Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada.

OBJECTIVES: To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia.

METHODS: Participants responded anonymously to a 40-item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses.

RESULTS: Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study.

CONCLUSIONS: Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers.