Doxycycline 2
DOXYCYCLINE AS POST-EXPOSURE PROPHYLAXIS (“DoxyPEP”) is a new approach to prevent sexually transmitted infections. Open Door Health is pleased to announce a clinic-wide effort to offer DoxyPEP to people!
Sexually transmitted infections (STIs) caused by bacteria are increasing across the United States including in Rhode Island. These include gonorrhea, chlamydia, and syphilis. These bacterial STIs can cause serious long-term complications. Testing for these STIs generally includes a blood test (syphilis) as well as urine, throat, and rectal testing (gonorrhea and chlamydia). All these STIs can be effectively treated with antibiotics.
Post-exposure prophylaxis (PEP) involves taking medication to prevent an infection after a possible exposure and is a common strategy for the prevention of HIV and other infections. PEP is different from pre-exposure prophylaxis (PrEP) which involves taking a medication before exposure occurs. PrEP has generally referred to a medication to prevent HIV.
Recently, a commonly prescribed antibiotic (doxycycline) has been shown that it can be taken as PEP to prevent bacterial STIs (i.e., syphilis, gonorrhea, and chlamydia). This is being referred to as “DoxyPEP”. The study demonstrated that using a single, oral dose of doxycycline 200mg within 72 hours after condomless oral, anal, or vaginal sex in gay, bisexual, and other men who have sex with men (MSM) and transgender women (TGW) led to significant reductions in chlamydia, gonorrhea, and syphilis. Taking doxycycline as PEP reduced syphilis by up to 87%, chlamydia by up to 88%, and gonorrhea by up to 57%.
Safety: Doxycycline is a broad-spectrum tetracycline antibiotic used to treat many different bacterial infections. Doxycycline is generally well tolerated. Adverse effects most commonly associated with doxycycline include photosensitivity and gastrointestinal symptoms including esophageal erosion and ulceration which are uncommon but can occur. Most adverse effects resolve when the medication is stopped. Long-term use of doxycycline has been prescribed safely for other medical indications (e.g., acne treatment and malaria prophylaxis).
Contact Us
If you are interested in being prescribed doxycycline as PEP, please call Open Door Health at (401) 648-4700.
Being Prescribed Doxycycline as PEP: The Centers for Disease Control and Prevention (CDC) has released preliminary considerations for doxycycline as PEP as an STI preventative strategy. Other settings such as the San Francisco Department of Public Health have released their own guidance. In general, doxycycline as PEP to prevent bacterial STIs includes the following:
- Taking 200 mg of doxycycline taken within 72 hours (ideally within 24 hours or as soon as possible) after condomless oral, anal, or vaginal sex. Doxycycline can be taken daily depending on sexual activity, but no more than 200 mg every 24 hours.
- At this time, the studies for doxycycline as PEP for bacterial STI prevention have only demonstrated effectiveness in MSM and TGW. Doxycycline as PEP in other groups can be considered in discussion with your medical provider.
- MSM and TGW who have had a prior bacterial STI (i.e., syphilis, gonorrhea, and chlamydia) should strongly consider doxycycline as PEP and particularly if there has been an STI diagnosis in the past 12 months.
- MSM and TGW who are on HIV PrEP and/or who are living with HIV infection should strongly consider doxycycline as PEP.
- At the initial visit for doxycycline as PEP, a person should be screened for HIV, syphilis, gonorrhea, and chlamydia. People taking doxycycline as PEP should follow-up every three (3) months for STI testing.
If you are interested in being prescribed doxycycline as PEP, please call Open Door Health at (401) 648-4700. We will get back to you in a timely manner to schedule and prescribe you doxycycline as PEP.
Here at Open Door Health, we are committed to improving sexual health in general and addressing the burden of STIs in the LGBTQ+ community in Rhode Island. If you aren’t interested in doxycycline as PEP, please consider routine STI screening and regular check-ins with your provider about your sexual health.
Thank you for taking the time to learn about this, and for allowing Open Door Health the privilege of participating in your healthcare.
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