The Big Picture

Rapid HIV screening in dental offices

Background

The United Nations estimates that worldwide 36.9 million people are living with HIV, with the disease now considered a chronic condition rather than the death sentence it was considered 30 years ago. New rates of HIV infection have fallen by 35% globally, and AIDS-related deaths have fallen by 42% (Fig 1). Most people diagnosed with HIV infection can expect to live a long, healthy life, similar to those diagnosed with diabetes. A key element in the HIV prevention strategy is improved

HIV Prevention Strategies and Diagnosis

Early diagnosis of HIV infection allows earlier access to effective treatments and reduces the risk of further transmission. People who know their HIV status tend to reduce their high-risk sexual behaviors by 68%, based on published studies. In the United Kingdom, HIV preventive policies are geared toward reducing HIV transmission by increasing prevention and early diagnosis efforts while improving treatment and care for those living with the virus. Routine HIV screening is done only for

Role of the Dentist

Dentists surveyed in various countries indicated a range of willingness to offer rapid HIV screening tests. For example, 61.5% of Australian dentists, 56.7% of US dentists, and 90% of Vietnamese dentists indicated a willingness to conduct the tests on patients.

Dentists’ attitudes concerning the need for HIV screening in the oral health care setting differ as well (Table 2). Dentists who thought the screening was needed tended to be younger, have fewer years of experience, work in a private

Barriers to Implementation

Dental practitioners cite a number of barriers to implementing rapid HIV screening in the dental practice. Among these are lack of training and knowledge, limited time for treatment, and concerns over who will pay for the tests. In addition, they worry that patients will not see the relevance of HIV testing to dentistry, will be upset or alienated by the experience, or will not receive the sensitive treatment and discussion appropriate to sexual health matters. Special contractual arrangements