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Difficult conversations within dentistry: HIV testing

BDJ In Practice volume 36, pages 24–25 (2023)Cite this article

The number of people living with Human Immunodeficiency Virus (HIV) in the UK is thought to be around 106,890.1 In 2021, 2,955 people were diagnosed with HIV in the UK.1 The UK government pledged a goal in 2019 of no new transmissions of HIV by 2030.2 To achieve this goal, there should be increased levels of HIV testing, and early recognition of indicative signs and symptoms which have been associated with undiagnosed HIV. Dentists can play an important role in implementing these processes.

Recommending HIV testing to patients is not expected to be commonplace for dentists in general practice. However, due to the sensitivity of the topic, being aware of how to manage such conversations with patients is essential, particularly for dentists working within secondary care. British HIV Association testing guidelines have recommended that any healthcare professional should be competent to discuss a HIV test.5 Despite this, feelings of unease and concerns around these discussions have been recognised across various specialities in healthcare where such conversations are not routine.4 Dentists also have a professional responsibility to recognise oral mucosal abnormalities that may be indicators of an underlying systemic disease, such as HIV infection. On identifying such lesions, appropriate action should be undertaken. The authors appreciate that dentists in general practice will not have access to request HIV testing directly. Dentists should therefore be familiar with local services that the patient can access such as their general practitioner (GP), Genitourinary Medicine (GUM) clinic and self-testing services. The NHS has been working in partnership with Sexual Health, 24/7 'SH:24', in providing free self-test kits for HIV.6

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References

  1. A Stanford. HIV in the UK. 2022. Available online at: www.aidsmap.com/about-hiv/hiv-uk (accessed February 2023).

  2. Lester J, Martin V, Shah A, et al. HIV testing, PrEP, new HIV diagnoses, and care outcomes for people accessing HIV services: 2022 report. UK Health Security Agency, London. 2022. Available online at: www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2022-report (accessed February 2023).

  3. Coogan M M, Greenspan J and Challacombe S J. Oral lesions in infection with human immunodeficiency virus. Bulletin World Health Organisation 2005; 83: 700-706.

  4. EuroTEST. HIV Indicator Conditions: Guidance for Implementing HIV Testing in Adults in Health Care Settings.

  5. Palfreeman A, Sullivan A, Rayment M, et al. British HIV Association/British Association for Sexual Health and HIV/British Infection Association Adult HIV Testing Guidelines 2020. HIV Med 2020; 21: 1-26.

  6. NHS. Free Testing HIV. Available from: https://freetesting.hiv/ (accessed February 2023).

  7. R McNeil. HIV: Support the patients, not the stigma. Br Dent J 2018; 225: 213.

  8. Caton J G, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol 2018; 89: S1-8.

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Authors and Affiliations

  1. Liverpool University Dental Hospital, Liverpool, United Kingdom

    Rachel Botrugno, Lily Parsons & Anne Field

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  1. Rachel Botrugno
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  2. Lily Parsons
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  3. Anne Field
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Correspondence to Rachel Botrugno.

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Botrugno, R., Parsons, L. & Field, A. Difficult conversations within dentistry: HIV testing. BDJ In Pract 36, 24–25 (2023). https://doi.org/10.1038/s41404-023-2015-9

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