{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:17:42Z","timestamp":1788254262417,"version":"build-2803163510"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: The COVID-19 pandemic exposed major vulnerabilities in healthcare accessibility and may have influenced preventive attitudes among people living with HIV (PLWH). However, the relationship between pandemic-related healthcare experiences and vaccination uptake remains insufficiently understood. Materials: A cross-sectional survey was conducted among 203 adults living with HIV receiving follow-up care in Romania between October 2025 and March 2026. The questionnaire evaluated vaccination uptake, vaccine-related perceptions, healthcare information sources, and pandemic-related experiences. Multivariable logistic regression analysis was performed to identify factors independently associated with vaccination uptake. Results: Only 38.9% of participants reported receiving at least one vaccine within the previous three years. The main barriers to vaccination were perceived lack of necessity, lack of physician recommendation, fear of adverse effects, and lack of trust. Multivariable logistic regression identified positive vaccine-related beliefs (OR = 0.454, 95% CI: 0.235\u20130.876, p = 0.019) and CD4+ T-cell count above 500 cells\/mm3 (OR = 0.448, 95% CI: 0.232\u20130.867, p = 0.017) as independently associated with lower odds of being non-vaccinated. More than half of participants (52.7%) reported at least one pandemic-related disruption or negative health impact. The pandemic-related negative impact composite was not significantly associated with vaccination status (p = 0.209), whereas confirmed COVID-19 infection was more frequent among vaccinated participants than among non-vaccinated participants (43.0% vs. 28.2%, p = 0.030). Pandemic-related negative impact was associated with a greater demand for physician-provided information (p = 0.011). Conclusions: Pandemic-related healthcare experiences were associated with greater demand for physician-provided preventive information, while confirmed COVID-19 infection was more frequent among vaccinated participants. Positive vaccine-related beliefs and higher CD4+ T-cell counts were independently associated with vaccination uptake, while lack of physician recommendation remained a major barrier to vaccination. These findings emphasize the critical role of physicians in improving vaccination coverage among people living with HIV in the post-pandemic era.<\/jats:p>","DOI":"10.3390\/vaccines14090751","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:31:13Z","timestamp":1788251473000},"page":"751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vaccination Uptake and Pandemic-Related Healthcare Experiences Among People Living with HIV in Romania: A Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Adrian Gabriel","family":"Marinescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8520-0375","authenticated-orcid":false,"given":"Aida-Isabela","family":"Adamescu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Department II, Discipline of Pathophysiology and Immunology, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lin","family":"Tili\u0219can","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Department II, Discipline of Pathophysiology and Immunology, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-8268","authenticated-orcid":false,"given":"Daniela","family":"Pi\u021bigoi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Department II, Discipline of Pathophysiology and Immunology, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Radiology and Medical Imaging, Emergency University Hospital, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0103-200X","authenticated-orcid":false,"given":"Lauren\u021biu Mih\u0103i\u021ba","family":"Stratan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9635-1177","authenticated-orcid":false,"given":"Carmen Cristina","family":"Vasile","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2318-5365","authenticated-orcid":false,"given":"Victor Daniel","family":"Miron","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Mardarescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalila","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreea Iuliana","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Aram\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department II, Discipline of Infectious Diseases II, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0019-934X","authenticated-orcid":false,"given":"\u0218tefan Sorin","family":"Aram\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Department II, Discipline of Pathophysiology and Immunology, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania"},{"name":"Department of Infectious Diseases, National Institute of Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 020021 Bucharest, 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J. Health Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101199","DOI":"10.1016\/j.imu.2023.101199","article-title":"Identifying resilience strategies for disruption management in the healthcare supply chain during COVID-19 by digital innovations: A systematic literature review","volume":"38","author":"Arji","year":"2023","journal-title":"Inf. Med. Unlocked"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mihai, N., Olariu, M.C., Ganea, O.A., Adamescu, A.I., Molagic, V., Aram\u0103, \u0218.S., Tili\u0219can, C., and Aram\u0103, V. (2024). Risk of Hepatitis B Virus Reactivation in COVID-19 Patients Receiving Immunosuppressive Treatment: A Prospective Study. J. Clin. Med., 13.","DOI":"10.20944\/preprints202409.1173.v1"},{"key":"ref_4","unstructured":"(2025). GBD 2019 Acute and Chronic Care Collaborators. Characterising acute and chronic care needs: Insights from the Global Burden of Disease Study 2019. Nat. Commun., 16, 4235."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jamda.2021.11.004","article-title":"Spillover effects of COVID-19 on essential chronic care and ways to foster health system resilience to support vulnerable non-COVID patients: A multistakeholder study","volume":"23","author":"Yoon","year":"2022","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Danhieux, K., Buffel, V., Pairon, A., Benkheil, A., Remmen, R., Wouters, E., and van Olmen, J. (2020). The impact of COVID-19 on chronic care according to providers: A qualitative study among primary care practices in Belgium. BMC Fam. Pract., 21.","DOI":"10.1186\/s12875-020-01326-3"},{"key":"ref_7","first-page":"86","article-title":"Impact of COVID-19 pandemic on chronic diseases care follow-up and current perspectives in low resource settings: A narrative review","volume":"13","author":"Fekadu","year":"2021","journal-title":"Int. J. Physiol. Pathophysiol. Pharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Brotherton, M. (2024). Persons living with HIV as a vulnerable group: An argument to ensure treatment, care, and support. Trop. Med. Infect. Dis., 9.","DOI":"10.3390\/tropicalmed9070155"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lazar, M., Moroti, R., Barbu, E.C., Chitu-Tisu, C.E., Tiliscan, C., Erculescu, T.M., Rosca, R.R., Frasila, S., Schmilevschi, E.T., and Simion, V. (2024). The Impact of HIV on Early Brain Aging\u2014A Pathophysiological (Re)View. J. Clin. Med., 13.","DOI":"10.3390\/jcm13237031"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1177\/10443894241272203","article-title":"Social stigma and vulnerabilities of women living with HIV\/AIDS in Kyrgyzstan: Service providers\u2019 perspectives","volume":"107","author":"Childress","year":"2026","journal-title":"Fam. Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e235058","DOI":"10.1001\/jamahealthforum.2023.5058","article-title":"Changes in health care access and preventive health screenings by race and ethnicity","volume":"5","author":"Alba","year":"2024","journal-title":"JAMA Health Forum"},{"key":"ref_12","unstructured":"European AIDS Clinical Society (2025). Immunisation in Persons with HIV, European AIDS Clinical Society. Available online: https:\/\/eacs.sanfordguide.com\/en\/eacs-hiv\/eacs-section4\/vaccination."},{"key":"ref_13","first-page":"E28","article-title":"Insights on common vaccinations in HIV-infection: Efficacy and safety","volume":"56","author":"Nicolini","year":"2015","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zaongo, S.D., Ouyang, J., Chen, Y., Jiao, Y.-M., Wu, H., and Chen, Y. (2022). HIV infection predisposes to increased chances of HBV infection: Current understanding of the mechanisms favoring HBV infection at each clinical stage of HIV infection. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.853346"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1038\/s41467-025-67258-7","article-title":"Persistent pneumococcal colonisation in antiretroviral-treated HIV infection is associated with nasal inflammation","volume":"17","author":"Phiri","year":"2026","journal-title":"Nat. Commun."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"ofw226","DOI":"10.1093\/ofid\/ofw226","article-title":"Meningococcal disease in patients with human immunodeficiency virus infection: A review of cases reported through active surveillance in the United States, 2000-2008","volume":"3","author":"Harris","year":"2016","journal-title":"Open Forum Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"663","DOI":"10.15585\/mmwr.mm7224a4","article-title":"Notes from the field: Increase in meningococcal disease among persons with HIV\u2014United States, 2022","volume":"72","author":"Rubis","year":"2023","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/JNC.0000000000000482","article-title":"Advancing vaccine uptake in people with HIV: A call for research on trust and intellectual humility in health care","volume":"35","author":"Barr","year":"2024","journal-title":"J. Assoc. Nurses AIDS Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e020730","DOI":"10.1136\/bmjgh-2025-020730","article-title":"Characterising concerns and misinformation shaping global HIV vaccine confidence and demand: A structured literature search and content analysis","volume":"11","author":"Bokolo","year":"2026","journal-title":"BMJ Glob. Health"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Liu, Y., Han, J., Li, X., Chen, D., Zhao, X., Qiu, Y., Zhang, L., Xiao, J., Li, B., and Zhao, H. (2021). COVID-19 vaccination in people living with HIV (PLWH) in China: A cross sectional study of vaccine hesitancy, safety, and immunogenicity. Vaccines, 9.","DOI":"10.3390\/vaccines9121458"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wu, S., Ming, F., Xing, Z., Zhang, Z., Zhu, S., Guo, W., Zou, S., Liu, J., Liu, Y., and Liang, K. (2022). COVID-19 vaccination willingness among people living with HIV in Wuhan, China. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.883453"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2151798","DOI":"10.1080\/21645515.2022.2151798","article-title":"COVID-19 vaccination in people living with HIV and AIDS (PLWHA) in China: A cross-sectional study","volume":"19","author":"Lv","year":"2023","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Qi, L., Yang, L., Ge, J., Yu, L., and Li, X. (2021). COVID-19 vaccination behavior of people living with HIV: The mediating role of perceived risk and vaccination intention. Vaccines, 9.","DOI":"10.3390\/vaccines9111288"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zurashvili, T., Chakhaia, T., King, E.J., DeHovitz, J., and Djibuti, M. (2024). HIV stigma and other barriers to COVID-19 vaccine uptake among Georgian people living with HIV\/AIDS: A mixed-methods study. PLoS Glob. Public Health, 4.","DOI":"10.1371\/journal.pgph.0003069"},{"key":"ref_25","first-page":"221","article-title":"Consensus Statement: Updated Recommendations for the Interdisciplinary Management of People Living with HIV in Romania","volume":"15","author":"Oprea","year":"2025","journal-title":"Germs"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Chivu, C.-D., Cr\u0103ciun, M.-D., Pi\u021bigoi, D., Aram\u0103, V., Luminos, M.L., Jugulete, G., Apostolescu, C.G., and Streinu Cercel, A. (2023). Vaccination and Factors Related to the Clinical Outcome of COVID-19 in Healthcare Workers\u2014A Romanian Front-Line Hospital\u2019s Experience. Vaccines, 11.","DOI":"10.3390\/vaccines11050899"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Drewes, J., Langer, P.C., Ebert, J., Kleiber, D., and Gusy, B. (2021). Sociodemographic, HIV-Related Characteristics, and Health Care Factors as Predictors of Self-Reported Vaccination Coverage in a Nationwide Sample of People Aging with HIV in Germany. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094901"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"23259582251328861","DOI":"10.1177\/23259582251328861","article-title":"Determinants of COVID-19 Vaccine Uptake Among People Living with Human Immunodeficiency Virus","volume":"24","author":"Mergenova","year":"2025","journal-title":"J. Int. Assoc. Provid. AIDS Care"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ciobanu, A.I., Ionescu, S., Tudor, A.M., M\u0103rd\u0103rescu, M., Stratan, L.M., Marinescu, A.G., Tiliscan, C., Adamescu, A.I., Ganea, O., and Aram\u0103, S.\u0218. (2026). Human Immunodeficiency Virus Infection in Romania Versus Europe: An Epidemiological and Public Health Perspective, 2024 Update. Infect. Dis. Rep., 18.","DOI":"10.3390\/idr18010009"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Cambrea, S.C., Marcu, E.A., Cucli, E., Badiu, D., Penciu, R., Petcu, C.L., Dumea, E., Halichidis, S., Pazara, L., and Mihai, C.M. (2022). Clinical and Biological Risk Factors Associated with Increased Mother-to-Child Transmission of HIV in Two South-East HIV-AIDS Regional Centers in Romania. Medicina, 58.","DOI":"10.3390\/medicina58020275"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Muhindo, R., Okoboi, S., Kiragga, A., King, R., Arinaitwe, W.J., and Castelnuovo, B. (2022). COVID-19 vaccine acceptability, and uptake among people living with HIV in Uganda. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0278692"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"492","DOI":"10.4103\/ijcm.ijcm_901_22","article-title":"Awareness and Hesitancy of COVID-19 and other Vaccines among People Living with HIV\/AIDS Attending Antiretroviral Therapy (ART) Center in North India","volume":"48","author":"Singh","year":"2023","journal-title":"Indian J. Community Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"W\u00fcrfel, L.M., Potthoff, A., Skaletz-Rorowski, A., Nambiar, S., and Abu Rached, N. (2025). Optimizing Immunization Strategies for Individuals Living with HIV: A Review of Essential Vaccines, Vaccine Coverage, and Adherence Factors. Vaccines, 13.","DOI":"10.3390\/vaccines13080798"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1007\/s10461-024-04344-9","article-title":"COVID-19 Vaccine Hesitancy Among People Living with HIV: A Systematic Review and Meta-Analysis","volume":"28","author":"Liu","year":"2024","journal-title":"AIDS Behav."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1080\/21645515.2020.1802163","article-title":"Predictors of vaccination rates in people living with HIV followed at a specialty care clinic","volume":"17","author":"Johnson","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Khubchandani, J., Prabhu, N., Craig, K., Wiblishauser, M., Mustapha, T., Srejon, R.R., and Batra, K. (J. Community Health, 2026). COVID-19 Vaccination Refusal and Non-Uptake Among People Living with HIV in the United States, J. Community Health, Epub ahead of print.","DOI":"10.1007\/s10900-026-01596-5"},{"key":"ref_37","unstructured":"European AIDS Clinical Society (EACS) (2023). EACS Guidelines, European AIDS Clinical Society. Available online: https:\/\/www.eacsociety.org\/guidelines\/."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wolder Ejlersen, E., Loft, J.A., Gelpi, M., Heidari, S.L., Rezahosseini, O., Poulsen, J.R., M\u00f8ller, D.L., Harboe, Z.B., Benfield, T., and Nielsen, S.D. (2025). Incidence of Confirmed Influenza and Pneumococcal Infections and Vaccine Uptake Among Virologically Suppressed People Living with HIV. Vaccines, 13.","DOI":"10.3390\/vaccines13040358"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e2415220","DOI":"10.1001\/jamanetworkopen.2024.15220","article-title":"COVID-19 Vaccination Coverage and Factors Associated With Vaccine Uptake Among People With HIV","volume":"7","author":"Hechter","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Horberg, M.A., Jefferson, C., Watson, E., Kim, S., Deneal, A.N., Gebo, K.A., Hogan, B.C., Humes, E., and Althoff, K.N. (2026). Effects of HIV status and vaccination on long COVID conditions within an integrated health care system. Commun. Med., Epub ahead of print.","DOI":"10.1038\/s43856-026-01761-w"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1080\/09540121.2021.1975628","article-title":"\u201cI have the strength to get through this using my past experiences with HIV\u201d: Findings from a mixed-method survey of health outcomes, service accessibility, and psychosocial wellbeing among people living with HIV during the COVID-19 pandemic","volume":"34","author":"Pantelic","year":"2022","journal-title":"AIDS Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1007\/s10865-023-00399-6","article-title":"COVID-19 health information trust and prejudicial attitudes predict healthcare disruptions in the first year of COVID-19 among people living with HIV","volume":"46","author":"Kalichman","year":"2023","journal-title":"J. Behav. Med."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Kalichman, S.C., Shkembi, B., Kalichman, M.O., and Eaton, L.A. (2021). Trust in health information sources and its associations with COVID-19 disruptions to social relationships and health services among people living with HIV. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10856-z"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/9\/751\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:43:32Z","timestamp":1788252212000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/14\/9\/751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["vaccines14090751"],"URL":"https:\/\/doi.org\/10.3390\/vaccines14090751","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}