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What is DoxyPEP?

Doxycycline Post-Exposure Prophylaxis, also known as, “DoxyPEP,” means taking doxycycline after sex to lower your chance of getting syphilis, chlamydia, and gonorrhea.

Doxycycline is an antibiotic medication commonly used to treat infections that are caused by bacteria.

DoxyPEP does not protect against infections that are caused by viruses, such as HIV, Mpox, or HPV.

Who can take DoxyPEP?

DoxyPEP has been effective in reducing syphilis, chlamydia, and gonorrhea when used by sexually active gay and bisexual men, other men who have sex with men (MSM), and transgender women who have sex with men who have had one or more of these infections in the past year.

If you take HIV pre-exposure prophylaxis (HIV PrEP) talk to your medical provider about whether you should also consider DoxyPEP.

There is not very much information on DoxyPEP for other populations, like cisgender women, cisgender heterosexual men, and transgender men; but if you think you are at higher risk of an STI, talk with your healthcare provider about your situation and whether you might benefit from DoxyPEP.

People who are already pregnant should not take DoxyPEP.

Why should I consider DoxyPEP?

DoxyPEP can reduce the chance of getting syphilis and chlamydia by more than 70% and gonorrhea by about 50%.

When should I take DoxyPEP?

For DoxyPEP, you will need to take 200mg of doxycycline ideally within 24 hours but no later than 72 hours after condomless sex.

If you have sex again within 24 hours of taking doxycycline, take another dose 24 hours after your last dose. DoxyPEP can be taken as often as every day when you are having condomless sex, but do not take more than 200mg of doxycycline in a 24-hour period.

Where can I get DoxyPEP?

You need a prescription for DoxyPEP. If you think you need DoxyPEP, talk to your healthcare provider. If you do not have a healthcare provider, contact one of the following clinics:

Hawai‘i Health & Harm Reduction Center (O‘ahu)
677 Ala Moana Blvd, Suite 226
Honolulu, Hawaii 96813
(808) 521-2437

Kumukahi Health + Wellness (East Hawaii Island)
Hilo Lagoon Center
101 Aupuni St, PH 1014C
Hilo, HI 96720
(808) 982-8800

Kumukahi Health + Wellness (West Hawai‘i Island)
Palani Court
74-5620 Palani Rd., Suite 101
Kailua-Kona, Hawai‘i 96740
(808) 331-8177

Malama Pono Health Services (Kaua‘i)
4370 Kukui Grove Street, Suite 115
Lihue, HI 96766
(808) 246-9577

Maui AIDS Foundation (Maui)
1935 Main Street, Suite 101
Wailuku, HI 96793
(808) 242-4900

What are the side effects of DoxyPEP?

Most people taking doxycycline have no or mild side effects. Some people experience sun sensitivity, an irritated throat, upset stomach, or diarrhea. You may be able to reduce side effects by wearing sunscreen if you notice sun sensitivity and taking doxycycline with food if it upsets your stomach.

What are we still learning?

• Ongoing use of doxycycline for DoxyPEP may cause changes in the normal mixture of organisms that live in your gut, on your skin, or other places in your body (your “microbiome”).
• When an antibiotic medication is used for an infection, the bacteria can change over time, which may cause the medication to be less effective. This is called antibiotic resistance.

We do not know if DoxyPEP can cause changes to your microbiome or lead to antibiotic resistance because studies are limited. Long term effects of taking DoxyPEP are still unknown. Talk to your healthcare provider to discuss the benefits and risks of DoxyPEP.

If you are a healthcare provider, review CDC’s Clinical Guidelines on the Use of Doxycycline.