Awareness, Attitudes, and Interest in Doxycycline Postexposure Prophylaxis as Bacterial Prophylaxis Against Sexually Transmitted Infections-New York City Sexual Health Clinics, June to August 2023.
If offered by a provider, doxyPEP would likely be accepted by patients of all gender groups, with 73% of surveyed NYC sexual health clinic patients reporting willingness to use it.
Key Findings
Results
The majority of surveyed patients reported willingness to use doxycycline postexposure prophylaxis (doxyPEP) if offered by their provider.
73% (205 of 280 patients) reported they would take doxyPEP if offered by their provider
55% (153 of 280 patients) reported they would take doxyPrEP if offered by their provider
Survey was self-administered and completed by 280 patients from 5 New York City sexual health clinics between June and August 2023
Willingness to use doxyPEP was observed across all gender groups surveyed, including men who have sex with men, other cisgender men, women, transgender persons, and gender nonconforming or nonbinary patients
Results
History or current use of HIV preexposure prophylaxis (PrEP) was significantly associated with greater willingness to use doxyPEP.
Adjusted risk ratio (aRR) for willingness to use doxyPEP among HIV PrEP users was 1.17 (95% CI, 1.07–1.27)
Poisson regression models were used to examine factors associated with willingness to use doxyPEP
This association remained significant after adjustment for other factors in the model
Results
Hispanic participants and participants identifying as non-Hispanic other race/ethnicity were significantly more likely to report willingness to use doxyPEP compared with non-Hispanic White participants.
Hispanic participants had an aRR of 1.27 (95% CI, 1.07–1.52) compared with non-Hispanic White participants
Non-Hispanic other group (Alaskan Native, American Indian, Native Hawaiian, Pacific Islander, multiracial) had an aRR of 1.28 (95% CI, 1.06–1.56) compared with non-Hispanic White participants
These findings were derived from Poisson regression models adjusting for multiple factors
Results
Possible antibiotic resistance was the highest concern among patients surveyed about doxyPEP.
Antibiotic resistance was identified as the top concern across the surveyed population
The survey collected information on knowledge, concerns, and willingness to use both doxyPrEP and doxyPEP
Other concerns were also assessed but antibiotic resistance ranked highest
Methods
The study included a diverse patient population across multiple gender groups at New York City sexual health clinics.
A total of 280 patients participated across 5 New York City sexual health clinics
Data were collected between June and August 2023
Patient groups included men who have sex with men, other cisgender men, women, transgender persons, and patients identifying as gender nonconforming or nonbinary
Racial/ethnic groups represented included non-Hispanic White, Hispanic, non-Hispanic other, and others based on regression model comparisons
Conclusions
The authors concluded that additional research on acceptability in other settings would help guide widespread implementation of doxyPEP.
The study was conducted only in sexual health clinic settings, which may limit generalizability
The authors note that doxyPEP has been proven effective at reducing transmission among men who have sex with men and transgender women
The findings support broad acceptability but the authors call for research in other settings to inform implementation
What This Means
This research suggests that most patients visiting New York City sexual health clinics are open to using doxycycline as a preventive treatment against bacterial sexually transmitted infections (STIs) like chlamydia, gonorrhea, and syphilis. When taken after a potential exposure to an STI, this strategy is called doxyPEP (doxycycline post-exposure prophylaxis). In this study, nearly three-quarters of the 280 patients surveyed said they would take doxyPEP if their doctor offered it, and more than half said they would take a pre-exposure version (doxyPrEP). Importantly, this willingness was seen across all gender groups, not just among men who have sex with men, who have been the primary focus of earlier doxyPEP research.
The study also found that people who were already using HIV PrEP (pre-exposure prophylaxis to prevent HIV) were more likely to say they would use doxyPEP, suggesting that familiarity with preventive medications may increase openness to new ones. Hispanic patients and patients from certain other racial/ethnic minority groups were more likely to express willingness to use doxyPEP compared to non-Hispanic White patients. The most common concern patients had about doxyPEP was the potential for antibiotic resistance — a legitimate public health consideration that ongoing research continues to monitor.
This research suggests that doxyPEP could be a broadly acceptable prevention tool for STIs among diverse patient populations if offered in clinical settings. However, since this study was conducted only in specialized sexual health clinics in New York City, the authors note that more research is needed in other healthcare settings to understand how well these findings would translate to broader implementation.
Leocadio C, Betancourt G, Tang J, Heth Z, Pathela P. (2025). Awareness, Attitudes, and Interest in Doxycycline Postexposure Prophylaxis as Bacterial Prophylaxis Against Sexually Transmitted Infections-New York City Sexual Health Clinics, June to August 2023.. Sexually transmitted diseases. https://doi.org/10.1097/OLQ.0000000000002138