A report from Jacqueline Tulsky, MD, a professor of clinical medicine, UCSF Department of Medicine based at San Francisco General Hospital and Trauma Center:
Would your dentist be willing to offer you an HIV test? Though not in sync with the title of the [AIDS 2012] session, this intriguing question was explored by Lisa Metsch and colleagues in a mailed survey of 2,567 members randomly selected to be a representative sample of members of the National Dental Association.
In exploring expanded venues for fulfilling the [Centers for Disease Control and Prevention] 2006 guidelines to screen all adults age 18 to 65 at least once in their lifetime, dental offices are potential high-yield sites. An estimated 3.6 million Americans report that they are at significant HIV risk, yet have never been HIV tested. Three quarters of these people have seen a dentist within the past 2 years. Dental care offers opportunities to serve at-risk individuals who are otherwise unlikely to be tested or to receive preventive care services.
The response rate on the survey was a robust 70% with 1,802 surveys returned. Preliminary data analysis revealed that while 41% of dentists would be willing to offer rapid HIV testing using fingerstick blood, the number rose to 63% when the question asked about performing rapid oral HIV tests in the office. Nearly 50% thought that HIV testing was part of a list of health care services that they should make available to patients.
The Perception of Others
In multivariate analysis, dentists were more willing to offer testing if they perceived their patients (adjusted odds ratio (AOR) = 3.5; CI: 2.7, 4.3) and their colleagues (AOR= 2.7; CI: 2.2 3.2), as having a positive attitude toward HIV testing by dentists.
The audience for the session was clearly intrigued by the possibility of testing inside a dental setting, but asked about the challenge of appropriate counseling and linkage to care. In discussions afterwards, the UCSF National Clinician’s Consultation Center, a free phone education and support program for medical professionals, was identified as a source of information about HIV testing and linkage to care throughout the U.S.