Use of dental care services among adolescents living with HIV on Antiretroviral Treatment in Kampala, Uganda: a cross-sectional study

TL;DR

This study finds that only 12% of HIV-positive adolescents in Kampala use dental care services, with factors like age and fear of HIV spread influencing their use.

Contribution

The study identifies socio-behavioral determinants of dental care use among HIV-positive adolescents in Uganda using Andersen’s behavioral model.

Findings

Only 12.3% of HIV-positive adolescents in Kampala have ever used dental care services.

Older adolescents (14–18 years) are more likely to use dental services than younger ones.

Fear of HIV spread and bad oral odor are associated with dental care use.

Abstract

The main purpose of this study to assess the prevalence and socio-behavioural determinants of ever-use of dental care services among the adolescents aged 10–18 years, living with HIV on Antiretroviral treatment (ART), attending selected HIV clinics in Kampala, Uganda.

A cross-sectional study was carried out between March and September 2020. The study conveniently recruited 154 adolescents between 10–18 years from 4 specific HIV clinics in Kampala. The Andersen’s behavioral model guided the selection of variables in terms of ever use of dental care services as the outcome- and predisposing, enabling, need related factors and dental health related behavior as exposure variables. Data was analyzed using Fischer’s exact test for cross-tabulation and modified Poisson regression for multivariate analysis.

The prevalence of ever-use of dental care services was 12.3%. The adolescents aged 14–18 years were more likely to have used dental care services (Prevalence ratio (PR) of 3.35 (Confidence Interval (CI) 1.48–7.59) than those aged 10–13 years. Fear of spread of HIV was negatively associated with ever-use of dental care services (PR of 0.06 and CI of (0.01–0.44). Participants who were afraid of going to the dentist were more likely to have ever used dental care services (PR of 2.98 and CI of 1.41–6.30) than those not afraid. Failure to receive dental treatment because it was not part of the medical appointment had a positive association with ever-use of dental care services (PR of 4.50 (CI: 1.14–17.80). Those who were satisfied with their dental condition were less likely to have ever-used dental care services (PR of 0.21 and CI of (0.05–0.94). Bad oral odor was positively associated with ever-use of dental care services with a PR of 2.80 and CI of 1.19–6.60. Use of soap for toothbrushing was positively associated with ever-use of dental care services (PR of 2.51, CI of 1.47–4.28).

The study found low frequency of dental care use among HIV infected adolescents in Kampala, Uganda, with age being a predisposing factor. Enabling factors included fear of HIV spread, dental appointment failure, and satisfaction with dental condition and bad oral odor while under personal oral hygiene and dental practices, use of soap for toothbrushing was an important association of use of dental care.