Digital Health Interventions in the UNAIDS 95-95-95 continuum: A Scoping Review

Abstract Background The HIV epidemic continues to be a public health threat. In 2023, there were 39.9 million living with HIV worldwide. UNAIDS set targets for HIV testing, treatment and viral suppression rates to be 95% for each measure (known as 95-95-95). By 2022 UNAIDS had achieved 86-89-93 progress towards the 95-95-95 targets. To close the gaps across the 95-95-95 continuum, the World Health Organisation has recommended the use of digital technologies. However, it is currently unknown what types of digital health interventions have been implemented to promote HIV testing and ART Initiation and ART adherence for adults worldwide since the launch of the targets in 2014, the duration of the interventions and whether they have been successful or not. A scoping review was conducted to map the evidence on digital health interventions implemented to promote HIV testing (1st 95) and ART Initiation and ART adherence (2nd 95) for adults worldwide since 2014. Methods JBI guidelines were followed. Databases were searched (CINAHL Ultimate, Embase, Medline (Ovid) and Scopus and the International Aids Society). Study quality was assessed using the Mixed Methods Appraisal Tool. Results 129 articles were included. Most of the studies were conducted in the WHO region of the Americas (n = 55) and more than half (n = 67) of the interventions were mHealth. Most of the digital interventions were implemented to promote HIV testing (n = 70). Many interventions targeted both men and women (n = 69). Reported interventions were short term (0-6 months) and there was evidence about their success. Conclusions This review highlights an over-reliance on mHealth interventions, with most focusing on HIV testing rather than ART initiation and adherence which are critical for achieving the 2nd and 3rd UNAIDS 95 targets. Future interventions should be more holistic, gender-responsive, and tailored to low- and middle-income settings. We recommend long-term interventions and conducting a meta-analyses. Key messages • This scoping review gives a new perspective on digital interventions implemented from 2014-2024 to support the UNAIDS HIV testing (1st 95) and ART initiation and adherence(2nd 95) targets globally. • This review highlights gaps in the types of digital interventions implemented, where they have been implemented, for whom, for how long and if they have been successful or not.