We know HIV-PrEP helps to prevent HIV, but what about options for other sexually transmitted infections (STIs) like gonorrhea, chlamydia, and syphilis?
What is Doxy-PEP?
Doxy-PEP is taking an antibiotic known as doxycycline within 72 hours after sexual activity. This can reduce the risk of acquiring gonorrhea, chlamydia, and syphilis. Some studies have suggested it can reduce the risk of some STIs by approximately 67%.
The medication is generally well tolerated, but like most antibiotics may cause stomach upset or possibly diarrhea. Although it is a shorter course being just 2 tablets/capsules for each dose, which can potentially reduce the risk of side effects.
Should everyone go on Doxy-PEP?
There are some unknowns relating to Doxy-PEP at this time so it is not an automatic consideration for everyone. Some things that are still being looked into include antibiotic resistance, impacts on our long term gastrointestinal health, and waiting for newer larger studies. However, there is some existing clinical experience of routine use of doxycycline with more frequency as it has been used in acne management for many years.
As a result all patients are not routinely automatically offered Doxy-PEP.
Is The PrEP Clinic offering this to their patients?
There are several factors that the Nurse Practitioners on the team consider when deciding on eligibility for a Doxy-PEP prescription. Recurrent/repeat STIs are one indicator it may be a good fit. If you are interested in discussing your eligibility, please let the clinic team know and we can book a consultation with your Nurse Practitioner. For general questions about Doxy-PEP our clinical pharmacists are also here to answer all your questions. Patients must be either in PrEP care or HIV treatment care with our clinic to be considered for Doxy-PEP.
What about Doxy-PrEP?
This is different from Doxy-PEP and people take doxycycline once a day continuously. The clinic is currently awaiting more studies before prescribing this method for any patients.
Luetkemeyer AF, et al. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. N Engl J Med. 2023 Apr 6;388(14):1296-1306. doi: 10.1056/NEJMoa2211934. PMID: 37018493; PMCID: PMC10140182.