Health & Disability Working Group, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA.
Public Health Rep. 2012 May;127 Suppl 2(Suppl 2):45-54. doi: 10.1177/00333549121270S207.
We identified factors associated with retention in oral health care for people living with HIV/AIDS (PLWHA) and the impact of care retention on oral health-related outcomes.
We collected interview, laboratory value, clinic visit, and service utilization data from 1,237 HIV-positive patients entering dental care from May 2007 to August 2009, with at least an 18-month observation period. Retention in care was defined as two or more dental visits at least 12 months apart. We conducted multivariate regression using generalized estimating equations to explore factors associated with retention in care.
In multivariate analysis, patients who received oral health education were 5.91 times as likely (95% confidence interval 3.73, 9.39) as those who did not receive this education to be retained in oral health care. Other factors associated with care retention included older age, taking antiretroviral medications, better physical health status, and having had a dental visit in the past two years. Patients retained in care were more likely to complete their treatment plans and attend a recall visit. Those retained in care experienced fewer oral health symptoms and less pain, and better overall health of teeth and gums.
Retention in oral health care was associated with positive oral health outcomes for this sample of PLWHA. The strongest predictor of retention was the receipt of oral health education, suggesting that training in oral health education is an important factor when considering competencies for new dental professionals, and that patient education is central to the development of dental homes, which are designed to engage and retain people in oral health care over the long term.
我们确定了与艾滋病毒/艾滋病（PLWHA）患者口腔保健保留相关的因素，以及保留护理对口腔健康相关结果的影响。
我们从 2007 年 5 月至 2009 年 8 月间进入牙科护理的 1237 名 HIV 阳性患者中收集了访谈、实验室值、就诊和服务利用数据，至少有 18 个月的观察期。保留护理定义为至少相隔 12 个月的两次或更多次牙科就诊。我们使用广义估计方程进行多变量回归，以探讨与保留护理相关的因素。
在多变量分析中，接受口腔健康教育的患者保留在口腔保健中的可能性是未接受该教育的患者的 5.91 倍（95%置信区间为 3.73，9.39）。其他与保留护理相关的因素包括年龄较大、服用抗逆转录病毒药物、身体健康状况较好以及过去两年内进行过牙科就诊。保留在护理中的患者更有可能完成治疗计划并参加召回就诊。保留在护理中的患者口腔健康症状和疼痛较少，牙齿和牙龈整体健康状况较好。
保留在口腔保健中与该组 PLWHA 的积极口腔健康结果相关。保留护理的最强预测因素是接受口腔健康教育，这表明在考虑新牙科专业人员的能力时，口腔健康教育培训是一个重要因素，而患者教育是牙科之家发展的核心，牙科之家旨在长期参与并保留人们的口腔保健。
