Diagnosis and Management of Sexually Transmitted Infections Using Artificial Intelligence Applications Among Key and General Populations in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

The Fourth Industrial Revolution (4IR) has significantly impacted healthcare, including sexually transmitted infection (STI) management in Sub-Saharan Africa (SSA), particularly among key populations (KPs) with limited access to health services. This review investigates 4IR technologies, including artificial intelligence (AI) and machine learning (ML), that assist in diagnosing, treating, and managing STIs across SSA. By leveraging affordable and accessible solutions, 4IR tools support KPs who are disproportionately affected by STIs. Following systematic review guidelines using Covidence, this study examined 20 relevant studies conducted across 20 SSA countries, with Ethiopia, South Africa, and Zimbabwe emerging as the most researched nations. All the studies reviewed used secondary data and favored supervised ML models, with random forest and XGBoost frequently demonstrating high performance. These tools assist in tracking access to services, predicting risks of STI/HIV, and developing models for community HIV clusters. While AI has enhanced the accuracy of diagnostics and the efficiency of management, several challenges persist, including ethical concerns, issues with data quality, and a lack of expertise in implementation. There are few real-world applications or pilot projects in SSA. Notably, most of the studies primarily focus on the development, validation, or technical evaluation of the ML methods rather than their practical application or implementation. As a result, the actual impact of these approaches on the point of care remains unclear. This review highlights the effectiveness of various AI and ML methods in managing HIV and STIs through detection, diagnosis, treatment, and monitoring. The study strengthens knowledge on the practical application of 4IR technologies in diagnosing, treating, and managing STIs across SSA. Understanding this has potential to improve sexual health outcomes, address gaps in STI diagnosis, and surpass the limitations of traditional syndromic management approaches.