Ending the Epidemic Interventions in the Dental Setting - UH3

Routine preventative HIV screening in all health care settings is considered a best practice by the Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (DHHS) Ending the Epidemic (ETE) Initiative, the New York State Blueprint to End the AIDS Epidemic. Despite this, many patients are not screened for HIV during routine care, including in dental care settings, resulting in missed opportunities for identifying undiagnosed HIV infections and providing education for pre-exposure prophylaxis (PrEP). This study will use information technology to support the delivery of HIV prevention and care best practices in the dental care setting. Dental residents will receive a Best Practice (BPA) alert whenever they have a patient who should be offered HIV screening. This BPA is linked to an order set to simplify ordering HIV tests and reporting results.

A critical knowledge gap for implementing these ETE activities in the dental setting is whether comprehensive ETE efforts could be integrated into existing dental teams consisting of practitioners, dental assistants and hygienists or require augmentation by a dedicated care navigator. To evaluate these two models, the investigators will conduct a crossover clinical trial in 3 urban general dentistry programs (NYP-Columbia, NYP-Cornell, NYP-Queens) randomized to one of 2 arms: (AB) Standard Dental Care Team model followed by crossover to an Enhanced Dental Care Team model with a Care Navigator, or (BA) Enhanced Dental Care Team model with a Care Navigator followed by crossover to a Standard Dental Care Team model.

• Provider acceptability of multicomponent HIV service package in dental clinics [Срок оценки: 5-10 months after start of each arm]
• Provider feasibility of multicomponent HIV service package in dental clinics [Срок оценки: 5-10 months after start of each arm]
• Proportion of patients receiving CDS prompt for HIV testing that complete subsequent HIV testing outside of the dental clinic [Срок оценки: Within 12 months following dental visit]
• Proportion of patients receiving CDS prompt for HIV testing with subsequent appointment at an HIV prevention clinic [Срок оценки: Within 12 months following dental visit]
• Proportion of patients receiving CDS prompt for HIV testing subsequently prescribed pre-exposure prophylaxis (PrEP) medication [Срок оценки: Within 12 months following dental visit]