PURPOSE: Enhancing HIV/sexually transmitted infection testing and reducing unsafe sexual behaviors and substance use are crucial for public health, particularly among youth. This pilot study examines the Storytelling 4 Empowerment (S4E) intervention's preliminary efficacy in these areas. METHODS: Using a community-engaged research approach, we conducted a randomized controlled trial with 100 adolescents and young adults (mean age = 19.27, standard deviation = 1.62) at a youth-focused clinic in Southeast Michigan. Participants were randomized to S4E, a brief digital health intervention, or usual care. Assessments occurred at baseline, postintervention, 3 and 6 months, with statistical analyses estimating effect sizes. RESULTS: S4E participants demonstrated higher HIV (52% vs. 12%; h = 0.95) and sexually transmitted infection (52% vs. 20.4%; h = 0.74) testing at 6-month follow-up. Reductions in condomless sex (12.9% vs. 1%; h = 0.35) and binge drinking (11.2% vs. 1.6%; h = 0.02) were reported at 3 months. Both youth and providers in the S4E group reported better clinician-youth communication than controls, and youth showed increased improvement over time (Cohen's d = 1.19 at 6 months). DISCUSSION: The S4E intervention demonstrated significant improvements in testing, risk behaviors, and communication. These findings suggest the need for larger-scaled randomized controlled trials to confirm the intervention's efficacy for youth in clinical settings.