{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:57:14Z","timestamp":1793131034489,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009054","name":"President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","award":["NU2GGH001629"],"award-info":[{"award-number":["NU2GGH001629"]}],"id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>South Africa has the largest number of people living with HIV worldwide. South Africa has implemented five population-based HIV prevalence surveys since 2002 aimed at understanding the dynamics and the trends of the epidemic. This paper presents key findings from the fifth HIV prevalence, incidence, and behaviour survey conducted in 2017 following policy, programme, and epidemic change since the prior survey was conducted in 2012. A cross-sectional population-based household survey collected behavioural and biomedical data on all members of the eligible households. A total of 39,132 respondents from 11,776 households were eligible to participate, of whom 93.6% agreed to be interviewed, and 61.1% provided blood specimens. The provided blood specimens were used to determine HIV status, HIV incidence, viral load, exposure to antiretroviral treatment, and HIV drug resistance. Overall HIV incidence among persons aged 2 years and above was 0.48% which translates to an estimated 231,000 new infections in 2017. HIV prevalence was 14.0% translating to 7.9 million people living with HIV. Antiretroviral (ARV) exposure was 62.3%, with the lowest exposure among those aged 15 to 24 years (39.9%) with 10% lower ARV coverage among males compared to females. Viral suppression among those on treatment was high (87.3%), whilst HIV population viral load suppression was much lower (62.3%). In terms of risk behaviours, 13.6% of youth reported having had an early sexual debut (first sex before the age of 15 years), with more males reporting having done so (19.5%) than females (7.6%). Age-disparate relationships, defined as having a sexual partner 5+ years different from oneself,) among adolescents were more common among females (35.8%) than males (1.5%). Self-reported multiple sexual partnerships (MSPs), defined as having more than one sexual partner in the previous 12 months, were more commonly reported by males (25.5%) than females (9.0%). Condom use at last sexual encounter was highest among males than females. Three quarters (75.2%) of people reported they had ever been tested for HIV, with more females (79.3%) having had done so than males (70.9%). Two-thirds of respondents (66.8%) self-reported having tested for HIV in the past 12 months. Finally, 61.6% of males in the survey self-reported as having been circumcised, with circumcision being more common among youth aged 15\u201324 years (70.2%), Black Africans (68.9%), and those living in both rural informal (tribal) areas (65%) and urban areas (61.9%). Slightly more (51.2%) male circumcisions were reported to have occurred in a medical setting than in traditional settings (44.8%), with more young males aged 15\u201324 (62.6%) and men aged 25\u201349 (51.5%) reporting to have done so compared to most men aged 50 and older (57.1%) who reported that they had undergone circumcision in a traditional setting. The results of this survey show that strides have been made in controlling the HIV epidemic, especially in the reduction of HIV incidence, HIV testing, and treatment. Although condom use at last sex act remains unchanged, there continue to be some challenges with the lack of significant behaviour change as people, especially youth, continue to engage in risky behaviour and delay treatment initiation. Therefore, there is a need to develop or scale up targeted intervention programmes to increase HIV testing further and put more people living with HIV on treatment as well as prevent risky behaviours that put young people at risk of HIV infection.<\/jats:p>","DOI":"10.3390\/ijerph19138125","type":"journal-article","created":{"date-parts":[[2022,7,3]],"date-time":"2022-07-03T22:50:46Z","timestamp":1656888646000},"page":"8125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":172,"title":["The HIV Epidemic in South Africa: Key Findings from 2017 National Population-Based Survey"],"prefix":"10.3390","volume":"19","author":[{"given":"Khangelani","family":"Zuma","sequence":"first","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"},{"name":"School of Public Health, University of the Witwatersrand, Johannesburg 2000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leickness","family":"Simbayi","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Cape Town 8000, South Africa"},{"name":"Department of Psychiatry & Mental Health, University of Cape Town, Cape Town 7925, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nompumelelo","family":"Zungu","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"},{"name":"The School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban 4000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sizulu","family":"Moyo","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Cape Town 8000, South Africa"},{"name":"School of Public Health and Family Medicine, University of Cape Town, Cape Town 7700, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmore","family":"Marinda","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Jooste","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Cape Town 8000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"North","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Cape Town 8000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Nadol","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getahun","family":"Aynalem","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehimario","family":"Igumbor","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa"},{"name":"School of Public Health, University of the Western Cape, Bellville, Cape Town 7535, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Sigida","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buyisile","family":"Chibi","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lehlogonolo","family":"Makola","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Cape Town 8000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lwando","family":"Kondlo","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Porter","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shandir","family":"Ramlagan","sequence":"additional","affiliation":[{"name":"Human Sciences Research Council, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SABSSM V Study Group Contributors","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"ref_1","unstructured":"Shisana, O., and Simbayi, L. (2002). The Nelson Mandela\/HSRC Study of HIV\/AIDS: South African National HIV Prevalence, Behavioural Risks and Mass Media: Household Survey 2002, HSRC Press."},{"key":"ref_2","unstructured":"Shisana, O., Rehle, T., Simbayi, L., Parker, W., Zuma, K., Bhana, A., Connolley, C., and Jooste, S. (2005). South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey, 2005, HSRC Press."},{"key":"ref_3","unstructured":"Shisana, O., Rehle, T., Simbayi, L.C., Zuma, K., Jooste, S., Pillay-Van Wyk, V., Mbelle, N., Van Zyl, J., Parker, W., and Zungu, N.P. (2009). South African National HIV Prevalence, Incidence and Communication Survey, 2008: A Turning Tide among Teenagers, HSRC Press."},{"key":"ref_4","unstructured":"Shisana, O., Rehle, T., Simbayi, L.C., Zuma, K., Jooste, S., Zungu, N., Labadarios, D., and Onoya, D. (2014). South African National HIV Prevalence, Incidence and Behaviour Survey, 2012, HSRC Press."},{"key":"ref_5","unstructured":"Simbayi, L.C., Zuma, K., Zungu, N., Moyo, S., Marinda, E., Jooste, S., Mabaso, M., Ramlagan, S., North, A., and van Zyl, J. (2019). South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017, HSRC Press."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rehle, T., Johnson, L., Hallett, T., Mahy, M., Kim, A., Odido, H., Onoya, D., Jooste, S., Shisana, O., and Puren, A. (2015). A Comparison of South African National HIV Incidence Estimates: A Critical Appraisal of Different Methods. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0133255"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2989\/16085906.2016.1153491","article-title":"New insights into HIV epidemic in South Africa: Key findings from the National HIV Prevalence, Incidence and Behaviour Survey, 2012","volume":"15","author":"Zuma","year":"2016","journal-title":"Afr. J. AIDS Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E223","DOI":"10.1016\/S2352-3018(15)00057-0","article-title":"Behaviour, not mobility, is a risk factor for HIV","volume":"2","author":"Colebunders","year":"2015","journal-title":"Lancet HIV"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.immuni.2016.12.013","article-title":"Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women","volume":"46","author":"Gosmann","year":"2017","journal-title":"Immunity"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1341597","DOI":"10.1080\/16549716.2017.1341597","article-title":"Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: Narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa","volume":"10","author":"Madiba","year":"2017","journal-title":"Glob. Health Action"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e252","DOI":"10.1016\/S2352-3018(15)00045-4","article-title":"Migration, sexual behaviour, and HIV risk: A general population cohort in rural South Africa","volume":"2","author":"McGrath","year":"2015","journal-title":"Lancet HIV"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s10461-015-1172-1","article-title":"\u201cOutness\u201d as a moderator of the association between syndemic conditions and HIV risk-taking behaviour among men who have sex with men in Tijuana, Mexico","volume":"20","author":"Pitpitan","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_13","unstructured":"SANAC (2017). National WHO Working Group on HIV Incidence Measurement and Data Use, SANAC."},{"key":"ref_14","unstructured":"UNAIDS (2017). Addressing a Blind Spot in Response to HIV: Reaching Men and Boys, UNAIDS."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1080\/13691058.2017.1309460","article-title":"\u201cI told her this is your life\u201d: Relationship Dynamics, Partner Support, and Adherence to Antiretroviral Therapy among South African Couples","volume":"19","author":"Conroy","year":"2017","journal-title":"Cult. Health Sex."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1186\/s12889-016-3024-y","article-title":"HIV risk perception and behavior among medically and traditionally circumcised males in South Africa","volume":"16","author":"Zungu","year":"2016","journal-title":"BMC Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1097\/QAD.0000000000001553","article-title":"Sexual partnership age pairings and risk of HIV acquisition in rural South Africa","volume":"31","author":"Akullian","year":"2017","journal-title":"AIDS"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1016\/S2352-3018(16)30226-0","article-title":"Age-mixing and the incidence of HIV among young women","volume":"4","author":"Gouws","year":"2016","journal-title":"Lancet HIV"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S2352-3018(16)30186-2","article-title":"Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: A community-wide phylogenetic study","volume":"4","author":"Kharsany","year":"2017","journal-title":"Lancet HIV"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/pubmed\/fdu010","article-title":"Determinants of multiple sexual partnerships in South Africa","volume":"37","author":"Onoya","year":"2015","journal-title":"J. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"181","DOI":"10.5114\/hivar.2018.78490","article-title":"Cohort effects on sexual behavior and risk of acquisition of sexually transmitted infections and HIV in a South African HIV prevention trial","volume":"17","author":"Nyirenda","year":"2018","journal-title":"HIV AIDS Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.1007\/s10461-017-1741-6","article-title":"HIV Prevalence and ART Use Among Men in Partnerships with 15\u201329 Year Old Women in South Africa: HIV Risk Implications for Young Women in Age-Disparate Partnerships","volume":"21","author":"Evans","year":"2017","journal-title":"AIDS Behav."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"19408","DOI":"10.7448\/IAS.18.2.19408","article-title":"Adolescent girls and young women: Key populations for HIV epidemic control","volume":"18","author":"Dellar","year":"2015","journal-title":"J. Int. AIDS Soc."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R., and Puren, A. (2005). Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLOS Med., 2.","DOI":"10.1371\/journal.pmed.0020298"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(07)60313-4","article-title":"Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial","volume":"369","author":"Gray","year":"2007","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(07)60312-2","article-title":"Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial","volume":"369","author":"Bailey","year":"2007","journal-title":"Lancet"},{"key":"ref_27","unstructured":"UNAIDS (2014). 90-90-90 An Ambitious Treatment Target to Help End the AIDS Epidemic, UNAIDS."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.puhe.2016.10.017","article-title":"Trends in HIV testing and associated factors among men in South Africa: Evidence from 2005, 2008 and 2012 national population-based household surveys","volume":"143","author":"Makusha","year":"2017","journal-title":"Public Health"},{"key":"ref_29","unstructured":"Statistics South Africa (2011). Spatial Metadata."},{"key":"ref_30","unstructured":"Statistics South Africa (2017). Mid-Year Population Estimates 2017."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1097\/QAD.0000000000001209","article-title":"Viral load criteria and threshold optimization to improve HIV incidence assay characteristics","volume":"30","author":"Kassanjee","year":"2016","journal-title":"AIDS"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4102\/sajhivmed.v18i1.694","article-title":"Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa","volume":"18","author":"Johnson","year":"2017","journal-title":"S. Afr. J. HIV Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Grebe, E., Welte, A., Johnson, L.F., van Cutsem, G., Puren, A., Ellman, T., Etard, J.-F., Huerga, H., and the Consortium for the Evaluation and Performance of HIV Incidence Assays (CEPHIA) (2018). Population-level HIV incidence estimates using a combination of synthetic cohort and recency biomarker approaches in KwaZulu-Natal, South Africa. PLoS ONE, 13.","DOI":"10.1101\/306464"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e389","DOI":"10.1016\/S2352-3018(21)00079-5","article-title":"HIV incidence trends in Africa: Young women at highest risk","volume":"8","author":"Karim","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e1521","DOI":"10.1016\/S2214-109X(19)30410-3","article-title":"Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: A systematic review and meta-analysis","volume":"7","author":"Birdthistle","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e831","DOI":"10.1016\/S2352-3018(19)30196-1","article-title":"Global, regional, and national incidence, prevalence, and mortality of HIV, 1980\u20132017, and forecasts to 2030, for 195 countries and territories: A systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017","volume":"6","author":"Frank","year":"2019","journal-title":"Lancet HIV"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Moyo, S., Young, P.W., Gouws, E., Naidoo, I., Wamicwe, J., Mukui, I., Marsh, K., Igumbor, E., Kim, A.A., and Rehle, T. (2018). Equity of antiretroviral treatment use in high HIV burden countries: Analyses of data from nationally-representative surveys in Kenya and South Africa. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201899"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-018-3158-x","article-title":"\u201cLate for testing, early for antiretroviral therapy, less likely to die\u201d: Results from a large HIV cohort study in China, 2006\u20132014","volume":"18","author":"Tang","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e25070","DOI":"10.1002\/jia2.25070","article-title":"Equity of child and adolescent treatment, continuity of care and mortality, according to age and gender among enrollees in a large HIV programme in Tanzania","volume":"21","author":"Chaudhury","year":"2018","journal-title":"J. Int. AIDS Soc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.dr.2018.02.001","article-title":"Stigma-based bullying interventions: A systematic review","volume":"48","author":"Earnshaw","year":"2018","journal-title":"Dev. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1097\/QAD.0000000000001416","article-title":"Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa","volume":"31","author":"Croome","year":"2017","journal-title":"AIDS"},{"key":"ref_42","first-page":"1","article-title":"Accuracy and determinants of perceived HIV risk among young women in South Africa","volume":"18","author":"Venkataramani","year":"2017","journal-title":"BMC Public Health"},{"key":"ref_43","first-page":"1","article-title":"Why increasing availability of ART is not enough: A rapid, community-based study on how HIV-related stigma impacts engagement to care in rural South Africa","volume":"16","author":"Steward","year":"2015","journal-title":"BMC Public Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1080\/17441692.2019.1633379","article-title":"Viral suppression among persons living with HIV in Trinidad & Tobago: Implications for targeted prevention programmes","volume":"14","author":"Edwards","year":"2019","journal-title":"Glob. Public Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2989\/16085906.2011.626283","article-title":"Determinants of age at sexual debut and associated risks among South African youths","volume":"10","author":"Zuma","year":"2011","journal-title":"Afr. J. AIDS Res."},{"key":"ref_46","first-page":"1","article-title":"Sexual risk behaviour in a cohort of HIV-negative and HIV-positive Rwandan women","volume":"147","author":"Mukanyangezi","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Vu, T.M.T., Boggiano, V.L., Tran, B.X., Nguyen, L.H., Tran, T.T., Latkin, C.A., Ho, C.S.H., and Ho, R.C.M. (2018). Sexual Risk Behaviors of Patients with HIV\/AIDS over the Course of Antiretroviral Treatment in Northern Vietnam. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15061106"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12982-018-0074-x","article-title":"Role of survey response rates on valid inference: An application to HIV prevalence estimates","volume":"15","author":"Marino","year":"2018","journal-title":"Emerg. Themes Epidemiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"590","DOI":"10.7196\/SAMJ.2017.v107i7.11207","article-title":"National South African HIV prevalence estimates robust despite substantial test non-participation","volume":"107","author":"Harling","year":"2017","journal-title":"South Afr. Med. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/8125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:42:00Z","timestamp":1760139720000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/13\/8125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,1]]},"references-count":49,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ijerph19138125"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19138125","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,1]]}}}