What is DoxyPEP?
DoxyPEP is short for Doxycycline Post-Exposure Prophylaxis. It’s where you take an antibiotic (doxycycline) after condomless sex (post-exposure) to prevent STIs (prophylaxis). DoxyPEP can be taken after condomless sex to help prevent syphilis, chlamydia and gonorrhea.
DoxyPEP does not prevent or treat HIV. If you are taking DoxyPEP, you need to also keep taking HIV PrEP or HIV treatment.
How do I take DoxyPEP?
A DoxyPEP dose is 200mg. This is usually two pills or capsules. It needs to be taken within 72 hours after condomless oral sex, anal sex or insertive vaginal sex. Ideally it should be taken within 24 hours.
For DoxyPEP to be the most effective, it needs to be taken every time you have condomless sex.
Who is DoxyPEP for?
DoxyPEP is for men who have sex with men, trans women and other gender-diverse people who were born with a penis. This is because the research supporting DoxyPEP (more on that below) showed it was effective in people with these body types.
Unfortunately, research suggests DoxyPEP is not as effective for people who were born with vaginas. This includes cis women, trans men and other gender-diverse people with this body type. At this time, DoxyPEP is not recommended for these people – however, you can speak to your clinician to decide what might be best for you.
DoxyPEP effectiveness
The evidence for DoxyPEP comes from three studies that followed men who have sex with men and transgender women. These studies took place in France and the USA and included people with and without HIV.
In these trials, DoxyPEP reduced the risk of chlamydia by 70-89%. It also reduced the risk of syphilis by 73-87%. In two of the studies, DoxyPEP reduced the risk of gonorrhea by 51-57%. DoxyPEP is less effective against gonorrhea because this bacteria is resistant to more types of antibiotics.
In one study, DoxyPEP did not reduce the risk of gonorrhea. This is likely because the strain of gonorrhea that was common among the participants in France is resistant to doxycycline.
Is DoxyPEP safe?
Doxycycline is a widely-used antibiotic with a low risk of side effects and drug interactions. It’s often used to prevent malaria and treat acne, where it can be safely taken for days or weeks at a time. It’s also used to treat some common infections.
Doxycycline can make you more sensitive to sunlight, so it’s important to wear sunscreen for at least 24 hours after you’ve taken it. If you’re having a horny beach vacation, be careful! Don’t forget to take shade breaks and re-apply.
Doxycycline can also cause nausea, but taking it with food can help this. Make sure you don’t lie down for 30 minutes afterwards.
Avoid dairy or metal-containing supplements (calcium, magnesium, zinc, antacids) for two hours before and after your dose. This is because they can interfere with how the medication is absorbed, making it less effective.
Some researchers have cautioned that using doxycycline for DoxyPEP may increase the risk of antibiotic resistance, particularly when used inconsistently. Public health units are carefully considering these risks alongside the benefits of reducing STI transmission. At the time of writing, DoxyPEP has been formally endorsed by America's Centers for Disease Control and Prevention. The Public Health Agency of Canada is currently conducting its review.
Can I take PrEP and DoxyPEP?
Yes! In fact, we recommend taking them both. If you are a good candidate for PrEP you will also be a good candidate for DoxyPEP. It's important to discuss the combined use of these medications with your healthcare provider, as both have potential risks and require regular monitoring.
PrEP and DoxyPEP are separate medications. DoxyPEP does not prevent HIV, so you need to keep taking your PrEP alongside it. With PrEP and DoxyPEP together, you can boost your protection to help prevent HIV and three major STIs. Yay, science!
How to get DoxyPEP
You should be able to get DoxyPEP from sexual health clinics that serve LGBTQ2S+ people. You can also get it from family doctors. However, access can vary depending on where you live – DoxyPEP is new, and not all clinics are informed.
Freddie can help you get DoxyPEP online! We can connect new and existing patients with DoxyPEP if they’re eligible. Ask your clinician for more information.
Not a patient yet? Get started with Freddie today! Please note, Freddie only provides DoxyPEP alongside PrEP. If you are a good candidate for DoxyPEP, you are also a good candidate for PrEP!
Because both treatments are a part of sexual healthcare, it's best to get them from the same provider. That way we can monitor your health the most effectively. If you are getting PrEP from another provider but are looking for DoxyPEP with Freddie, you will need to switch your PrEP care to us. Switching to Freddie for PrEP is easy – just ask your clinician.
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