# Dentists’ refusal to manage patients with HIV, tuberculosis, HBV, HCV, epilepsy, and financial limitations in Damascus, Syria: a cross-sectional study

## TL;DR

This study finds that many dentists in Damascus refuse to treat patients with HIV, tuberculosis, and hepatitis due to stigma or fear, highlighting challenges in healthcare access for vulnerable groups.

## Contribution

The study quantifies high refusal rates among dentists in Damascus for treating patients with specific diseases and financial limitations, revealing systemic healthcare challenges.

## Key findings

- 78% of dentists refused to treat HIV-positive patients.
- Dentists with more experience and foreign education were more likely to accept patients with HIV and hepatitis.
- Refusal rates for tuberculosis, HIV, and hepatitis were significantly correlated.

## Abstract

This study investigates refusal rates of dentists in Damascus, Syria, to manage patients who disclose that they are carriers of tuberculosis, human immunodeficiency virus (HIV), hepatitis B and C (HBV/HCV), and patients with dental phobia, asthma, epilepsy, patients unable to afford dental care, and children. The aims are to identify to what extent dentists refuse patients who are diagnosed carriers of certain blood born viruses, require extra measures, take a lot of time, or do not pay.

A cross-sectional study was conducted in Damascus by distributing paper and electronic questionnaires to dental clinics based on the administrative divisions of the city.

A total of 246 responses were collected. The average years of dental practice among respondents was 9.39 ± 9.8. Rates of refusal were as follows: children (n = 55, 22.4%), tuberculosis (n = 176, 71.5%), HIV (n = 192, 78.0%), HBV/HCV (n = 98, 39.8%), dental phobia (n = 58, 23.6%), asthma (n = 12, 4.9%), and epilepsy (n = 73, 29.7%). Acceptance of patients with tuberculosis, HIV, and HBV/HCV was positively associated with greater years of experience. Dentists who graduated outside of Syria were more likely to accept treating patients with HIV and HBV/HCV. A significant correlation was found between refusal rates for patients with tuberculosis, HIV and HBV/HCV.

The proportion of dentists in Damascus refusing to treat patients who disclose that they are carriers of tuberculosis, HIV/AIDS, and HBV/HCV was notably high. Managing patients who cannot afford treatment often involved reducing fees. The findings provide valuable insights into the systemic challenges in healthcare delivery and propose possible improvements in managing vulnerable population in resource-constrained settings.