HIV infection and oral health care in South Africa.

This study determined the knowledge, attitude and practice of oral health care workers in public clinics in South Africa towards HIV/AIDS and investigated the implementation of infection control measures. A total of 727 questionnaires were distributed to dentists, dental therapists, oral hygienists and chairside assistants in the public dental clinics of 9 provinces, of which 276 were returned from 8 provinces, giving a response rate of 38%. The questionnaire covered demographic factors and assessed issues such as knowledge, infection control practices, continuing education, legal, ethical and psychosocial issues and available support for HIV/AIDS. The common oral manifestations seen by respondents were candidiasis, acute necrotising ulcerative gingivitis (ANUG), hairy leukoplakia and Kaposi's sarcoma. Of the 174 who had a previous HIV test, 48% were for insurance purposes and 21% for post-needle-stick injury. Over 10% of the respondents indicated that gloves were not available at all, that there was an inadequate supply of water, and that there was no autoclave in their clinic. Nearly 50% of the clinicians had not had hepatitis B vaccination in the last 3 years. Fifteen respondents (5.4%) were not willing to treat HIV-positive patients. Only 48% had access to a written post-exposure management protocol and post-exposure medication was available to only 36.6%. The vast majority of the respondents clearly expressed a need for additional education on HIV/AIDS. The study demonstrated a need to add knowledge, enhance personal skills and improve the application of universal precautions.