More than 80 per cent of oral health patients are willing to receive rapid HIV-testing in dental settings, which could help reduce the spread of the HIV according to a groundbreaking study revealed this week at a Sydney University HIV Testing Symposium.
The first of its kind study of 521 Sydney-based dental patients assessed patients’ willingness to undergo rapid HIV testing in dental settings, their preference for HIV testing-type type and their willingness to pay for the test.
“This represents an important opportunity for the dental profession to consider its place in the delivery of health services in Australia,” A/Prof Schifter from the Faculty of Dentistry at The University of Sydney told Bite magazine last year.
“In terms of a broader preventative health initiative-and that is the emphasis-I think it [rapid HIV testing] fits really well within the remit of dental practice. I don’t see it as particularly different from screening for oral cancer.”
Last year we reported that in Australia, at the end of 2011 an estimated 24,731 people were living with diagnosed HIV infection; representing an increase of 8.2 per cent from 2010. Until this time, the number of new diagnoses had been relatively stable (around 1000 per year). If these people have the opportunity to learn more about HIV and possible treatments, they should certainly take it.
Undeniably, dentists have the strongest professional interest and knowledge of saliva, as well as the oral manifestations of HIV infection. But does this make them the best practitioners to be screening and advising patients about a potentially life-altering and life-threatening disease?
Rapid HIV testing is a screening test that swiftly detects the presence of HIV antibodies in a person’s body by testing blood or oral fluids. It can be done as a simple finger prick or a saliva swab, and results can be made available within 20 minutes.
Rapid HIV testing is currently unavailable in dental settings anywhere in the world although the technology has been widely available for a decade. Australians will soon be able to access rapid HIV-testing themselves after the federal government last week announced that it had lifted restrictions preventing the manufacture and sale of oral home-testing kits.
“Dentists are well placed to offer rapid HIV testing because they’re located throughout the community, have ongoing relationships with their patients, and have the necessary training and expertise to recognise systemic diseases that have oral manifestations, such as HIV/AIDS,” says the study’s lead author, Dr Anthony Santella.
Dr Santella, a public health scientist and lecturer from Western Sydney Sexual Health Centre, Sydney Medical School, believes Australia needs to take an innovative approach to HIV testing.
“To combat the rise in HIV incidence, you need more novel evidence-based strategies and the rapid test has proven very efficacious in other countries,” he says. “To apply this in a dental setting would provide this opportunity.”
The new research finding has important policy implications, according to Dr Santella: “If rapid HIV testing was widely available in dental settings it could help to reduce the spread of the virus by informing people who aren’t aware that they are HIV-positive.
“It’s important that policymakers and other stakeholders consider expanding rapid HIV testing beyond medical and sexual health clinics because the average time from HIV infection to diagnosis in Australia is currently more than three years.”
“As well, we have fresh evidence that around 45 per cent of dentists feel prepared and willing to perform rapid HIV-testing. This means it would be feasible to offer rapid HIV testing through dental settings, especially in targeted at risk communities.”
Among those saying they’d be willing to undergo rapid HIV testing in a dental setting, 76 per cent preferred an oral saliva swab, 15 per cent preferred a pin prick test, and eight per cent preferred a traditional blood test that draws blood through a needle.?Fast facts:
• Sixty per cent of Australians see their dentist once in 12 months with 80 per cent seeing a dentist in the course of 2 years.
• Ten to 20 per cent of people living with HIV are undiagnosed and therefore run the risk of spreading the virus unknowingly.
• The Australian Government’s HIV Strategy aims to reduce the sexual transmission of HIV by 50 per cent by 2015, as a key step towards a 2020 elimination target.