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

项目摘要 确定改善艾滋病毒感染者牙科和精神卫生保健的因素 口腔健康受损和精神疾病，包括药物使用， 影响艾滋病毒感染者和艾滋病患者。龋齿、唾液腺等疾病 疾病、溃疡、牙周炎、白斑病和念珠菌病与HIV有关， 对生活质量产生负面影响。抑郁、焦虑、物质使用和其他精神疾病 威尔斯亲王医院的疾病也与更多的牙齿问题和未得到满足的口腔健康需要有关。 此外，患者、提供者和系统障碍干扰了口腔保健的接受， PWH。艾滋病护理、行为健康护理和牙科护理在很大程度上是孤立的， 不同的卫生保健诊所和不同的专业人员共同努力，提供协调 在乎非常需要进一步调查个人和系统一级的障碍， 行为健康和口腔健康对PWH来说是交叉的。根据RFA-DE-23-002， 建议的计划会在两年内对400间威尔斯亲王医院进行每半年一次的评估， 普罗维登斯/波士顿艾滋病研究中心艾滋病毒诊所，以确定可改变的个人和 参与和坚持口腔，艾滋病毒和行为的系统级障碍和促进因素 保健口腔、行为和HIV症状的纵向变化与 还将审查它们与障碍和促进者的关系。此外，深入 对40名来自纵向研究的PWH和20名卫生保健工作者（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进一步细节， 促进者关心，并提出改进的机会。使用这种组合的定量 和定性数据，策略将被选择为临床为基础的计划，以提高口腔和 威尔斯亲王医院的行为健康护理。成员检查，也称为参与者验证，将 审查选定的战略和行动的可行性和可接受性， 20名来自纵向研究的PWH和10名来自牙科， 行为和HIV临床环境。这将是最大、最深入、最有前景的一次 到目前为止，威尔斯亲王医院的口腔健康评估，评估行为健康和其他 直接影响口腔健康结果的因素。这些结果将直接为一项研究提供信息， 本研究的目的是改善威尔斯亲王医院的口腔和行为健康。

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.