{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:55:47Z","timestamp":1790477747802,"version":"4.1.0"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002879","name":"Canadian HIV Trials Network, Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CTN283"],"award-info":[{"award-number":["CTN283"]}],"id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100021570","name":"Strategy for Patient-Oriented Research","doi-asserted-by":"publisher","award":["383427"],"award-info":[{"award-number":["383427"]}],"id":[{"id":"10.13039\/100021570","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015631","name":"Merck Canada","doi-asserted-by":"publisher","award":["IISP-53538"],"award-info":[{"award-number":["IISP-53538"]}],"id":[{"id":"10.13039\/501100015631","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016913","name":"MSDAVENIR","doi-asserted-by":"publisher","award":["DS-2018-0072"],"award-info":[{"award-number":["DS-2018-0072"]}],"id":[{"id":"10.13039\/100016913","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Adherence to antiretroviral therapy (ART) is a priority in HIV care. Our goal was to develop and validate a new, short patient-reported outcome measure to screen for barriers to daily oral ART adherence in HIV care in Canada and France. The overarching design was that of a multi-phase, multi-site instrument development project. It involved a previously published qualitative research synthesis (to develop a conceptual framework from which to generate items). Here, we present the results of cognitive interviews (for content validity testing of the preliminary items) and of a longitudinal survey-based study where the revised 7-item instrument (the I-Score) was administered at two timepoints (baseline, 4 weeks), along with five indirect measures of ART adherence, including self-reported HIV viral load and, for a subset of Montreal participants, plasma viral load. The survey data was used to analyze the instrument\u2019s measurement properties, namely structural validity (e.g., with Pearson inter-item correlations); construct validity, including cross-cultural validity, for a variety of sociodemographic groups (with receiver operating curve (ROC) analyses and areas under the curve (AUC); reliability (with the intraclass correlation coefficient (ICC)); and measurement error (with the standard error of measurement (SEM)). Study participants were adults living with HIV on antiretroviral therapy recruited from hospital-based infectious disease centers and community-based organizations in Montreal, Toronto, and Paris. The qualitative synthesis of 41 studies led to a framework composed of 6 barrier domains. One item was generated per domain. The 6-item measure was submitted to cognitive testing with 12 adults living with HIV, leading to several changes, including the division of one item into two, creating a 7-item measure. Overall, 305 adults living with HIV participated in the survey. Inter-item correlations were low to moderate, suggesting no redundant items. Among conclusive results, AUC\u2019s were all above the predefined threshold (\u2265 0.70) for self-reported viral load and plasma viral load for the global sample and across all subgroups examined. The ICC, at 0.81, was also above the predefined threshold (\u2265 0.70). The SEM was 0.43. Overall, the evidence generated supports the 7-item I-Score measure\u2019s content validity, construct validity\/cross-cultural validity, reliability, and acceptable measurement error, in its specified context of use.<\/jats:p>","DOI":"10.1371\/journal.pone.0324241","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T19:09:32Z","timestamp":1767726572000},"page":"e0324241","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["A multi-phase project to develop a patient-reported measure of barriers to antiretroviral therapy adherence for use in HIV care: The 7-Item I-Score"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8364-7421","authenticated-orcid":true,"given":"Kim","family":"Engler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lessard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Vicente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3069-2875","authenticated-orcid":true,"given":"Darrell H. S.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Lacombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Lebouch\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"pone.0324241.ref001","unstructured":"Public Health Agency of Canada. Estimates of HIV incidence, prevalence and Canada\u2019s progress on meeting the 90-90-90 HIV targets, 2020; 2022. Available from: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/estimates-hiv-incidence-prevalence-canada-meeting-90-90-90-targets-2020.html"},{"key":"pone.0324241.ref002","unstructured":"Public Health Agency of Canada. HIV in Canada: 2022 surveillance highlights; 2023. Available from: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/hiv-2022-surveillance-highlights.html"},{"key":"pone.0324241.ref003","unstructured":"Government of Quebec. Portrait \u00e9pid\u00e9miologique des infections transmissibles sexuellement et par le sang, r\u00e9gion de Montr\u00e9al, 2013-2022 Mise \u00e0 jour incluant les donn\u00e9es sur l\u2019infection par le virus de l\u2019immunod\u00e9ficience humaine, ann\u00e9e 2022. Secteur Pr\u00e9vention et Contr\u00f4le des maladies infectieuses Direction r\u00e9gionale de sant\u00e9 publique de Montr\u00e9al CIUSSS du Centre-Sud-de l\u2019\u00cele-de-Montr\u00e9al; 2023. Available from: https:\/\/santemontreal.qc.ca\/fileadmin\/fichiers\/professionnels\/DRSP\/sujets-a-z\/ITSS\/Portrait_epidemiologique-ITSS_Montreal_2023-11.pdf"},{"issue":"11","key":"pone.0324241.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002183","article-title":"Patient-reported barriers to adherence to antiretroviral therapy: a systematic review and meta-analysis","volume":"13","author":"Z Shubber","year":"2016","journal-title":"PLoS Med"},{"issue":"13","key":"pone.0324241.ref005","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1097\/QAD.0000000000003648","article-title":"Adherence to oral antiretroviral therapy in Canada, 2010-2020","volume":"37","author":"JB Angel","year":"2023","journal-title":"AIDS"},{"issue":"15","key":"pone.0324241.ref006","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000003361","article-title":"Adherence to antiretroviral therapy and virologic failure: a meta-analysis","volume":"95","author":"WM Bezabhe","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"7","key":"pone.0324241.ref007","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1007\/s10461-011-9942-x","article-title":"Adherence to highly active antiretroviral therapy (HAART): a meta-analysis","volume":"15","author":"C Ortego","year":"2011","journal-title":"AIDS Behav"},{"issue":"2","key":"pone.0324241.ref008","doi-asserted-by":"crossref","first-page":"47","DOI":"10.5897\/JAHR11.046","article-title":"Integrating a web-based, patient-administered assessment into primary care for HIV-infected adults","volume":"4","author":"R Fredericksen","year":"2012","journal-title":"J AIDS HIV Res"},{"issue":"7","key":"pone.0324241.ref009","article-title":"Accuracy of measures for antiretroviral adherence in people living with HIV","volume":"7","author":"R Smith","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0324241.ref010","article-title":"Epidemiological fact sheet","author":"World Health Organization","year":"2023","journal-title":"HIV statistics, globally and by WHO region"},{"issue":"5","key":"pone.0324241.ref011","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1093\/cid\/civ941","article-title":"Continuous retention and viral suppression provide further insights into the HIV care continuum compared to the cross-sectional HIV care cascade","volume":"62","author":"J Colasanti","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"12","key":"pone.0324241.ref012","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1089\/apc.2012.0439","article-title":"Antiretroviral treatment interruption and loss to follow-up in two HIV cohorts in Australia and Asia: implications for \u201ctest and treat\u201d prevention strategy","volume":"27","author":"R Guy","year":"2013","journal-title":"AIDS Patient Care STDS"},{"issue":"1","key":"pone.0324241.ref013","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/QAI.0000000000000084","article-title":"Discontinuation of antiretroviral therapy among adults receiving HIV care in the United States","volume":"66","author":"AJ Hughes","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"pone.0324241.ref014","doi-asserted-by":"crossref","first-page":"2919","DOI":"10.1080\/21505594.2021.2004743","article-title":"Persistent low-Level viremia in persons living with HIV undertreatment: an unresolved status","volume":"12","author":"C Crespo-Bermejo","year":"2021","journal-title":"Virulence"},{"issue":"12","key":"pone.0324241.ref015","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(22)00462-4","article-title":"The virological consequences of low-level viraemia","volume":"10","author":"BO Olakunde","year":"2022","journal-title":"Lancet Glob Health"},{"issue":"2","key":"pone.0324241.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003028","article-title":"Emerging priorities for HIV service delivery","volume":"17","author":"N Ford","year":"2020","journal-title":"PLoS Med"},{"issue":"10","key":"pone.0324241.ref017","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1080\/09540121.2013.764394","article-title":"Minimal interference: a basis for selecting ART for prevention with positives","volume":"25","author":"B Lebouch\u00e9","year":"2013","journal-title":"AIDS Care"},{"issue":"1","key":"pone.0324241.ref018","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s41687-019-0124-3","article-title":"A review of HIV-specific patient-reported measures of perceived barriers to antiretroviral therapy adherence: what themes are they covering?","volume":"3","author":"K Engler","year":"2019","journal-title":"J Patient Rep Outcomes"},{"issue":"2","key":"pone.0324241.ref019","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3390\/jpm11020134","article-title":"Acceptability of a patient portal (Opal) in HIV clinical care: a feasibility study","volume":"11","author":"D Chu","year":"2021","journal-title":"J Pers Med"},{"issue":"1","key":"pone.0324241.ref020","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s41687-022-00435-0","article-title":"Content validation of a new measure of patient-reported barriers to antiretroviral therapy adherence, the I-Score: results from a Delphi study","volume":"6","author":"K Engler","year":"2022","journal-title":"J Patient Rep Outcomes"},{"key":"pone.0324241.ref021","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/hex.12845","article-title":"Evaluation of a project to engage patients in the development of a patient-reported measure for HIV care (the I-Score Study)","volume":"22","author":"I-Score Consulting Team","year":"2019","journal-title":"Health Expect"},{"issue":"6","key":"pone.0324241.ref022","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1177\/2374373520975728","article-title":"Challenges of patient engagement in an HIV clinical research program: a qualitative analysis of stakeholder accounts","volume":"7","author":"D Lessard","year":"2020","journal-title":"J Patient Exp"},{"issue":"2","key":"pone.0324241.ref023","doi-asserted-by":"crossref","first-page":"14","DOI":"10.35680\/2372-0247.1566","article-title":"A patient\u2019s narrative of engaging HIV care: lessons learned to harness resources and improve access to care","volume":"8","author":"D Lessard","year":"2021","journal-title":"Patient Exp J"},{"key":"pone.0324241.ref024","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/09540121.2018.1469725","article-title":"Barriers to antiretroviral therapy adherence in developed countries: a qualitative synthesis to develop a conceptual framework for a new patient-reported outcome measure","volume":"30","author":"K Engler","year":"2018","journal-title":"AIDS Care"},{"issue":"8","key":"pone.0324241.ref025","doi-asserted-by":"crossref","DOI":"10.2196\/12836","article-title":"Assessing the content validity of a new patient-reported measure of barriers to antiretroviral therapy adherence for electronic administration in routine HIV Care: proposal for a web-based Delphi study","volume":"8","author":"K Engler","year":"2019","journal-title":"JMIR Res Protoc"},{"key":"pone.0324241.ref026","volume-title":"Adherence to long-term therapies: evidence for action","author":"E Sabat\u00e9","year":"2003"},{"key":"pone.0324241.ref027","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3389\/fphar.2020.00572","article-title":"Practical barriers to medication adherence: what do current self- or observer-reported instruments assess?","volume":"11","author":"AHY Chan","year":"2020","journal-title":"Front Pharmacol"},{"issue":"10","key":"pone.0324241.ref028","article-title":"Development of an item bank to measure medication adherence: systematic review","volume":"22","author":"YH Kwan","year":"2020","journal-title":"J Med Internet Res"},{"issue":"5","key":"pone.0324241.ref029","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1007\/s11136-018-1829-0","article-title":"COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study","volume":"27","author":"CB Terwee","year":"2018","journal-title":"Qual Life Res"},{"key":"pone.0324241.ref030","article-title":"Canada\u2019s progress towards ending the HIV epidemic","author":"Public Health Agency of Canada","year":"2024","journal-title":"Government of Canada"},{"issue":"68","key":"pone.0324241.ref031","doi-asserted-by":"crossref","first-page":"3522","DOI":"10.21105\/joss.03522","article-title":"Taguette: open-source qualitative data analysis","volume":"6","author":"R Rampin","year":"2021","journal-title":"JOSS"},{"issue":"5","key":"pone.0324241.ref032","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","article-title":"COSMIN guideline for systematic reviews of patient-reported outcome measures","volume":"27","author":"CAC Prinsen","year":"2018","journal-title":"Qual Life Res"},{"key":"pone.0324241.ref033","doi-asserted-by":"crossref","first-page":"2325958221995612","DOI":"10.1177\/2325958221995612","article-title":"Development of the Canadian women-centred HIV Care model using the knowledge-to-action framework","volume":"20","author":"M Loutfy","year":"2021","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"pone.0324241.ref034","volume-title":"Factor analysis","author":"RL Gorusch","year":"1983","edition":"2"},{"key":"pone.0324241.ref035","volume-title":"A step-by-step approach to using the SAS\u00ae system for factor analysis and structural equation modeling","author":"L Hatcher","year":"1994"},{"key":"pone.0324241.ref036","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"4","key":"pone.0324241.ref037","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/01.qai.0000225020.73760.c2","article-title":"Visual analog scale of ART adherence: association with 3-day self-report and adherence barriers","volume":"42","author":"KR Amico","year":"2006","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"2","key":"pone.0324241.ref038","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/hiv.12284","article-title":"A simple self-reported adherence tool as a predictor of viral rebound in people with viral suppression on antiretroviral therapy","volume":"17","author":"JL O\u2019Connor","year":"2016","journal-title":"HIV Med"},{"issue":"10","key":"pone.0324241.ref039","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1080\/08870446.2017.1283037","article-title":"Predicting adherence to combination antiretroviral therapy for HIV in Tanzania: a test of an extended theory of planned behaviour model","volume":"32","author":"K Banas","year":"2017","journal-title":"Psychol Health"},{"issue":"1","key":"pone.0324241.ref040","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11904-018-0377-0","article-title":"Adherence measurements in HIV: new advancements in pharmacologic methods and real-time monitoring","volume":"15","author":"JR Castillo-Mancilla","year":"2018","journal-title":"Curr HIV\/AIDS Rep"},{"key":"pone.0324241.ref041","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1471-2288-10-22","article-title":"The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content","volume":"10","author":"LB Mokkink","year":"2010","journal-title":"BMC Med Res Methodol"},{"issue":"3","key":"pone.0324241.ref042","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1111\/bcp.12194","article-title":"What are validated self-report adherence scales really measuring?: a systematic review","volume":"77","author":"T-M-U Nguyen","year":"2014","journal-title":"Br J Clin Pharmacol"},{"issue":"3","key":"pone.0324241.ref043","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/QAI.0000000000002142","article-title":"Antiretroviral adherence level necessary for HIV viral suppression using real-world data","volume":"82","author":"KK Byrd","year":"2019","journal-title":"J Acquir Immune Defic Syndr"},{"key":"pone.0324241.ref044","article-title":"Guidelines for the use of antiretroviral agents in adults and adolescents with HIV","author":"Panel on Antiretroviral Guidelines for Adults and Adolescents","year":"2023","journal-title":"Laboratory testing. Department of Health and Human Services"},{"key":"pone.0324241.ref045","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2022"},{"issue":"2","key":"pone.0324241.ref046","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1136\/bmjebm-2019-111264","article-title":"On reporting and interpreting statistical significance and p values in medical research","volume":"26","author":"H Aguinis","year":"2021","journal-title":"BMJ Evid Based Med"},{"issue":"3","key":"pone.0324241.ref047","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s guide to correlation coefficients","volume":"18","author":"H Akoglu","year":"2018","journal-title":"Turk J Emerg Med"},{"key":"pone.0324241.ref048","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression","author":"DW Hosmer","year":"2013","edition":"3"},{"issue":"4857","key":"pone.0324241.ref049","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1126\/science.3287615","article-title":"Measuring the accuracy of diagnostic systems","volume":"240","author":"JA Swets","year":"1988","journal-title":"Science"},{"issue":"10","key":"pone.0324241.ref050","article-title":"Routine provision of feedback from patient-reported outcome measurements to healthcare providers and patients in clinical practice","volume":"10","author":"C Gibbons","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"22","key":"pone.0324241.ref051","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000120","article-title":"Toward patient-centered care: a systematic review of how to ask questions that matter to patients","volume":"93","author":"A Rosenzveig","year":"2014","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"pone.0324241.ref052","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1007\/s10865-016-9770-6","article-title":"Visual analogue scale (VAS) measurement of antiretroviral adherence in people living with HIV (PLWH): a meta-analysis","volume":"39","author":"DJ Finitsis","year":"2016","journal-title":"J Behav Med"},{"issue":"10","key":"pone.0324241.ref053","doi-asserted-by":"crossref","first-page":"2719","DOI":"10.1007\/s11136-023-03411-3","article-title":"Use of the visual analogue scale for health state valuation: a scoping review","volume":"32","author":"M \u00c5str\u00f6m","year":"2023","journal-title":"Qual Life Res"},{"issue":"4","key":"pone.0324241.ref054","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s11904-009-0024-x","article-title":"Improving the self-report of HIV antiretroviral medication adherence: is the glass half full or half empty?","volume":"6","author":"IB Wilson","year":"2009","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"5","key":"pone.0324241.ref055","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: appropriate use and interpretation","volume":"126","author":"P Schober","year":"2018","journal-title":"Anesth Analg"},{"issue":"8","key":"pone.0324241.ref056","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.jval.2014.08.2671","article-title":"Predicting adherence to medications using health psychology theories: a systematic review of 20 years of empirical research","volume":"17","author":"EAF Holmes","year":"2014","journal-title":"Value Health"},{"issue":"10","key":"pone.0324241.ref057","article-title":"Measurement properties of existing patient-reported outcome measures on medication adherence: systematic review","volume":"22","author":"YH Kwan","year":"2020","journal-title":"J Med Internet Res"},{"issue":"12","key":"pone.0324241.ref058","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0261006","article-title":"Implementation of an electronic patient-reported measure of barriers to antiretroviral therapy adherence with the Opal patient portal: Protocol for a mixed method type 3 hybrid pilot study at a large Montreal HIV clinic","volume":"16","author":"K Engler","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0324241.ref059","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1186\/s12889-023-15873-8","article-title":"Temporal trends in inequalities of the burden of HIV\/AIDS across 186 countries and territories","volume":"23","author":"P Deng","year":"2023","journal-title":"BMC Public Health"},{"issue":"5","key":"pone.0324241.ref060","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(23)00051-6","article-title":"Long-acting antiretrovirals and HIV treatment adherence","volume":"10","author":"JB Nachega","year":"2023","journal-title":"Lancet HIV"},{"key":"pone.0324241.ref061","unstructured":"European AIDS Clinical Society. Use of Patient Reported Outcome Measures (PROMs) in HIV Clinical Care; 2023. Available from: https:\/\/eacs.sanfordguide.com\/prevention-non-infectious-co-morbidities\/eacs-patient-reported-outcome-measures-in-hiv-care"},{"issue":"12","key":"pone.0324241.ref062","doi-asserted-by":"crossref","DOI":"10.2196\/39015","article-title":"HIV-specific reported outcome measures: systematic review of psychometric properties","volume":"8","author":"Z Wang","year":"2022","journal-title":"JMIR Public Health Surveill"},{"issue":"2","key":"pone.0324241.ref063","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s11136-017-1711-5","article-title":"Developing a patient-reported outcome measure for HIV care on perceived barriers to antiretroviral adherence: assessing the needs of HIV clinicians through qualitative analysis","volume":"27","author":"I Toupin","year":"2018","journal-title":"Qual Life Res"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T19:09:51Z","timestamp":1767726591000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324241"}},"subtitle":[],"editor":[{"given":"Marianne","family":"Clemence","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":63,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0324241","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}