Background Dental caries is among the most frequent oral conditions in HIV-positive (HIV+) persons. There is a lack of baseline information on dental caries prevalence and associated risk factors among HIV+ individuals in comparison to HIV-negative (HIV-) people in Rwanda. Objective This study was conducted to determine the prevalence of dental caries and associated risk factors among HIV+ and HIV- adults at an HIV clinic of Kigali Teaching Hospital (CHUK) in Kigali, Rwanda.   Methods A comparative cross-sectional study was conducted among 200 HIV+ and 200 HIV- adults aged 18 years and above attending the HIV clinic of CHUK. An oral examination was performed by a calibrated examiner. Caries was assessed using the WHO Decayed (D), Missing (M), and Filled Teeth (F) index (DMFT). Descriptive statistics, Chi-square, t-tests, and multiple logistic regression were used to analyze data. Results Overall, a higher prevalence (50.5%) of HIV+ adults had dental caries experience (DMFT>0) compared to HIV- counterparts (40.5%) (p=0.045). The prevalence of Decayed teeth (D) was also higher (23.5%) among HIV+ participants compared to HIV- persons (13.6%) (p=0.011). The Mean(SD) DMFT scores among HIV+ and HIV- participant were 2.28 (3.68) and 1.29 (2.21) respectively (p=0.001). After performing multiple logistic regression analysis, the predictors of dental caries in HIV+ persons were being a female (OR= 2.33; 95%CI= 1.14-4.75), frequent dental visits (OR= 4.50; 95% CI=1.46-13.86) and detectable RNA viral load (OR= 4.50; 95% CI=1.46-13.86). In HIV- participants, the middle age range (36-45 years), and frequent dental visits were significantly associated with dental caries (OR= 6.61; 95%CI=2.14-20.37) and (OR=3.42;  95%CI: 1.337-8.760) respectively. Conclusion The prevalence of dental caries was higher in HIV+ adults than in HIV- counterparts. The reported higher prevalence of caries in HIV+ persons was associated with being a female, detectable viral load, and frequent dental visits. Therefore, there is a need for effective oral health interventions specific to HIV+ individuals in Rwanda to raise awareness of the risk of dental caries and provide preventive oral health services among this population. To ensure timely oral health care among HIV+ persons, there is a need for an effort from policymakers and other stakeholders to integrate oral health care services within the HIV treatment program in Rwanda.

The authors have declared no competing interest.

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JM was funded by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [reference no. 107768/Z/15/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training, and Science in Africa (DELTAS Africa) programme. The statements made and views expressed are solely the responsibility of the Fellow. The funders had no role in study design, data collection, and data analysis, decision to publish, or preparation of the manuscript. URL: www.cartafrica.org

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The ethical clearances to conduct the study were received from Human Research Ethics Committee (No M200351) from the University of Witwatersrand, Institutional Review Board (No 573/CMHSIRB/2019) from University of Rwanda and Research ethics committee of Kigali Teaching Hospital ( No EC/CHUK/026/2020). The informed written consents were given to all participants before data correction. The confidentiality of patients was observed by using an anonymous questionnaire.

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