D2 DENT 8004 Module IV: HIV Care

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Questions and Answers

Which component of stigma involves the act of excluding individuals from social activities?

  • Discrimination
  • Labeling
  • Social exclusion (correct)
  • Stereotyping

According to the model laid out by Link and Phelan, what is NOT one of the components of stigma?

  • Stereotyping
  • Power relations
  • Discrimination
  • Cognitive dissonance (correct)

What phase of the HIV/AIDS epidemic is characterized by stigma, discrimination, and denial?

  • The epidemic of stigma-discrimination-denial (correct)
  • The remembrance phase
  • The AIDS epidemic
  • The HIV epidemic

Which of the following best describes an effect of stigma on healthcare providers?

<p>Compromised provider-patient relationships (B)</p> Signup and view all the answers

Which of the following is not referenced as a key initiative developed to combat the impact of stigma and discrimination?

<p>Psychological assessments (D)</p> Signup and view all the answers

Which characteristic is essential for effective healthcare providers in the context of managing stigma?

<p>High emotional intelligence (B)</p> Signup and view all the answers

What is the primary focus of the initiatives developed in response to stigma and discrimination?

<p>To promote social inclusion and acceptance (B)</p> Signup and view all the answers

What percentage of people living with HIV/AIDS are likely to experience at least one oral manifestation related to their condition?

<p>90% (A)</p> Signup and view all the answers

Which oral health issue specifically arises from xerostomia in people living with HIV/AIDS?

<p>Periodontal disease (A)</p> Signup and view all the answers

What significant effect has the epidemic of stigma-discrimination-denial had on individuals?

<p>Negative impact on life and well-being (A)</p> Signup and view all the answers

What is a key concern when treating patients with HIV regarding their perception of care?

<p>Patients often believe that treatment is stigmatizing. (A)</p> Signup and view all the answers

Which of the following is NOT listed as an oral manifestation associated with HIV?

<p>Gingival hyperplasia (B)</p> Signup and view all the answers

What is one of the challenges faced in the management of HIV that relates to patient misunderstanding?

<p>Patients often misunderstand the importance of regular lab tests. (B)</p> Signup and view all the answers

Among adult patients with HIV, which other type of need is considered more unmet than dental care needs?

<p>Medical needs (B)</p> Signup and view all the answers

Which factor may influence how patients with HIV feel about their treatment options?

<p>The cultural background of the patient. (A)</p> Signup and view all the answers

What is a common fungal infection seen in people living with HIV/AIDS?

<p>Candidiasis (A)</p> Signup and view all the answers

What might impact a healthcare provider's understanding of their patient's experience living with HIV?

<p>Possession of a bias training certificate. (D)</p> Signup and view all the answers

Which oral manifestation is characterized by painful sores that may appear on the inner mouth or tongue?

<p>Canker sores (B)</p> Signup and view all the answers

What should healthcare providers be aware of to effectively communicate with HIV patients?

<p>Patients may come from backgrounds with language barriers. (A)</p> Signup and view all the answers

Kaposi's sarcoma is most commonly associated with which oral manifestation in individuals with HIV?

<p>Red band gingivitis (C)</p> Signup and view all the answers

Which aspect of patient care is crucial for successful HIV management?

<p>Implementing regular follow-ups without fail. (D)</p> Signup and view all the answers

What oral health condition is characterized by a red band around the gums and is associated with HIV?

<p>Gingivitis (B)</p> Signup and view all the answers

How does the interpretation of lab results play a role in HIV management?

<p>Lab results provide information necessary for adjusting treatment plans. (C)</p> Signup and view all the answers

In what way is stigma related to HIV treatment management?

<p>Stigma can prevent patients from receiving timely care. (B)</p> Signup and view all the answers

What is a key aspect of managing dental care for Persons Living with HIV/AIDS (PLWHA)?

<p>Integrating nutrition counseling and medical history (D)</p> Signup and view all the answers

What percentage of Persons Living with HIV/AIDS (PLWHA) do not receive regular dental care?

<p>58-64% (B)</p> Signup and view all the answers

Which of the following is NOT mentioned as part of the HIV dental management strategy?

<p>Advanced surgical procedures (C)</p> Signup and view all the answers

What role does the Ryan White Funds play in HIV dental care?

<p>It defrays oral health care expenses (B)</p> Signup and view all the answers

Which factor is recommended for assessment in the dental management of HIV patients?

<p>Xerostomia assessment (D)</p> Signup and view all the answers

Which of the following interventions is emphasized for PLWHA regarding tobacco?

<p>Providing cessation awareness and counseling (C)</p> Signup and view all the answers

What is the focus of the clinical management approach mentioned in the content?

<p>Comprehensive medical management (D)</p> Signup and view all the answers

Why might dental care for PLWHA be inadequate?

<p>Lack of effective communication with healthcare providers (D)</p> Signup and view all the answers

What is one of the primary objectives of the course mentioned?

<p>Recognize marginalization in health care access due to disease states (A)</p> Signup and view all the answers

Which organization is not mentioned as a resource in addressing HIV/AIDS stigma?

<p>World Health Organization (WHO) (A)</p> Signup and view all the answers

What aspect of health care does the material indicate persons with HIV experience differently compared to the general population?

<p>Accessibility of dental care (A)</p> Signup and view all the answers

What is a suggested focus for person management and oral disease prevention strategies?

<p>Use case-based scenarios for discussing management (D)</p> Signup and view all the answers

What factor may contribute to the reduced access to oral and general health care for patients with HIV?

<p>Negative societal attitudes and stigma (D)</p> Signup and view all the answers

Among the topics discussed, which of the following refers to a comparison made regarding patients with HIV?

<p>Caries and periodontal disease prevalence in patients with HIV versus the general population (C)</p> Signup and view all the answers

What is an expected outcome from the reflection activity using Qualtrics?

<p>Understanding personal biases towards PLWHA (B)</p> Signup and view all the answers

Which type of barriers are highlighted in regard to HIV patients receiving care?

<p>Clinical barriers understood through case-based scenarios (A)</p> Signup and view all the answers

What primary function does the Human Immunodeficiency Virus (HIV) serve in the body?

<p>Attacks the body's immune system by targeting CD4/T cells (A)</p> Signup and view all the answers

What is one of the common barriers to compliance with HIV medication?

<p>Being sick or depressed (C)</p> Signup and view all the answers

Which of the following is a common side effect experienced by patients taking ART medications?

<p>Nausea and vomiting (C)</p> Signup and view all the answers

What is the primary goal of antiretroviral therapy (ART) for HIV patients?

<p>Slow the progression of the virus and reduce viral load (D)</p> Signup and view all the answers

How does HIV primarily transmit from one person to another?

<p>Certain body fluids (B)</p> Signup and view all the answers

Which of the following is noted as a consequence of untreated HIV infection?

<p>Destruction of CD4/T cells leading to severe immunodeficiency (D)</p> Signup and view all the answers

What could be classified as a significant challenge in long-term treatment adherence for HIV?

<p>Treatment fatigue after prolonged therapy (B)</p> Signup and view all the answers

Which symptom is typically not associated with HIV medication side effects?

<p>Excessive hair growth (C)</p> Signup and view all the answers

Flashcards

PLW

A person who is living with HIV.

Implicit Bias

Unconscious, automatic assumptions we hold about others.

Bias Training

Training that aims to reduce unconscious bias and improve fairness in interactions with others.

Impact of Implicit Bias

The impact of implicit bias can lead to unfair treatment or discrimination.

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Medical Management of HIV

Understanding and managing HIV effectively involves a combination of medical knowledge and considerate patient care.

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Culturally Competent Care

Providing culturally appropriate care to patients from diverse backgrounds.

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Access to Healthcare as a Human Right

The understanding that access to healthcare is a fundamental human right for everyone, regardless of their background or circumstances.

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Patient-Provider Interaction

The interaction between medical professionals and patients is a complex and multifaceted process.

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What is HIV?

A virus that can lead to acquired immunodeficiency syndrome (AIDS).

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What is a retrovirus?

A type of virus that inserts its genetic material into the host's DNA.

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How is HIV spread?

HIV is spread through contact with certain bodily fluids like blood, semen, vaginal fluids, and breast milk.

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What does HIV attack?

HIV targets and destroys CD4 cells, also known as T cells, which are crucial for immune response.

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How is HIV treated?

Treatment for HIV involves using a combination of drugs to slow the progression of the virus in the body.

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What is ART?

Antiretroviral therapy (ART) is a combination drug therapy that effectively reduces the amount of HIV in the blood and body fluids.

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What are some common side effects of HIV medications?

HIV medications can sometimes cause side effects like nausea, vomiting, diarrhea, fatigue, and headaches.

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What are some common compliance barriers for HIV medications?

Some common barriers to taking HIV medications consistently include forgetting, busy schedules, work/travel obligations, sickness, depression, and treatment fatigue.

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Xerostomia

A condition characterized by dry mouth, often caused by medications or medical conditions like HIV.

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Higher incidence of Caries

An increased rate of cavities.

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Oral health issues in PLWHA

Oral health problems are more common among PLWHA compared to the general population.

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Red band gingivitis

Redness and swelling of the gums, a symptom often seen in PLWHA.

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Burning Mouth Syndrome

A painful condition with mouth sores and ulcers impacting speech and eating.

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Oral Hairy Leukoplakia

The presence of white lesions on the sides of the tongue, a common oral manifestation in PLWHA.

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Thrush

A condition caused by a fungal infection in the mouth, commonly seen in PLWHA with weakened immune systems.

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HIV-Dental Management: Prevention is key

The prevention of oral health issues in individuals living with HIV/AIDS (PLWHA) is crucial. Providing oral health education, nutritional advice, and dental care are key components to addressing this need.

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Lab Considerations in HIV Dental Management

Dental professionals should consider medical lab results like neutrophil, platelet, CD4, and WBC counts when treating PLWHA.

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Why do many PLWHA not receive regular dental care?

A significant portion of individuals living with HIV/AIDS do not receive regular dental care. Barriers like cost, access, and fear of stigma play a role.

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Ryan White Funds: Oral health care

The Ryan White HIV/AIDS Program provides funding for dental care for PLWHA, helping to address financial barriers.

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ACP: A Dental Tool for PLWHA

Amorphous Calcium Phosphate (ACP) is a dental product used in the management of oral health issues in HIV/AIDS patients.

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Comprehensive Dental Assessment in HIV

Caries risk assessment, periodontal risk assessment, oral cancer screening, and xerostomia evaluation are essential parts of comprehensive dental care for PLWHA.

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Tobacco Cessation in HIV Dental Care

Tobacco cessation counseling is vital in HIV dental management, as smoking worsens oral health and overall health outcomes.

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Medical Consult in HIV Dental Management

A medical consult with a physician might be needed to discuss overall health and manage HIV-related conditions, especially when considering dental treatment for PLWHA.

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HIV/AIDS Stigma in Healthcare

Stigma and negative attitudes towards people living with HIV/AIDS (PLWHA) can significantly impact their access to healthcare, including dental care.

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Study Objective: Provider Attitudes

The study aims to understand how healthcare providers feel about treating PLWHA and how they perceive their peers, family, and loved ones would react.

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Data Collection Method

The study used Qualtrics, an online survey platform, to collect data from participants.

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Oral Health and HIV/AIDS

The study focuses on the impact of HIV/AIDS on oral health and the prevalence of dental problems like caries and periodontal disease in PLWHA compared to the general population.

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Barriers to Dental Care for PLWHA

The study aims to identify and explain the challenges faced by PLWHA in accessing dental care, using real-life examples.

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Managing People with HIV/AIDS

The study examines different approaches to managing PLWHA, including preventive measures, oral health management, and dental strategies.

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Study Acknowledgments and Resources

The study acknowledges and cites valuable resources, individuals, and organizations that contributed to its findings.

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Addressing HIV/AIDS Stigma

The study emphasizes the importance of understanding and addressing the stigma surrounding HIV/AIDS to improve access to healthcare and promote better health outcomes for PLWHA.

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Institutionalized

The process of making something part of a formal system or structure, like rules, laws, or procedures, often through formal channels.

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HIV Stigma

A negative perception or belief about a person or group based on their HIV status.

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HIV Discrimination

Unfair or negative treatment of an individual or group because of their HIV status.

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Labeling and Stereotyping

Labeling refers to applying a negative label to someone based on their HIV status. It's often the first step in the process of stigma. Stereotyping refers to generalizing and making assumptions about someone based on their HIV status.

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Social Exclusion

Social exclusion is the process of shutting out a person or group and preventing them from participating in normal activities due to their HIV status.

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Power Relation

Power relations refer to the power imbalances between people with HIV and those without. This can lead to discrimination and exploitation.

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The HIV Epidemic

The initial phase of the HIV epidemic, characterized by the spread of the virus and lack of awareness.

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The AIDS Epidemic

The later phase of the HIV epidemic, marked by more AIDS-related illnesses and deaths. Also, a period when misinformation and fear contribute to stigma.

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The Epidemic of Stigma-Discrimination-Denial

The ongoing phase of the HIV epidemic, characterized by the social burden and impact of stigma and discrimination surrounding the disease. This phase extends beyond the medical aspects and affects the overall well-being of individuals and communities.

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Study Notes

D2 DENT 8004 Module IV: Person Centered Care - Persons Diagnosed with HIV

  • Learning Outcomes:
    • Recognize that certain disease states and patient factors can marginalize individuals from receiving oral and general health care, and provide examples.
    • Understand the epidemiological impact of persons with HIV.
    • Understand the prevalence of caries and periodontal disease in HIV-positive individuals compared to the general population.
    • Identify barriers to accessing care for persons with HIV and similar populations.
    • Apply person-centered management, dental management, and oral disease prevention strategies.

Information for today's session:

  • Safe space: Create a safe and supportive learning environment.
  • Information: Provide essential background information.
  • Knowledge: Equip you with relevant knowledge.
  • Intellectual awareness: Encourage critical thinking about the topic.
  • Emotional awareness: Acknowledge and address potential emotional responses.
  • Opportunity for pre-clinical interaction with patients: Preparing you for clinical encounters with patients with HIV, allowing for reflective time before direct patient interaction.

HIV: Pre-reflection Activity

  • Reflect on treating people living with HIV/AIDS (PLWHA).
  • Consider how friends, family, or significant others might react to treating PLWHA.
  • Reflect on your personal biases and potential discomfort treating individuals who are different from yourself or live with other disadvantages.
  • Think about the impact on patient care when dealing with implicit bias or personal prejudices.

HIV Medical Overview

  • Human Immunodeficiency Virus (HIV) can lead to Acquired Immunodeficiency Syndrome (AIDS).
  • HIV is a retrovirus.
  • HIV spreads through certain body fluids.
  • HIV attacks the body's immune system, targeting CD4/T cells.
  • HIV can render the body defenseless against infections, diseases, cancers, and opportunistic infections.
  • Treatment involves antiretroviral therapy (ART) to slow viral progression.
  • ART reduces viral load in the blood and body fluids.
  • Viral suppression to undetectable levels can be achieved within 6 weeks with ART.

HIV Medications and Compliance Barriers

  • Common compliance barriers include difficulty swallowing pills, busy schedules, work/travel demands, illness, depression, treatment fatigue, and side effects.
  • Newer ARTs often have mild and manageable side effects.

HIV-Epidemiology Canada

  • The prevalence of HIV in Canada is increasing since 2014, around 5%.
  • In 2016, an estimated 63,110 Canadians lived with HIV.
  • The HIV prevalence rate is 173 per 100,000 Canadians.

HIV-Epidemiology U.S.

  • Today, approximately 1.1 million people in the U.S. are living with HIV.
  • In 2015, 38,500 new HIV infections occurred.
  • The prevalence of HIV among different populations in the U.S. is reported.

HIV Diagnoses by Age

  • Data shows significant numbers of diagnoses across different age groups.
  • An increasing number of people aged 50+ are diagnosed with HIV in recent years.

HIV-Epidemiology: Prevalence and Incidence

  • Prevalence is the proportion of persons with a disease in a population at a specified moment or time period.
  • Incidence refers to new cases of a disease or injury within a specific timeframe.

Caries Epidemiology

  • 91% of U.S. adults aged 20-64 have had dental caries.
  • 27% of U.S. adults have untreated dental decay.
  • Root caries are a major cause of tooth loss among the elderly.

HIV-Oral Clinical Manifestations

  • Oral health problems are frequently observed in PLWHA (an acronym for People Living with HIV/AIDS).
  • HIV can cause oral conditions in 30-60% of patients.
  • Xerostomia (dry mouth) is a significant concern.
  • Other common findings include: Candidiasis, Herpes Simplex Virus outbreak, Kaposi's sarcoma, canker sores, mouth ulcers, red band gingivitis, ulcerative periodontitis, oral hairy leukoplakia, and burning mouth syndrome.

HIV Oral Clinical Manifestations: Unmet Needs

  • PLWHA have higher unmet oral health needs compared to the general population.
  • Oral health needs exceed unmet medical needs.

HIV-Dental Management

  • Prevention of dental problems is key.
  • Comprehensive oral health assessments, including nutrition counseling.
  • Collection of detailed medical and dental histories to understand the patient's unique circumstances and needs.
  • Consideration of medical lab results in treatment planning.
  • Identification of caries and periodontal disease risks.
  • Assessment for oral cancer and xerostomia.
  • Support for tobacco cessation.

HIV-Stigma and Discrimination

  • Stigma is widespread and affects people living with HIV/AIDS (PLWHA).

  • Negative beliefs, feelings, and attitudes towards PLWHA are detrimental.

  • PLWHA are frequently discriminated against.

  • Stigma can influence and reinforce other social determinants of health such as poverty, race, sex, and sexual orientation.

  • Stigma has negative impacts on mental health and treatment compliance.

  • Barriers to Dental Care for PLWHA: Lack of insurance, limited income, lack of available providers, limited awareness, and stigma.

  • Other Issues and Considerations in Study: Training and education related to HIV for healthcare professionals is crucial. Focus on appropriate emotional and cognitive factors.

The Results:

  • Qualtrics post reflection questionnaire is due next Monday, with a link to be sent on the current day.

Module IV Summary

  • This module focuses on person-centered care in relation to individuals living with HIV, covering epidemiology, medical management, common oral manifestations, dental management, and the significant impact of stigma and discrimination on access to care.

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