Provider and Patient Acceptance of HIV Testing in a Dental Clinic

In 2006 the US Center for Disease Control and prevention (CDC) revised the recommendations for HIV testing to increase the level of HIV screening of patients and thus foster earlier detection of HIV infection, identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services. It was suggested that a dental setting would be an appropriate site for HIV testing because of the regular frequency with which patients see a dentist rather than a physician. A study was conducted to determine the provider acceptance of offering HIV testing using the OraQuick Rapid HIV Test to patients admitted into the clinics at New York University College of Dentistry (NYUCD) and a follow-up study was conducted to monitor patient willingness to be tested. The provider acceptance study consisted of a survey to assess dental providers' previous experience with HIV testing and their attitudes towards conducting routine HIV testing within the context of a dental clinic setting. The survey was completed by 106 NYUCD clinical faculty. The most prominent barrier to conducting HIV testing was the lack of familiarity with the protocol, the associated paperwork, processing, and logistics of testing. The majority of faculty who took the survey (55.1%) felt that NYUCD has sufficient resources to provide the necessary subsequent referral services and access to care for persons identified as HIV positive. In the patient willingness to be tested study, initially, recruitment materials were given to patients by a receptionist along with other documents required for registration. In addition, patients were informed that that the test would require 30 min at the end of the dental visit. Most of the patients approached in this manner declined to participate. Subsequently the protocol was changed so that the patient was approached by the dental practioner and the oral sample taken early in the dental visit, thus eliminating the wait time. This greatly increased the % of patients participating in testing to 82.3. Of particular interest was that ~47% of the patients asked to participate declined because they had already been recently screened or were identified as HIV+. These studies demonstrate that dental care providers recognized the importance of HIV testing and had an optimistic outlook as to how HIV+ test results could be handled in a clinic setting and that many dental patients accepted HIV testing in a dental environment. These results support further attempts to incorporate rapid HIV testing as part of a program of routine patient care at NYUCD.

This project was supported by an NYUCD Dean’s Research Award to MG, a NYSTAR grant to DM, and NIH grant U01DE017855