Rapid Oral Testing for HIV in the Dental Clinic

Approximately one quarter of a million people in the US infected with HIV do not know it.  Routine testing for HIV is essential to reduce the number infected, who are unaware of their status (Beckwith, et al. 2005).  In February, 2010, the Dental Clinic at Lutheran Medical Center, Brooklyn, New York piloted free rapid oral tests (ROT) for HIV as part of a federally funded grant.  Barriers regarding logistics, data management, and cultural considerations were identified and overcome with modifications.  LMC Dental follows newly enacted state legislation, effective September 1, 2010, requiring primary care providers to routinely offer HIV tests to people aged 13 – 64, (http://www.nyc.gov/html/doh/html/pr2010/pr043-10.shtml, 2010).

Patients who accepted the ROT, between February and September, 2010, (N=111) were surveyed.  According to National Health Interview Survey (Pollack, et al. 2010) of the estimated 3.6 million people who report that they are at risk for HIV but have never been tested, 75% have seen a dentist in the past 2 years. Thus, dental clinics provide an untapped opportunity for HIV testing. In accordance with the new legislation, HIV testing is routine and not risk-based, enabling a greater number of individuals to be tested through an opt-out model. (Patton, et al. 2002, Dietz, et al. 2008., Vernillo & Caplan, 2007., National Association of Community Health Centers, 2006, Ramos & Hisiger, ROT In the Dental Clinic, 2010, paper presented at LMC Dental Medicine Faculty Development Conference, September 20-22, 2010).

This project served a small sample, and benefits to the community are not yet quantified.  Refinement  will allow additional testing, the impact of which includes early diagnosis and prevention of transmission.  LMC Dental’s ROT project exemplifies the role of the dental profession in screening for HIV, thereby contributing to improved integration of disciplines and service, and a holistic approach to patient care.