US study: 1 in 20 LA dentists refuses to treat anyone with HIV

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A Williams Institute study has found that 5% of dentists they polled refuse services to people living with HIV/AIDS, but said this rate is comparatively good for the US healthcare industry.

The study authors say another 5% of the 612 dentists’ offices in Los Angeles County, California would take people living with HIV as patients, but would only offer teeth-cleaning services, ask them to come in on separate days or isolate them from other patients.

Co-author Brad Sears, Roberta A. Conroy Scholar of Law and Executive Director of the Williams Institute, said: “Thirty years into the epidemic, HIV-positive patients continue to face discrimination when accessing dental care.

“While it is definitely encouraging that 90% of dentists in Los Angeles County do treat HIV-positive patients, it is likely that the rate of discrimination is higher in other parts of the country.”

The study used what it termed “testers”, people who would call dental offices posing as potential new HIV-positive patients.

Over 600 dental offices in Los Angeles County were contacted in 2007 and 2008.

Calls to the offices were made in English and Spanish, and by callers who said they had private dental insurance and state-subsidised cover.

The Institute points out that the 10% rate of discrimination among dentists is lower than that of other health care providers.

Los Angeles County studies conducted by Brad Sears between 2003 and 2006 found that 55% of obstetricians, 46% of skilled nursing facilities, and 25% of plastic surgeons had policies that specifically discriminated against people living with HIV or AIDS.

Sears says: “The study suggests that consistent legal enforcement and education efforts, both during dental school and afterwards, have had a positive effect on dentists, and have thus created expanded access to care for people living with HIV/AIDS.”

The study cites dentists’ main reasons for refusing HIV-positive patients were that they were not equipped to treat HIV-positive patients and that extra infection control precautions would be required.

Co-author Fariba S. Younai, Professor of Clinical Sciences & Vice Chair, Division of Oral Biology and Medicine, UCLA School of Dentistry said: “Dentists can treat HIV-positive patients safely and effectively.

“The same standard infection control precautions should be used with all patients and every patient should be treated as if they had a blood borne disease. Thus, every dental office should be equipped to treat HIV-positive patients.”

Discrimination was twice as high for those people who had Denti-Cal, the state-subsidised insurance, as opposed to a private scheme.

Rates of discrimination were also higher in areas experiencing higher rates of HIV-infection, and with more lower-income people or a larger non-white population and women among the infected.

Co-author Tom Donohoe, an Associate Professor at UCLA’ David Geffen School of Medicine, said: “The findings indicate that training and education efforts over the past 20 years have had a positive effect.

“Many of the dental clinics tested responded with affirmations such as, ‘Of course we would accept you, we do not discriminate here.’ However, the data also suggest the need for more targeted education efforts to ensure equal access to dental services.”