"It was pain. That's it. It was pain." Lack of oral health care among otherwise healthy young adults living with HIV in South Africa: A qualitative study

• Published in: PloS one 2017-12, Vol.12 (12), p.e0188353-e0188353
• Main Authors: Lambert, R Frederick, Orrell, Catherine, Haberer, Jessica E
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Adults; AIDS; Biology and Life Sciences; CD4 antigen; Communities; Data processing; Demographic aspects; Dental care; Dental caries; Dental Health Services - utilization; Dentists; Diabetes; Disease prevention; Drug therapy; Economic aspects; Ethics; Female; Health aspects; Health care; Health care policy; Health education; Health facilities; Health problems; Health services; Health Services Accessibility; HIV; HIV Infections - physiopathology; HIV patients; Human immunodeficiency virus; Humans; Low income areas; Male; Medical diagnosis; Medical tests; Medicine and Health Sciences; Oral Health; Oral hygiene; Pain; People and places; Population; Poverty; Primary care; Public health; Public sector; Qualitative analysis; Qualitative research; School effectiveness; Socioeconomic factors; South Africa; Studies; Young Adult; Young adults; Youth
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0188353

The purpose of this study is to understand engagement with and availability of dental services among people living with HIV in a low-income community of South Africa. In depth qualitative interviewing was used to collect data, which was analyzed using an inductive content analytical approach. The study was conducted in Gugulethu, a township community located outside of Cape Town, South Africa. Local public sector health services provided free of charge are the main source of primary health and dental care for this population. Participants included South African adults (age 18-35) recently diagnosed with HIV who had a CD4 count >350 cells/mm3. Many participants had little to no experience with dental care, did not know which health care providers are appropriate to address oral health concerns, were not aware of available dental services, utilized home remedies to treat oral health problems, harbored many misperceptions of dental care, avoided dental services due to fear, and experienced poverty as a barrier to dental services. Our findings suggest that integration of oral healthcare into medical care may increase patient knowledge about oral health and access to care. Leveraging the relatively robust HIV infrastructure to address oral disease may also be an effective approach to reaching these participants and those living in resource poor communities generally.