Perspectives on oral health integration into HIV care and research in low-resource settings: insights from patients and key stakeholders in Uganda

Abstract

Oral health conditions are common among people living with HIV (PLHIV), yet many have unmet needs for oral health care. In most low-income countries like Uganda, oral health is not yet integrated into HIV care settings. We explore stakeholder’s perspectives on oral health integration in HIV care and research settings in Uganda. We conducted four focus group discussions (FGDs) among people living with HIV (PLHIV) and eighteen (18) semi-structured interviews among key stakeholders including policy makers, educators and practitioners in fields of HIV and oral health. The participants for both interviews and FGDs were selected purposively. The interviews and FGDs were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis in OpenCode software version 4.03. Participants reported that oral conditions are common and had substantial physical, nutritional, psychological, and social consequences. Participants reported significant financial barriers to accessing oral healthcare and expressed reluctance to seek services outside HIV clinics due to fear of disclosure of their HIV status. Participants consistently emphasized that oral health is often neglected within HIV care settings, citing inadequate skills among health care providers, limited involvement of oral health professionals, and the absence of clear policies supporting integration. Key barriers to integrating oral health into HIV care and research included limited local evidence to inform policy, insufficient funding, inadequate infrastructure, and weak multidisciplinary collaboration. Participants highlighted the need for capacity building, generation of local research evidence, and leveraging the existing HIV care and academic infrastructure to support integrated HIV-oral health services and research. Oral health remains a neglected yet important component of HIV care with significant consequences on the quality of life of PLHIV. Strengthening HIV-oral health research capacity and integrating oral health care within HIV care clinics through multidisciplinary collaboration, targeted training/capacity building and locally generated evidence are essential for informed policy and improved comprehensive HIV care in low-resource settings. Not applicable.