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Sub\u2010Saharan Africa, Asia and the Pacific are home to 82% of PLHIV, where limited access to healthcare resources underscores the urgency of innovative strategies to combat the epidemic effectively. Social network interventions (SNIs) hold promise for improving HIV testing and linkage services by engaging populations at greatest risk. This review evaluates the key design features and effectiveness of SNIs for HIV testing and linkage in low\u2010 and middle\u2010income countries (LMICs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched four databases (Medline, Embase, Global Health, Web of Science) for the period from 1st January 2003 until 16th June 2023. A combination of the terms \u201cSocial Network,\u201d \u201cHIV,\u201d \u201ctesting\u201d and \u201clinkage\u201d with an LMIC filter was used. We included interventional study designs that compared an SNI for HIV testing and\/or linkage to care against non\u2010network comparator approaches. Narrative synthesis and random effects meta\u2010analyses were conducted to synthesize the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 6763 records, 13 studies met the inclusion criteria; eight were randomized controlled trials, and five were non\u2010randomized designs. Nine studies engaged key populations. The most common strategy involved recruiting and training seeds, who then delivered HIV services to network members. The use of networks varied significantly across the papers. The network approaches used were induction (<jats:italic>n<\/jats:italic> = 11), alteration (<jats:italic>n<\/jats:italic> = 1) and a combination of individual and segmentation approaches (<jats:italic>n<\/jats:italic> = 1). The pooled estimates showed that SNIs had a modest effect on the uptake of HIV testing RR 1.12 [95% CI 1.08\u22121.17) but the directionality of effect for the proportion newly diagnosed positive (RR 0.88 [95% CI 0.74\u22121.04]) and linkage to care (RR 0.98 [95% CI 0.86\u22121.08]) was towards the null.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>SNIs improved the uptake of HIV testing and exhibit important variability in their design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a need for more studies designed to capture the complex relational dynamics of network interventions and to provide strong evidence on their isolated effects. Additionally, it is necessary to expand the use of network approaches to other priority populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO Number<\/jats:title><jats:p>CRD42023434770<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26458","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T05:35:01Z","timestamp":1745645701000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The key design features and effectiveness of social network interventions for HIV testing and linkage services in low\u2010 and middle\u2010income countries: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9656-8255","authenticated-orcid":false,"given":"Madalo","family":"Mukoka","sequence":"first","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology Kamuzu University of Health Sciences  Blantyre Malawi"},{"name":"Department of Infectious Disease Epidemiology and International Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-5572","authenticated-orcid":false,"given":"Takondwa C.","family":"Msosa","sequence":"additional","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology Kamuzu University of Health Sciences  Blantyre Malawi"},{"name":"Department of Global Health Amsterdam University Medical Centres  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-296X","authenticated-orcid":false,"given":"Hussein H.","family":"Twabi","sequence":"additional","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology Kamuzu University of Health Sciences  Blantyre Malawi"},{"name":"Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robina","family":"Semphere","sequence":"additional","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology Kamuzu University of Health Sciences  Blantyre Malawi"},{"name":"School of Health and Wellbeing University of Glasgow  Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3100-5512","authenticated-orcid":false,"given":"Marriott","family":"Nliwasa","sequence":"additional","affiliation":[{"name":"Helse Nord Tuberculosis Initiative Department of Pathology Kamuzu University of Health Sciences  Blantyre Malawi"},{"name":"School of Health and Wellbeing University of Glasgow  Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-491X","authenticated-orcid":false,"given":"Guy","family":"Harling","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Price","sequence":"additional","affiliation":[{"name":"Malawi Epidemiology and Intervention Research Unit  Lilongwe Malawi"},{"name":"Department of Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-3754","authenticated-orcid":false,"given":"Katherine","family":"Fielding","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology and International Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-9430","authenticated-orcid":false,"given":"Augustine T.","family":"Choko","sequence":"additional","affiliation":[{"name":"Malawi\u2010Liverpool\u2010Wellcome Clinical Research Programme  Blantyre Malawi"},{"name":"Department of International Public Health Liverpool School of Tropical Medicine  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"The Urgency of Now: AIDS at a Crossroads \u2014 2024 global AIDS update [Internet]. 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