About Doxy PEP for prevention of STIs | Asia’s Leading Sexual Health Clinics

About Doxy PEP for the prevention of STIs when you have condomless sex

What is DoxyPEP

Doxy-PEP stands for doxycycline post-exposure prophylaxis. It involves taking one 200mg pill of doxycycline, a kind of tetracycline, as soon as possible but no later than three days after having sex without a condom. The study observed its effects over the course of a year in men who have sex with men (MSM) and transgender women and found it reduced bacterial STIs, specifically gonorrhoea, chlamydia, and syphilis, by two-thirds each quarter.

The San Francisco Department of Public Health is now recommending Doxy PEP for certain individuals, including cisgender men and trans women with a history of bacterial STIs and condomless sex in the past year. PULSE CLINIC is also providing Doxy PEP to men who have sex with men, trans women, trans men, and other TGNCI+ folks who may be at risk for chlamydia, gonorrhea, and syphilis even if they have not been diagnosed in the past year. Doxy PEP is not currently recommended for cisgender women at this time, although it is being studied and we hope to have results soon.

Doxycycline is good for STI PEP because it is relatively cheap, does not interact negatively with many common prescription drugs, is very safe to use for most people, and is already used as treatment for chlamydia and syphilis. Doxycycline is also already commonly prescribed as PEP in the USA to prevent Lyme disease and leptospirosis after suspected exposure. Long-term use of doxycycline is also prescribed as a treatment for acne and as a form of malaria prevention.

Effectiveness

Recent research showed that Doxy PEP reduced bacterial STIs overall by 66% (among people on PrEP) and 62% (among people living with HIV). In three large randomized controlled trials, 200 mg of doxycycline taken within 72 hours after sex has been shown to reduce syphilis and chlamydia infections by >70% and gonococcal infections by approximately 50%.

Because it is an antibiotic, DoxyPEP only prevents infection with bacteria and not other things that cause STIs like viruses (including HIV and hepatitis B) or parasites (including crabs and scabies).

As reported at the 2022 International AIDS Conference, doxycycline reduced the risk of acquiring chlamydia by 74% and syphilis by 77% for people with HIV. For those taking PrEP, the risk reduction was 88% for chlamydia and 87% for syphilis. DoxyPEP was less effective at preventing gonorrhoea, with a risk reduction of 57% for people with HIV and 55% for HIV-negative people. The French DoxyVAC trial also showed that doxycycline reduced the risk of acquiring these STIs.

The evidence currently available suggests that DoxyPEP is particularly effective at preventing chlamydia (~70-89% effective) and syphilis (~73-87%) infection. Two studies have shown that DoxyPEP is 51-57% effective at preventing gonorrhoea infection but one found that DoxyPEP had no effect on gonorrhoea. One proposed explanation for this difference is that DoxyPEP may be less effective in areas where doxycycline-resistant strains of gonorrhoea are common.

Defining ‘effective’: The efficacy of DoxyPEP is typically measured by comparing the rates of bacterial STIs in a group of people taking DoxyPEP compared to a similar group of people not taking DoxyPEP. When we say DoxyPEP is 79% effective at preventing syphilis, we mean that a study found that there were 79% fewer cases of syphilis among people taking DoxyPEP than people not taking it.

According to The New York Times, "evidence so far supports doxy-PEP’s use only in men who have sex with men and in transgender women. In those groups, the antibiotic cut rates of syphilis and chlamydia by about 90 percent and gonorrhea by about 55 percent".

New research shows DoxyPEP is highly effective for gay men and trans women. You can also refer to these resources when you speak to your doctor.

• British Columbia Centre for Disease Control Statement on DoxyPEP (October 2023)
  Includes clinical guidance and prescribing protocols
• Doxycycline for bacterial STI prevention by CATIE (Canadian)
• NIH-funded study finds doxycycline reduces sexually transmitted infections by two-thirds (April 2023)
• Sexual Health Prevention Tool Associated with Declines in Sexually Transmitted Infections in San Francisco (March 2024)
  
  

How to use it. How do I take DoxyPEP?

• Take 200 mg of doxycycline within 24 hours (no later than 72 hours) after condomless oral, anal, vaginal and/or front hole sex. JUST ONE TIME.
• If you have sex again, take another dose 24 hours after your last dose.
• It will be most effective if you take it within the first 24 hours, so treat it like a morning-after medication
• You can take Doxy PEP as often as every day, but don’t take more than 200 mg every 24 hours. 
• Take doxycycline with plenty of water. If you get an upset stomach, try taking it with food. 
• Take it with 8 oz of water and food, if possible, to help decrease any potential side effects like nausea or headaches
  

Reminders

• Don’t share Doxy PEP with others. If your friends or partners want to use it, refer them to us or their provider.
• Wear sunscreen if you’re taking Doxy PEP. It can cause your skin to be more sensitive to the sun.
  Some people are more sensitive to the sun when they take it, so be sure to wear sunscreen and/or stay covered when spending extended time outdoors
• Avoid dairy, calcium, antacids, or multivitamins within 2 hours before or after Doxy PEP. These can reduce absorption in your stomach.
• Doxycycline has been used for over fifty years and is considered to be generally safe and well-tolerated. This holds true even when used over long periods of time.
  

How to get it 

1. If you are client of PULSE CLINIC, You can get Doxycycline from PULSE Pharmacy Online
2. If you’re not an existing client at PULSE Clinic, you have a few options. 
• Ask your primary care provider or sexual health care provider about Doxy PEP and if they can provide a prescription. If they don’t know about Doxy PEP, ask them to read more HERE for more information. 
• Visit PULSE CLINIC anywhere in Thailand (Bangkok, Pattaya, Phuket, Chiang Mai),
  Hong Kong, Singapore, Malaysia (Bukit Bintang, Bangsar, Penang), and the Philippines (Manila)

What else should I know before starting DoxyPEP?

• It is safe to take PrEP for HIV and DoxyPEP at the same time.
• DoxyPEP treatment is not 100% protective, but recent studies have shown that it can decrease your likelihood of contracting syphilis, chlamydia, and gonorrhea by about 60%.
• Since this treatment method is relatively new, we are still learning about the effects of DoxyPEP on the ‘good’ bacteria of the gut, the bacteria that live on our skin (for example, staph), and possible resistance to STIs such as gonorrhea.
• Doxycycline is not a new medication, but this use of it is. Doxycycline has long been used as a common antibiotic due to its safety, mild potential side effects, and low cost.
• Chlamydia and syphilis have shown no resistance to doxycycline, despite it having been used as a common antibiotic for decades.

DoxyPEP vs DoxyPrEP

You may also have heard of DoxyPrEP.

DoxyPrEP is not as common as DoxyPEP. DoxyPrEP uses Doxycycline as a pre-exposure prophylaxis to prevent STIs. It is taken every day to prevent STIs. This means DoxyPrEP stays in your system and targets harmful bacteria to prevent infection whenever you are exposed.

DoxyPEP is post-exposure prophylaxis for STIs, which means you only take Doxycycline after unprotected sex.

Are you interested in taking DoxyPEP or want to learn more?

DoxyPEP is one option to help you prevent sexually transmitted illnesses if you have unprotected sex.
Get in touch anytime with our pharmacists at PULSE CLINIC and Pharmacy if you have any questions. We’re here for you.

Order Doxycyline for STI prevention online today!

For more information about the medication and ordering process, please contact us at pulseliving@pulse-clinic.com or chat with us on your preferred platform. 

  +66-84-226-2569     @pulserx       PulseClinic

Who is currently using DoxyPEP and HOW?

DoxyPEP is currently authorised for prescription in San Francisco and other parts of the US for cisgender men and transgender women who have had a bacterial STI in the past year and who also report having had sex (oral, anal, vaginal and/or frontal) without condoms with at least one cisgender male or transgender female partner in the past year.

DoxyPEP is not currently authorised for prescribed use in the UK. However, a number of studies have found that some people are already taking doxycycline as PEP. A survey of European men who have sex with men using HIV PrEP found that 8% of them are already using DoxyPEP. A 2019 survey of men who have sex with men in the UK found that 9% of HIV PrEP users had purchased antibiotics to prevent STI infections. In the absence of a prescription, it is likely that these people are purchasing doxy online to protect themselves against STIs.

A lot of people who are living in Asia or travelling through Asia are also getting DoxPEP through 20 branches of PULSE CLINIC and PHarmacy throughout Asia.
PULSE CLINIC is the the frontline on DoxyPEP prescription and dispensary for people in Asia since the beginning of 2024.

DoxyPEP may be useful for anyone who is at an elevated risk of acquiring a bacterial STI. This will include people who are less likely to use condoms regularly. According to current UK data, the groups that are more likely to acquire a bacterial STI, and therefore might benefit from DoxyPEP, are: gay and bisexual men and other men who have sex with men as well as curious people who are exporing sex with men.

Are you interested in taking DoxyPEP or want to learn more?

DoxyPEP is one option to help you prevent sexually transmitted illnesses if you have unprotected sex.
Get in touch anytime with our pharmacists at PULSE CLINIC and Pharmacy if you have any questions. We’re here for you.

Call us, email or come in any time!

Order Doxycyline for STI prevention online today!

For more information about the medication and ordering process, please contact us at pulseliving@pulse-clinic.com or chat with us on your preferred platform. 

  +66-84-226-2569     @pulserx       PulseClinic