a dental setting. The major barriers posed in these studies were lack of education, knowledge and training to administer HIV test, negative reactions from patients, financial constraints, giving out positive test results, and dealing with staff fear [5][6][7][8][9]. Therefore, there is a need to overcome these barriers in order to broaden the scope of HIV testing in the oral health setting.…”

Evaluating Point‐of‐Care HIV Screening in Dental Hygiene Education Settings: Patient, Faculty, and Student Perspectives

“…Individuals who are unaware of their serostatus may contribute to the 50% of new HIV infections 2 . Alternate settings for voluntary HIV opt‐out screening at point‐of‐care (POC), including dental settings, 3 – 5 may be able to reach those potentially infected individuals 6 . HIV screening in dental settings has been introduced in Canada—initially in Vancouver in 2011—but studies have found that it has not been fully successful, mostly because dentists feared their clinic would be labeled an “HIV clinic” and could not bill for the time spent administering the test 5 , 6 .…”

“…Alternate settings for voluntary HIV opt‐out screening at point‐of‐care (POC), including dental settings, 3 – 5 may be able to reach those potentially infected individuals 6 . HIV screening in dental settings has been introduced in Canada—initially in Vancouver in 2011—but studies have found that it has not been fully successful, mostly because dentists feared their clinic would be labeled an “HIV clinic” and could not bill for the time spent administering the test 5 , 6 . Dental hygiene settings have been suggested as better suited for such screenings, 6 given the increased acceptability among dental hygienists, 5 the extended amount of time they spend with patients, and their focus on health promotion and disease prevention.…”

“…The STOP program aims to ensure timely access to high‐quality and safe HIV/AIDS treatment; reduce the number of new HIV infections; reduce the impact of HIV/AIDS through effective screening and early detection; and improve the efficiency and cost‐effectiveness of HIV/AIDS service delivery by linking patients directly to proper care. As described elsewhere, 6 fourth‐year dental hygiene students and supervising dental hygiene clinical faculty members received education and training in POC HIV screening and then implemented the screening in four community dental hygiene clinics over 36 weeks in 2015–16. The current study constitutes an evaluation of that program.…”