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Review
. 2025 Sep;54(9):1857-1869.
doi: 10.18502/ijph.v54i9.19854.

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

Hossein Moameri  1 , Mojtaba Norouzi  2   3 , Ghulam Raza Mohammadyan  2   4 , Sahar Salehi  2 , Shoboo Rahmati  5
Affiliations
Review

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

Hossein Moameri et al. Iran J Public Health. 2025 Sep.

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.

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

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Figures

Fig. 1:
Fig. 1:
PRISMA 2020 flow diagram for new systematic reviews, which included searches of databases and registers only
Fig. 2:
Fig. 2:
Effectiveness of eHealth interventions on HIV PrEP
Fig. 3:
Fig. 3:
Funnel plot to show the distribution of 12 studies
Fig. 4:
Fig. 4:
Result of sensitivity analysis of the 12 studies
See this image and copyright information in PMC

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