{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:12:59Z","timestamp":1785420779172,"version":"3.56.0"},"reference-count":48,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009392","name":"Prince Sattam bin Abdulaziz University","doi-asserted-by":"crossref","award":["PSAU\/2025\/03\/32295"],"award-info":[{"award-number":["PSAU\/2025\/03\/32295"]}],"id":[{"id":"10.13039\/100009392","id-type":"DOI","asserted-by":"crossref"}]},{"award":["PSAU\/2025\/03\/32295"],"award-info":[{"award-number":["PSAU\/2025\/03\/32295"]}],"id":[{"id":"https:\/\/ror.org\/04jt46d36","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: This study aimed to estimate self-reported prevalence of HIV and gonorrhea among primary healthcare attendees in Riyadh and to identify key demographic, behavioral, and clinical predictors, acknowledging that diagnoses were based on participant self-report rather than laboratory confirmation. Methods: A cross-sectional survey was conducted between March and July 2023 across 48 primary healthcare centers in Riyadh. A total of 14,239 adult participants (aged \u226518 years) completed an electronically administered questionnaire that included self-reported prior diagnoses of HIV and gonorrhea. Multivariable logistic regression models were used to identify independent predictors of self-reported HIV and gonorrhea. Results: The self-reported prevalence of HIV was 2.6% (95% CI: 2.35\u20132.87%), and gonorrhea was 3.1% (95% CI: 2.83\u20133.40%). Several factors were independently associated with higher odds of self-reported infection. Younger age (&lt;50 years) increased risk (HIV: AOR = 2.19; gonorrhea: AOR = 1.57), as did female sex (HIV: AOR = 1.67; gonorrhea: AOR = 1.59), higher education (HIV: AOR = 1.29; gonorrhea: AOR = 1.23), married status (HIV: AOR = 1.76; gonorrhea: AOR = 1.49), and insurance coverage (HIV: AOR = 2.01; gonorrhea: AOR = 1.88). Behavioral and clinical factors included smoking (HIV: AOR = 4.79; gonorrhea: AOR = 2.41), hypertension (HIV: AOR = 2.58; gonorrhea: AOR = 1.49), obesity (HIV: AOR = 11.55; gonorrhea: AOR = 9.02), hypercholesterolemia (HIV: AOR = 2.24; gonorrhea: AOR = 2.53), and heart disease (HIV: AOR = 11.31; gonorrhea: AOR = 8.77). The notably high associations for obesity and heart disease should be interpreted with caution, as they may be influenced by detection bias or residual confounding within the healthcare-seeking sample. Conclusions: This study provides key insights into the self-reported burden and predictors of HIV and gonorrhea in Saudi Arabia. While identifying significant demographic and metabolic risk profiles, the high magnitude of certain clinical associations must be interpreted with caution due to potential detection bias and residual confounding. Given the reliance on self-reported data, these findings should be viewed as an epidemiological baseline rather than absolute prevalence. Prioritizing clinical context over statistical values and strengthening integrated, laboratory-based surveillance within primary care will be essential for improving early detection and evidence-based prevention strategies in the region.<\/jats:p>","DOI":"10.3390\/healthcare14101369","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T08:56:27Z","timestamp":1779094587000},"page":"1369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self-Reported Prevalence and Predictors of HIV and Gonorrhea Among Primary Healthcare Attendees: A Cross-Sectional Study from Saudi Arabia"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6981-8052","authenticated-orcid":false,"given":"Saad","family":"Alshahrani","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj 16273, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badr F.","family":"Al-Khateeb","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1976-2000","authenticated-orcid":false,"given":"Roa","family":"Altaweli","sequence":"additional","affiliation":[{"name":"Department of Maternity and Pediatric Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-4072","authenticated-orcid":false,"given":"Raed","family":"Aldahash","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"},{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noof","family":"Alwatban","sequence":"additional","affiliation":[{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"College of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Alhabas","sequence":"additional","affiliation":[{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"College of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wejdan Ali","family":"AlNowaisir","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Imam Abdulrahman bin Faisal, Dammam 34212, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-6058","authenticated-orcid":false,"given":"Amani","family":"Alharthy","sequence":"additional","affiliation":[{"name":"Department of Health Science, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3786-2379","authenticated-orcid":false,"given":"Lubna","family":"Alnaim","sequence":"additional","affiliation":[{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Al-Ahsa 31982, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Almudaihim","sequence":"additional","affiliation":[{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"College of Applied Health Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf","family":"El-Metwally","sequence":"additional","affiliation":[{"name":"Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia"},{"name":"College of Public Health & Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e38199","DOI":"10.1097\/MD.0000000000038199","article-title":"Global perspectives on the burden of sexually transmitted diseases: A narrative review","volume":"103","author":"Elendu","year":"2024","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.clindermatol.2023.12.002","article-title":"The global burden of sexually transmitted infections","volume":"42","author":"Sinka","year":"2024","journal-title":"Clin. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e3563","DOI":"10.1093\/cid\/ciaa1894","article-title":"Safety and effectiveness of an all-oral, bedaquiline-based, shorter treatment regimen for rifampicin-resistant tuberculosis in high human immunodeficiency virus (HIV) burden rural South Africa: A retrospective cohort analysis","volume":"73","author":"Tack","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e807","DOI":"10.1016\/S2352-3018(24)00212-1","article-title":"Global, regional, and national burden of HIV\/AIDS, 1990\u20132021, and forecasts to 2050, for 204 countries and territories: The Global Burden of Disease Study 2021","volume":"11","author":"Carter","year":"2024","journal-title":"Lancet HIV"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.clindermatol.2024.02.001","article-title":"The global burden of HIV","volume":"42","author":"Payagala","year":"2024","journal-title":"Clin. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"296","DOI":"10.2991\/jegh.k.210621.001","article-title":"Global epidemiology of HIV\/AIDS: A resurgence in North America and Europe","volume":"11","author":"Govender","year":"2021","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/09564624221149770","article-title":"The burden of chlamydia, gonorrhea, and syphilis in older adults in the United States: A systematic review","volume":"34","author":"Htet","year":"2023","journal-title":"Int. J. STD AIDS"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/OLQ.0000000000001763","article-title":"Estimated incidence and prevalence of gonorrhea in the United States, 2006\u20132019","volume":"50","author":"Pollock","year":"2023","journal-title":"Sex. Transm. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/infdis\/jiad047","article-title":"The estimated lifetime quality-adjusted life-years lost due to chlamydia, gonorrhea, and trichomoniasis in the United States in 2018","volume":"227","author":"Li","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1544","DOI":"10.1016\/S2214-109X(24)00266-3","article-title":"WHO global research priorities for sexually transmitted infections","volume":"12","author":"Gottlieb","year":"2024","journal-title":"Lancet Glob. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e25673","DOI":"10.1002\/jia2.25673","article-title":"Missed opportunities for sexually transmitted infections testing for HIV pre-exposure prophylaxis users: A systematic review","volume":"24","author":"Ong","year":"2021","journal-title":"J. Int. AIDS Soc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kiyingi, J., Nabunya, P., Bahar, O.S., Mayo-Wilson, L.J., Tozan, Y., Nabayinda, J., Namuwonge, F., Nsubuga, E., Kizito, S., and Nattabi, J. (2022). Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0273238"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Chemaitelly, H., Harfouche, M., Smolak, A., Ageeb, R., Mohamoud, Y.A., Alaama, A.S., Hermez, J.G., and Abu-Raddad, L.J. (2024). Epidemiology of gonorrhea in countries of the Middle East and North Africa: Systematic review, meta analyses, and meta regressions. BMC Glob. Public Health, 2.","DOI":"10.1186\/s44263-024-00088-9"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Obeid, D., Alsuwairi, F., Alnemari, R., Al-Qahtani, A., Kurdi, W., Alfareh, M., Alsanea, M., Alabdulkareem, M., Alharbi, L., and Alhamlan, F.S. (2024). Sexually transmitted infections in the middle east and North Africa: Comprehensive systematic review and meta-analysis. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-10153-1"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"102793","DOI":"10.1016\/j.jiph.2025.102793","article-title":"Burden of six common sexually transmitted infections groups in North Africa and Middle East Region from 1990 to 2021: A systematic analysis of global burden of diseases","volume":"18","author":"Shahsavand","year":"2025","journal-title":"J. Infect. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1016\/j.jiph.2023.06.012","article-title":"Human immunodeficiency virus in Saudi Arabia: Current and future challenges","volume":"16","author":"Dirar","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4103\/jfcm.jfcm_136_22","article-title":"Stigmatization and discrimination against people living with HIV\/AIDS: Knowledge, attitudes, and practices of healthcare workers in the primary healthcare centers in Madinah, Saudi Arabia, 2022","volume":"29","author":"Alharbi","year":"2022","journal-title":"J. Fam. Community Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2174\/011570162X306347240617192913","article-title":"Knowledge about HIV and stigmatizing attitudes of medical students in Saudi Arabia towards patients with HIV\/AIDS: A cross-sectional nationwide study","volume":"22","author":"Hakami","year":"2024","journal-title":"Curr. HIV Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Malli, I.A., Kabli, B.A., and Alhakami, L.A. (2023). Sexually transmitted diseases among Saudi women: Knowledge and misconceptions. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20064858"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"884","DOI":"10.3855\/jidc.7020","article-title":"Sexually transmitted infections case notification rates in the Kingdom of Saudi Arabia, 2005\u20132012","volume":"10","author":"Memish","year":"2016","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/0253-7184.74976","article-title":"Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections","volume":"31","author":"Alzahrani","year":"2010","journal-title":"Indian J. Sex. Transm. Dis. AIDS"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"402","DOI":"10.3855\/jidc.5964","article-title":"Prevalence and behavioral risk factors for STIs\/HIV among attendees of the Ministry of Health hospitals in Saudi Arabia","volume":"9","author":"Filemban","year":"2015","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_23","first-page":"762","article-title":"Sampling methods in research: A review","volume":"7","author":"Makwana","year":"2023","journal-title":"Int. J. Trend Sci. Res. Dev."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Henzi, A., Puke, M., Dimitriadis, T., and Ziegel, J. (2022). A safe Hosmer-Lemeshow test. arXiv.","DOI":"10.51387\/23-NEJSDS56"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.1016\/S2352-3018(22)00328-9","article-title":"Adult HIV-1 incidence across 15 high-burden countries in sub-Saharan Africa from 2015 to 2019: A pooled analysis of nationally representative data","volume":"10","author":"Rosenberg","year":"2023","journal-title":"Lancet HIV"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Hodgins, C., Stannah, J., Kuchukhidze, S., Zembe, L., Eaton, J.W., Boily, M.-C., and Maheu-Giroux, M. (2022). Population sizes, HIV prevalence, and HIV prevention among men who paid for sex in sub-Saharan Africa (2000\u20132020): A meta-analysis of 87 population-based surveys. PLoS Med., 19.","DOI":"10.1371\/journal.pmed.1003861"},{"key":"ref_27","first-page":"IDRT.S5250","article-title":"What is the real prevalence of HIV-infection in Saudi Arabia?","volume":"3","author":"Alothman","year":"2010","journal-title":"Infect. Dis. Res. Treat."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mazroa, M.A.l., Kabbash, I.A., Felemban, S.M., Stephens, G.M., Al-Hakeem, R.F., Zumla, A.I., and Memish, Z.A. (2012). HIV case notification rates in the Kingdom of Saudi Arabia over the past decade (2000\u20132009). PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0045919"},{"key":"ref_29","first-page":"13","article-title":"Factors associated with prevalence of HIV among youths: A review of Africa perspective","volume":"3","author":"Obeagu","year":"2023","journal-title":"Madonna Univ. J. Med. Health Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/OLQ.0000000000001355","article-title":"Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2018","volume":"48","author":"Kreisel","year":"2021","journal-title":"Sex. Transm. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Mutai, C.K., McSharry, P.E., Ngaruye, I., and Musabanganji, E. (2021). Use of machine learning techniques to identify HIV predictors for screening in sub-Saharan Africa. BMC Med. Res. Methodol., 21.","DOI":"10.1186\/s12874-021-01346-2"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1038\/s41564-022-01177-x","article-title":"Sexually transmitted infections and female reproductive health","volume":"7","author":"Muzny","year":"2022","journal-title":"Nat. Microbiol."},{"key":"ref_33","first-page":"385","article-title":"Educational inclusion and social interaction: A literature review","volume":"27","author":"Rosa","year":"2019","journal-title":"Trends Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.30574\/wjarr.2025.25.1.0199","article-title":"The influence of community-level digital health interventions by peer educators on HIV\/AIDS prevention among adolescents: A scoping review","volume":"25","author":"Oktavia","year":"2025","journal-title":"World J. Adv. Res. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e25883","DOI":"10.1002\/jia2.25883","article-title":"Increasing awareness of HIV pre-exposure prophylaxis (PrEP) and willingness to use HIV PrEP among men who have sex with men: A systematic review and meta-analysis of global data","volume":"25","author":"Sun","year":"2022","journal-title":"J. Int. AIDS Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/20905998.2024.2387511","article-title":"Breaking the silence\u2013systematic review of the socio-cultural underpinnings of men\u2019s sexual and reproductive health in Middle East and North Africa (MENA): A handful of taboos?","volume":"23","author":"Arafa","year":"2025","journal-title":"Arab J. Urol."},{"key":"ref_37","unstructured":"Alomair, N. (2022). Sexual and Reproductive Health of Women in Saudi Arabia: Needs, Perceptions, and Experiences. [Doctoral Dissertation, UCL (University College London)]."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Huda, M.N., Ahmed, M.U., Uddin, M.B., Hasan, M.K., Uddin, J., and Dune, T.M. (2022). Prevalence and demographic, socioeconomic, and behavioral risk factors of self-reported symptoms of sexually transmitted infections (STIs) among ever-married women: Evidence from Nationally representative surveys in Bangladesh. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031906"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Shri, N., and Muhammad, T. (2021). Association of intimate partner violence and other risk factors with HIV infection among married women in India: Evidence from National Family Health Survey 2015\u201316. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-12100-0"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S0140-6736(21)00397-4","article-title":"Insurance coverage and financing landscape for HIV treatment and prevention in the USA","volume":"397","author":"Kates","year":"2021","journal-title":"Lancet"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1007\/s12529-023-10218-6","article-title":"Associations between health insurance coverage with HIV detection and prevention behaviors among individuals with undiagnosed HIV or at increased risk for HIV infection in the USA","volume":"31","author":"Foley","year":"2024","journal-title":"Int. J. Behav. Med."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Adugna, D.G., and Worku, M.G. (2022). HIV testing and associated factors among men (15\u201364 years) in Eastern Africa: A multilevel analysis using the recent demographic and health survey. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14588-6"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1521\/aeap.2023.35.1.36","article-title":"Systematic review of social determinants of health associated with HIV testing among Hispanic\/Latino gay, bisexual, and other men who have sex with men in the United States","volume":"35","author":"Crepaz","year":"2023","journal-title":"AIDS Educ. Prev."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Subramanya, V., McKay, H.S., Brusca, R.M., Palella, F.J., Kingsley, L.A., Witt, M.D., Hodis, H.N., Tracy, R.P., Post, W.S., and Haberlen, S.A. (2019). Inflammatory biomarkers and subclinical carotid atherosclerosis in HIV-infected and HIV-uninfected men in the Multicenter AIDS Cohort Study. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214735"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/JNC.0000000000000240","article-title":"A review of chronic comorbidities in adults living with HIV: State of the science","volume":"32","author":"Webel","year":"2021","journal-title":"J. Assoc. Nurses AIDS Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/QAI.0000000000001554","article-title":"Inflammation-Related Morbidity and Mortality Among HIV-Positive Adults: How Extensive Is It?","volume":"77","author":"Hart","year":"2018","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12955-021-01702-2","article-title":"Health-related quality of life of people living with HIV\/AIDS: The role of social inequalities and disease-related factors","volume":"19","author":"Nigusso","year":"2021","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Armoon, B., Higgs, P., Fleury, M.-J., Bayat, A.-H., Moghaddam, L.F., Bayani, A., and Fakhri, Y. (2021). Socio-demographic, clinical and service use determinants associated with HIV related stigma among people living with HIV\/AIDS: A systematic review and meta-analysis. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06980-6"}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1369\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:14:25Z","timestamp":1779423265000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,16]]},"references-count":48,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["healthcare14101369"],"URL":"https:\/\/doi.org\/10.3390\/healthcare14101369","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,16]]}}}