Online Reddit discussions about DoxyPEP reflect active negotiation of evolving biomedical evidence and personal risk, extend beyond MSM communities, and highlight access to LGBTIQA+-friendly clinicians and telehealth as facilitators while provider knowledge gaps act as barriers.
A large corpus of Reddit posts about DoxyPEP was identified and analyzed using unsupervised topic modeling (BERTopic).
Reddit discussions about DoxyPEP encompassed multiple dominant themes including prevention strategies, sexual practices, antimicrobial resistance, and healthcare access.
DoxyPEP discussions on Reddit extended beyond men who have sex with men (MSM) to include heterosexual, polyamorous, and swinger communities.
Access to LGBTIQA+-friendly clinicians and telehealth services were identified as facilitators of DoxyPEP uptake, while provider knowledge gaps acted as barriers.
Online discussions reflected nuanced engagement with antimicrobial resistance concerns rather than simple misinformation.
The authors concluded that clearer clinical guidance and community-level information-sharing could support informed and equitable DoxyPEP implementation.
This research suggests that online communities on Reddit are actively discussing doxycycline post-exposure prophylaxis (DoxyPEP) — a strategy where people take an antibiotic after potential exposure to sexually transmitted infections (STIs) like syphilis and chlamydia — in complex and nuanced ways. The researchers used an artificial intelligence-based text analysis tool to analyze over 8,000 Reddit posts made between 2020 and 2025, finding that the conversations covered topics like prevention strategies, sexual practices, concerns about antibiotic resistance, and difficulties accessing healthcare. Importantly, discussions were not limited to gay and bisexual men, who were the primary focus of major clinical trials; heterosexual people, polyamorous individuals, and swingers were also actively discussing DoxyPEP as a tool for managing their sexual health risks. The study also found that people's access to DoxyPEP was shaped by real-world factors: having access to LGBTIQA+-friendly doctors or telehealth services made it easier to get DoxyPEP, while doctors who were unfamiliar with the approach acted as barriers. Rather than finding widespread misinformation, the researchers found that community members were thoughtfully weighing evolving medical evidence and their own personal circumstances — suggesting these communities are engaged and health-literate, even if formal guidance has not always kept pace. This research suggests that public health authorities and healthcare providers could better support DoxyPEP uptake by providing clearer and more consistent clinical guidelines, training more providers on this prevention strategy, and partnering with community organizations to share accurate information. It also highlights that DoxyPEP's real-world audience is broader and more diverse than clinical trial populations, which has implications for how health campaigns and access programs are designed.
Zi-Han Xu, Fa-Bian Y. S. Kong, J. Hocking, C. de Kock, Mike Conway. (2026). What are people saying about DoxyPEP? A topic-based analysis of Reddit discussions.. Sexual Health. https://doi.org/10.1071/SH26178