{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:11:16Z","timestamp":1789189876606,"version":"build-2803163510"},"reference-count":103,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,9,11]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Autistic individuals identify with a wider range of sexual orientations than non-autistic individuals, including higher rates of bisexual orientation in autistic men. Gay, bisexual and other men who have sex with men are at greater risk for HIV. Prevalence data of autistic traits in people living with HIV or using Pre-Exposure Prophylaxis (PrEP) for HIV are lacking so far. Such data, combined with insights in barriers and facilitators for safer sex in autistic people living with HIV or using PrEP, are a first step to improve health support for autistic people in HIV clinics. This support is crucial since autistic individuals have worse physical and mental health outcomes. The objective of this research is to determine the prevalence of autistic traits within the group of people living with HIV or using PrEP in Belgium and to describe specific facilitators and barriers for sexual safer behaviour in people living with HIV and PrEP users with autistic traits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The research is a cross-sectional, observational and multicentre study with recruitment of individual participants. The research consists of two phases. In phase 1, adults coming for HIV\/AIDS care or HIV PrEP in participating Belgian HIV Reference Centres will be invited to fill in the validated Autism Spectrum Quotient questionnaire. In phase 2, participants with a score above the predefined cut-off for autistic traits (&gt;26), who agreed to be informed about this score, will be invited to complete an additional survey, inquiring facilitators and barriers for sexual safer behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination of results<\/jats:title>\n                    <jats:p>Institutional Review Board Institute of Tropical Medicine Antwerp, 25 July 2022, REF 1601\/22 and University Hospital of Antwerp, 12 September 2022, Project ID 3679: BUN B3002022000111. Study results will be published in peer-reviewed journals and presented to Belgian HIV Reference Centres and at conferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075667","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T13:42:24Z","timestamp":1695994944000},"page":"e075667","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Measuring the prevalence of autistic traits in a cohort of adults living with HIV or taking HIV pre-exposure prophylaxis and mapping safer-sex barriers and facilitators: a study protocol"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-3535","authenticated-orcid":false,"given":"Veerle","family":"Huyst","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Dewinter","sequence":"additional","affiliation":[{"name":"School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilse","family":"Noens","sequence":"additional","affiliation":[{"name":"Parenting and Special Education Research Unit, University of Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Platteau","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7565-1359","authenticated-orcid":false,"given":"Achilleas","family":"Tsoumanis","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"2025121512523982000_13.9.e075667.1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . DSM-5: Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. American Psychiatric Publishing, 2013. doi:10.1176\/appi.books.9780890425596","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2025121512523982000_13.9.e075667.2","doi-asserted-by":"publisher","DOI":"10.1177\/1362361313477246"},{"key":"2025121512523982000_13.9.e075667.3","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2017.112"},{"key":"2025121512523982000_13.9.e075667.4","doi-asserted-by":"publisher","DOI":"10.1177\/1362361315588200"},{"key":"2025121512523982000_13.9.e075667.5","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1002\/aur.2864","article-title":"Autism-related language preferences of English-speaking individuals across the globe: A mixed methods investigation","volume":"16","author":"Keating","year":"2023","journal-title":"Autism Res"},{"key":"2025121512523982000_13.9.e075667.6","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1177\/13623613221117914","article-title":"Autistic person\u2019 or \u2018person with autism\u2019? person-first language preference in Dutch adults with autism and parents","volume":"27","author":"Buijsman","year":"2023","journal-title":"Autism"},{"key":"2025121512523982000_13.9.e075667.7","doi-asserted-by":"publisher","DOI":"10.1002\/AUR.2696"},{"key":"2025121512523982000_13.9.e075667.8","doi-asserted-by":"publisher","DOI":"10.1017\/S003329171400172X"},{"key":"2025121512523982000_13.9.e075667.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.0963-7214.2005.00334.x"},{"key":"2025121512523982000_13.9.e075667.10","doi-asserted-by":"publisher","DOI":"10.1002\/mrdd.10029"},{"key":"2025121512523982000_13.9.e075667.11","unstructured":"Nelson S , Professor A , Smiley K , et al . Unveiling the autism epidemic. J Neurol Clin Neurosci 2018;2."},{"key":"2025121512523982000_13.9.e075667.12","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s10803-016-2942-y","article-title":"Change in autism diagnoses prior to and following the introduction of DSM-5","volume":"47","author":"Bent","year":"2017","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s00406-020-01189-w","article-title":"Missed diagnoses and Misdiagnoses of adults with autism spectrum disorder","volume":"272","author":"Fusar-Poli","year":"2022","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"2025121512523982000_13.9.e075667.14","doi-asserted-by":"crossref","first-page":"3370","DOI":"10.1007\/s10803-017-3258-2","article-title":"Diagnosing ASD in adults without ID: accuracy of the ADOS-2 and the ADI-R","volume":"47","author":"Fusar-Poli","year":"2017","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2014.06.011"},{"key":"2025121512523982000_13.9.e075667.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.06.005"},{"key":"2025121512523982000_13.9.e075667.17","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12886"},{"key":"2025121512523982000_13.9.e075667.18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s13229-019-0308-y","article-title":"Quantifying compensatory strategies in adults with and without diagnosed autism","volume":"11","author":"Livingston","year":"2020","journal-title":"Molecular Autism"},{"key":"2025121512523982000_13.9.e075667.19","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718002283"},{"key":"2025121512523982000_13.9.e075667.20","doi-asserted-by":"publisher","DOI":"10.1177\/1362361315577517"},{"key":"2025121512523982000_13.9.e075667.21","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-016-2722-8"},{"key":"2025121512523982000_13.9.e075667.22","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S2215-0366(19)30289-5","article-title":"Prevalence of Co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis","volume":"6","author":"Lai","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"2025121512523982000_13.9.e075667.23","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/1362361319853442","article-title":"I was exhausted trying to figure it out\u2019: the experiences of females receiving an autism diagnosis in middle to late adulthood","volume":"24","author":"Leedham","year":"2020","journal-title":"Autism"},{"key":"2025121512523982000_13.9.e075667.24","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1080\/21642850.2019.1684920","article-title":"Living with autism without knowing: receiving a diagnosis in later life","volume":"7","author":"Stagg","year":"2019","journal-title":"Health Psychol Behav Med"},{"key":"2025121512523982000_13.9.e075667.25","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1007\/s10803-016-2872-8","article-title":"The experiences of late-diagnosed women with autism spectrum conditions: an investigation of the female autism phenotype","volume":"46","author":"Bargiela","year":"2016","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.26","doi-asserted-by":"publisher","DOI":"10.1177\/1362361315576221"},{"key":"2025121512523982000_13.9.e075667.27","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1002\/aur.2604","article-title":"The sexual health, orientation, and activity of autistic adolescents and adults","volume":"14","author":"Weir","year":"2021","journal-title":"Autism Res"},{"key":"2025121512523982000_13.9.e075667.28","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000149371.37294.66"},{"key":"2025121512523982000_13.9.e075667.29","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2007.0092"},{"key":"2025121512523982000_13.9.e075667.30","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s11904-015-0294-4","article-title":"Primary and secondary HIV prevention among persons with severe mental illness: recent findings","volume":"12","author":"Hobkirk","year":"2015","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2025121512523982000_13.9.e075667.31","unstructured":"UNAIDS . Better integration of mental health and HIV services needed. 2018. Available: https:\/\/www.unaids.org\/en\/resources\/presscentre\/featurestories\/2018\/october\/mental-health-and-hiv-services#:~:text=People%20living%20with%20HIV%20are,at%20higher%20risk%20of%20HIV"},{"key":"2025121512523982000_13.9.e075667.32","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S2215-0366(15)00357-0","article-title":"Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness: a systematic review and meta-analysis","volume":"3","author":"Hughes","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"2025121512523982000_13.9.e075667.33","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2011.579990"},{"key":"2025121512523982000_13.9.e075667.34","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2011.582125"},{"key":"2025121512523982000_13.9.e075667.35","doi-asserted-by":"publisher","DOI":"10.1007\/s11195-014-9351-y"},{"key":"2025121512523982000_13.9.e075667.36","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-013-1813-z"},{"key":"2025121512523982000_13.9.e075667.37","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1002\/jclp.22319","article-title":"Romantic relationships and relationship satisfaction among adults with Asperger syndrome and high-functioning autism","volume":"73","author":"Strunz","year":"2017","journal-title":"J Clin Psychol"},{"key":"2025121512523982000_13.9.e075667.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2018.03.002"},{"key":"2025121512523982000_13.9.e075667.39","unstructured":"ECDC . HIV infection and AIDS. annual Epidemiological report for 2017, European centre for disease prevention and control, Stockholm. 2019. Available: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/hiv-infection-aids--annual-epidemiological-report-2017.pdf"},{"key":"2025121512523982000_13.9.e075667.40","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-014-2093-y"},{"key":"2025121512523982000_13.9.e075667.41","doi-asserted-by":"crossref","first-page":"4834","DOI":"10.1007\/s10803-019-04204-9","article-title":"Characterising the sexuality and sexual experiences of autistic females","volume":"49","author":"Pecora","year":"2019","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.42","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.chc.2020.02.007","article-title":"Sexuality and gender issues in individuals with autism spectrum disorder","volume":"29","author":"Pecora","year":"2020","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"key":"2025121512523982000_13.9.e075667.43","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1007\/s40489-022-00310-0","article-title":"A systematic review of sexual violence among autistic individuals","volume":"10","author":"Dike","year":"2023","journal-title":"Rev J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2007.10.002"},{"key":"2025121512523982000_13.9.e075667.45","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-011-9897-z"},{"key":"2025121512523982000_13.9.e075667.46","doi-asserted-by":"publisher","DOI":"10.1016\/j.chiabu.2008.09.006"},{"key":"2025121512523982000_13.9.e075667.47","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-016-3446-6","article-title":"The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India","volume":"16","author":"Tomori","year":"2016","journal-title":"BMC Public Health"},{"key":"2025121512523982000_13.9.e075667.48","doi-asserted-by":"crossref","DOI":"10.1186\/s13034-021-00390-6","article-title":"Health-related risky behaviors in Chinese adolescents with autism: a cross-sectional study","volume":"15","author":"Sun","year":"2021","journal-title":"Child Adolesc Psychiatry Ment Health"},{"key":"2025121512523982000_13.9.e075667.49","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3509-x"},{"key":"2025121512523982000_13.9.e075667.50","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-015-2579-2"},{"key":"2025121512523982000_13.9.e075667.51","doi-asserted-by":"publisher","DOI":"10.1177\/1744629516665242"},{"key":"2025121512523982000_13.9.e075667.52","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.160192"},{"key":"2025121512523982000_13.9.e075667.53","doi-asserted-by":"crossref","DOI":"10.1186\/1471-244X-9-35","article-title":"Psychiatric and Psychosocial problems in adults with normal-intelligence autism spectrum disorders","volume":"9","author":"Hofvander","year":"2009","journal-title":"BMC Psychiatry"},{"key":"2025121512523982000_13.9.e075667.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.03.025"},{"key":"2025121512523982000_13.9.e075667.55","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1001\/jamapediatrics.2015.3935","article-title":"Association of psychiatric and neurologic Comorbidity with mortality among persons with autism spectrum disorder in a Danish population","volume":"170","author":"Schendel","year":"2016","journal-title":"JAMA Pediatr"},{"key":"2025121512523982000_13.9.e075667.56","doi-asserted-by":"publisher","DOI":"10.1159\/000255958"},{"key":"2025121512523982000_13.9.e075667.57","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2262-7"},{"key":"2025121512523982000_13.9.e075667.58","doi-asserted-by":"publisher","DOI":"10.1177\/1362361316661261"},{"key":"2025121512523982000_13.9.e075667.59","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1363\/psrh.12221","article-title":"Sexual and reproductive health services for autistic young people in the United States; A conceptual model of utilization","volume":"55","author":"Holmes","year":"2023","journal-title":"Perspect Sex Reprod Health"},{"key":"2025121512523982000_13.9.e075667.60","doi-asserted-by":"crossref","unstructured":"Holmes LG , Ames JL , Massolo ML , et al . Improving the sexual and reproductive health and health care of autistic people. Pediatrics 2022;149. doi:10.1542\/peds2020-049437J","DOI":"10.1542\/peds.2020-049437J"},{"key":"2025121512523982000_13.9.e075667.61","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1002\/aur.2340","article-title":"INSAR special interest group report: Stakeholder perspectives on priorities for future research on autism, sexuality, and intimate relationships","volume":"13","author":"Dewinter","year":"2020","journal-title":"Autism Res"},{"key":"2025121512523982000_13.9.e075667.62","doi-asserted-by":"publisher","DOI":"10.1080\/10810730600671862"},{"key":"2025121512523982000_13.9.e075667.63","doi-asserted-by":"publisher","DOI":"10.1363\/47e5715"},{"key":"2025121512523982000_13.9.e075667.64","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/jcpp.12837","article-title":"Cognitive mechanisms of inhibitory control deficits in autism spectrum disorder","volume":"59","author":"Schmitt","year":"2018","journal-title":"J Child Psychol Psychiatry"},{"key":"2025121512523982000_13.9.e075667.65","doi-asserted-by":"publisher","DOI":"10.1177\/1362361310366314"},{"key":"2025121512523982000_13.9.e075667.66","doi-asserted-by":"crossref","unstructured":"Li J-C , Tsai S-J , Chen T-J , et al . Sexually transmitted infection among adolescents and young adults with autism spectrum disorder: A nationwide longitudinal study. J Autism Dev Disord 2022. doi:10.1007\/s10803-022-05732-7","DOI":"10.1007\/s10803-022-05732-7"},{"key":"2025121512523982000_13.9.e075667.67","unstructured":"Deblonde J , Rouck M , Montourcy M , et al . Epidemiologie Van AIDS en HIV-Infectie in Belgi\u00eb, Toestand op 2020. 2021. doi:10.25608\/bbbj-e471"},{"key":"2025121512523982000_13.9.e075667.68","unstructured":"Deblonde J , De Rouck M , Montourcy M , et al . n.d. Epidemiologie Van AIDS en HIV-Infectie in Belgi\u00eb, rapport 2021. doi:10.25608\/9bnm-ht18"},{"key":"2025121512523982000_13.9.e075667.69","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005653411471"},{"key":"2025121512523982000_13.9.e075667.70","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-005-3300-7"},{"key":"2025121512523982000_13.9.e075667.71","doi-asserted-by":"crossref","first-page":"2402","DOI":"10.1007\/s10803-020-04699-7","article-title":"The predictive value of the AQ and the SRS-A in the diagnosis of ASD in adults in clinical practice","volume":"51","author":"Bezemer","year":"2021","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.72","unstructured":"Gibbs GR . Thematic Coding and Categorizing In: Analyzing Qualitative Data, in Qualitative Research kit: Analyzing qualitative data. 2012."},{"key":"2025121512523982000_13.9.e075667.73","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/capr.12165","article-title":"Using thematic analysis in counselling and psychotherapy research: A critical reflection","volume":"18","author":"Clarke","year":"2018","journal-title":"Couns and Psychother Res"},{"key":"2025121512523982000_13.9.e075667.74","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/15532739.2019.1594484","article-title":"LGBTQ + and autism spectrum disorder: experiences and challenges","volume":"21","author":"Hillier","year":"2020","journal-title":"Int J Transgend Health"},{"key":"2025121512523982000_13.9.e075667.75","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1177\/1557988318797437","article-title":"Stigma and shame experiences by MSM who take prep for HIV prevention: A qualitative study","volume":"12","author":"Dubov","year":"2018","journal-title":"Am J Mens Health"},{"key":"2025121512523982000_13.9.e075667.76","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1038\/sj.bdj.2018.530","article-title":"The people living with HIV Stigmasurvey UK 2015: Stigmatising experiences and dental care","volume":"225","author":"Okala","year":"2018","journal-title":"Br Dent J"},{"key":"2025121512523982000_13.9.e075667.77","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1080\/09540121.2018.1479027","article-title":"The people living with HIV stigma survey UK 2015: HIV-related sexual rejection and other experiences of stigma and discrimination among gay and heterosexual men","volume":"30","author":"Hibbert","year":"2018","journal-title":"AIDS Care"},{"key":"2025121512523982000_13.9.e075667.78","doi-asserted-by":"crossref","first-page":"e574","DOI":"10.1016\/S2352-3018(22)00076-5","article-title":"Integrating HIV and mental health interventions to address a global Syndemic among men who have sex with men","volume":"9","author":"Operario","year":"2022","journal-title":"Lancet HIV"},{"key":"2025121512523982000_13.9.e075667.79","doi-asserted-by":"publisher","DOI":"10.1177\/1744629507083585"},{"key":"2025121512523982000_13.9.e075667.80","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1007\/s10803-016-2872-8","article-title":"The experiences of late-diagnosed women with autism spectrum conditions: an investigation of the female autism phenotype","volume":"46","author":"Bargiela","year":"2016","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.81","unstructured":"ECDC . HIV infection and AIDS. annual Epidemiological report for 2017. European Centre for Disease Prevention and Control, Stockholm 2019. Available: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/hiv-infection-aids--annual-epidemiological-report-2017.pdf"},{"key":"2025121512523982000_13.9.e075667.82","doi-asserted-by":"crossref","unstructured":"Pecora LA , Hancock GI , Hooley M , et al . Gender identity, sexual orientation and adverse sexual experiences in autistic females. Molecular Autism 2020;11. doi:10.1186\/s13229-020-00363-0","DOI":"10.1186\/s13229-020-00363-0"},{"key":"2025121512523982000_13.9.e075667.83","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1177\/13623613211050694","article-title":"A way to be me: autobiographical reflections of autistic adults diagnosed in mid-to-late adulthood","volume":"26","author":"Lilley","year":"2022","journal-title":"Autism"},{"key":"2025121512523982000_13.9.e075667.84","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.58.8.721"},{"key":"2025121512523982000_13.9.e075667.85","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10m06304"},{"key":"2025121512523982000_13.9.e075667.86","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1521\/aeap.2015.27.1.72","article-title":"Loneliness, HIV-related stigma, and condom use among a predominantly rural sample of HIV-positive men who have sex with men (MSM","volume":"27","author":"Hubach","year":"2015","journal-title":"AIDS Educ Prev"},{"key":"2025121512523982000_13.9.e075667.87","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1089\/aut.2018.0038","article-title":"Original research loneliness in adults on the autism spectrum","volume":"1","author":"Ee","year":"2019","journal-title":"Autism Adulthood"},{"key":"2025121512523982000_13.9.e075667.88","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1177\/13623613221077721","article-title":"Loneliness in autistic adults: A systematic review","volume":"26","author":"Umagami","year":"2022","journal-title":"Autism"},{"key":"2025121512523982000_13.9.e075667.89","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1080\/09540121.2018.1436687","article-title":"Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK","volume":"30","author":"Hibbert","year":"2018","journal-title":"AIDS Care"},{"key":"2025121512523982000_13.9.e075667.90","doi-asserted-by":"publisher","DOI":"10.1080\/09687599.2020.1822782"},{"key":"2025121512523982000_13.9.e075667.91","doi-asserted-by":"crossref","first-page":"3190","DOI":"10.1007\/s10803-016-2844-z","article-title":"Towards an agenda for research for Lesbian, gay, Bisexual, Transgendered and\/or Intersexed people with an autism spectrum diagnosis","volume":"46","author":"Bennett","year":"2016","journal-title":"J Autism Dev Disord"},{"key":"2025121512523982000_13.9.e075667.92","unstructured":"WHO and ECDC . HIV\/AIDS surveillance in Europe 2022. 2022."},{"key":"2025121512523982000_13.9.e075667.93","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/1362361319858860","article-title":"Self-reported motivations for offending by autistic sexual offenders","volume":"24","author":"Payne","year":"2020","journal-title":"Autism"},{"key":"2025121512523982000_13.9.e075667.94","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.avb.2015.04.003","article-title":"Autism spectrum disorder and sexual offending: Responsivity in forensic interventions","volume":"22","author":"Higgs","year":"2015","journal-title":"Aggression and Violent Behavior"},{"key":"2025121512523982000_13.9.e075667.95","doi-asserted-by":"publisher","DOI":"10.1016\/0010-0277(85)90022-8"},{"key":"2025121512523982000_13.9.e075667.96","unstructured":"Smet K , van Driel S . Levensloop model: Werken met autisme. Antwerpen - Apeldoorn: Garant, 2009."},{"key":"2025121512523982000_13.9.e075667.97","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60801-1"},{"key":"2025121512523982000_13.9.e075667.98","doi-asserted-by":"publisher","DOI":"10.1002\/aur.1433"},{"key":"2025121512523982000_13.9.e075667.99","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.pnpbp.2015.03.011","article-title":"MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults","volume":"64","author":"Danforth","year":"2016","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"2025121512523982000_13.9.e075667.100","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13cr08917"},{"key":"2025121512523982000_13.9.e075667.101","doi-asserted-by":"publisher","DOI":"10.1177\/0956462416651229"},{"key":"2025121512523982000_13.9.e075667.102","doi-asserted-by":"crossref","DOI":"10.1186\/s12981-018-0201-3","article-title":"Increases in Condomless Chemsex associated with HIV acquisition in MSM but not Heterosexuals attending a HIV testing center in Antwerp, Belgium","volume":"15","author":"Kenyon","year":"2018","journal-title":"AIDS Res Ther"},{"key":"2025121512523982000_13.9.e075667.103","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1177\/0956462416666753","article-title":"Men who have sex with men diagnosed with a sexually transmitted infection are significantly more likely to engage in Sexualised drug use","volume":"28","author":"Ottaway","year":"2017","journal-title":"Int J STD AIDS"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-075667","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T20:52:54Z","timestamp":1765831974000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-075667"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":103,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,29]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/bmjopen-2023-075667"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-075667","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}