A qualitative study of rapid HIV testing and Lesbian, Gay, Bisexual, Transgender, and Queer competency in the oral health setting: Practices and attitudes of New York state dental directors

Purpose: Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) cultural competency and awareness in healthcare settings have been recognized for minimizing health disparities, yet their integration within the oral health community has been minimal. Furthermore, despite evidence showing the compatibility of rapid HIV testing (RHT) in the oral health setting, actual uptake by dentists has been limited. The purpose of this qualitative study was to document New York State dental directors' perspectives and attitudes regarding issues relevant to the LGBTQ patient care and RHT. Materials and Methods: Semi-structured interviews (N=10) were conducted with New York State dental directors practicing in areas of high HIV prevalence. A deductive and inductive qualitative approach was used to develop an interview guide, in accordance with the Theory of Planned Behavior, that elicited their perspectives, attitudes, and perspectives on RHT and LGBTQ issues. Results: Thematic analysis of the interviews revealed that many dentists cited limited, if any, training and experience in RHT and LGBTQ patient care. Additionally, there was also an evident dichotomy between dentists who were offering RHT and dentists who were knowledgeable and well-versed in LGBTQ issues. Barriers to implementation included time constraints and minimal training and knowledge. Conclusions: While potential facilitators such as test kit reimbursement and patient referral sources could enable LGBTQ and RHT training and uptake, actual implementation in the oral health setting will likely require additional trainings, more involved collaboration with primary care providers, and an overall cultural change amongst the dental profession.