Technology-facilitated sexual violence against women and its health impact: a mixed-methods systematic review

Technology-facilitated sexual violence (TFSV) is a significant public health issue, profoundly impacting women’s health. This systematic review aimed to synthesize evidence on the association between TFSV and mental and physical health in women aged 16 years and older. Following PRISMA guidelines, a systematic search was conducted across seven databases (CINAHL, Embase, PubMed, PsycINFO, Web of Science Core Collection, Scopus, and Sociological Abstracts) up to May 2025. The protocol was pre-registered in PROSPERO (CRD420251053409). Data synthesis was conducted using a mixed-methods approach, specifically a convergent segregated design, in which quantitative and qualitative evidence were analyzed separately and later integrated during the interpretation phase to provide a comprehensive understanding of TFSV’s impact. Across 21 studies (17 quantitative, 3 qualitative and 1 mixed-methods) from 11 countries, quantitative research consistently linked TFSV exposure to depression, anxiety, post traumatic stress disorder (PTSD), stress, and negative feelings or perceptions about one’s own body, capturing the prevalence and magnitude of these outcomes. Most quantitative studies were cross-sectional, limiting insight into long-term effects, and reported effect sizes were generally small to moderate. This review additionally highlighting that very few studies isolated the unique effect of TFSV from co-occurring forms of violence. Qualitative studies complemented these findings by detailing the enduring emotional and relational consequences of TFSV, including shame, guilt, loss of control, social isolation, and difficulties in intimate relationships, as well as coping strategies such as social support, activism, and selective digital withdrawal. This review provides evidence that TFSV is significantly associated with adverse mental health outcomes, challenging the misconception that it is less severe than offline violence. It underscores the need for clearer analytical approaches to isolate TFSV from other forms of violence and highlights critical gaps in research on physical health impacts. Evidence on physical health outcomes was scarce, with few studies reporting small associations with somatic symptoms, medication use, or general health, underscoring a critical gap in the literature. This evidence should inform public health responses, policy, and support services to address this pervasive form of structural violence.