Mobile health applications for enhancing mental health access and outcomes among adolescents and young people living with HIV: a systematic review

Background: Mental health (MH) disorders remain a major global public health concern, disproportionately affecting adolescents and young people living with HIV (AYPLHIV). Limited access to MH services, stigma, and a shortage of trained professionals hinder effective care, particularly in low-resource settings. Mobile health (mHealth) applications have emerged as accessible and scalable tools for improving MH support and reducing disparities in service delivery. This systematic review assessed the effectiveness of mHealth applications in improving access to MH services and outcomes among AYPLHIV and comparable populations globally. Methods: A systematic search was conducted across PubMed, PsycINFO, Web of Science, and the Cochrane Library for studies published between January 2020 and March 2025. Eligible studies evaluated mobile or app-based interventions designed to enhance MH access, engagement, or outcomes. Systematic reviews, meta-analyses, SMS-only interventions, and non-empirical studies were excluded. Two independent reviewers (CM and PS) screened articles, extracted data, and assessed study quality using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Data were synthesized narratively following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 framework. Results: < 0.05). Peer-based models delivered via WhatsApp demonstrated high feasibility and acceptability among AYPLHIV, while cognitive behavioral therapy (CBT) and mindfulness-based apps such as IntelliCare and Headspace produced outcomes comparable to traditional care in several settings. Key facilitators included personalization, app usability, and human or AI-enabled feedback (e.g., chatbot support), while barriers included privacy concerns, connectivity constraints, and low digital literacy. Conclusions: mHealth applications substantially improve access to and delivery of MH services for AYPLHIV and related groups. Integration of these tools into existing health systems, combined with culturally tailored design, ethical AI use, and sustainability strategies, can strengthen MH care globally. Future research should address long-term impact, cost-effectiveness, and equity in implementation. Supplementary Information: The online version contains supplementary material available at 10.1186/s12982-026-01998-9.