Identifying Factors to Improve Dental and Mental Health Care among People with HIV

项目摘要 确定改善HIV感染者的牙科和精神卫生保健的因素 口腔健康受损和精神障碍，包括药物使用不成比例 影响艾滋病毒/艾滋病患者(PWH)。龋齿、唾液腺等病症 疾病、溃疡、牙周炎、白斑和念珠菌病与艾滋病毒和 对生活质量产生负面影响。抑郁、焦虑、药物使用和其他精神疾病 PWH中的疾病也与更多的牙齿问题和未得到满足的口腔健康需求有关。 此外，患者、提供者和系统障碍干扰了口腔保健服务的接受。 威尔斯亲王医院。艾滋病毒护理、行为保健和牙科护理基本上是孤立的，这使得 不同的医疗诊所和不同的专业人员通力合作，提供协调一致的 关心。迫切需要进一步调查个人和系统层面的障碍是如何， 行为健康和口腔健康是PWH的交叉点。针对RFA-DE-23-002，这 拟议项目将在两年内对400座威尔斯亲王医院进行两年一次的评估， 普罗维登斯/波士顿艾滋病研究中心艾滋病毒诊所，以识别可修改的个人和 在口头、艾滋病毒和行为方面的参与和遵守的系统级障碍和促进者 医疗保健。口腔、行为和HIV症状的纵向变化与 还将审查他们与障碍和促进者的关系。此外，深入了解 采访了来自纵向研究的40名威尔斯亲王医院和20名医护人员(来自牙科， 行为和艾滋病毒临床环境)将提供有关障碍性质的更多细节 促进者关心，并提出改进的机会。使用此组合的量化 和定性数据，将选择策略用于以临床为基础的计划，以改善口腔和 威尔斯亲王医院的行为卫生保健。成员检查，也称为参与者验证，将 通过焦点检查选定的战略和行动的可行性和可接受性 来自纵向研究的20名PWH和来自牙科的10名医护人员组成的组， 行为和艾滋病毒临床环境。这将是最大的、深入的、有前景的 到目前为止对PWH中口腔健康的评估，评估行为健康和其他 直接影响口腔健康结果的因素。这些结果将直接为研究提供信息 这项研究之外的议程，以改善威斯康星医院患者的口腔和行为健康。

Project Summary Identifying Factors to Improve Dental and Mental Health Care among People with HIV Impaired oral health and psychiatric disorders, including substance use, disproportionally impact people with HIV and AIDS (PWH). Conditions such as dental caries, salivary gland disease, ulcers, periodontitis, leukoplakia, and candidiasis are associated with HIV and can negatively impact quality of life. Depression, anxiety, substance use and other psychiatric disorders in PWH are also associated with more dental problems and unmet oral health needs. In addition, patient, provider, and system barriers interfere with the receipt of oral health care for PWH. HIV care, behavioral health care, and dental care are largely siloed, making it difficult for different health care clinics and different professionals to work together to provide coordinated care. There is great need to investigate further how individual and system-level barriers, behavioral health, and oral health intersect for PWH. In response to RFA-DE-23-002, this proposed project will conduct biannual assessments over two years of 400 PWH, from the Providence/Boston Center for AIDS Research HIV clinics, to identify modifiable individual and system-level barriers and facilitators for engagement and adherence in oral, HIV, and behavioral health care. Associations of longitudinal changes in oral, behavioral, and HIV symptoms and their relationships with barriers and facilitators will also be examined. In addition, in-depth interviews with 40 PWH from the longitudinal study, and 20 health care workers (from dental, behavioral, and HIV clinical settings) will provide further details on the nature of the barriers and facilitators to care, and suggest opportunities for improvement. Using this combined quantitative and qualitative data, strategies will be selected for clinic-based programs to improve oral and behavioral health care among PWH. Member checking, also known as participant validation, will examine the feasibility and acceptability of the selected strategies and actions through focus groups with 20 PWH from the longitudinal study and 10 health care workers from dental, behavioral, and HIV clinical settings. This will be one the largest, in-depth, prospective assessments to date of oral health among PWH that assesses behavioral health and other factors that directly influence oral health outcomes. These results will directly inform a research agenda beyond this study to improve oral and behavioral health among PWH.