Telenursing for Health Self-management in People Living With HIV in the World: A Systematic Review and Meta-analysis

ABSTRACT: Self-management is essential for people living with HIV. Telenursing has emerged as a strategy to expand access to care, but its effectiveness for HIV self-management remains unclear. This systematic review and meta-analysis, conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Joanna Briggs Institute guidelines, synthesized evidence from randomized controlled trials (RCTs) evaluating nurse-led telenursing interventions delivered by mobile applications, web platforms, or telephone. Searches of seven databases and gray literature up to July 2025 identified nine RCTs (n = 1,437). Meta-analyses showed no significant effect of telenursing on antiretroviral therapy adherence (mean difference [MD] = 0.00; 95% confidence interval, -0.69 to 0.69; I2 = 0%) or self-efficacy (MD = 1.13; 95% confidence interval, -0.26 to 2.52; I2 = 17.4%). Despite null pooled effects, some studies reported improvements in patient activation, fatigue management, and confidence. Overall certainty of evidence ranged from low to moderate. Nurse-led telenursing may support short-term empowerment and symptom management but requires stronger multicenter trials.