USC University of Southern California

An Imposing Front in the War Against HIV/AIDS

With an exploding incarcerated population and widespread risky behaviors, inmates of the US prison system face an alarmingly high risk of blood borne infection, including HIV/AIDS. Prison health care professionals, including dentists, play critical roles in preventing HIV transmission throughout the population.

Roseann Mulligan, associate dean of Community Health Programs, and other School of Dentistry staff and faculty visit California prisons and jails to educate dentists that serve correctional facilities about HIV transmission, symptoms, testing and patient education. These HIV and Dentistry Updates, provided through the Pacific AIDS Education and Training Center (PAETC), aim to keep oral health professionals serving at-risk communities informed of the latest science and clinical knowledge about HIV/AIDS. Mulligan is director of PAETC’s Oral Health Training and chair of the center’s Oral Health Advisory Committee.

The team has completed two visits this year, each drawing clinicians from several facilities for the informative updates, and future visits are being planned, said project manager Carolyn Bedoian. Health care professionals in correctional facilities need the latest information on HIV/AIDS due to inmates’ high risk of infection; hazardous prison environments, with dangers ranging from risky sexual activity and violence to illicit drug use and unsanitary tattoos, can provide HIV with millions of transmission opportunities.

“We go where the epidemic is,” Mulligan said. “The infection rate in jails and prisons is nearly four times higher than the general public.”

Dentists practicing in correctional facilities have the opportunity to spot early HIV/AIDS symptoms, including oral manifestations such as mouth sores, as well as educate patients about risk factors for infection. A new advancement in the prevention of the spread of this epidemic is the rapid oral or finger-stick blood testing on site. For a dentist to take a swab of oral exudates for the rapid test would be relatively easy. The hope is that with updated training, oral health professionals in correctional facilities will spot warning signs earlier and encourage more patients to get tested, which could help slow the spread of the disease once more HIV-positive patients become aware of their status, Mulligan said.

“People do change their behavior after a positive test,” she said. “Studies have shown that HIV-positive individuals are more likely to behave responsibly when they learn of their diagnosis.”