Knowledge and Attitude of Faculty Members Working in Dental Institutions towards the Dental Treatment of Patients with HIV/AIDS

A Cross-Sectional Study to Assess HIV/AIDS-Related Stigma and Its Drivers Among Dental Healthcare Providers in Islamabad, Pakistan

Introduction HIV-related stigma and discrimination among healthcare providers are some of the strongest obstacles to effectively responding to HIV and achieving health-related quality of life. In the Pakistani context, HIV-related discrimination has been explored mainly among people living with HIV (PLHIV), and no study has investigated HIV-related stigma from the perspective of dental healthcare providers. Aim This study aimed to investigate the HIV-related stigma among dental healthcare workers in Pakistan and understand the factors associated with it. Methodology This cross-sectional study was conducted for a period of three months (December 2021 to February 2022) among 601 consenting dental healthcare providers in all public and private dental healthcare facilities in Islamabad, Pakistan. Pretested questionnaires collected information on demographics, work-related characteristics, knowledge, attitudes, and practices regarding HIV/AIDS. HIV-related stigma was assessed through "the stigma index" developed by USAID and was measured as a continuous variable. Multivariate linear regression analysis evaluated the independent effect of different factors associated with HIV-related stigma. Results HIV-related stigma remains highly prevalent within both public and private dental healthcare facilities in ICT and among all cadres of dental healthcare providers. Among associated factors, misconceptions in HIV knowledge are highly significant (p < 0.001) and those with a higher score of incorrect HIV knowledge had higher levels of stigma. Healthcare providers who read any HIV-related manual or guidelines were found to be less stigmatized as compared to those who have not been exposed to any such literature (p=0.029). Dentists (p=0.04) showed higher levels of stigma as compared to dental assistants and dental hygienists, while employees of private hospitals (p=0.0) and private clinics (p=0.0) were far more stigmatized by HIV in comparison to dental healthcare providers in public hospitals. Conclusion This study provides the first-ever analysis of HIV-related stigma and its drivers in the dental healthcare settings in Pakistan and highlights multiple individual, clinical, and policy-level factors associated with it. In order to address this stigma, it is essential for healthcare institutions to create supportive and inclusive healthcare settings, by providing education and training to care providers in order to increase their understanding of the disease itself. In addition, healthcare institutions can take steps to ensure that their policies and practices are inclusive and non-discriminatory, such as implementing policies that prohibit discrimination based on HIV status and providing confidential care. On the other hand, care providers must work to recognize their own biases and strive to provide non-discriminatory and culturally sensitive care to all patients. The findings of this study could be used as a baseline and insight by organizations like the National AIDS Control Program into possible targets for future exploration and interventions to effectively reduce the stigma toward PLHIV in dental healthcare settings.

Medical Ethics Knowledge and Attitude Among Dental Students from Two Universities in The Middle East

Background:

Dentists are obligated to provide patients with ethical and harmless treatment.

Objective:

This study aimed to assess the knowledge, attitude and practices of medical ethics among dental students in two dental faculties in the Middle East.

Methods:

A cross-sectional study using a validated online self-administrated questionnaire was completed by dental students who started clinical training at Mansoura University, Egypt, and from Umm Al-Qura University (UQU), Saudi Arabia. Descriptive statistics and chi-square tests were used for the statistical analysis.

Results:

Participants were 649 dental students. About 77% of Mansoura’s students were aware of the Hippocratic Oath compared to 89.6% of UQU students (p=0.000). No significant difference was found between the two faculties in the presence of ethical topics in their curriculum and the mode of teaching. About 67% of respondents reported obtaining written consent from UQU patients compared to only 10.5% of Mansoura’s patients. Nearly 86.3% and 63.3% of dental students at Mansoura and UQU, respectively, believed that they knew the best, irrespective of the patients’ opinion. In case of any wrongdoing during treatment, 88.7% of Mansoura’s and 93.9% of UQU students agreed to inform the patients. Regarding patient autonomy, only 51.2% and 65.3% of dental students at Mansoura and UQU, respectively, respected the patient’s wishes during treatment., The majority of students from both faculties had less knowledge regarding services and duties related to the ethical committee.

Conclusion:

Gaps in knowledge, attitude and practices of medical ethics were found among dental students of the two faculties, especially among Mansoura’s students. Attention should be paid to improving the present situation.

Final year dental students' perception and practice of professionalism and ethical attitude in ten Sudanese dental schools: A cross-sectional survey

Introduction:

Professionalism and ethics are essential components of all dental schools. Therefore, this study aimed to assess the level of professionalism among Sudanese undergraduate dental students.

Materials and Methods:

This descriptive cross-sectional study was conducted among 307 students in the final year undergraduate Dental Surgery Bachelor program with 155 public and 152 private university students. We collected data through a self-administrated, semistructured questionnaire.

Results:

Although most of the students enrolled in dental schools due to their performance at higher school (P value 0.00), this has no significant effect on their attendance and academic performance afterward (P value 0.25). The perception of the students toward ethics teaching was generally positive in both public (77.34%) and private schools (78.77%). Ethics was represented in the curriculum of both private (51.7%) and public (48.3%) dental schools as perceived by their students. 95.43% and 94.00% of public and private students, respectively, would always or sometimes work in teams, and 98.02% and 94.04% of public and private students, respectively, would always or sometimes respect patients' preference (P value 0.01). A total of 95.33% of the dental students would consult or refer patients with unexpected situations. Only 26% of all students would treat infectious diseases themselves.

Conclusion:

About three-quarters of Sudanese dental students showed a satisfactory level of perception toward the importance of teaching dental ethics and professionalism. It was reflected in an excellent attitude for teamwork and respecting patients' choices. The demand for teaching professionalism course in every dental school will increase gradually, and family physicians with interest in medical education may play a pivotal role in teaching professionalism to dental students.

Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals

Background

The aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State.

Methods

Dentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests.

Results

From the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001).

Conclusion

Most dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.

Exploring educational and promotional opportunities for implementing oral rapid human immunodeficiency virus testing among dentists in India

CONTEXT

Human immunodeficiency virus (HIV) is a public health problem in India. Dentist plays an important role in diagnosing since oral lesions are common in HIV-positive patients and have an ethical responsibility to provide treatment to them.

AIMS

This study aims to explore educational and promotional opportunities for implementing oral rapid HIV testing (ORHT) among dentists in Bengaluru, India.

SETTINGS AND DESIGN

A cross-sectional study was conducted among 300 dentists. Dentists were included from private practice, dental practice in general hospital, and dental teaching/hospitals.

SUBJECTS AND METHODS

A 43-item questionnaire was used to assess demographics, educational knowledge on HIV and ORHT, attitude toward HIV patients, and willingness to promote ORHT and perceived barriers of performing ORHT.

STATISTICAL ANALYSIS USED

The data were evaluated using SPSS 22. Student's t-test, Chi-square, Pearson correlation, and binary logistics were used keeping P value at 5%.

RESULTS

Mean age of the participants was 38.97 ± 7.69 years with equal distribution of gender and practice. Majority were postgraduates (63.0%) and having general practice (56.6%). Although two-thirds of the participants belong to high score category, the mean knowledge level is below 50%. Mean score of knowledge was 10.70 ± 2.5. One hundred and thirty (43.3%) dentists were aware of ORHT, and 228 (76%) thought that ORHT was needed in the dental clinic. Dentist having specialty practice felt more accepting of ORHT (odds ratio = 2.455, 95% confidence interval 1.186-5.463). The lack of knowledge and training was the main barrier (39%) to conduct ORHT.

CONCLUSIONS

The level of knowledge of the dentist about HIV/AIDS was acceptable. Majority of the dentist thought that ORHT is needed in a dental clinic. Overall, there was positive attitude toward HIV patients and ORHT.

Human immunodeficiency virus related discrimination in general dentistry

Objectives:

To investigate HIV related discrimination among general dentists in Jeddah, Saudi Arabia; and to list factors affecting or causing healthcare providers to discriminate people living with HIV (PLWH).

Methods:

The current study takes place in Jeddah, western Saudi Arabia. The duration for accepting all responses was between March and November, 2017. In this cross-sectional study, we used a self-administered, structured questionnaire. The sample size was 430 general dentists practicing in Jeddah, Saudi Arabia. Descriptive statistics, mean, and standard deviation were calculated. Bivariate and multivariate analysis was carried out at p<0.05 level of significance. The Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY, USA) was used for data analysis.

Results:

In our study population, the total HIV related discrimination was 67.4%. Approximately 98.1% defer PLWH to the last appointment of the day, while 84.7% refer them to specialists. Furthermore,100% reported wearing double gloves, and 94.7% where wearing protective eye shields if they encounter HIV-patient in the clinic. Male participants were found to be 23% more likely to be discriminative compared to female participants, Moreover, participants who are confident to provide both surgical and non-surgical dental treatment for PLWH were found to be 52% less likely to be discriminative towards PLWH. Also, HIV discrimination is 33% higher in the private practice compared to the governmental practice.

Conclusion:

Human immunodeficiency virus related discrimination in the study population was affected by dentists’ gender, type of practice, and self-protective attitudes.