Author(s), Year | Country/study setting/study design | Participants (sample size, gender, age) | Implementation/study objective | Intervention description (features, duration) | Primary outcomes | Main results |
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Lou et al. 2006 [36] | Country: China Setting: School-based (two high schools and four colleges) Study design: Quasi-experimental (non-randomized intervention and control groups) | Sample size: 1337 participants (624 in the intervention group, and 713 in the control group) Gender: Males and Females Age: 14–24 years | To examine intervention effect on adolescent and young people HIV/STI-related knowledge and changes inattitudes and behaviors | Intervention group: participants received access to a web-based intervention that offered sexual and reproductive health knowledge, service information, counseling, and discussion. Control group: No special sexual education was provided. Received their usual care mHealth Component: Web application Duration: 10 months | HIV and STI knowledge, attitude score, and proportion of sex-related behaviors | The median scores of the overall knowledge on each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs), and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group compared with those in the control group at post-intervention (p < 0.0001) |
Odeny et al., 2012 [38]; Odeny et al. 2014 [34] | Country: Kenya Setting: Clinic-based Study design: Two-arm parallel-group RCT | Sample size: 1200 participants (600 in the intervention group, and 600 in the control group) Gender: Males only Age: 18–20 years | To examine the effect of text messaging to deter resumption of sex before 42 days post-circumcision, and post-operative clinic visit after circumcision | Intervention group: participants received usual care (which consisted of HIV testing and counseling, screening and treatment for STIs, condom promotion and provision, risk reduction, and safe sex counseling, the male circumcision procedure and post-operative review) and SMS about post-operative care, appointment reminders and healthy sex behaviors (including abstinence) for the first 7 days and on days 8, 14, 21, 28, 35, 41, and 42 post-procedure Control group: participants received usual care (which consisted of HIV testing and counseling, screening and treatment for sexually transmitted infections, condom promotion and provision, risk reduction, and safe sex counseling, the MC procedure, and postoperative review) only mHealth Component: SMS Duration: 2 months | Health-seeking behavior of clinic attendance | Increase in sexual and reproductive health clinic visits among participants in the intervention groupcompared to those in the control group |
Country: Ghana Setting: School-based Study design: RCT | Sample size: 498 participants (10 schools in the intervention group consisting of 205 participants, and 12 schools in the control group consisting of 291 participants) Gender:Females only Age: 14-24 years | To assess the reach of the intervention among the target population and intervention effect on sexual and reproductive health knowledge | Intervention group: Participants received an interactive mobile phone quiz game where participants could win mobile phone credit by texting correct answers to SRH questions. The messages focused on pregnancy prevention and contained information on topics of reproductive anatomy, pregnancy, STIs, and contraception including male and female condoms, birth control pills, and emergency contraception. Control group: Received one message each week with information about malaria mHealth Component: SMS Duration: 12 weeks | Increase in sexual and reproductive health knowledge | 81% of participants engaged with the mHealth intervention. The intervention was effective at increasing knowledge of sexual reproductive health across all strata. Higher levels of engagement were associated with higher knowledge scores up to a year later. Participants in the intervention group who were sexually active reported lower odds of self-reported pregnancy from baseline to 15 months | |
Winskell et al. 2018 [33]; Sabben et al. 2019 [44] | Country: Kenya Setting: Community-based (participants were recruited from schools) Study design: RCT | Sample size: 60 participants (30 participants in the intervention group and 30 participants in the control group) Gender: Males and Females Age: 11–14 years | The determine the influence of the intervention on increased age of sexual debut and condom use at sexual debut | Intervention group: participants receivedTumaini, a narrative-based game for android smartphones. The game comprisesapproximately 12 h of discrete gameplay and is designed to be replayed so that players can observe the outcomes of the different decisions. The game was designed to increase age and condom use at first sex by increase knowledge about sexual health and HIV; building risk-avoidance and risk-reduction skills and related self-efficacy; challenging HIV stigma and harmful gender norms and attitudes; fostering future orientation, goal setting, and planning, and promoting dialog with adult mentors Control group: Received standard of care, no additional intervention beyond any existing sex education from family, school, and peers mHealth Component: Mobile application Duration: 16 days over 3-week school holiday period | Increase condom use at sexual debut, increase sexual health-related knowledge | Participants in the intervention arm showed significant gains in sexual health-related knowledge and self-efficacy compared to participants in the control arm at 6-week postintervention completion |
Ybarra et al. 2012 [39]; Ybarra et al. 2013 [40]; Ybarra et al. 2014 [35] | Country: Uganda Setting: School-based Study design: RCT | Sample size: 366 participants (183 participants in the intervention group and 183 participants in the control group) Gender: Males and females Age: 12 years and older | To increase abstinence and/or condom use | Intervention group: Participants received CyberSenga five 1-h online modules (+ booster module), tailored for gender and culture. The topics covered included (1) information about HIV (e.g., what is HIV and how is it prevented), (2) decision making and communication (e.g., steps to solving a problem; strategies for communicating your solution to others assertively), (3) motivations to be healthy (e.g., reasons why adolescents choose to be abstinent versus to have sex), (4) how to use a condom to be healthy (e.g., demonstration of correct condom use, testimonials from people similar to the participants who used condoms), (5) healthy relationships (e.g., components of healthy relationships; strategies to address coercive gifts), and (6) review. Control group: Participants received “treatment as usual” (i.e., school-delivered sexuality programming) mHealth Component: Web application (Website) Duration: 12 weeks | Increase condom use, promote abstinence at 3-month post-intervention | At 3-month post-intervention: Abstinence–intervention versus comparison group: 81% vs. 74%, p = 0.08); unprotected sex—no difference. At 6-month post-intervention: no significant differences in the main outcomes. Abstinence, I booster group vs. I no booster vs. C: (80% vs. 57% vs. 55%). |
Zhu et al. 2019 [37] | Country: China Setting: Community (recruited through WeChat) Study design: RCT | Sample size: 100 participants (50 participants in the intervention group and 50 participants in the control group) Gender: Males only Age: 18–29 years | To examine preliminary effects of interventions on HIV testing, and use of the HIVST kits, and condom use | Intervention group: participants received two oral HIVST kits and access to WeTest, a WeChat group that provided app-based messages and referrals to health services related to HIV. Control group: Participants received two oral HIVST kits only mHealth Component: Mobile application Duration: 4 weeks | HIV testing, condom use | Participants in the intervention group had significantly higher rates of HIV testing (adjusted rate ratio RR=1.99, 95% confidence interval (CI) 1.07–3.84) and higher rates of testing via oral HIVST (adjusted RR=2.17, 95% CI 1.08–4.37) compared to participants in the control group. |