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The HIV/AIDS Program: Part F Community Based Dental Partnership Program

 
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Section 1: Filling Gaps in HIV Dental Care

Ryan White Community
Based Dental Partnerships

Since inception, varied strategies have been crafted to enhance HIV dental services, training of staff, and management of dental partnerships, as follows:

  • Service delivery (e.g., reducing no-show rates through special support and reinforcement methods, co-location of medical and dental services)

  • Patient education (e.g., one-on-one discussions during appointments, smoking cessation support, patient education software for in-clinic learning)

  • Partnership operations that broaden service and training networks (e.g., collaborative arrangements that work under structured rules such as memoranda of agreement, referral networks that serve to ease appointment-making and service linkages for clients, collaborative planning to raise resources and target services)

  • Consumer involvement (e.g., advisory boards, patient satisfaction surveys, focus groups)

  • Student/provider training (e.g., on-site rotations in community clinics and one-on-one and small group discussions between patients and dental students, targeting of dental residents and dental hygiene students).

Ryan White's Community Based Dental Partnership Program

The Dental Partnership is one of multiple HIV-focused oral health programs under the HRSA-administered Ryan White HIV/AIDS Program, which funds community and State-level programs to deliver HIV primary care and support services such as HIV medications and outpatient care. Ryan White has funded dental care since its inception in 1991, both as a primary care service under all of its programs as well as under its HIV oral health initiatives. The Dental Partnership is a relatively new Ryan White oral health initiative given that the first funds were awarded in 2002, over a decade after the Ryan White program’s beginning. As such, the Partnership represents an evolution in the Ryan White HIV/AIDS Program’s efforts to expand the Nation’s capacity to deliver oral health care to PLWH.

The Dental Partnership is comprised of 12 Federal grantees located in 13 States and communities around the Nation that deliver HIV dental care while simultaneously training dental professionals in these areas in order to expand community capacity to deliver HIV oral health care. Since the program’s first full year of operations in 2004, the number of clients getting HIV dental care has grown steadily: 4,328 patients received services in 2006—a 34 percent increase.

Likewise, the number of dental professionals (primarily, dental school students) trained in HIV oral health care has grown. Nearly 2,500 dental students, dental residents, and dental hygienists received training from program from 2004 through 2006. The number of dental providers delivering direct clinical services to patients with HIV increased from 766 in 2004 to 943 in 2006. These results speak to the creativity and resourcefulness of Dental Partnerships in the context of funding levels that have remained relatively flat over the program’s history. (See Section 2: Dental Partnership Activities for more detailed data)

This report presents data on clients served and dental providers trained, along with insights on successful strategies for providing high quality oral health care to HIV infected patients. Data and program activities are for calendar years 2004, 2005, and 2006, during which Federal funds of $2.9 to $3.4 million annually were awarded to 12 Dental Partnership grantees in 13 States. The average annual grant award was under $300,000. Dental Partnerships are largely comprised of University-based dental schools working in partnership with an array of community agencies—collectively, around 50 major agencies across all sites. Examples of these community partners include AIDS service organizations, Section 330 Federally-funded Health Centers, community colleges, and regional AIDS Education and Training Centers funded by the Ryan White HIV/AIDS Program.

Dental Partnerships use the following two-pronged strategy to deliver oral health care to PLWH while building community capacity to deliver such care in the future:

  • Oral health services are delivered in a community setting, where clients are easiest to reach and where dental care can be integral to primary care and supports that help PLWH enter and remain in care. This community-based approach is in notable contrast to institutional service settings like dental schools, which over the course of the AIDS epidemic have taken on a considerable amount of the work in serving PLWH.
  • Dental schools and community agencies have created training opportunities in order to expand the pool of dental professionals who are trained and willing to care for PLWH in community settings.