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Meta-analyses were conducted by Review Manager, version 5.
Results Among manuscripts identified, 26 studies met the inclusion criteria. We found 18 studies from high-income countries, 8 in middle-income countries, and 0 in low-income countries. Eight were randomized controlled trials, and 18 were observational studies.
The focus of 21 studies was HIV testing, four on HIV testing and linkage to care, and one on antiretroviral therapy adherence. Social media interventions were used to do the following: Social media interventions to improve HIV services beyond HIV testing in low- and middle-income countries and among other key populations need to be considered.
Acquired immune deficiency syndrome AIDS -related deaths have been reduced [ 1 ], and More programs are needed for key populations who are disproportionately affected by HIV and who have difficulty accessing services across the HIV care continuum [ 5 ].
Barriers to HIV interventions among key populations are complex and include persistent stigma and discrimination, punitive laws, and low risk perception [ 7 - 9 ].
Innovative approaches to reach these populations with equitable, accessible, and acceptable services will be essential to achieve targets [ 3 ]. As social media has expanded globally, these platforms have been adopted to deliver HIV interventions, especially for key populations [ 1011 ].
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Social media is defined as an Internet-based platform that allows the creation and exchange of user-generated content, usually using either mobile or Web-based technologies [ 12 ].
Popular social media platforms, such as Facebook and YouTube, have over 1. Social media possesses the characteristics of interactivity, allows users to generate content [ 14 ], and attracts high user engagement [ 15 ]. Specifically, social media can enable convenient access, at any time and place, to information and services on stigmatized diseases such as HIV.
In addition, social media can be used to form online communities to seek social support, which is known to improve treatment adherence and uptake of HIV services [ 16 ]. Systematic reviews have been conducted recently on the relationship between social media and HIV outcomes [ 10111718 ]. These studies generally define social media broadly eg, to include eHealth and mHealth interventions or examine usage of social media for a variety of purposes, including recruitment, surveillance, communication, and HIV prevention and treatment.
These studies have not focused on social media interventions among key populations [ 56 ]. Key populations are of special importance because they influence epidemic dynamics and likely have a disproportionate influence on the effectiveness of the response to HIV [ 5 ].
To address these gaps in a rapidly growing field, this systematic review and meta-analysis looks at the effectiveness of social media interventions in promoting HIV testing, linkage to care, adherence to treatment, and retention along the HIV care continuum among key populations.
In Augustthe following databases were systematically searched without restriction on publication date: Search Strategy and Selection Criteria The search strategy was designed with a librarian to identify studies regarding social media interventions to promote HIV testing, linkage, adherence, and retention among key populations Multimedia Appendix 1.