Doxy PEP - Reduce your risk of STD's

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Doxycycline post-exposure prophylaxis (doxy PEP) is an emerging strategy aimed at reducing the incidence of bacterial sexually transmitted infections (STIs) such as syphilis, chlamydia, and gonorrhea. This approach involves taking a 200 mg dose of doxycycline (usually 2 tablets or capsules) within 72 hours after unprotected sexual activity to prevent these infections. The Centers for Disease Control and Prevention (CDC) recommend doxy PEP for men who have sex with men (MSM) and transgender women (TGW) who have been diagnosed with a bacterial STI in the past 12 months. cdc.gov



Benefits of Doxy PEP

Clinical studies have demonstrated the effectiveness of doxy PEP in reducing STI rates among high-risk populations:

  • Reduction in Syphilis and Chlamydia: Research indicates that doxy PEP can decrease the incidence of syphilis and chlamydia infections by over 70%. 

    cdc.gov

  • Reduction in Gonorrhea: The same studies show approximately a 50% reduction in gonococcal infections among those using doxy PEP. 

    cdc.gov

These findings suggest that doxy PEP can be a valuable tool in STI prevention strategies for certain high-risk groups.

Risks and Considerations

While doxy PEP offers significant benefits, it's essential to consider potential risks:

  • Antimicrobial Resistance: There is concern that widespread use of doxycycline for STI prevention could contribute to increased antimicrobial resistance, particularly in pathogens like Neisseria gonorrhoeae. 

    pmc.ncbi.nlm.nih.gov

  • Side Effects: Common side effects of doxycycline include gastrointestinal discomfort, photosensitivity (increased sensitivity to sunlight), and, in rare cases, esophageal irritation.

  • Limited Data in Certain Populations: The efficacy of doxy PEP has been primarily studied in MSM and TGW populations. Its effectiveness and safety in cisgender women, heterosexual men, transgender men, and non-binary individuals assigned female at birth remain unclear. 

    cdc.gov

CDC Recommendations

The CDC provides specific guidelines for the use of doxy PEP:

  • Target Population: MSM and TGW with a documented bacterial STI (syphilis, chlamydia, or gonorrhea) in the past 12 months should be counseled about doxy PEP as a preventive measure. 

    cdc.gov

  • Dosage and Timing: A single 200 mg dose of doxycycline should be taken as soon as possible, ideally within 24 hours but no later than 72 hours after unprotected oral, vaginal, or anal sex. 

    cdc.gov

  • Comprehensive Sexual Health Approach: Doxy PEP should be part of a broader sexual health strategy that includes regular STI screening, risk-reduction counseling, appropriate vaccinations, and linkage to HIV pre-exposure prophylaxis (PrEP) or HIV care services as needed. 

    cdc.gov

Discussing Doxy PEP with Your Healthcare Provider

If you're considering doxy PEP, it's crucial to have an open and informed discussion with your healthcare provider:

  1. Assess Your Risk: Share your sexual history and any previous STI diagnoses to help determine if doxy PEP is appropriate for you.

  2. Understand the Benefits and Risks: Discuss the potential advantages of doxy PEP in reducing STI risk and weigh them against possible side effects and the concern of antibiotic resistance.

  3. Develop a Plan: If doxy PEP is deemed suitable, your provider will prescribe the correct dosage and guide you on how to take it properly. They will also recommend regular follow-up appointments for STI testing and to reassess the continued need for doxy PEP.

Remember, doxy PEP is most effective when used as part of a comprehensive approach to sexual health, including consistent condom use, regular STI screenings, and open communication with sexual partners and healthcare professionals.

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