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Groenewegen H, Vissink A, Spijkervet FKL, Bierman WFW, Delli K. Quality Assessment of Internet Information Regarding Periodontitis in Persons Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:857. [PMID: 39063434 PMCID: PMC11276730 DOI: 10.3390/ijerph21070857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/18/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
The Internet is the most used source of HIV information second to information received from healthcare professionals. The aim of this study was to assess the quality of Internet information about periodontitis in people living with HIV (PLWH). An Internet search was performed on 18 April 2024 using the search terms "Periodontitis", "Periodontal disease", and "Gum disease" in combination with "HIV" in the most popular search engines (Google™, Bing™, and YAHOO!®). The first 20 results from each search term engine were pooled for analysis. Quality was assessed by JAMA benchmarks. Readability was assessed using the Flesch reading ease score (FRES). Origin of the site, type of author, and information details were also recorded. The quality of Internet information about periodontitis in PLWH varied. The mean JAMA score was 2.81 (SD = 1.0). The websites were generally fairly difficult to read (mean FRES = 57.1, SD = 15.0). Most websites provided some advice about self-treatment of oral problems, accompanied by a strong recommendation to seek professional dental care. In conclusion, advanced reading skills on periodontitis in PLWH were required and quality features were mostly not provided. Therefore, healthcare professionals should be actively involved in developing high-quality information resources and direct patients to evidence-based materials on the Internet.
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Affiliation(s)
- Hester Groenewegen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (F.K.L.S.); (K.D.)
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (F.K.L.S.); (K.D.)
| | - Fred K. L. Spijkervet
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (F.K.L.S.); (K.D.)
| | - Wouter F. W. Bierman
- Department of Internal Medicine, Division of Infectious Diseases, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands;
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (F.K.L.S.); (K.D.)
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Wadhwa S, Finn TR, Kister K, Matsumura S, Levit M, Cantos A, Shah J, Bohn B, Lalla E, Grbic JT, Demmer RT, Yin MT. Postmenopausal women with HIV have increased tooth loss. BMC Oral Health 2024; 24:52. [PMID: 38191383 PMCID: PMC10775528 DOI: 10.1186/s12903-023-03744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND With effective antiretroviral therapy, people with HIV (PWH) are living longer and aging; the majority of PWH in the United States are now over the age of 50 and in women have gone through the menopause transition. Menopause potentiates skeletal bone loss at the spine, hip, and radius in PWH. The alveolar bone which surronds the teeth is different than long bones because it is derived from the neural crest. However, few studies have assessed the oral health and alveolar bone in middle aged and older women with HIV. Therefore, the objective of this study was to evaluate periodontal disease and alveolar bone microarchitecture in postmenopausal women with HIV. METHODS 135 self-reported postmenopausal women were recruited (59 HIV-, 76 HIV + on combination antiretroviral therapy with virological suppression) from a single academic center. The following parameters were measured: cytokine levels (IFN-γ, TNF-α, IL-1β, IL-2, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, IL-17 A, OPG, and RANKL) in gingival crevicular fluid, bleeding on probing, probing depth, clinical attachment loss, number of teeth present, alveolar crestal height, and alveolar bone microarchitecture. RESULTS The mean age of participants was 57.04+/-6.25 years and a greater proportion of women with HIV were black/African American (HIV + 68.42%, HIV- 23.73%; p < 0.001). There was no significant difference in bleeding on probing (p = 0.17) and attachment loss (p = 0.39) between women who were HIV infected vs. HIV uninfected. Women with HIV had significantly higher RANKL expression in Gingival Crevicular Fluid (HIV + 3.80+/-3.19 pg/ul, HIV- 1.29+/-2.14 pg/ul ; p < 0.001), fewer teeth present (HIV + 17.75+/-7.62, HIV- 22.79+/-5.70; p < 0.001), ), lower trabecular number (HIV + 0.08+/-0.01, HIV- 0.09+/-0.02; p = 0.004) and greater trabecular separation (HIV + 9.23+/-3.11, HIV- 7.99+/-3.23; p = 0.04) compared to women without HIV that remained significant in multivariate logistic regression analysis in a sub-cohort after adjusting for age, race/ethnicity, smoking status, and diabetes. CONCLUSION Postmenopausal women with HIV have deterioration of the alveolar trabecular bone microarchitecture that may contribute to greater tooth loss.
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Affiliation(s)
- Sunil Wadhwa
- Division of Orthodontics, Columbia University College of Dental Medicine, New York, NY, USA.
| | - Taylor R Finn
- Division of Orthodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Karolina Kister
- Division of Orthodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Satoko Matsumura
- Division of Oral and Maxillofacial Radiology, Columbia University College of Dental Medicine, New York, NY, USA
| | - Michael Levit
- Division of Orthodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Anyelina Cantos
- Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Jayesh Shah
- Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Bruno Bohn
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Evanthia Lalla
- Division of Periodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - John T Grbic
- Division of Foundational Sciences, Columbia University College of Dental Medicine, New York, NY, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Michael T Yin
- Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Doughty J, Macdonald ME, Muirhead V, Freeman R. Oral health-related stigma: Describing and defining a ubiquitous phenomenon. Community Dent Oral Epidemiol 2023; 51:1078-1083. [PMID: 37462247 DOI: 10.1111/cdoe.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/19/2023] [Accepted: 07/07/2023] [Indexed: 11/15/2023]
Abstract
This paper is the fourth of a series of narrative reviews to critically rethink underexplored concepts in oral health research. The series commenced with an initial commissioned framework of Inclusion Oral Health, which spawned further exploration into the social forces that undergird social exclusion and othering. The second review challenged unidimensional interpretations of the causes of inequality by bringing intersectionality theory to oral health. The third exposed how language, specifically labels, can perpetuate and (re)produce vulnerability by eclipsing the agency and power of vulnerabilised populations. In this fourth review, we revisit othering, depicted in the concept of stigma. We specifically define and conceptualize oral health-related stigma, bringing together prior work on stigma to advance the robustness and utility of this theory for oral health research.
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Affiliation(s)
- J Doughty
- NIHR Clinical Lecturer, School of Dentistry, University of Liverpool, Liverpool, UK
| | - M E Macdonald
- Clinical Reader and Honorary Consultant in Dental Public Health, Centre for Dental Public Health and Primary Care, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - V Muirhead
- J&W Murphy Foundation Endowed Chair in Palliative Care Research. Professor, Division of Palliative Medicine. Nova Scotia Health Affiliate Scientist (Research). Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - R Freeman
- Past co-director Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
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Huyst V, Dewinter J, Noens I, Platteau T, Tsoumanis A. Measuring the prevalence of autistic traits in a cohort of adults living with HIV or taking HIV pre-exposure prophylaxis and mapping safer-sex barriers and facilitators: a study protocol. BMJ Open 2023; 13:e075667. [PMID: 37775292 PMCID: PMC10546106 DOI: 10.1136/bmjopen-2023-075667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Autistic individuals identify with a wider range of sexual orientations than non-autistic individuals, including higher rates of bisexual orientation in autistic men. Gay, bisexual and other men who have sex with men are at greater risk for HIV. Prevalence data of autistic traits in people living with HIV or using Pre-Exposure Prophylaxis (PrEP) for HIV are lacking so far. Such data, combined with insights in barriers and facilitators for safer sex in autistic people living with HIV or using PrEP, are a first step to improve health support for autistic people in HIV clinics. This support is crucial since autistic individuals have worse physical and mental health outcomes. The objective of this research is to determine the prevalence of autistic traits within the group of people living with HIV or using PrEP in Belgium and to describe specific facilitators and barriers for sexual safer behaviour in people living with HIV and PrEP users with autistic traits. METHODS AND ANALYSIS The research is a cross-sectional, observational and multicentre study with recruitment of individual participants. The research consists of two phases. In phase 1, adults coming for HIV/AIDS care or HIV PrEP in participating Belgian HIV Reference Centres will be invited to fill in the validated Autism Spectrum Quotient questionnaire. In phase 2, participants with a score above the predefined cut-off for autistic traits (>26), who agreed to be informed about this score, will be invited to complete an additional survey, inquiring facilitators and barriers for sexual safer behaviour. ETHICS AND DISSEMINATION OF RESULTS Institutional Review Board Institute of Tropical Medicine Antwerp, 25 July 2022, REF 1601/22 and University Hospital of Antwerp, 12 September 2022, Project ID 3679: BUN B3002022000111. Study results will be published in peer-reviewed journals and presented to Belgian HIV Reference Centres and at conferences.
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Affiliation(s)
- Veerle Huyst
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jeroen Dewinter
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Ilse Noens
- Parenting and Special Education Research Unit, University of Leuven, Leuven, Belgium
| | - Tom Platteau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
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Sojak L, Simekova K, Piesecka L, Wiesinger M, Jarcuska P. Attitudes and Perspectives of People Living With Human Immunodeficiency Virus: Findings From the Positive Perspectives Survey in Slovakia. Int J Public Health 2021; 66:642869. [PMID: 34744591 PMCID: PMC8565261 DOI: 10.3389/ijph.2021.642869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To investigate the perspectives and attitudes of people living with human immunodeficiency virus (PLHIV) in Slovakia. Methods: A cross-sectional, computer-assisted web survey on health status, emotional support, stigmatisation, communication with physician, treatment, perception, decision-making, concerns, and treatment history. A representative sample of >10% of all PLHIV (N = 895) in Slovakia was invited to participate. Results: Mean age of the 117 respondents was 35.4 (±8.9) years, 52.8% had higher education, and 67.0% were in full-time employment. Most (89.4%) were receiving antiretroviral therapy (ART), and 81.8% had undetectable viral load. Most (85.1%) were satisfied with their ART, and side effects were the primary reason for switching therapies. Most (60.8%) had informed only close friends or relatives about their HIV status, only 3 (2.9%) spoke openly about it, and 60.0% hid their ART from others. Of the 31 respondents (31.6%) who experienced stigmatisation, it was primarily from dentists and other physicians who refused to treat them. Conclusion: In general, PLHIV in Slovakia receive ART and are satisfied with it. They do not speak openly about their HIV status, and some have experienced discrimination.
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Affiliation(s)
- Lubomir Sojak
- Department of Infectology and Geographical Medicine, Center for Treatment of HIV/AIDS Patients, Academic L. Derer's University Hospital, Bratislava, Slovakia
| | - Katarina Simekova
- Department of Infectology and Travel Medicine, Center for Management and Treatment of HIV, University Hospital, Martin, Slovakia
| | - Lubica Piesecka
- Infectology Clinic FSVaZ by UKF, Faculty Hospital, Nitra, Slovakia
| | | | - Pavol Jarcuska
- Department of Infectology and Travel Medicine, Center for Management and Treatment of HIV, L Pasteur University Hospital and PJ Safarik University, Kosice, Slovakia
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Yuvaraj A, Mahendra VS, Chakrapani V, Yunihastuti E, Santella AJ, Ranauta A, Doughty J. HIV and stigma in the healthcare setting. Oral Dis 2020; 26 Suppl 1:103-111. [PMID: 32862542 DOI: 10.1111/odi.13585] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
People living with HIV (PLHIV) continue to endure stigma and discrimination in the context of health care despite global improvements in health outcomes. HIV stigma persists within healthcare settings, including dental settings, manifesting itself in myriad, intersecting ways, and has been shown to be damaging in the healthcare setting. Stigmatising practices may include excessive personal protective equipment, delaying the provision of care or unnecessary referral of PLHIV to specialist services in order to access care. The workshop entitled "HIV and Stigma in the Healthcare Setting" provided an overview of the concept and manifestation of HIV stigma and explored the disproportionate burden it places on groups that face additional disadvantages in accessing care. The final part of the workshop concluded with a review of institutional and community-based interventions that worked to reduce HIV stigma and group discussion of the ways in which these strategies might be adapted to the dental workforce.
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Affiliation(s)
- Anandi Yuvaraj
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | | | - Evy Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Indonesia
| | | | - Amitha Ranauta
- Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India.,DBT/Wellcome Trust India Alliance, The Humsafar Trust, Mumbai, India
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Freeman R, Doughty J, Macdonald ME, Muirhead V. Inclusion oral health: Advancing a theoretical framework for policy, research and practice. Community Dent Oral Epidemiol 2019; 48:1-6. [PMID: 31625202 DOI: 10.1111/cdoe.12500] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022]
Abstract
In response to headlines about the oral health of persons experiencing social exclusion resonating in high-income countries, and research demonstrating the need for urgent action, a symposium entitled 'International Perspectives on Socially Inclusive Dentistry: A Call to Action' was organized for the IADR International Meeting of 2018. The aim of the symposium was to initiate an international dialogue on barriers to care, multidisciplinary action and examples of best practice for service delivery for people experiencing social exclusion; in other words, to develop the idea of inclusion oral health. Through our international exchange, what emerged was an awareness of a lack of professional consensus: What exactly is inclusion oral health? A theoretical framework to push forward the policy, research and practice agenda was clearly needed. This paper advances such a framework. Over the decades, dentistry has forged an approach to service delivery mainly through a business, demand-led model. While oral health continues to improve globally, an important consequence of this approach is that it compounds the social exclusion that many people are already experiencing because of a constellation of economic, political, cultural and individual factors. Thus, many people are simply not getting the dental care they need. In contrast, drawing on the theoretical literature on social exclusion, intersectionality and othering, we suggest that dentistry could act as an agent for social inclusion as a more responsive, all-encompassing form of oral health care and delivery. This paper advances a theoretical framework for inclusion oral health, and an action plan to show how inclusion oral health may become one solution in an armamentarium to tackle the global phenomena of oral health inequities.
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Affiliation(s)
- Ruth Freeman
- Dental Health Services Research Unit, School of Dentistry, University of Dundee, Dundee, UK
| | - Janine Doughty
- Pathway Homelessness and Inclusion Oral Health Fellow, University College London, London, UK
| | | | - Vanessa Muirhead
- Centre for Dental Public Health and Primary Care, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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HIV/AIDS: Running away? Br Dent J 2018; 225:579. [DOI: 10.1038/sj.bdj.2018.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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HIV: Support the patients, not the stigma. Br Dent J 2018. [DOI: 10.1038/sj.bdj.2018.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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