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However, interactions between HIV, cortisol levels, and health outcomes have not been well described among people living with HIV on effective therapy. Furthermore, methods for measuring cortisol are disparate across studies. We describe the literature reporting cortisol levels in people living with HIV, describe methods to measure cortisol, and explore how this relates to health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched the PubMed database for articles published in the past 20\u00a0years regarding HIV and cortisol with \u226550% of participants on antiretroviral therapies. Articles included observational, case\u2010control, cross\u2010sectional, and randomized controlled trials analyzing cortisol by any method. Studies were excluded if abnormal cortisol was due to medications or other infections. Variables were extracted from selected studies and their quality was assessed using the Newcastle\u2013Ottawa Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 19 articles were selected and included, covering the prevalence of abnormal cortisol (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), exercise (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), metabolic syndrome and\/or cardiovascular disease (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), mental health and cognition (<jats:italic>n<\/jats:italic>\u00a0=\u00a09), and sex\/gender (<jats:italic>n<\/jats:italic>\u00a0=\u00a06). Cortisol was measured in serum (<jats:italic>n<\/jats:italic>\u00a0=\u00a07), saliva (<jats:italic>n<\/jats:italic>\u00a0=\u00a08), urine (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), and hair (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) specimens. Comparisons between people with and without HIV were inconsistent, with some evidence that people with HIV have increased rates of hypocortisolism. Depression and cognitive decline may be associated with cortisol excess, whereas anxiety and metabolic disease may be related to low cortisol; more data are needed to confirm these relationships.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Data on cortisol levels in the era of antiretroviral therapy remain sparse. Future studies should include controls without HIV, appropriately timed sample collection, and consideration of sex\/gender and psychosocial factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13272","type":"journal-article","created":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T04:29:02Z","timestamp":1648441742000},"page":"880-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stressing the need for validated measures of cortisol in HIV research: A scoping review"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7507-3747","authenticated-orcid":false,"given":"Shayda A.","family":"Swann","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine University of British Columbia  Vancouver British Columbia Canada"},{"name":"Women\u2019s Health Research Institute  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"King","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Research Institute  Vancouver British Columbia Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9l\u00e8ne C. 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