Schuyler, AshleyAlidina, ZainabDolcini, M. MargaretHarper, GaryFortenberry, J. DennisSingh, RyanJamil, OmarPollack, LanceCatania, Joseph2024-10-152024-10-152021Schuyler A, Alidina Z, Dolcini MM, et al. Pre-Exposure Prophylaxis (PrEP) Dissemination: Adapting Diffusion Theory to Examine PrEP Adoption. AIDS Behav. 2021;25(10):3145-3158. doi:10.1007/s10461-021-03345-2https://hdl.handle.net/1805/43962PrEP 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.en-USPublisher PolicyAfrican AmericanDiffusionHIV/AIDSMSMSocial stigmaArticle