A Qualitative Study of Patients’ Attitudes toward HIV Testing in the Dental Setting

An estimated 1.1 million people in the USA are living with HIV/AIDS. Nearly 200,000 of these individuals do not know that they are infected. In 2006, the CDC recommended that all healthcare providers routinely offer HIV screening to adolescent and adult patients. Nurse-dentist collaborations present unique opportunities to provide rapid oral HIV screening to patients in dental clinic settings and reach the many adults who lack primary medical providers. However, little is known about the feasibility and acceptability of this type of innovative practice. Thus, elicitation research was undertaken with dental providers, students, and patients. This paper reports the results of qualitative interviews with 19 adults attending a university-based dental clinic in New York City. Overall, patients held very positive attitudes and beliefs toward HIV screening in dental sites and identified important factors that should be incorporated into the design of nurse-dentist collaborative HIV screening programs. 1. Introduction An estimated 1.1 million people are currently living with HIV in the USA, yet one in five are unaware of their status [1]. Early diagnosis and treatment have dramatically increased lifespan and reduced HIV transmission; yet 55% of adults, ages 18–64, report they have never been tested for HIV. Among those who have been tested and were found to be infected, at least one-third discovered their status late in the course of their illness, thus missing the opportunity to receive the maximum benefits that early treatment provides [1]. To facilitate early diagnosis and treatment, the Centers for Disease Control and Prevention (CDC) issued revised recommendations in 2006 for widespread HIV testing [2]. The new recommendations proposed that HIV testing be offered to all individuals, ages 13 to 64, in all healthcare settings on an “opt-out” basis, rather than waiting for patients to request testing. These revisions brought HIV testing in line with other STI protocols and helped reduce what had been referred to as “HIV exceptionalism” [3]. Requirements that were specific to HIV testing that were often viewed as barriers to expanded screening, for example, written informed consent, were eliminated [2]. In addition, the CDC recommended that prevention counseling no longer be required. These revised standards, along with the availability of rapid testing technology, have helped bring HIV screening to new venues [4–6]. Dental practice sites represent new venues with great promise [6–8] and the potential to reach millions of Americans who see a dentist but not a