Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth

J Adolesc Health. 2018 Jun;62(6):651-660. doi: 10.1016/j.jadohealth.2018.02.007.

Abstract

Purpose: Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth.

Methods: Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English.

Results: Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016).

Conclusions: After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.

Keywords: Adolescent sexual health; Digital health; HIV prevention; Sex education; Sexually transmitted diseases; Technology-based interventions; eHealth; mHealth.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Condoms / statistics & numerical data
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Pregnancy
  • Pregnancy, Unplanned*
  • Randomized Controlled Trials as Topic
  • Safe Sex / psychology
  • Sexual Abstinence / psychology
  • Sexual Abstinence / statistics & numerical data*
  • Sexually Transmitted Diseases / prevention & control*
  • Social Media
  • Young Adult