Dental insurance, dental care utilization, and perceived unmet dental needs in women living with HIV: Results from the Women's Interagency HIV Study

Carrigan Leigh Parish, Daniel J. Feaster, Margaret R. Pereyra, Maria Alcaide, Mardge Cohen, Susanna Levin, Deborah Gustafson, Daniel Merenstein, Bradley Aouizerat, Jessica Donohue, Jennifer Webster-Cyriaque, Gina Wingood, Mirjam Kempf, Lisa R. Metsch

Research output: Contribution to journalArticle

Abstract

Objectives: Dental care is the most commonly cited unmet health-care service due to cost. Previous research has highlighted the unmet dental needs of people living with HIV (PLWH). Understanding associations among dental insurance availability, dental care utilization, and the presence of unmet dental needs among PLWH is a public health priority. Methods: Oral health surveys were collected cross-sectionally (April–October 2016) among 1,442 women living with HIV (WLWH) in the Women's Interagency HIV Study. Logistic regression models were used to analyze the association between having versus not having dental insurance by type (Ryan White, private, Medicaid/Medicare) and two primary outcomes: a) typical frequency of dental visits (at least annually, less than annually) and b) reporting an unmet dental need in the past 6 months. Results: All dental insurance types were associated with higher odds of receiving annual dental care and, for those with either Medicare/Medicaid or private insurance, lower odds of having an unmet dental need. When WLWH were asked to describe their oral health, poor self-reported condition was associated with both an unmet dental need (odds ratio [OR]: 4.52, 95 percent Confidence Interval [CI] [3.29–6.20]) and lower odds of annual dental care utilization (OR: 0.44, 95 percent CI [0.34–0.57]). Self-reported depressive symptom burden was also linked to having an unmet dental need (OR: 2.10, 95 percent CI [1.46–3.01]). Conclusions: Dental insurance coverage increases dental care utilization and is associated with better oral health among WLWH. In the era of health-care reform, dental insurance coverage may be instrumental for enhancing treatment outcomes.

Original languageEnglish (US)
JournalJournal of Public Health Dentistry
DOIs
StateAccepted/In press - Jan 1 2019

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Dental Insurance
Dental Care
Tooth
HIV
Oral Health
Insurance Coverage
Odds Ratio
Medicaid
Confidence Intervals
Medicare
Logistic Models
Health Priorities
Health Care Reform
Health Surveys
Insurance
Health Services
Public Health
Depression
Delivery of Health Care
Costs and Cost Analysis

Keywords

  • access to dental care
  • dental insurance
  • HIV
  • oral health

ASJC Scopus subject areas

  • Dentistry(all)
  • Public Health, Environmental and Occupational Health

Cite this

Dental insurance, dental care utilization, and perceived unmet dental needs in women living with HIV : Results from the Women's Interagency HIV Study. / Parish, Carrigan Leigh; Feaster, Daniel J.; Pereyra, Margaret R.; Alcaide, Maria; Cohen, Mardge; Levin, Susanna; Gustafson, Deborah; Merenstein, Daniel; Aouizerat, Bradley; Donohue, Jessica; Webster-Cyriaque, Jennifer; Wingood, Gina; Kempf, Mirjam; Metsch, Lisa R.

In: Journal of Public Health Dentistry, 01.01.2019.

Research output: Contribution to journalArticle

Parish, CL, Feaster, DJ, Pereyra, MR, Alcaide, M, Cohen, M, Levin, S, Gustafson, D, Merenstein, D, Aouizerat, B, Donohue, J, Webster-Cyriaque, J, Wingood, G, Kempf, M & Metsch, LR 2019, 'Dental insurance, dental care utilization, and perceived unmet dental needs in women living with HIV: Results from the Women's Interagency HIV Study', Journal of Public Health Dentistry. https://doi.org/10.1111/jphd.12336
Parish, Carrigan Leigh ; Feaster, Daniel J. ; Pereyra, Margaret R. ; Alcaide, Maria ; Cohen, Mardge ; Levin, Susanna ; Gustafson, Deborah ; Merenstein, Daniel ; Aouizerat, Bradley ; Donohue, Jessica ; Webster-Cyriaque, Jennifer ; Wingood, Gina ; Kempf, Mirjam ; Metsch, Lisa R. / Dental insurance, dental care utilization, and perceived unmet dental needs in women living with HIV : Results from the Women's Interagency HIV Study. In: Journal of Public Health Dentistry. 2019.
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abstract = "Objectives: Dental care is the most commonly cited unmet health-care service due to cost. Previous research has highlighted the unmet dental needs of people living with HIV (PLWH). Understanding associations among dental insurance availability, dental care utilization, and the presence of unmet dental needs among PLWH is a public health priority. Methods: Oral health surveys were collected cross-sectionally (April–October 2016) among 1,442 women living with HIV (WLWH) in the Women's Interagency HIV Study. Logistic regression models were used to analyze the association between having versus not having dental insurance by type (Ryan White, private, Medicaid/Medicare) and two primary outcomes: a) typical frequency of dental visits (at least annually, less than annually) and b) reporting an unmet dental need in the past 6 months. Results: All dental insurance types were associated with higher odds of receiving annual dental care and, for those with either Medicare/Medicaid or private insurance, lower odds of having an unmet dental need. When WLWH were asked to describe their oral health, poor self-reported condition was associated with both an unmet dental need (odds ratio [OR]: 4.52, 95 percent Confidence Interval [CI] [3.29–6.20]) and lower odds of annual dental care utilization (OR: 0.44, 95 percent CI [0.34–0.57]). Self-reported depressive symptom burden was also linked to having an unmet dental need (OR: 2.10, 95 percent CI [1.46–3.01]). Conclusions: Dental insurance coverage increases dental care utilization and is associated with better oral health among WLWH. In the era of health-care reform, dental insurance coverage may be instrumental for enhancing treatment outcomes.",
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AU - Parish, Carrigan Leigh

AU - Feaster, Daniel J.

AU - Pereyra, Margaret R.

AU - Alcaide, Maria

AU - Cohen, Mardge

AU - Levin, Susanna

AU - Gustafson, Deborah

AU - Merenstein, Daniel

AU - Aouizerat, Bradley

AU - Donohue, Jessica

AU - Webster-Cyriaque, Jennifer

AU - Wingood, Gina

AU - Kempf, Mirjam

AU - Metsch, Lisa R.

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N2 - Objectives: Dental care is the most commonly cited unmet health-care service due to cost. Previous research has highlighted the unmet dental needs of people living with HIV (PLWH). Understanding associations among dental insurance availability, dental care utilization, and the presence of unmet dental needs among PLWH is a public health priority. Methods: Oral health surveys were collected cross-sectionally (April–October 2016) among 1,442 women living with HIV (WLWH) in the Women's Interagency HIV Study. Logistic regression models were used to analyze the association between having versus not having dental insurance by type (Ryan White, private, Medicaid/Medicare) and two primary outcomes: a) typical frequency of dental visits (at least annually, less than annually) and b) reporting an unmet dental need in the past 6 months. Results: All dental insurance types were associated with higher odds of receiving annual dental care and, for those with either Medicare/Medicaid or private insurance, lower odds of having an unmet dental need. When WLWH were asked to describe their oral health, poor self-reported condition was associated with both an unmet dental need (odds ratio [OR]: 4.52, 95 percent Confidence Interval [CI] [3.29–6.20]) and lower odds of annual dental care utilization (OR: 0.44, 95 percent CI [0.34–0.57]). Self-reported depressive symptom burden was also linked to having an unmet dental need (OR: 2.10, 95 percent CI [1.46–3.01]). Conclusions: Dental insurance coverage increases dental care utilization and is associated with better oral health among WLWH. In the era of health-care reform, dental insurance coverage may be instrumental for enhancing treatment outcomes.

AB - Objectives: Dental care is the most commonly cited unmet health-care service due to cost. Previous research has highlighted the unmet dental needs of people living with HIV (PLWH). Understanding associations among dental insurance availability, dental care utilization, and the presence of unmet dental needs among PLWH is a public health priority. Methods: Oral health surveys were collected cross-sectionally (April–October 2016) among 1,442 women living with HIV (WLWH) in the Women's Interagency HIV Study. Logistic regression models were used to analyze the association between having versus not having dental insurance by type (Ryan White, private, Medicaid/Medicare) and two primary outcomes: a) typical frequency of dental visits (at least annually, less than annually) and b) reporting an unmet dental need in the past 6 months. Results: All dental insurance types were associated with higher odds of receiving annual dental care and, for those with either Medicare/Medicaid or private insurance, lower odds of having an unmet dental need. When WLWH were asked to describe their oral health, poor self-reported condition was associated with both an unmet dental need (odds ratio [OR]: 4.52, 95 percent Confidence Interval [CI] [3.29–6.20]) and lower odds of annual dental care utilization (OR: 0.44, 95 percent CI [0.34–0.57]). Self-reported depressive symptom burden was also linked to having an unmet dental need (OR: 2.10, 95 percent CI [1.46–3.01]). Conclusions: Dental insurance coverage increases dental care utilization and is associated with better oral health among WLWH. In the era of health-care reform, dental insurance coverage may be instrumental for enhancing treatment outcomes.

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