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INNOVATIONS IN PROVIDING ORAL HEALTH SERVICES TO HIV POSITIVE PERSONSNancy Young, Ernesto Guevara,[object Object]
Innovations in providing oral health services to hiv positive persons
East Texas Dental/OralCare Services,[object Object]
Special Health Resources for Texas ,[object Object],Was established in 1995 as an HIV/AIDS Service Organization serving HIV + and Substance Abusing Persons in East Texas. ,[object Object],    In 2006 serving 1,200 HIV + persons with comprehensive medical and case management care, we believed that increasing our dental services from 1 day per week to 2 would make a difference in the health care outcomes of those we serve. 	,[object Object]
Special Programs of National Significance (SPNS) Grant,[object Object],15 sites around the country were recipients of this grant, SHRT is the only one in Texas.,[object Object],Innovation in Oral Health Care Initiative for HIV positive people in partnership with the ECHO research team at Boston University.,[object Object]
DENTAL Servicesto HIV Positive Patients ,[object Object],Longview /Tyler /Texarkana,[object Object],Sites,[object Object],DDS Services,[object Object],Oral Health Case Management,[object Object],Dental Hygiene ,[object Object],Oral Health Education,[object Object]
Implementation,[object Object],SHRT model integrates the delivery of comprehensive dental/oral health care into a primary health care services.,[object Object],Hired Project Director, Nancy Young, LCDC.,[object Object],Contracted with Dr. Damon Spencer from Baylor College of Dentistry in Dallas as our dentist. ,[object Object],Partnership with Texas A&M University Baylor College of Dentistry provides Dental Student Internship placement in SHRT dental clinics, supervised by Damon Spencer, DDS.,[object Object],Hired Oral Health Case Manager, Ernesto Guevara, bilingual, who had 5 years RW Medical Case Management experience.,[object Object]
Implementation,[object Object],Hired Registered Dental Hygienist.,[object Object],Increased dental chairs from 2 to 7.,[object Object],Recruitment has been from within our own agency through Ryan White Medical Case Managers utilizing our referral and follow-up tracking process. ,[object Object],All newly identified positive persons enrolled in services are referred for a comprehensive oral health exam.,[object Object],Partnership with Stephen F. Austin State University as our evaluators.,[object Object]
Implementation,[object Object],Unique to this program are the intensive oral health case management services provided during the Baseline and Follow-up Interviews.,[object Object],Patient retention rate 88%, due to SHRT one stop shop where patients  receive medical services, case management, housing, transportation, medication assistance, substance abuse and mental health services.,[object Object],SHRT serves 23 counties in rural East Texas.,[object Object]
Initial Results From the Multisite Study,[object Object]
Baseline Results,[object Object],2494 in database from all sites,[object Object],Mean age of patients is 44 years old,[object Object],Mean years HIV positive is 10 years,[object Object],Patients are: 40% Black, 33% White, 21% Latino and 75% Male,[object Object],53% of patients had not received dental care in 2 or more years.,[object Object]
Additional Demographics,[object Object]
HIV Status - Baseline,[object Object],[object Object]
 57% have a CD4 of 350 or greater
 78% report current ART use
 98% have a regular place for HIV care
 85% have an HIV case manager
 94% have seen HIV provider in past 6 months,[object Object]
Symptoms in the past 12 months?,[object Object],Tooth decay/cavity			52%,[object Object],Sensitivity				50%,[object Object],Dissatisfied with appearance	50%,[object Object],Toothache				43%,[object Object],Bleeding gums			36%,[object Object]
How would you describe the health of your teeth and gums?,[object Object],[object Object]
Very Good10%
Good 23%
Fair 31%
Poor32%,[object Object]
Very Good26%
Good 33%
Fair 					20%
Poor5%
Very Poor				1%,[object Object]
46% flossing in the past 30 days; 19% report once a day
52% report smoking in the past 30 days

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Innovations in providing oral health services to hiv positive persons

Notas del editor

  1. 2503 is not the final N. We are working on finalizing the database. The N will be lower once we remove those patients who have withdrawn their consent.1.2% (30) of our sample is transgendered and 15 of those are from SF.
  2. Cleaning only w/o any problem was 49%
  3. Cleaning only w/o any problem was 49%