A study from the Williams Institute finds that while 90% of Los Angeles County dentists will treat HIV positive patients, 1 out of 20 still refuse to do so. This, researchers say, shows that while many barriers have been broken there is still work to do in educating against discriminatory treatment of people living with HIV/AIDS.
To carry out this study researchers used trained “testers” posing as prospective HIV-positive patients. These testers called 612 dental offices in Los Angeles County between 2007 and 2008. Calls were made in English and Spanish, and by callers who said they had private dental insurance as well as Denti-Cal, a dental benefit tied to California’s Medicaid program that was largely de-funded in 2009.
The study demonstrated that apart from a blanket ban, an additional 5% of dental providers treated people living with HIV/AIDS differently than other patients. Differences in treatment, which potentially violates anti-discrimination laws, included offering people living with HIV/AIDS only the most basic services like tooth cleaning, or in some instances treating them in isolated rooms or only on certain days of the week.
In fact, the most common reasons dentists used for refusing new HIV-positive patients was that they were not equipped for so-called special infection controls. According to the study’s co-author Fariba S. Younai, Professor of Clinical Sciences & Vice Chair, Division of Oral Biology and Medicine, UCLA School of Dentistry, this is misleading.
“Dentists can treat HIV-positive patients safely and effectively,” says Professor Younai. “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.”
The study found that people living with HIV/AIDS who had Denti-Cal as opposed to private dental insurance faced twice the rate of discrimination. Compounding this, rates of discrimination were found to be higher when prospective patients identified as low-income, people of color, or as women. In terms of geography, rates of discrimination were significantly higher in the San Gabriel Valley and South Public Health Service Planning Areas (SPAs), as compared to other parts of Los Angeles County.
However, it is important to stress these findings show that the number of dentists with unlawful blanket policies refusing to serve people living with HIV/AIDS is lower than those rates found among other health care providers. Similar studies of health care providers in Los Angeles County conducted by this research team during the 2003-2006 period found that 55% of obstetricians, 46% of skilled nursing facilities, and 25% of plastic surgeons had such policies. Therefore it is important not to single out dentists but see this as a path to discussing the larger issue.
Study co-author Brad Sears, Executive Director of the Williams Institute, summarizes the finding thus: “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.”
Sears adds, “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.]”
Study co-author Tom Donohoe, Associate Professor of Family Medicine at UCLA’s David Geffen School of Medicine and Director, stresses the importance of education in reducing discrimination against patients living with HIV/AIDS:
“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.’”
Donohoe adds that continued education efforts will be needed to further reduce the rates of discrimination people living with HIV/AIDS face.
Care2 blogger Jessica Pieklo is reporting from Ghana as a guest of The Global Fund to help bring attention to efforts to eradicate malaria, tuberculosis and HIV/AIDS. You can read more of Care2.com’s coverage here.
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