Treating a patient with AIDS

[PredentUndergrad]

Greetings Dentists.

My question is "How would you feel about treating a patient with AIDS?". I came across this question while searching for dental dilemmas. I honestly don't know why this question in under the dental dilemmas category. Where is the problem? Is there a problem of figuring this out before the patient knows? And what's not ethical about treating a patient with AIDS?
I am just trying to gain a general idea and insight about this case.

Thank you!

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[ButlerCard]

I have never experienced this first hand but the way I look at it is that if you follow proper infection control then whats the difference? If you know a patient doesn't have aids to you just go in without gloves and eyeware and say "bring on the blood!"? In school they taught us to treat every patient like they have a disease because you never know if they do or not. True, they fill out a health history, but how can we know if they are telling the truth or if they even know their true health history? Just take the same precautions you would take for any other patient and you will be fine.

 

[THS]

ButlerCard has the correct answer. Some patients will not disclose HIV status, so you should treat all patients with precaution. If you are more careful with an HIV+ patient, then that means that you are doing something wrong with non-infectious patients.

 

[DrJeff]

As mentioned above, just assume that all your patients have just about every type of infectious disease possible and then follow the standard infection control protocols and all will be fine.

The only real issue then is the patient's immediate health status for that scheduled appointment time (I.e. are they with a particularly low platelet count at that time? Or are the in a heightened state of immunosuppression due to a recent treatment? etc)

 

[1Overdrive]

As mentioned above, just assume that all your patients have just about every type of infectious disease possible and then follow the standard infection control protocols and all will be fine.

The only real issue then is the patient's immediate health status for that scheduled appointment time (I.e. are they with a particularly low platelet count at that time? Or are the in a heightened state of immunosuppression due to a recent treatment? etc)

This is the right answer.

 

[OhioDMD]

They are protected from discrimination by the Americans with Disabilities Act

What constitutes discrimination?

Discrimination is the failure to give a person with a disability the equal opportunity to use or enjoy the public accommodation’s goods, services, or facilities. Examples of ADA violations would include:

• A dentist who categorically refused to treat all persons with HIV or AIDS.

• A moving company that refused to move the belongings of a person who had AIDS, or that refused to move the belongings of a person whose neighbor had AIDS.

• A health club that charged extra fees to persons who had HIV, or that prohibited members with HIV from using the steam room or sauna, or that limited the hours during which members with HIV could use the club’s facilities.

• A day care center that categorically refused admission to children with HIV or the children of mothers with HIV.

• A funeral home that refused to provide funeral services for a person who died from AIDS-related complications.

• A building owner who refused to lease space to a not-for-profit organization that provided services to persons with HIV or AIDS.

• A cosmetology school that refused to enroll a student once they learned that she had HIV.

• An overnight summer camp where children sleep in group cabins that requires a camper with HIV to sleep in the camp infirmary.

The ADA also requires public accommodations to take steps to ensure that persons with disabilities have equal access to their goods and services. For example, the ADA requires public accommodations to make reasonable changes in their policies, practices, and procedures; to provide communication aids and services; and to remove physical barriers to access when it is readily achievable to do so.


Most patients with full blown AIDS generally have such ongoing medical expense that they usually end up on public assistance. If you don't accept public assistance then realistically you have minimized your exposure. Personally I have treated at least a dozen AIDs and ARC patients over the years (including extractions). If you follow existing guidelines and are careful to avoid needle sticks and instrument punctures then treating a patient with AIDS or ARC is no different than any other patient.

 

[PredentUndergrad]

Thank you all for your contributions. This is very helpful !

 

[DGDDS]

Yes, as mentioned above - treat all patients the same, regardless of any category they may fit in.

That said - I actually really enjoy interacting with my patients with HIV/AIDS - overall they seem very in tune with their health, remember all the names and dosages of their medications, know their labs, ask good questions, etc. Many of them find a positive diagnosis of HIV to be a point in their lives when they really take ownership of their health. Maybe I'm biased because I've had fantastic patients with HIV, but I'd take any of those wonderful individuals over another patient who doesn't believe they need the hypertensive/diabetic/antidepressant medication they've been prescribed by their physician because they know better and are going the ginkgo balboa/naturopathic route.