What is DoxyPEP (dPEP)?

DoxyPEP (dPEP) is a post-exposure preventative treatment for syphilis, chlamydia, and gonorrhea. Think of it as a morning-after pill but for bacterial Sexually Transmitted Infections (STIs) instead of pregnancy: take one dose after a condomless sexual encounter to greatly reduce your risk of contracting bacterial STIs after condomless sex.  DoxyPEP is not 100% effective (see below for efficacy against each STI) but can reduce your risk greatly.  This is one very effective tool to help reduce the continued increase we are seeing with STI rates each year.

DoxyPEP does NOT help prevent:

• HIV
• Mpox (monkeypox)
• Other viral infections

Who should consider DoxyPEP?

You should consider DoxyPEP if you were assigned male at birth, are at least 12 years old, and:

• Have been diagnosed with at least one bacterial STI (i.e., chlamydia, gonorrhea, syphilis) in the last 12 months
• Have had condomless oral and/or anal sexual contact with at least one individual assigned male at birth in the last 12 months
• Living with HIV (HIV+) or on HIV Pre-Exposure Prophylaxis (PrEP)

How can I get DoxyPEP?

1. Make sure you’re eligible to take DoxyPEP (see “Who should consider DoxyPEP?” above)
2. Schedule a routine primary care visit at our office
3. Tell your scheduler or indicate in your online submission that you’re interested in starting DoxyPEP
4. Attend your appointment: the provider will do STI testing and basic bloodwork to confirm your eligibility
5. Once your test results come back and your eligibility is confirmed, we will provide you with a doxycycline prescription
6. Pick up your prescription at your pharmacy
7. Keep the bottle in your medicine cabinet or on your nightstand until you need it!

What else should I know before starting DoxyPEP?

• It is safe to take PrEP for 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% overall.
• 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.

What should I know for after I start DoxyPEP?

• Patients taking DoxyPEP will need to follow-up with their primary-care provider every three months for routine STI testing, standard bloodwork, and refills on the DoxyPEP prescription.
• If you are having symptoms of an STI while taking DoxyPEP or have a known exposure to an STI, please come in to get tested and treated – otherwise, continue your routine testing every three months.

How does dPEP work?

• The Theory behind how this medicine works:
  • The normal treatment of a full infection is up to a 7 day course of medicine depending on the bacterial STI diagnosed.  With dPEP, if you take the medicine within 24 hours of a sexual contact, the theory is since you were just recently exposed to an STI, the lower one time dose of the medicine can get rid of the small amount of bacteria.  If for example, you do not take the medicine after a sexual act and the bacteria you were exposed to actually infects you to become a full on "infection", you then need a longer course of therapy to treat the larger population of bacteria.
  • This is why it is important you take dPEP even after "trusted" or "safe" sexual contacts (those contacts you consider to be STI negative because you know them or they are your partner), because if they were to accidentally exposure you before they know they had an infection, the small dPEP dose might not be fully effective for your future sexual contacts.