Table 1.

Study characteristics, impact on stigma, and corresponding themes.

	Author/Year/Country	Objective/interventions (if relevant)	Method	Sample & Sample size	Findings/Conclusion	Impact of web apps on stigma	Theme
							Sharing Stigma Post	Content Display	Disclosure
1	Bauermeister et al. (2019), USA	To determine if engagement in stigma-related discussions in online forums changes stigma over time.	Baseline, Follow-up surveys & analysis of forum post	238 YBMSM aged 18–30 years	YBMSM who discussed experiencing HIV stigma in the forums reported decreased stigma over time. Those whose posts indicate anticipated stigma reported an increase in stigma over time	Public; Reduced	X
2	Chen et al. (2019) China	To examine the influence of perceived threats on seeking social support among gay men living with HIV.	Content analysis of “Weibo” post	133 gay men with HIV	Perceived threat was a motivation to seek online support. However, people who experienced high perceived stigma and perceived severity of HIV reported posting more emotional support seeking messages	General; No Change	X	X
3	Israel et al. (2019), USA	To develop and test the efficacy of an online intervention to reduce internalized stigma among bisexual adults with STIs.	Randomized control design	702 bisexual adults with STI	Internalized binegativity and internalize stigma were reduced in the intervention group compared to the control group. The intervention reduced anticipated stigma in the intervention group	Internal; Reduced
4	Dudina and Tsareva (2018), Russia	How people living with HIV/AIDS discuss status disclosure in online platforms in the context of stigmatization.	Analysis of forum post and follow-up interview	Unspecified	Online communities were related to disclosure and HIV stigmatization. differences in how newly diagnosed and those who live with HIV for a long time react to and manage stigma in online spaces	Public; Worsened	X		X
5	Karamouzian et al. (2018), Canada	Compared how stigma differs between online vs. face-to-face and how each mode reduced/exacerbated stigma.	Semi-structured exploratory interviews	71 youth aged 15–24 years	Online testing can potentially ameliorate experiences of external stigma. Internalized stigma, exacerbated by internal feelings of shame around STIs continues to persist.	Improved Public, not Internal		X
6	Flickinger et al. (2018), USA	To determine whether online discussions of stigma change the stigma levels of people living with HIV at baseline and after 12-months.	Analysis of messaging boards & stigma scores.	77 &1834 stigma-related posts	People who posted stigma-related content were more likely to show reduced stigma levels after 12 months of follow-up.	Public; Reduced	X
7	Ho et al. (2017), USA	To examine how stigma is perpetuated on HIV testing websites and how it differs based on the levels of online monitoring	Analysis of online post	210 threads and 319 post	Users largely displayed self-stigmatizing attitudes toward HIV testing in online forums.	Public; Worsened	X
8	Klein and Lomonaco (2016), USA	To develop an HIV digital health program for managing stigma in MSM.	Surveys and focus group discussions	61 HIV care providers and black MSM	Stigma prevention/management and a safe space/forums for people with STI were the main factors that inform the design of the technology.	General; No Change		X
9	Noltensmeyer et al. (2016), USA	To use a stigma management theory to develop a web-based sexuality education and stigma management program.	Questionnaire and interviews	171 University student Missouri	People who publicly challenge stigma were less likely to accept that they have a stigmatizing attribute. Individuals who challenge public stigma have greater self-efficacy in practicing safe sex.	Public; Reduced	X
10	Payton and Kvasny (2016), USA	To understand the technology affordance associated with the HIV prevention and stigma awareness website	Focus group discussions	60 female black students	Students largely expressed concerns about stigma by association, their personal reputations, online social capital resulting in accidental disclosure of status	General; Worsened	X		X
11	Witzel et al. (2016), UK	Evaluate how users’ privacy concerns influence their engagement with sexual health programs on Facebook	Semi-structured phone interview	40 black African gay or bisexual men	Safety concerns, implied disclosure, and stigma by association were identified as barriers to using sexual health-related websites.	General; Worsened		X	X
12	Christensen et al. (2013). USA	Test the effectiveness of shame and stigma-reducing video game intervention	Randomized control design	935 MSM	MSM in the “SOLVE” intervention reported more reduction in shame and stigma over three months than the control group.	Internal; Reduced
13	Kang and An (2013), USA	To evaluate whether drug prescription websites for stigmatized medical conditions contained stigma-reducing components	Content Analysis of websites	88 drug websites ( e.g HIV, herpes, chlamydia)	Websites for drug prescription on stigmatized conditions are underutilized in disseminating stigma-reducing information, as half of the websites did not contain any stigma alleviating element.	General; No Change		X
14	Byron et al (2013), Australia	To examine the potential for sexual health information on social media	Focus group discussions	22 people aged 16–22	Fear of stigma and privacy concerns were raised. The use of humorous videos were noted as the best way to avoid stigma	No reported impact	X		X
15	Davis et al. (2012) Canada	Understand young people's views on how sexual health websites can address stigma	Interviews and focus group discussions	31 young people in Vancouver	More explicit content elicited negative responses from participants and many reacted negatively seeing sexual health information presented callously or crudely.	General; Worsened		X	X
16	Magee et al. (2012), USA	Explore aspects of the internet for sexual health information, how the internet may reduce/ exacerbate stigma	Interviews and surveys	32 LGBTQ people aged 16–24 years	The main reason for not using online health information includes the stigma associated with being caught accessing sexual health information/ stigma by association	General; Worsened	X	X	X
17	Shearer et al. (2012), Australia	Apply destigmatizing strategies in online video content and examine success in creating destigmatizing messages.	Thematic content analysis of 103 videos	103 videos	Five destigmatizing strategies were identified in the videos. Humorous messages were found to aggravate stigma	Public; Worsened		X	X

Note YBMSM: Young Black Men who Sleep with Men; MSM: Men who Sleep with Men; LGBTQ: Lesbian, Gay, Bisexual, Transgender, and Queer.