Oral health-related quality of life among low-income adults living with HIV


Dr. Scott L. Tomar, Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, 1329 SW 16th Street, Suite 5180, PO Box 103628, Gainesville, FL 32610-3628. Tel.: +1-352-273-5968; Fax: +1-352-273-5985; e-mail: stomar@dental.ufl.edu. Scott L. Tomar is with the Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry. Margaret Pereyra and Lisa R. Metsch are with the Department of Epidemiology and Public Health, University of Miami Miller School of Medicine.


Objectives: To explore oral health-related quality of life and its correlates among low-income human immunodeficiency virus (HIV)-positive patients receiving primary HIV care.

Methods: Data were from a randomized experimental trial evaluating an intervention to increase use of oral health services by low-income HIV-positive adults. Interviews were conducted in English or Spanish among 594 adults receiving HIV medical care but not dental care. Oral health-related quality of life was measured with the 49-item Oral Health Impact Profile (OHIP-49). Primary predictor variables included measures of HIV disease: duration of HIV infection, CD4 cell count, and HIV viral load. Other predictors included sociodemographic and behavioral factors.

Results: Overall, 62.6 percent of participants had experienced at least one oral health impact very often or fairly often in the 4 weeks preceding the survey, with a mean of 5.8 impacts. The mean number of impacts was significantly higher for women, the unemployed, those living in temporary housing, and current smokers. Neither the prevalence nor the mean number of impacts differed significantly by duration of HIV infection, CD4(+) T lymphocyte cell count, or HIV viral load. In bivariate analysis, women had higher mean OHIP-49 scores than men overall (62.6 versus 50.5, P < 0.05) and for most subscales, indicating that women experienced more oral health impacts. In the final multivariate model, significant correlates of OHIP-49 were sex, race/ethnicity, living situation, and smoking status.

Conclusions: Oral health impacts are prevalent among adults in South Florida living with HIV, particularly among women, cigarette smokers, those in prison or other institutional settings, and certain racial and ethnic groups.