Digital health innovation in HIV prevention and sexual health promotion: current applications and future prospects of mobile health and telehealth

Digital health is now a delivery strategy for HIV prevention and sexual health promotion, not simply a channel for health education. Mobile messaging, web-based testing, HIV self-testing (HIVST) support, mobile applications, social media recruitment, telehealth, tele-pre-exposure prophylaxis (PrEP), and chatbot-assisted workflows can reduce barriers related to stigma, distance, clinic capacity, and confidentiality. These tools also create an opportunity for primary HIV and sexually transmitted infection (STI) prevention before high-risk patterns are established, using positive, age-appropriate messages that support consent, healthy relationships, condom and vaccine uptake, timely testing, and informed prevention choices. This narrative review synthesizes evidence from trials, systematic reviews, implementation studies, and program evaluations, emphasizing quantitative outcomes and implementation limits. The most consistent benefits are seen for service actions with clear endpoints: HIVST, online STI testing, PrEP initiation through telehealth, and interactive text-message support for adherence. Effects are less consistent for sustained PrEP persistence, complex behavior change, linkage after reactive self-tests, and equity. Digital tools can improve access among men who have sex with men, adolescents and young adults, women, sex workers, and rural populations. Still, they can also reproduce inequities when privacy, cost, literacy, device access, legal vulnerability, and laboratory infrastructure are not addressed. Future systems should integrate prevention education and digital entry points with laboratories, pharmacies, clinicians, community navigators, human escalation, privacy governance, and equity monitoring. The field should now move from platform-centered pilots toward accountable hybrid sexual health systems.