RECOMMENDATIONS

Biomedical Prevention of STIs

  • Clinicians should offer doxy-PEP to cisgender men and transgender women who engage in condomless sex with partner(s) assigned male sex at birth and who:
    • Have had a bacterial STI diagnosed within the past year (A1), or
    • Have no or unknown history of STIs and ongoing risk of STI exposure (A2)
  • Clinicians should engage in shared decision-making with cisgender men who are at ongoing risk of STI exposure and engage in condomless sex with multiple partners assigned female sex at birth, offering doxy-PEP on a case-by-case basis. (B3)
  • When prescribing doxy-PEP, clinicians should use the dosing regimen of oral doxycycline 200 mg taken ideally within 24 hours (up to 72 hours) after condomless sex (A1) and counsel patients (A*) on the key points for patient education outlined in Table 1: Considerations for Doxy-PEP Implementation.
  • For individuals taking doxy-PEP, clinicians should screen for HIV, chlamydia, gonorrhea, and syphilis at least every 3 months. (A1)
  • Clinicians should offer HIV PrEP to individuals who do not have HIV and are initiating or using doxy-PEP. (A*)
  • Clinicians should offer HIV treatment to individuals with HIV who are not on antiretroviral therapy and are initiating or using doxy-PEP. (A1)

Abbreviations: doxy-PEP, doxycycline post-exposure prophylaxis; PrEP, pre-exposure prophylaxis; STI, sexually transmitted infection.

From: Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections

Cover of Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections
Doxycycline Post-Exposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections [Internet].
DiMarco DE, Urban MA, Vail RM, et al.
Baltimore (MD): Johns Hopkins University; 2024 Oct.
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