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

Area of Science:

• Public Health
• Health Behavior Theory
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) uptake remains low among African-American men who have sex with men (AAMSM).
• Understanding the factors influencing PrEP adoption is crucial for targeted HIV prevention strategies.
• Young AAMSM (AAYMSM) represent a key demographic for PrEP intervention research.

Purpose of the Study:

• To apply Diffusion-of-Innovations (DOI) theory to examine PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM).
• To identify stage-specific predictors of PrEP diffusion across different stages of adoption.
• To inform the development of tailored interventions to enhance PrEP uptake in this population.

Main Methods:

• Quantitative and qualitative analyses were employed to assess PrEP diffusion.
• Participants (N=181) aged 17-24 years were categorized by their stage in the PrEP adoption process.
• Statistical analyses examined associations between demographic, psychosocial factors, and DOI stages.

Main Results:

• The majority of AAYMSM (72.4%) were in the persuasion stage (aware of PrEP but not adopted).
• PrEP awareness was associated with lower social stigma and higher health literacy.
• Sexual risk behaviors and education level predicted PrEP adoption, which was achieved by 12.2% of participants.
• Perceived PrEP efficacy and side effects influenced adoption receptivity in the persuasion stage.

Conclusions:

• PrEP adoption predictors are specific to the stage of diffusion within the DOI framework.
• Interventions should address social stigma and enhance health literacy to promote PrEP awareness.
• Tailoring interventions based on the community's distribution across DOI stages is essential for improving PrEP diffusion among AAYMSM.