Prevalence of Oral Soft Tissue Lesions and Their Associations with Oral Hygiene Practices, Addictive Habits, and CD4 Counts Among Lesbian, Gay, Bisexual, Transgender, and Queer Individuals Living with Human Immunodeficiency Virus

OBJECTIVES: Oral manifestations often reflect underlying immune suppression and disease progression. These lesions can profoundly affect the quality of life, leading to pain, difficulty in eating, and social stigma. In the lesbian, gay, bisexual, transgender, and queer (LGBTQ) population living with human immunodeficiency virus (HIV), additional sociobehavioral factors, such as discrimination, mental health challenges, and barriers to healthcare access, may exacerbate oral health issues. MATERIAL AND METHODS: This cross-sectional study aimed to evaluate the prevalence of oral soft tissue lesions and their associations with oral hygiene practices, addictive habits, and CD4 counts in 56 LGBTQ adults with HIV (mean age 34.8 ± 7.2 years). Participants were recruited from an outpatient clinic and underwent comprehensive oral examinations using World Health Organization criteria, self-reported questionnaires on hygiene and addictions, and a review of recent CD4 counts. RESULTS: All participants reported addictions, predominantly smoking (44.6%), smokeless tobacco (37.5%), and alcohol (30.3%), with polyaddiction in 39.3% of the participants. Soft-tissue lesions were detected in 60.7% of patients, including candidiasis (26.8%), oral hairy leukoplakia (14.3%), aphthous ulcers (10.7%), linear gingival erythema (8.9%), and tobacco pouch keratosis (7.1%). Lesion prevalence was significantly higher among irregular brushers (100%, P = 0.034), poly-addicts (86.4%, P = 0.002), and those with CD4 counts <350 cells/mm3 (78.9% vs. 42.3% for ≥350 cells/mm3, P = 0.011). Specific associations included tobacco use and leukoplakia/keratosis (P = 0.029) and alcohol use and candidiasis (P = 0.041). CONCLUSIONS: Multidisciplinary interventions emphasizing oral hygiene education, addiction cessation programs, and integrated dental-HIV care are essential to reduce morbidity and enhance the overall well-being of LGBTQ individuals with HIV.