Protecting Our Communities: What You Need to Know About DoxyPEP
When it comes to protecting your sexual health, staying informed and empowered is essential. One of the newest tools in the fight against sexually transmitted infections (STIs) is DoxyPEP—doxycycline post-exposure prophylaxis. It's gaining attention in LGBTQ+ communities, particularly among Black and Brown individuals, as a way to prevent common STIs like syphilis, chlamydia, and gonorrhea. Let's discuss what it is, how it works, and why it matters to us.
What Is DoxyPEP?
DoxyPEP involves taking a dose of the antibiotic doxycycline after sex to reduce the chances of getting certain STIs. Doxycycline has been used since the 1960s to treat various infections, including acne, pneumonia, skin infections, Lyme disease, dental infections, and STIs. Similar to how HIV PrEP (pre-exposure prophylaxis) works, DoxyPEP targets bacterial infections like chlamydia and syphilis. Recent studies have shown it can be highly effective, particularly among populations with higher rates of STIs. While DoxyPEP reduces chlamydia and syphilis infections by over 70%, it offers moderate protection against gonorrhea at approximately 50% (Bachmann LH, Barbee LA, Chan P, et al., 2024). Combining DoxyPEP with other STI prevention methods can provide a high level of protection and empower you in managing your sexual health.
Why DoxyPEP Matters to Black and Brown LGBTQ+ Communities.
Our communities often face health disparities that make accessing quality care and STI prevention options challenging. DoxyPEP offers a proactive way to manage your sexual health, especially if you’re already using other prevention methods like PrEP for HIV. With STI rates disproportionately affecting Black and Brown LGBTQ+ individuals, DoxyPEP provides an additional layer of protection. Moreover, having an STI such as chlamydia, gonorrhea, syphilis, or herpes can significantly increase the likelihood of acquiring HIV, as these infections can compromise the skin barrier, facilitating easier entry of HIV into the bloodstream.
Limitations of DoxyPEP for Cisgender Black Women
While DoxyPEP is a promising tool for many, it's important to acknowledge its limitations. Most current research has focused on same-gender-loving (SGL) men and transgender women. This means that cisgender Black women, who also experience high rates of STIs, particularly HIV, haven't been as extensively studied. More inclusive research is needed to ensure DoxyPEP's effectiveness and safety across all groups (NIH, 2024).
Considerations for DoxyPEP Use
While DoxyPEP represents an exciting advancement in STI prevention, consider the following factors:
- Effects on the gut microbiome: Doxycycline, like other antibiotics, can impact the body's natural microbiome—the collection of bacteria that aid in digestion, immune function, and overall health. Frequent antibiotic use may disrupt gut flora, potentially leading to digestive issues or an increased risk of infections caused by antibiotic-resistant bacteria. To support gut health, consider incorporating probiotics (such as yogurt, kefir, or supplements), prebiotic foods (like garlic, onions, and bananas), and a diet rich in fiber and fermented foods (Chaphalkar, 2024).
- Antibiotic Resistance: The widespread use of DoxyPEP has raised concerns about the development of antibiotic-resistant strains of STIs and other bacteria. Over time, certain infections, including gonorrhea, may become more difficult to treat if bacteria develop resistance to commonly used antibiotics. Continued research and responsible antibiotic use are essential. To uphold responsible antibiotic stewardship, consider the following:
- Use DoxyPEP Only When Necessary: Take it only when there's a concern about STI exposure, as advised by a healthcare provider.
- Stay Up-to-Date on STI Screenings: Regular STI screening helps detect infections early and ensures appropriate treatment.
- Combine with Other Prevention Strategies: Utilize condoms, regular STI screening, vaccinations, maintain awareness during sexual activity, and engage in open communication with partners to reduce overall exposure to STIs.
- Support Research and Advocacy: Advocate for continued research to develop new antibiotics and prevention strategies to maintain effective treatments. Amplifying the voices and representation of Black and Brown communities in these efforts is crucial to ensure research includes diverse populations and addresses the specific needs of those disproportionately affected by STIs (Bachmann LH, Barbee LA, Chan P, et al., 2024).
- HIV Prevention and Risk Compensation: Some studies suggest that individuals using HIV prevention strategies like PrEP or DoxyPEP may engage in behaviors that increase STI exposure, such as reduced condom use or increased sexual partners. While these prevention methods are highly effective, it's important to balance their benefits with regular STI screening and other healthy sexual practices to maintain overall sexual health.
Why Use DoxyPEP?
- Reduces chlamydia & syphilis risk by 70% or more
- Moderate protection against gonorrhea (~50-60%)
- Works best when taken within 24 hours after sex
- Easy, discreet, and effective
How to Use DoxyPEP
- Take one 200mg dose of doxycycline within 24-72 hours after condomless sex.
- Not for daily use—DoxyPEP is meant for post-exposure prevention, not ongoing STI protection.
- Combine with other STI prevention methods, such as PrEP, condoms, and regular STI screenings.
Possible Side Effects: Mild nausea, stomach upset, and sun sensitivity.
How to Get DoxyPEP
DoxyPEP isn't yet a mainstream recommendation, but you can obtain it from informed providers. If you're interested in incorporating DoxyPEP into your sexual health routine, consult your healthcare provider. Clinics specializing in LGBTQ+ care and sexual health, such as TNJ Wellness, are excellent starting points.
DoxyPEP for STI Prevention - Get DoxyPEP at TNJ Wellness
Following these simple steps will get you quick, easy, and discreet access to DoxyPEP directly from TNJ Wellness:
- Text "DoxyPEP" to (202) 774-9726 and follow the secure link.
- Confirm your phone number and enter your basic details.
- Complete the brief form to ensure this service is right for you.
- Pay the service fee securely.
- Receive your prescription discreetly along with an optional resource guide, a discount coupon, and pharmacy pickup instructions. Mail-order options may be available.
Additional Resources:
LGBTQ+ Sexual Health Resources
Questions? For more information about DoxyPEP, STI prevention, or sexual health services, contact TNJ Wellness or speak with a trusted healthcare provider.
References
Bachmann LH, Barbee LA, Chan P, et al. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR Recomm Rep 2024; 73 (No. RR-2):1–8. DOI: Retrieved from: https://www.cdc.gov/mmwr/volumes/73/rr/rr7302a1.htm
Bachmann LH, Barbee LA, Chan P, et al. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR Recomm Rep 2024;73(No. RR-2):1–8. Retrieved from: https://www.cdc.gov/sti/hcp/doxy-pep/index.html
Chaphalkar, S. (2024). Doxycycline Increases Antimicrobial Resistance in the Gut Without Disrupting Microbiome Diversity. Retrieved from: https://www.news-medical.net/news/20241007/Doxycycline-increases-antimicrobial-resistance-in-the-gut-without-disrupting-microbiome-diversity
National Institutes of Health (NIH). (2023). Biomedical STI Prevention Evidence Inadequate for Cisgender Women. Retrieved from: https://www.nih.gov/news-events/news-releases/biomedical-sti-prevention-evidence-inadequate-cisgender-women