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Early adopters of doxycycline as post-exposure prophylaxis to prevent bacterial sexually transmitted infections in a real-world clinical setting
  1. Philip A Chan1,2,
  2. Yelena Malyuta2,
  3. Hannah Parent1,
  4. Jun Tao1,
  5. Maximillian Erbe2,
  6. Peter Salhaney2,
  7. Michaela Maynard2,
  8. William DeWitt2,
  9. Antonio Reisopoulos2,
  10. Amy Nunn2,3
  1. 1Department of Medicine, Brown University, Providence, Rhode Island, USA
  2. 2Rhode Island Public Health Institute, Providence, Rhode Island, USA
  3. 3Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
  1. Correspondence to Dr Philip A Chan, Department of Medicine, Brown University, Providence, Rhode Island, USA; Philip_Chan{at}


Objectives Doxycycline as post-exposure prophylaxis (DoxyPEP) is a novel prevention approach which has demonstrated efficacy in preventing bacterial sexually transmitted infections (STIs) in men who have sex with men (MSM) and transgender women (TGW) including people who are living with HIV and those on HIV pre-exposure prophylaxis (PrEP). We evaluated patient knowledge and interest in DoxyPEP, as well as early adopters of its use.

Methods In 2023, patients presenting for HIV and STI services at a primary care and sexual health clinic were asked about DoxyPEP knowledge, interest and use. Bivariate and multivariate analyses were used to evaluate demographics and behaviours associated with these outcomes.

Results A total of n=421 people presented for care. Of these, 314 were MSM/TGW. Fifteen percent were Black/African-American, and 21% were Hispanic/Latino. A total of 50% of MSM/TGW had heard of DoxyPEP, 49% were interested and 18% reported prior DoxyPEP use. Having a history of STI infection ever (adjusted OR (aOR) 5.95, 95% CI 2.69 to 13.13) and in the past 12 months (aOR 2.99, 95% CI 1.56 to 5.72) were both associated with DoxyPEP use. Individuals who had ever used HIV PrEP had nearly three times the odds of ever taking DoxyPEP (aOR 2.88, 95% CI 1.56 to 5.30). There was no association between the use of DoxyPEP and race, ethnicity or HIV status.

Conclusions Among MSM and TGW, there is already significant awareness, interest and use of DoxyPEP to prevent bacterial STIs. Public health efforts should focus on improving access and delivery of this STI prevention intervention to MSM and TGW.

  • sexual health
  • sexual behavior
  • sexual and gender minorities
  • preventive health services

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors PAC accepts full responsibility for the work, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.