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ABSTRACTPurposeTo explore the experiences and expectations of HIV‐related stigma in dental settings.MethodsThis was a cross‐sectional study of 60 HIV+ adult volunteers. We conducted audio‐recorded interviews; responses to four open‐ended questions were analyzed qualitatively for theme and content.ResultsTwenty‐seven participants (45%) reported ever having anticipated being judged, stigmatized or treated with disrespect in a dental setting due to HIV status. Thematic response categories included concerns about: (i) receiving humane and respectful treatment, (ii) being judged or stereotyped and (iii) giving HIV to the dentist. Regarding hesitancy to visit the dentist, subjects equally endorsed fear of the dentist (35%) and concerns about confidentiality and receiving humane treatment (35%).ConclusionHIV+ individuals encounter many fears and concerns related to dental care; fear of the dentist and concerns about confidentiality and receiving humane treatment appear to be central issues. Dental providers should be aware of and better manage these issues.

AbstractAimsPeriodontal diseases (PDs) affect nearly half of Americans ≥30 years old and are common in human immunodeficiency virus‐positive (HIV+) adults. A validated measure of oral hygiene skill could improve tailored prevention‐focused health communication.MethodsWe developed Oral Hygiene Skill Mastery (OHSIM), a provider‐observed measure of toothbrushing and flossing ability. We examined OHSIM's inter‐rater reliability (IRR) and concurrent validity using a blinded, cross‐sectional study design with a convenience sample of HIV+/− adults. Clinical outcome measures included bleeding on probing (BOP) and abbreviated plaque and gingival indices. Analyses included IRR and, after identifying relevant predictor variables for each outcome, backward elimination regression and structural equation modeling (SEM) were used to demonstrate concurrent validity.ResultsWe saw 173 research participants (reliability: n = 61; validity: n = 112). The average IRR was α = 0.73 for toothbrushing and α = 0.84 for flossing. Toothbrushing and flossing skill were moderately correlated (r = 0.49, P < 0.001). SEM analyses demonstrated that OHSIM toothbrushing significantly and independently predicted variance in plaque and gingival indices and BOP, while OHSIM flossing skill significantly and independently predicted plaque index and BOP.ConclusionOHSIM is a provisionally reliable and valid provider‐observed measure of toothbrushing and flossing skill. Most predictors of clinical outcomes were modifiable behaviors. Toothbrushing quality is a critical component of oral health.