Doxy-PEP
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%.
What are the side effects?
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.
The medication is taken with a lot of water and a person should not to lie down for at least 30 minutes after taking it. This reduces the risk throat irritation or related injury. Doxycycline may also make you more sensitive to sunlight.
Can you still get gonorrhea, chlamydia or syphilis on it?
While Doxy-PEP can reduce the risk, it is still possible to acquire STIs on it. In our clinic experience we have had this happen with several patients and Doxy-PEP does not protect as well against gonorrhea specifically. As a PrEP patient with us, you’ll still undergo routine checks while taking Doxy-PEP.
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 as it has been used in acne management for many years. As a result, all patients are not automatically offered Doxy-PEP but patients can request it with the team.
If you are a clinic patient with more frequent occurrences of syphilis, gonorrhea, and/or chlamydia your Nurse Practitioner will also discuss this option with you.
How is Doxy-PEP typically taken?
The typical prescription for Doxy-PEP is taking two tablets/capsules (200mg) within 24-72 hours after a possible risk exposure.
For example, a person has sex on a Monday at 12pm. They would need to take their Doxy-PEP dose by Thursday at 12pm.
It is covered by most drug plans, including the Ontario Drug Benefit Program / Trillium. Ongoing PrEP Clinic patients do not pay for Doxy-pep if they don’t have coverage.
Is The PrEP Clinic offering this to their patients?
There are several factors that the Nurse Practitioners on the team consider when determining if Doxy-PEP is right for you. Getting more frequent STIs is an indicator it may be a good fit. If you are interested in discussing this, 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 ongoing PrEP care or HIV treatment care with our clinic to be prescribed 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.
Authors
- Nurse Practitioner Osahon
- Pharmacist Drew
All about testing.
Not sure when or where to get checked? Read our guidelines for all things testing, plus find more resources to support your sexual health.
Thinking about getting on PrEP?
PrEP requires a prescription and our clinic team can prescribe and monitor your care on it. We offer online phone appointments across all of Ontario. If near our in-person clinics we also offer full-service care in Toronto, Brampton, and Ottawa.