Empirical Investigation of Dentists’ Attitudes Toward HIV-Positive Patients and Their Influence on Treatment Quality in Nigeria

Discriminatory attitudes among healthcare workers toward HIV-positive patients represent a significant barrier to equitable healthcare access, and empirically characterising these attitudes and their clinical consequences in Nigerian dentistry is important for addressing HIV-related stigma. This study empirically investigated dentist attitudes toward HIV-positive patients and their relationship to treatment quality across four geopolitical zones: South West (Lagos), South South (Port Harcourt), North Central (Abuja), and North West (Kano). A cross-sectional survey was conducted among 240 registered dentists using a validated attitude scale and a clinical vignette-based assessment of recommended treatment for HIV-positive versus HIV-negative patients with identical dental presentations. Results showed that 28.7 percent expressed attitudes reflecting HIV stigma on the validated scale. When managing HIV-positive patients in vignettes, 23.8 percent recommended less invasive or substandard management compared to HIV-negative patients with the same condition. Stigma attitude was a significant predictor of differential treatment recommendation (OR = 4.21, p < 0.001). Dentists with formal HIV oral health training showed significantly lower stigma scores. Religious affiliation interacted with stigma scores but not consistently across zones. The study concludes that HIV-related stigma affects a significant minority of Nigerian dentists and influences clinical decision-making. Recommendations include mandatory HIV oral health and de-stigmatisation modules in dental undergraduate curricula, continuing education programmes, and anonymous peer consultation mechanisms for managing complex HIV-positive cases. Keywords: HIV stigma, dentist attitudes, HIV-positive patients, treatment quality, dental care discrimination