Go Back Original Article June, 2021

Pre-Exposure Prophylaxis (PrEP) Dissemination: Adapting Diffusion Theory to Examine PrEP Adoption

Author James Dennis Fortenberry Author Gary W. Harper Author Ashley Schuyler Author Zainab Alidina Author M. Margaret Dolcini Author Omar Jamil Ahmed Author Lance Pollack Author Joseph Catania

Abstract

PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17–24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most AAYMSM were in the persuasion stage (PrEP-aware, hadn’t adopted; 72.4%). Our results suggest that model antecedents are DOI stage-specific. PrEP awareness (knowledge stage) was associated with lower levels of social stigma (p < .03) and greater health literacy (p < .05), while sexual risk (p < .03) and education (p < .03) predicted PrEP adoption (12.2%). PrEP efficacy and side effects were primary innovation characteristics influencing adoption receptivity in the persuasion stage. Interventions to improve PrEP diffusion should be tailored to stage-specific antecedents depending on how a community is stratified across the DOI stages.

Keywords

hiv/aids pre-exposure prophylaxis (prep) african american men who have sex with men (msm) prep adoption social stigma health literacy sexual risk diffusion of innovations (doi) prep awareness prep efficacy prep side effects hiv prevention public health interventions prep dissemination hiv risk reduction community health prep uptake health disparities behavioral health diffusion msm prep
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Volume 25
Issue 10
Pages 3145–3158
DOI 10.1007/s10461-021-03345-2
ISSN 1573-3254
Impact Metrics