Effects of Digital Health Interventions to Promote Safer Sex Behaviors Among Youth: Systematic Review and Bayesian Network Meta-Analysis

This is the first NMA to compare the effectiveness of DHIs on condom use and HIV/STI outcomes among youth populations. It demonstrates that the impact of DHIs on HIV prevention varies substantially by intervention modality and outcome type. While TCI demonstrates the most consistent improvement in condom use at last sex, SWI and IOI may be more effective for promoting consistent condom use, though estimates remain imprecise. However, wide prediction intervals and low-certainty evidence suggest that self-reported behavioral changes may not translate into reductions in HIV/STI incidents without integration with offline services and broader structural support. Future trials might consider including standardized outcome indicators and longer follow-up to generate more precise estimates of the effectiveness of DHIs and guide generalization of youth-centered digital HIV/STIs prevention.