Background: Economic Empowerment HIV prevention programs for adolescent girls and young women (AGYW) in sub-Saharan Africa are gaining traction as effective strategies to reduce HIV risk and vulnerabilities among this population. While intervention effectiveness is critical, there are numerous factors beyond effectiveness that shape an intervention's impact. The purpose of this systematic review was to examine the extent to which evidence-based economic empowerment HIV prevention programs for AGYW in SSA report on internal and external validity, as conceptualized by the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework.

Methods:We searched PubMed, Ovid/MEDLINE, Science Direct, Ebscohost, PsycINFO, Scopus, and Web of Science for evidence-based economic empowerment HIV interventions for AGYW in SSA. Two researchers coded each article using a validated RE-AIM data extraction tool and independently abstracted information from each article.

Results: A total of 29 articles met the predefined eligibility criteria. Efficacy/Effectiveness (72.4%) was the highest reported RE-AIM dimension, followed by maintenance (65.6%),reach (62.9%), adoption (55.7%) and implementation (35.6%).The majority of the studies focused on reporting internal validity indicators such as sample size, intervention location, and effectiveness, with minimal reporting of external validity elements such as start-up costs, implementation costs, intervention fidelity, and study participants representativeness.

Conclusion: Results of the review emphasize the need for future economic empowerment HIV prevention programs for AGYW in SSA to report multiple implementation strategies and highlight considerations for translating such programs into real-world settings. Particularly researchers should pay close attention to reporting setting-level adoption, implementation cost and maintenance of these interventions.