HIV Patients See Positive Impact on Oral Health at The Project of Primary Health Care

July 31, 2018

Patients with HIV are a special patient population treated by Primary Health Care, Inc. (PHC), a community health center located in Des Moines, Ames, and Marshalltown. Recently Cayce Good, the Policy and Communications Intern for the Iowa Primary Care Association, visited with a few staff members at PHC’s site devoted to providing dental services for HIV patients.

The Project of Primary Health Care is PHC’s site in Des Moines focused on HIV. As part of The Ryan White HIV/AIDS Program, they receive federal funding specifically used for the treatment of patients living with HIV. This is provided for the underserved patient population so the health center does not have to use other funds it receives to provide services for this group. There are two provisions of service required by the Iowa Department of Public Health (IDPH). Sites who receive this funding must provide supportive services (part B) and clinical services (part C) for patients living with HIV. Supportive services, as defined by the IDPH, assist with case management, meaning providers must help patients access care, assist with low income patients, work with individuals to make and keep appointments, offer transportation services, manage other aspects of their lives, and provide other services needed that may be specific to a client’s case to help improve health outcomes. Clinical services, as defined by the Health Resources and Services Administration (HRSA), are the components for funding comprehensive primary health care services in outpatient settings for people living with HIV.

When providing services to this population, there are only a few challenges faced by PHC, which they have addressed effectively. Maggie Kadding, a dental hygienist at PHC, told us that patients with HIV do not have anything unique about their mouths that distinguish them from non-HIV patients. They may show symptoms of issues that need to be addressed related to HIV, but PHC identifies these issues and refers patients to other medical providers if further treatment is necessary. With more than 500 patients living with HIV treated at PHC, the biggest challenge can be educating the community to let them know there is a safe place to get affordable care. Most of the patients served are covered by an insurance plan, so making sure these people continue to schedule follow up and preventative appointments is extremely important. Another focus of PHC is bridging the gap between medical and dental care. At the Iowa PCA, the importance of integrated care services is a priority. PHC has done a great job of implementing this with the HIV population in Des Moines. Whether it be dental, medical, or behavioral health services, the staff at PHC unanimously agreed that the integration of care will help improve patient health outcomes.

The goal of improving population health outcomes is shared by community health centers around the state and the Iowa PCA. For special population groups, like patients living with HIV, educating them while they are in for appointments can help boost their confidence and strengthen relationships with familiar providers. Tena Springer, director of dental operations at PHC, said staying involved in community events, such as parades and festivals, is helpful as it allows their patients to see them outside the office. The stigma surrounding HIV is a barrier to getting care in itself. Because of this, some cases can’t be resolved by simply providing things like transportation, financial assistance, or education. All these things help, but sometimes it takes a strong relationship between providers and patients to help overcome the fear of going to an appointment.  At The Project of Primary Health Care, it is apparent how committed and energized the staff is about improving relationships and making sure patients get the care they need just by speaking with the providers and staff.

At the Iowa PCA, we are extremely proud of the efforts and work being done at PHC to treat an important group of people in central Iowa. We will continue to work alongside PHC and other community health centers to educate communities around the state of Iowa on the importance of providing health care services to people living with HIV. We are excited to see the growth of The Project of Primary Health Care in the future, and we invite all to reach out to their nearest community health center for any questions you may have regarding your HIV status, testing, or care services available.