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HIV Testing in the Dental Chair

Date of Report: 09/2010
Source: New York/New Jersey AETC

The need for and benefits of early detection of HIV along with the availability of rapid oral HIV tests makes the dental care setting an important potential site for HIV testing. The New York/New Jersey AETC (NY/NJ AETC) in collaboration with state dental associations conducted an online needs assessment survey of dental practitioners in NY and NJ to assess barriers and facilitators to HIV testing in the dental setting. Building on the results of the assessment, the Oral Health Regional Resource Center of the NY/NJ AETC (New York State Department of Health--AIDS Institute) developed a technical assistance manual for oral health settings entitled HIV Testing in the Dental Chair .

In 2009, the NY/NJ AETC conducted a survey of dentists in collaboration with the New York and New Jersey Dental Associations. A total of 165 dentists responded; the majority (75%) were practicing in a private dental office and in "general dentistry". Most dentists (65%) were interested in learning more about HIV testing and the majority (60%) agreed that the American Dental Association should support a policy in favor of HIV testing in dental settings. At the same time, HIV screening was viewed less a part of dentists' professional role than, for example, smoking or hypertension screenings. Dentists reported having had limited training regarding HIV and lack of knowledge and training were perceived by dentists as the most important barriers (77%). Among other barriers were fear of delivering positive results and reimbursement issues.

While some dentists are ready to implement pioneering HIV testing programs, especially in higher prevalence communities, they require technical assistance to do so. In addition, the majority of private practice dentists are in need of introductory information about HIV testing.

The results of this needs assessment informed the development of the HIV Testing in the Dental Chair manual. The manual, which was presented at the 2010 Ryan White All Grantee Meeting, includes a self- assessment tool for agencies interested in testing implementation, with key questions to consider and a self-assessment of feasibility; a guide to developing protocols for testing, including regional requirements; implementation guidelines; a summary of available test kits; a summary of quality control requirements; training and educational resources; state forms; and, regional resources for patient referral for follow-up confirmatory testing.

Bringing together these resources for the dental setting in combination with the provision of technical assistance and hands on clinical training has facilitated the implementation of rapid testing in dental settings in the region. The NY/NJ AETC Oral Health Regional Resource Center has provided technical assistance over the last eighteen months to a number of dental clinics and private providers in New York State, and elsewhere using this manual. Many settings in New York State, including dental clinics as well as private offices, have begun implementing HIV testing and have already identified preliminary positive patients. NY/NJ AETC provides ongoing support to these sites to meet their training needs.

If you would like more information on replicating a similar program in your AETC, contact either:

dot Howard Lavigne, NY/NJ AETC
Oral Health RRC Program Director
Hel01@health.state.ny.us
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dot Cheryl Stolarski,DMD,
NY/NJ AETC Dental Co-Director
crs03@health.state.ny.us
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