Doxy-PEP is a new sexual health tool available for gay and bisexual men and transgender women by prescription from the doctor. The antibiotic doxycycline can be taken within 72 hours after condomless sex, including oral and anal to prevent an STI. It’s like a morning-after pill but for bacterial STIs. Photo: David M. Mosqueda
This article is part of an on-going health series to offer useful news and tools that will help empower LGBTQ+ readers to make informed choices about their health.
Doxy-PEP is a new sexual health tool available for gay and bisexual men and transgender women by prescription from the doctor.
The antibiotic doxycycline can be taken within 72 hours after condomless sex, including oral and anal to prevent an STI. It’s like a morning-after pill but for bacterial STIs.
Doxy-PEP significantly reduces your chance of acquiring syphilis, gonorrhea, and chlamydia.
Here’s what we know about doxy-pep.
What is doxy-pep?
Doxycycline is an antibiotic used to treat bacterial STIs: Chlamydia, gonorrhea, and syphilis. It is not used to treat HIV and hepatitis. They are viral STIs. Pep just means “post exposure prophylaxis.”
When taking doxy-pep, the chances of contracting chlamydia was reduced between 74 and 88%, and syphilis was reduced between 77 and 87%. The chances of contracting gonorrhea dropped by 56%, the California Department of Public Health said.
Some strains of gonorrhea in the U.S. are resistant to doxycycline, but it is approximately 26%. This is why regular testing, regardless of prevention method, is important, as nothing is 100% effective at prevention.
Doxycycline is not FDA approved for STI PEP and there is no national organizational guidance for its use as STI prevention. However, Centers for Disease Control and Prevention has released considerations for doxy-PEP as an STI preventative strategy and San Francisco Department of Public Health has released their own guidance.
When should I take it?
Two 100 mg pills of doxycycline should be taken ideally within 24 hours, but no later than 72 hours, after condomless sex. That means oral and anal when a condom isn’t used the whole time you play.
If you have sex again within 24 hours of taking doxycycline, take another dose 24 hours after your last dose. You can take doxycycline as often as every day when you are having condomless sex, but don’t take more than 200 mg (two 100 mg pills) every 24 hours.
For example, a person might go to an orgy Friday night and have multiple partners and different interactions (anal and oral) with or without a condom. They may wake up Saturday and take their doxycycline. Then they go out Saturday night, and sure enough, find themselves with a bar cutie. They can take doxycycline again on Sunday because it’s 24 hours since their previous dose.
Side effects
Since this antibiotic has been around for a long time, it’s very well tolerated. Take doxycycline with plenty of water or something else to drink so it does not get stuck when you swallow. Common side effects are nausea and vomiting, especially on an empty stomach. If your stomach is upset by doxycycline, taking it with food may help.
Sensitivity to sunlight is possible. Be sure to use your sunscreen.
Avoid dairy, calcium, antacids, or multivitamins a few hours before and two hours after doses.
Refrain from lying down for 30 minutes after as well. The medication could cause some reflux.
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