Doxy-PEP

Doxy-PEP is a medication used to prevent sexually transmitted infections (STIs), especially syphilis and chlamydia.

It involves taking 200mg of the antibiotic doxycycline, as a single dose within 72 hours after sex (oral sex, vaginal sex or anal sex).

• Take doxycycline 200mg within 72 hours (3 days) after condomless sex.
• The dose is taken orally, typically as two 100mg tablets.Take it with food and a glass of water to prevent stomach upset.
• Avoid lying down for at least 1 hour after swallowing the tablets, as they may irritate your food pipe.
• Do not take Doxy-PEP more than once every 72 hours.
• Do not take antacids, iron, calcium, zinc or fibre supplements within 2 hours of taking Doxy-PEP, as they can interfere with its absorption.
• Doxycycline may increase sun sensitivity, so you may need to wear sunscreen while outdoors.

Doxy-PEP is intended for occasional use and should not replace other STI prevention methods like consistent condom use and regular STI testing.

If used correctly, Doxy-PEP reduces the risk of contracting syphilis by 70-80% and reduces the risk of contracting chlamydia by 70-90%.

Doxy-PEP may be available to those who think they need extra protection against syphilis and chlamydia. This can include:

• Gay, bisexual, and other men who have sex with men, and trans women
• People with recent STI diagnoses (within the last 12 months)
• People who have been diagnosed with syphilis in the past
• People with multiple sexual partners
• People who do not regularly use condoms during sex

Your health professional will assess if Doxy-PEP is suitable for you.

Doxy-PEP prescriptions are available through healthcare providers, including:

• General Practitioners (GPs): Many GPs can prescribe Doxy-PEP.
• Sexual Health Clinics: Specialized clinics offer STI prevention services.
• Community Health Services: Some community organizations provide access to Doxy-PEP.

• Doxy-PEP is considered a safe medication when prescribed and taken correctly.
• For some people, Doxy-PEP is unsuitable. These include people who are pregnant or those taking certain medications (such as isotretinoin). Your healthcare professional will be able to assess your suitability.
• While Doxy-PEP reduces the risk of syphilis and chlamydia, it is less effective at preventing other STI’s such as gonorrhea and does not protect against HIV or other blood borne viruses, so consistent condom use and regular STI testing are recommended.
• Doxy-PEP is accessible from most pharmacies and can be obtained with either a PBS or a private prescription.

If you have questions or need more information about Doxy-PEP, consider the following resources:

• SHQ Sexual Health Helpline: Call (08) 9227 6178 for confidential advice and information.
• ASHM Doxy-PEP Decision Making Tool: A resource to help you and your healthcare provider make an informed decision about Doxy-PEP.

Australasian Society for HIV Medicine. 2023 Consensus statement on doxycycline prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual, and other men who have sex with men in Australia. Sydney: ASHM, 2023. https://ashm.org.au/about/news/doxy-pep-statement/ (viewed Sept 2023).