Oral health perceptions and adherence with dental treatment referrals among caregivers of children with HIV

Results from a 3-year longitudinal study on the oral manifestations of AIDS (OMA) among seropositive children and their siblings indicated poor adhere nce with recommendations for dental treatment (Broder, Catalanotto, Reisine , & Variagiannis, 1996). The purposes of this study were to (a) to examine oral health behaviors, attitudes, and perceived barriers to care among care givers of children with HIV and their siblings who were referred for dental care, and (b) develop and evaluate a 5-week summer pilot program to increa se adherence with referral for dental treatment. Telephone interviews with caregivers were conducted to identify barriers to care and to implement ser vices to increase attendance in the dental clinic for their children. Inter views were completed with 28 of the 38 (74%) caregivers recruited from the OMA study (previously cited) who had children referred for dental treatment at the final (sixth) oral health research exam. Twelve of their 58 childre n (21%) had obtained dental care privately, 25 (62.5%) initiated treatment and 2 (6.3%) completed treatment at the referred dental school during the 5 -week pilot program. Although caregivers of children with HIV and their sib lings were responsive to the initial efforts of the program's service coord inators, follow-up data from the coordinators' records and chart abstractio n revealed that the majority of the participants did not appear for their s econd or third appointments. The inteniew reports suggested that caregivers expect dental treatment, such as restorations, at each appointment and do not regard exams/treatment planning as treatment. Personal/family and healt h care delivery system factors were expressed barriers to dental care. Impl ications for future programs and investigations are discussed.