Table 3.

Conditions and outcomes of included interventions.

Author (year)	Number of groups	Intervention condition 1	Intervention condition 2	Control condition	Outcomes measured	Results
Anand et al [59], (2020)	2	An digital video-based discussion and interaction platform, Vialogues, with monthly HIV education sessions. The website was integrated with counseling and testing support services, as well as video-uploading and messaging functions for counselors and participants to discuss.	N/Aa	Private clinic-based HIV counseling and testing.	HIV knowledge, percentage of condom use for anal intercourse, condom-use self-efficacy	Unchanged HIV knowledge level at baseline and after intervention in both arms; significant increase in percentage of condom use in the intervention group; no significant changes in condom-use self-efficacy among intervention group participants.
Bauerm-eister et al [70], (2019)	2	A mobile app, myDEX, equipped with 6 sessions on sexual health information and skills tailored for YMSMb. Each session consisted of a core message, a deep discussion regarding the topics, as well as an interactive activity. Features like a diary, role-playing, quizzes, and practice opportunities were included.	N/A	An Information-only static site with HIV prevention contents split into 6 sessions.	Condomless anal sex events and condom-use self-efficacy	Intervention participants were less likely to engage in condomless anal sex than participants from the control group; control participants were more likely to forego condoms than participants from the intervention group
Brody et al [60], (2022)	2	Participants could choose to receive text or voices messages. 180 messages comprising of 10 health themes will be sent, including gender-based violence, cervical cancer, vaginal health, contraception, hygiene, pregnancy termination, general health information, alcohol use, HIV and STIc transmission and prevention, pregnancy and miscarriage. A message was sent 2 times for 10 wk, and the message from each topic area was repeated every 10 wk for 60 wk. An option to be contacted by outreach workers for free was provided after each message.	N/A	Existing standard care.	HIV test, STI testing when symptoms arise, contraceptive usage, and condom use with nonpaying and paying partner	No significant differences in HIV-preventive behaviors, including HIV or STI testing, contraceptive usage and condom use with nonpaying and paying partner.
Bull et al [78], (2009)	2	An interactive website, Keep It Real, was developed. It contained 5 modules with 60-90 s long role model stories focusing on condom use and HIV risks. Quizzes were included to test understanding. A booster session at 1-mo follow-up showed the same messages again.	N/A	A computer kiosk at a clinical setting with text-based information on condom use and HIV risks. Quizzes were included to test understanding. A booster session at 1-mo follow-up showed the same messages again.	Proportion of protected sex acts by condoms and condom-use self-efficacy	No significant effects on protected sex acts and condom-use self-efficacy.
Bull et al [77], (2012)	2	A Facebook page, “Just/US,” was developed and ran for 2 mo. Eight topics focusing on communication skills and condom-use efficacy were delivered through daily contents in different formats, eg, videos, quizzes, games, and discussions.	N/A	A Facebook page called “18-24 News” showing interesting news tailored for people aged 18-24 from 6 PM to midnight. Sexual health contents were avoided.	Condom use at last sex and proportion of protected sex acts by condoms	Condom use at last sex remained stable in intervention group but decreased in the control group.; proportion of protected sex acts remained stable in intervention group but significantly decreased in the control group.
Christensen et al [69], (2013)	2	A simulation video game, SOLVE, was used to simulate common obstacles encountered by YMSM at different scenarios. Depending on participants’ decisions, different choice points would be awarded. Sexuality affirmations were included to reduce shame for MSMd.	N/A	No intervention.	Number of unprotected anal intercourse UAIe	Significant indirect decrease in number of UAI caused by shame reduction in the intervention group
Cordova et al [79], (2020)	2	In addition to the clinic’s usual services, a mobile app, Storytelling 4 Empowerment, was developed to deliver HIV, tobacco, and substance use knowledge through 3 modules. A clinician version with participants’ history and risk assessments was also developed to facilitate communication during in-person counseling sessions.	N/A	The clinic’s usual services on sexual health as well as a printed copy of Storytelling 4 Empowerment tobacco module contents.	Sexual risk self-efficacy, sexual risk prevention knowledge, sexual risk behaviors	Small insignificant effect sizes in sexual risk self-efficacy change scores within the intervention group.; larger gains of sexual risk prevention knowledge, including HIV, in intervention group compared to the control group; greater, but insignificant reduction in condomless sex among intervention participants than control participants.
Ezegbe et al [52], (2018)	2	An 8-wk long, twice a week, digital storytelling intervention. The REDStory intervention contained digital sessions with videos from social media platforms, as well as offline therapist discussion sessions with video narration activities.	N/A	No intervention	HIV knowledge	Significant improvement in HIV knowledge among schoolchildren from intervention group than control group
Fiellin et al [80], (2017)	2	A 2D role-playing adventure game, PlayForward, with interactive features where players can make their own decisions in different social contexts to learn about HIV prevention; 2 one-h sessions per week for 6 wk.	N/A	Twelve irrelevant video games, eg, Angry Birds, with the same number and length of sessions as the experiment group.	Sexual health knowledge	Significant increase in sexual health knowledge in intervention group compared to control group
Hightow-Weidman et al [68], (2012)	2	The website, HealthMpowerment.org, contained 7 main sessions with interactive features, including resources, quizzes of different levels, personalized health, and sex journals. Included. four 30-min weekly sessions	NA	A list of 5 Web sites providing general HIV information.	Number of protected sex acts, condom-use self-efficacy, and HIV knowledge	Significant increase in self-reported condom use among participants from both groups at 1-mo follow-up; no significant difference in condom-use self-efficacy and HIV knowledge between the intervention and control group.
Hightow-Weidman et al [67], (2019)	2	Website, HealthMpowerment.org, was revised with a knowledge library on HIV prevention with interactive features, including discussion forums, personal space for uploading information and digital physician consultation.	NA	Website with a smaller-scale knowledge library.	Number of acts of CAIf	Significant decline in rate of CAI in the intervention group compared to the control group.
Jones et al [81], (2013)	2	A 12-wk soap opera video series, Love, Sex, and Choices was produced and streamed to smartphones. Each episode was 15-20 min long with contents describing different high-risk situations. Principles of HIV risk reduction were modeled by main characters.	N/A	A 12-wk text messaging intervention containing HIV risk reduction written messages delivered by smartphones.	Percentage unprotected vaginal and anal sex acts	Significant decline in unprotected sex acts in both the intervention and control group; intervention group had a lower percentage of unprotected sex acts compared to the control group at follow-up, given they were the same at baseline.
Klein and Card [82], (2011)	2	A computer-delivered multimedia software developed from an in-person intervention SiHLE. It contained 2 1-h sessions, centering on HIV prevention and sexual decision-making skills delivered through multimedia channels, including games, quizzes, and videos. All sessions were narrated by teenage female health educators.	N/A	A general health education session with 2 laptop-delivered videos about healthy diet and nutritious eating. The 2 videos were 65 min long in total.	HIV knowledge, condom-use self-efficacy, and percentage of condom protected vaginal intercourse acts	Significant improvement in HIV knowledge in both intervention and control group, with higher improvement among intervention group; significant increase in condom-use self-efficacy among nonsexually active participants in the intervention group; significant increase in percentage condom use among intervention participants, compared to no change in condom use in the control group.
Lau et al [56], (2016)	3	A website with videos based on STDg-related cognitions. Contents of the videos included HIV and syphilis information as well as means of prevention.	In addition to videos based on STD-related cognitions from intervention 1, a fear-arousing video based on STD-related emotions was added in intervention 2, highlighting consequences of social loss due to STDs.	A website with text HIV-related facts and information.	Number of UAI	No significant association between 3 treatment groups and prevalence of UAI was discovered; significant within-group reduction in UAI in all 3 groups; significant reduction in UAI with casual sex partners in intervention group 2 with fear appeal.
Levy et al [61], (2021)	2	Psychological inoculation was used to design an interactive website with HIV knowledge as well as 10 challenging sentences regarding condom use barriers and social pressure. Participants had to refute relative statements. Exaggerated versions would be provided for weak refutation.	N/A	A static website with HIV knowledge and 10 additional true or false questions on condom use to control for the experimental group.	Frequency of condom use	Frequencies of condom use increased in control group but not experiment group.
Logie et al [55], (2023)	3	Weekly SMS will be sent to ask how they are doing and have 2 choices of response, “fine” or “not fine.” Participants who responded “not fine” or did not respond will be followed-up by a peer navigator within 2 d and a week, respectively [86].	HIV self-testing kit, along with instruction, condoms, lubricant, information pamphlet, and referral information for confirmatory testing	Information about HIV testing and services at local clinics and a leaflet on HIV-preventive strategies [86].	HIV testing frequency, knowledge of HIV status, condom-use self-efficacy, and consistent condom use [86]	Significant increase in HIV testing, HIV status in knowledge in both intervention groups comparing to control group; significant improvement in condom usage self-efficacy comparing intervention groups and the control group; not significant difference in consistent condom use comparing the intervention groups and control group.
Marsch et al [75], (2011)	2	On top of the traditional intervention (the same as the control measures), a self-directed web-based program which contained 19 modules on HIV risk reduction and relative risks brought by drug abuse would be added. The system provided customized selection of modules based on participants’ risk assessment survey results.	N/A	A 1-h individual or small group educator-delivered sessions by trained HIV prevention specialists on basic HIV-related information as well as drug-related risks. In addition, a 15 min long video was played.	HIV prevention knowledge, condom-use self-efficacy	Significant increase in HIV prevention knowledge in both groups, while participants from intervention group showed larger increases compared to that of control group; significant increase in skills to correctly use condoms in both groups without intergroup differences.
Marsch et al [76], (2015)	2	A self-directed web-based program, the Therapeutic Education System, which contained 19 modules on HIV risk reduction and relative risks brought by drug abuse. The system provided customized selection of modules based on participants’ risk assessment survey results.	N/A	Two 1-h individual or small group educator-delivered sessions by trained HIV prevention specialists on basic HIV-related information as well as drug-related risks. In addition, a 20 min long video was played.	HIV knowledge and condom-use self-efficacy	Increase in HIV knowledge in both groups without significant intergroup differences; increase in condom-use self-efficacy in both groups without significant intergroup differences.
McCrimmon et al [83], (2024)	2	A self-directed web-based program adapted Health Education and Relationship Training, which included 6 modules on safe sex motivation, sexual communication skills, HIV and STI knowledge, safer sexual self-efficacy, and sexual norms and attitudes. Interactive activities include games, animated characters and quizzes [87].	N/A	A 45-min attention matched web-based program that targets growth mindsets was delivered [87].	Condom use intention, attitude and norm, HIV and STI knowledge, and safe sex communication self-efficacy	Higher improvement in attitude toward condom and HIV and STI knowledge in intervention group compared to control group; no significant difference in condom use intention and norm; safe sex communication self-efficacy
Mustanski et al [66], (2013)	2	Three digital sessions with 7 interactive modules in the Keep It Up! Intervention website (around 2 h in total). Different contents, including videos, animations, and games, were implemented. Contents were tailored to YMSM. A 6-wk booster session was applied.	N/A	Same number of modules and sessions as the intervention group with didactic noninteractive texts and images on HIV-related information. No tailored contents for YMSM.	Number of unprotected anal sex acts and HIV knowledge	A small decrease in rate of unprotected anal sex acts in intervention group, but an increase in the control group; a large increase in HIV knowledge in both groups, with no significant difference between groups.
Mustanski et al [65], (2018)	2	Three digital sessions with 7 interactive modules in the Keep It Up! Intervention website (around 1 h in total). Different contents, including videos, animations, and games, were implemented. Contents were tailored to YMSM. 3- and 6-mo booster sessions were applied.	N/A	Same number of modules and sessions as the intervention group with static texts and images on HIV-related information. No tailored contents for YMSM.	Incident STI, reporting number of casual CASh acts and CAS partners	Significant reduction in STI and reported CAS for intervention group versus control group; no difference between intervention and control groups regarding incident HIV.
Nelson et al [64], (2022)	2	Interactive website with 9 modules focusing on 4 main topics, including male anatomy, HIV or STI-related knowledge, general sexual health information, and pornography truths. The website included adventure games, questions and answers videos, and illustrations. Participants needed to unlock the first 3 modules before given the access to the remaining 6 modules.	N/A	Website of Centers for Disease Control and Prevention, as well as Web sites of national HIV and STI testing resources.	HIV knowledge and condom knowledge	Insignificant differences of HIV knowledge scores among intervention and control group; no difference on condom knowledge scores among intervention and control group.
Newcomb et al [71], (2023)	2	Five sessions regarding sexual health, HIV risk and relationship functioning were conducted. Three videos on these topics were sent to participants each time, then 3 videoconference group sessions were implemented to build skill. Two individual coaching video conference for each coupon were delivered for skill implementation.	N/A	A single 90-min session. HIV-negative or unknown couple: Testing Together protocol (HIV testing and education). HIV-Positive: Medication and Risk Reduction Counseling (explore motivators and barriers to antiretroviral adherence and plan for it). Serodiscordant: receive both of the above.	STI, CAS, HIV testing, and PrEPi use	Significantly lower STI positive cases, CAS frequency in intervention group; no difference on HIV testing and PrEP use among intervention and control group.
Peskin et al [73], (2015)	2	An interactive computer-based video game, IYG-Tech, with thirteen 45 min long modules on sexual health. Animated scenarios, videos, quizzes, fact sheets, role-playing and discussion platforms were built-in activities aiming to equip students with necessary sexual health life-skills.	N/A	Standard textbook health education.	Number of condomless sex, knowledge of STIs, and condom-use self-efficacy	No significant differences in the number of condomless sex among the 2 groups; intervention students had greater knowledge about STIs and higher condom-use self-efficacy than control students in the 1-y follow-up.
Santa Maria et al [74], (2021)	2	A mobile app, MY-RID, was delivered to homeless young adults. Participants firstly set a goal of behavioral change for HIV prevention, then answered daily assessment questions (EMAk) followed by tailored messages regarding their specific goal and real-time risk predictors.	N/A	The same mobile app and assessment items were applied, but the focus was on general health behaviors. General messages, instead of tailored ones, would be received.	Frequency of condomless sex acts	No significant intervention effect was observed on frequency of condomless sex acts.
Schnall et al [63], (2022)	2	A mobile app, MyPEEPS Mobile, was developed based on a group-based intervention. It focused on the stories of 4 YMSM (peeps) and aimed to build knowledge, self-awareness, and self-efficacy in sexual risk reduction through 21 mobile activities, completed throughout a 3-mo period.	N/A	Delayed intervention receiving MyPEEPS mobile at 9-mo follow-up after data collection.	Number of condomless sex acts	Significant reduction in condomless anal sex acts among intervention group participants, compared to the control group participants; most pronounced and long-lasting effect on Black participants, compared to participants of other races.
Swendeman et al [84], (2024)	4	IGj1: coaching and peer support and SMS text messaging; coaching: weekly telehealth strength-based coaching, 30-min for first 2 mo then 5-20 min following, covering assessment, linkage to services, goal setting, problem solving, and cognitive and behavioral skills training; peer Support: up to 16 wk to discuss and support on a moderated digital private forum; seed discussion topics were posted twice a week [88]; SMS text messaging: Daily SMS sent for 24 mo, covering sexual health, physical and mental health, substance use, and medication reminders if applicable, and a weekly self-monitoring survey on HIV or STI symptoms, risky sexual behaviors, and medication adherence.	IG2: coaching and SMS text messaging; IG3: peer support and SMS text messaging	SMS text messaging only.	PrEP use and adherence, consistent condom use, and PEP prescription and adherence	All intervention groups had higher increase in PrEP use compared to the control group; intervention group1 had sustained an increase in PrEP use compared to all other groups; no significant differences between PrEP adherence, PrEP prescription and adherence.
Widman et al [72], (2018)	2	A 45 min long digital intervention, HEART for Girls, with 5 modules targeting motivations, HIV knowledge, social norms, safer sex self-efficacy, and sexual communication skills. Sexual assertiveness skills were emphasized throughout all modules.	NA	A 45 min long attention-matching digital intervention, Growing Minds, with 5 modules on academic and social growth mindsets.	HIV knowledge, condom-use self-efficacy, and condom use at last sexual intercourse	Significant increase in HIV knowledge in the intervention group compared to the control group; significant increase in condom-use self-efficacy in the intervention group compared to the control group; better, but insignificant condom use among participants in the intervention group compared to the control group.
Widman et al [85], (2020)	2	A 45 min long digital intervention, HEART for Teens, with 5 modules targeting motivations, HIV knowledge, social norms, safer sex self-efficacy, and sexual communication skills. Sexual assertiveness skills were emphasized throughout all modules. More male characters were added compared to HEART for Girls.	N/A	A 45 min long attention-matching digital intervention, Growing Minds, with 5 modules on academic and social growth mindsets.	HIV knowledge and condom-use self-efficacy	Higher HIV knowledge and condom-use self-efficacy in intervention group compared to control group; similar intervention effects across 2 boys and girls.
Wray et al [62], (2019)	2	In addition to the standard posttest counseling services, a mobile app, Game Plan, was provided after HIV testing. Reflective exercises to prompt self-talk and goal setting functions were incorporated into the app to motivate behavioral change. This is a one-off intervention with follow-up surveys for 3 mo.	N/A	Standard post-HIV testing counseling with referral services.	Number of CAS events	Insignificant effect on number of CAS events in participants from both the intervention and control group.
Ybarra et al [53], (2013)	3	The CyberSenga website had 5 1-h intervention modules focusing on information about HIV and healthy sexual relationship, as well as skills needed for decision-making and condom use. Four versions of materials were developed tailoring different needs according to participants’ genders and sexual experiences.	Same as the first intervention group but with a booster module at 4 mo after intervention.	Treatment as usual: no extra interventions other than HIV programs currently being provided at schools.	Reporting number of unprotected sex acts in the past 3 mo	No significant differences at the rates of unprotected sex in intervention and control groups in the past 3 mo.
Ybarra et al [54], (2015)	3	The CyberSenga website had 5 1-h intervention modules focusing on information about HIV and healthy sexual relationship, as well as skills needed for decision-making and condom use. Four versions of materials were developed tailoring different needs according to participants’ genders and sexual experiences.	Same as the first intervention group but with a booster module at 4 mo after intervention.	Treatment as usual: no extra interventions other than HIV programs currently being provided at schools.	HIV prevention-related information	Intervention group participants answered greater percentages of questions correctly, compared with control group participants; improvement of HIV-related knowledge was the greatest among intervention participants with the booster module.
Yi et al [57], (2024)	2	LGBTQk-affirmative cognitive behavioral therapy: 10 modules covering goal setting, LGBTQ-related stress and its reactions, automatic thoughts, emotion avoidance, emotion-driven behaviors, and behavioral skill training and experiment. Each module contained videos, 4-5 pages of psychoeducation, exercises and homework.	N/A	Weekly self-monitoring survey for 10 wk.	HIV-transmission-risk behaviors, HIV or syphilis result, condom self-efficacy, perceived condom use benefits, and mental and behavioral health	No significant differences in HIV-transmission-risk behaviors and social cognitive mechanisms between intervention group and control group; no positive HIV or syphilis cases reported; intervention group showed greater improvements in depression and anxiety in follow-ups.
Zhang et al [58], (2024)	2	Different web-based videos based on participants’ behavioral assessment results: (1) video for those at lower risk: promote capacity to refuse peers’ invite to have sex with female sex workers or nonregular female sex partners. Content includes high-risk nature, sex partner may be asymptomatic, severe interpersonal consequences, transmit to HIV or STI to stable partners; (2) video for people at high risk to promote their HIV testing: the benefits of taking up HIV testing and the procedures of free HIV testing and counseling at local Centers for Disease Control	N/A	Basic HIV-related knowledge.	Sexual intercourse with female sex partners and sex workers, respectively, condomless sex with female sex partner and sex worker, respectively, and uptake of HIV testing	Significant difference was observed in 6-mo follow-up in lower frequency of sexual intercourse with nonregular female sex partners of intervention group, compared with the control group; no significant differences in all other outcomes or time points.

^aN/A: not applicable.

^bYMSM: young men who have sex with men.

^cSTI: sexually transmitted infection.

^dMSM: men who have sex with men.

^eUAI: unprotected anal intercourse.

^fCAI: condomless anal intercourse.

^gSTD: sexually transmitted disease.

^hCAS: condom anal sex.

ⁱPrEP: pre-exposure prophylaxis.

^jIG: intervention group.

^kLGBTQ: lesbian, gay, bisexual, transgender, and queer.