Utilization of Dental Services in Context of HIV in Sudan

1Faculty of dentistry, University of Science and Technology, Sudan, 2Centre for International Health, University of Bergen, Norway and 3Institute of Clinical Dentistry, Faculty of Medicine and Odontology, University of Bergen, Norway

Objectives: Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the frequency of dental care utilization in the past 2 years and the extent to which Andersen’s model in terms of predisposing- (socio-demographics), enabling- (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing- and need related factors.

Methods: Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) March-July 2008. A total of 1262 patients with un-known HIV-status (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically and interviewed.

Results: A total of 53.9% attended a dental clinic at least once in the past 2 years. Logistic regression revealed that predisposing factors; travelling inside Sudan (OR=0.5) were associated with lower odds and females were associated with higher odds (OR= 2.0) for dental-service utilization. Enabling factors; higher knowledge of HIV transmission (OR= 0.6) and higher HIV related experience (OR= 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR=1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR= 4.8).

Conclusion: Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV-infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.