Abstract
HIV-positive patients often experience increased oral and dental health challenges due to compromised immunity, long-term antiretroviral therapy (ART), stigma, and discrimination. These factors can lead to reduced access to oral care, delayed treatment, and exacerbation of oral diseases, which may further contribute to disease transmission among close contacts and healthcare providers. This study aimed to assess the prevalence of oral health issues, evaluate the decayed, missing, and filled teeth (DMFT) index, and identify factors associated with poor oral health outcomes among HIV-positive patients in Tabriz, Iran, in 2024. This cross-sectional study included 134 HIV-positive patients referred to a counseling center. Demographic and clinical information was obtained from the counseling center's software. Oral examinations were performed by trained professionals, and a structured questionnaire was completed for each participant after obtaining informed consent. Data on DMFT index and the prevalence of periodontal diseases, mucosal lesions, and other oral health issues were collected and analyzed using SPSS 26 software. Statistical correlations were explored between DMFT index and variables such as smoking, drug use, education level, and CD4 count. Among the 134 participants (96 men and 38 women) with a mean age of 44 years, the average duration of HIV infection was 106 months. The DMFT index averaged 16.7 and was significantly associated with smoking, drug use, education level, and CD4 count (p < 0.05). Periodontal disease was the most prevalent condition (69%), followed by angular cheilitis (17.9%) and aphthous ulcers (16.4%). Mucosal lesions such as candidiasis, hairy leukoplakia, and cancer had a prevalence of less than 5%. Financial constraints (66%) and stigma or discrimination (27%) were identified as the primary barriers to accessing dental services. A high DMFT index and periodontal disease prevalence were observed. Smoking, drug use, lower education, and CD4 count were significantly associated with worse outcomes (p < 0.05). Financial barriers and stigma hindered access to care. This approach can improve oral health outcomes and reduce barriers to care for this vulnerable population.