The impact of digital health interventions on HIV testing uptake among adolescents: a systematic review and meta-analysis of randomized controlled trials 10.55131/jphd/2024/220224
Main Article Content
Abstract
The global prevalence of HIV has reached its peak among individuals aged 20 to 39. While digital media has been widely employed for promoting sexual health, its application in boosting HIV testing rates among adolescent remains relatively restricted. This systematic review seeks to gauge the efficacy of digital-driven health education in enhancing HIV testing rates within the youth population. The study was included original studies published in English, quantitative with RCT, involving adolescent that are published from 2013 to 2023. The publications were identified using CINAHL, Embase, MEDLINE, PubMed, Scopus, Web of Science electronic databases with keywords of adolescent, telemedicine, and HIV testing. We also used the hand-searching method from other systematic review and meta-analysis articles. We did a critical appraisal and found a low-risk bias on four RCT studies. All included articles were coded according to relevant exposures or outcomes and analyzed to assess frequencies. Four studies from the United States, United Kingdom, and China were included in the synthesis. Uptake of HIV testing among adolescent give digital media interventions had a significant difference of 1.90 times compared to the group that did not give digital media intervention (p<0.00001). Digital media intervention significantly increased HIV testing engagement among adolescent. HIV screening programs using digital media are needed to optimize access to HIV testing services.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
The path that ends AIDS: UNAIDS Global AIDS Update 2023. Geneva: Joint United Nations Programme on HIV/AIDS [Internet]. Available on: https://www.unaids.org/en/resources/documents/2023/global-aids-update-2023
Inwani I, Chhun N, Agot K, Cleland CM, Rao SO, Nduati R, et al. Preferred HIV Testing Modalities Among Adolescent Girls and Young Women in Kenya. J Adolesc Health. 2021;68(3):497-507. doi: 10.1016/ j.jadohealth.2020.07.007.
Susanto T, Rahmawati I, Wuryaningsih EW, Saito R, Syahrul S, Kimura R, et al. Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent. Epidemiol Health. 2016;38:e2016041. doi: 10.4178/ epih.e2016041.
Zarei E, Khabiri R, Tajvar M, Nosratnejad S. Knowledge of and attitudes toward HIV/AIDS among Iranian women. Epidemiol Health. 2018;40:e2018037. doi: 10.4178/ epih.e2018037.
Mandiwa C, Namondwe B, Munthali M. Prevalence and correlates of comprehensive HIV/AIDS knowledge among adolescent girls and young women aged 15-24 years in Malawi: evidence from the 2015-16 Malawi demographic and health survey. BMC Public Health. 2021;21(1):1508. doi: 10.1186/s12889-021-11564-4.
Suantari D. Misconceptions and stigma against people living with HIV/AIDS: a cross-sectional study from the 2017 Indonesia Demographic and Health Survey. Epidemiol Health. 2021;43:e2021094. doi: 10.4178/ epih.e2021094.
Javidi H, Widman L, Lipsey N, Brasileiro J, Javidi F, Jhala A. Redeveloping a Digital Sexual Health Intervention for Adolescents to Allow for Broader Dissemination: Implications for HIV and STD Prevention. AIDS Educ Prev. 2021; 33(2):89-102. doi: 10.1521/aeap.2021. 33.2.89.
Holloway IW, Winder TJA, Lea CH, Tan D, Boyd D, Novak D. Technology use and preferences for mobile phone–based HIV prevention and treatment among black young men who have sex with men: Exploratory research. JMIR MHealth UHealth. 2017;5(4). doi: 10.2196/mhealth.6436.
Wilson E, Leyrat C, Baraitser P, Free C. Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sex Transm Infect. 2019;95(8):569-74. doi: 10.1136/sextrans-2019-053992
Wilson E, Free C, Morris TP, Syred J, Ahamed I, Menon-Johansson AS, et al. Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial. PLOS Med. 2017;14(12):e1002479. doi: 10.1371/ journal.pmed.1002479
Biello KB, Horvitz C, Mullin S, Mayer KH, Scott H, Coleman K, et al. HIV self-testing and STI self-collection via mobile apps: experiences from two pilot randomized controlled trials of young men who have sex with men. Mhealth. 2021;7:26. doi: 10.21037/ mhealth-20-70.
Aronson ID, Zhang J, Rajan S, Bugaighis M, Marsch LA, Ibitoye M, et al. Mobile Augmented Screening to Increase HIV Testing Among Emergency Department Patients as Young as 13 Years. Cureus. 2021; 13(6):e15829. doi: 10.7759/cureus. 15829.
Trujillo D, Turner C, Le V, Wilson EC, Arayasirikul S. Digital HIV Care Navigation for Young People Living With HIV in San Francisco, California: Feasibility and Acceptability Study. JMIR Mhealth Uhealth. 2020;8(1): e16838. doi: 10.2196/16838.
Wadham E, Green C, Debattista J, Somerset S, Sav A. New digital media interventions for sexual health promotion among young people: a systematic review. Sex Health. 2019; 16(2):101-23. doi: 10.1071/ SH18127.
Bailey JV, Wayal S, Aicken CRH, Webster R, Mercer CH, Nazareth I, Rait G, Peacock R Murray E. Interactive digital interventions for prevention of sexually transmitted HIV. AIDS. 2021;35(4):643-53.
Ibitoye M, Lappen H, Freeman R, Jordan AE, Aronson ID. Technology-Based Interventions to Increase Point-of-Care HIV Testing and Linkage to Care Among Youth in the US: A Systematic Review. AIDS Behav. 2021;25(6):1829-38. doi: 10.1007/ s10461-020-03112-9.
Setyani RA, Probandari A, Poncorini EP. Digital media interventions for HIV screening and testing among adolescent and young people: a systematic review and meta-analysis. PROSPERO 2021 CRD42021290765 [Internet]. [cited 2021 Dec 1]. Available from: https://www.crd. york.ac.uk/prospero/display_record.php?ID=CRD42021290765.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ. 2009;339(7716):332-6.
Jackson N. The Cochrane Collaboration Handbook for systematic reviews of health promotion and public health interventions. Cochrane. 2006:0-2.
Nimavat BD, Zirpe KG, Gurav SK. Critical analysis of a randomized controlled trial. Indian J Crit Care Med. 2020;24(Suppl 4):S215-22. doi: 10.5005/jp-journals-10071-23638.
Ma LL, Wang YY, Yang ZH, Huang D, Weng H, Zeng XT. Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better? Mil Med Res. 2020;7(1):7. doi: 10.1186/s40779-020-00238-8.
Eldridge S, Campbell M, Campbell M, Dahota A, Giraudeau B, Higgins J, et al. Revised Cochrane risk of bias tool for randomized trials (RoB 2.0) additional considerations for cluster-randomized trials [Internet]. [cited 2021 March 15]. Available from: https://www.unisa.edu.au/contentassets/72bf75606a2b4abcaf7f17404af374ad/rob2-0_cluster_parallel_guidance. pdf
Doleman B, Freeman SC, Lund JN, Williams JP, Sutton AJ. Funnel plots may show asymmetry in the absence of publication bias with continuous outcomes dependent on baseline risk: presentation of a new publication bias test. Res Synth Methods. 2020; 11(4):522-34. doi: 10.1002/jrsm.1414.
Dekkers OM. Meta-analysis: Key features, potentials and misunderstandings. Res Pract Thromb Haemost. 2018;2(4):658-63. doi: 10.1002/rth2.12153.
Israel H, Richter RR. A Guide to Understanding Meta-Analysis. Journal of Orthopaedic & Sports Physical Therapy. 2011;41(7):496-504
Patel AV, Abrams SM, Gaydos CA, Jett-Goheen M, Latkin CA, Rothman RE, et al. Increasing HIV testing engagement through provision of home HIV self-testing kits for patients who decline testing in the emergency department: a pilot randomisation study. Sex Transm Infect. 2019; 95(5):358-60. doi: 10.1136/sextrans-2018-053592.
Zhu X, Zhang W, Operario D, Zhao Y, Shi A, Zhang Z, et al. Effects of a Mobile Health Intervention to Promote HIV Self-testing with MSM in China: A Randomized Controlled Trial. AIDS Behav. 2019;23(11):3129-39. doi: 10.1007/s10461-019-02452-5.
Mielke D, Rohde V. Randomized controlled trials-a critical re-appraisal. Neurosurg Rev. 2021;44(4):2085-9. doi: 10.1007/s10143-020-01401-4.
Gul M. Bias in a randomized controlled trial and how these can be minimised. African J Psychiatry (South Africa). 2016;19(2):2-4.
Kahan BC, Cro S, Doré CJ, Bratton DJ, Rehal S, Maskell NA, et al. Reducing bias in open-label trials where blinded outcome assessment is not feasible: strategies from two randomised trials. Trials. 2014;15:456. doi: 10.1186/ 1745-6215-15-456.
Cao B, Bao H, Oppong E, Feng S, Smith KM, Tucker JD, et al. Digital health for sexually transmitted infection and HIV services: a global scoping review. Curr Opin Infect Dis. 2020;33(1):44-50. doi: 10.1097/ QCO.0000000000000619.
Pai N, Esmail A, Saha Chaudhuri P, Oelofse S, Pretorius M, Marathe G, et al. Impact of a personalised, digital, HIV self-testing app-based program on linkages and new infections in the township populations of South Africa. BMJ Glob Health. 2021;6(9). doi: 10.1136/bmjgh-2021-006032.