Effectiveness of eHealth on Human Immunodeficiency Viruses Pre-Exposure Prophylaxis among Key Population: A Systematic Review and Meta-Analysis

Hossein  Moameri; Mojtaba  Norouzi; Ghulam Raza  Mohammadyan; Sahar  Salehi; Shoboo  Rahmati

doi:10.18502/ijph.v54i9.19854

Hossein Moameri Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
Mojtaba Norouzi Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
Ghulam Raza Mohammadyan Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
Sahar Salehi Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
Shoboo Rahmati Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

DOI: https://doi.org/10.18502/ijph.v54i9.19854

Keywords: Telemedicine; eHealth; Pre-exposure prophylaxis; Human immunodeficiency viruses

Abstract

Background: eHealth has proven effective in changing health-related behaviors and overcoming barriers to HIV care. This systematic review and meta-analysis aimed to review the effect of eHealth on HIV Pre-Exposure Prophylaxis (PrEP).

Methods: A systematic review and meta-analysis was conducted in international databases without a time limit until August 2024 to identify studies evaluating the effectiveness of eHealth interventions for PrEP among key populations. This search strategy used a combination of keywords related to "eHealth”, “HIV”, and "pre-exposure prophylaxis". A random effects model was used to compute the pooled measure of association (relative risk). The results were combined using a random-effects model for meta-analysis. The I² index was also used to measure heterogeneity between the studies.

Results: Twelve articles involving 3,578 participants were included in the meta-analysis. The findings showed that using websites had a positive effect on PrEP (RR=1.90, 95% CI: 1.30-2.79). Moreover, e-health interventions had the greatest effect on PrEP uptake among female sex workers (FSWs) (RR=2.27, 95% CI: 1.62-3.17). Furthermore, e-health demonstrated a notable effect on PrEP uptake (RR=1.90, 95% CI: 1.30-2.79), particularly in studies with follow-up less than six months (RR=1.85, 95% CI: 1.19-2.09). Additionally, studies conducted in the United States reported the most significant effect of e-health on PrEP (RR= 1.71, 95% CI: 1.38-2.11; I² = 0.41%).

Conclusion: eHealth interventions have the potential to improve the effectiveness of PrEP among key populations. Integrating e-health interventions with comprehensive healthcare services and providing continuous support can improve PrEP uptake, adherence, and retention in the future.