Use of generative AI for health among urban youth in Pakistan: A mixed-methods study

Generative AI (GAI) tools are increasingly used informally for health, yet evidence from low- and middle-income countries (LMICs) is limited. This study generates early evidence on such health systems from the fifth most populous country: Pakistan. We used a youth-led convergent mixed-methods design among digitally connected urban youth in Pakistan (survey N = 1240, 20 interviews). The primary outcome was any GAI use for health. We fitted multivariable logistic regression models and conducted reflexive thematic analysis. Overall, 69.0% of participants reported using GAI for health. Higher odds of use were observed among women (aOR = 1.57, 95% CI [1.17-2.11], p = 0.003) and youth reporting any mental or physical condition (aOR = 1.82, 95% CI [1.34-2.48], p < .001). Greater trust in AI strongly predicted use (per-level aOR = 4.21, 95% CI [2.98-6.01], p < .001). High confidence using AI (aOR = 1.81, 95% CI [1.11-3.07], p = 0.022), awareness of AI risks (aOR = 1.67, 95% CI [1.20-2.31], p = 0.002), and prior use of other (non-generative) digital health tools (aOR = 4.48, 95% CI [2.59-8.23], p < .001) were also associated with higher likelihood of use. Telemedicine use was significant though weaker in magnitude (aOR = 1.58, 95% CI [1.01-2.54], p = 0.049). Interviews highlighted three themes: (1) access and affordability driving first-line use; (2) emotional safety and informational support, especially for stigmatized concerns; (3) perceived empowerment in interpreting tests, organizing symptoms, and preparing for clinical visits. Given constrained, stigmatizing, and costly services, GAI may function as an adjunct step for health information and emotional support in Pakistan's health ecosystem.