Doxy PEP has been proven to reduce the risk of getting certain bacterial sexually transmitted infections among those in higher-risk groups, particularly individuals with frequent or multiple sexual partners
In the ongoing evolution of sexual health, a new acronym – Doxy PEP – is making headlines and sparking conversations in clinics, on college campuses and within queer communities across North America. Short for Doxycycline Post-Exposure Prophylaxis, Doxy PEP is redefining what the prevention of sexually transmitted infections (STIs) can look like in the 21st century.
But what exactly is Doxy PEP, and why are sexual health experts so excited about it?
A new era of STI prevention
Doxy PEP is a promising protocol that uses the antibiotic doxycycline as a post-exposure prophylaxis – taken after sex rather than before – to reduce the risk of contracting certain STIs. Think of it like Plan B, but for bacterial STIs like chlamydia, syphilis and, to a lesser extent, gonorrhea.
Here’s how it works: within 72 hours after condom-less sex, a person takes a 200 mg dose of doxycycline. The antibiotic circulates in the bloodstream, working to kill any potential bacteria before they have a chance to cause an infection.
Studies – particularly among gay, bisexual and other men who have sex with men (MSM), as well as transgender women – have shown striking results. In one of the most talked-about studies, conducted in San Francisco and Seattle, Doxy PEP reduced the incidence of chlamydia by more than 80 per cent and syphilis by nearly 90 per cent, and showed modest benefits for gonorrhea (although emerging resistance remains a concern).
Who is it for?
Right now, Doxy PEP is not prescribed for everyone. The US Centers for Disease Control and Prevention (CDC) released draft guidelines in 2023 recommending its use for:
- Gay and bisexual men and transgender women
- People who have had a bacterial STI in the past year
- People who are at ongoing risk of acquiring STIs
It is effective for those in higher-risk groups, particularly individuals with frequent or multiple sexual partners.
Importantly, Doxy PEP is not a substitute for HIV PrEP (pre-exposure prophylaxis): the two work together. Think of PrEP as preventing HIV, and Doxy PEP as the new tool in the toolkit for fighting other STIs.
What are the concerns?
As with any antibiotic, there are concerns about overuse and antibiotic resistance. Medical experts stress that Doxy PEP should be used judiciously and as part of a broader, individualized approach to sexual health.
Some critics also argue that Doxy PEP might encourage riskier sexual behaviour, a common critique of any preventive treatment that operates post-exposure. But public health experts emphasize that harm reduction – not abstinence – is the cornerstone of modern sexual wellness.
So…should you take it?
If you’re part of a community that’s at higher risk for STIs, Doxy PEP could be a game changer. But it’s not a one-size-fits-all solution. Speak with your healthcare provider – ideally someone with a strong understanding of 2SLGBTQI+ or sexual health medicine – to determine if it’s right for you.
Doxy PEP represents a new kind of thinking: empowering people with more options, more tools and more control over their sexual health. As STI rates continue to rise globally, Doxy PEP may be one of the most important developments in the sexual health space in years.
Bottom line: Doxy PEP isn’t about replacing condoms or other forms of protection; it’s about adding another layer of safety in an ever-evolving landscape of love, sex and health.
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