Abstract
BACKGROUND: Oral health-related quality of life (OHRQOL) is a subjective measure of how oral health affects social and physical functioning. Women of reproductive age face barriers that contribute to oral health disparities, such as caregiving responsibilities; for women with HIV (WWH), additional disparities include barriers to care and HIV-related oral manifestations. Understanding OHRQOL among reproductive-aged women can help identify unmet oral health care needs and assess whether WWH have poorer OHRQOL than women without HIV who are at high risk (WWoH) on the basis of these HIV-specific inequalities. METHODS: The Study of Treatment and Reproductive Outcomes is a cohort study of reproductive-aged WWH and WWoH in 6 southern US cities. Participants completed oral health questionnaires, including the Oral Health Impact Profile, to assess OHRQOL. RESULTS: Of the 764 women analyzed (478 WWH, 286 WWoH), most reported good OHRQOL (81.4% of WWH, 86.0% of WWoH), with no difference according to HIV status. Having unmet oral health care needs (odds ratio [OR], 6.80; 95% CI, 4.44 to 10.40) was significantly associated with poor OHRQOL, as were psychosocial measures (ie, depression, loneliness, and stress) and current smoking status (OR, 3.02; 95% CI, 1.94 to 4.70). Significantly protective OHRQOL factors included dental insurance (OR, 0.49; 95% CI, 0.31 to 0.78) and annual oral health care use (OR, 0.42; 95% CI, 0.28 to 0.62). Patterns of association were generally consistent across WWH and WWoH, with some differences according to race and ethnicity and insurance status. CONCLUSIONS: OHRQOL is strongly associated with behavioral, psychosocial, and dental-related factors. Addressing unmet oral health care needs and psychosocial stressors may improve OHRQOL among WWH and WWoH. PRACTICAL IMPLICATIONS: Assessing factors affecting oral health care use and unmet needs should guide care delivery. Future interventions should consider comprehensive oral and mental health care to enhance well-being in this population.