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Everything You Need to
Know About DoxyPEP for
STD Prevention

By Simona Byler
April 19, 2024

We don’t love love everything about the times we live in. But modern advancements in STD and STI treatment? That’s something we can’t imagine living without. Gone are the days of silently suffering through itching, burning, and overall discomfort—something we are all grateful for!

But, besides treating infections once they happen, did you know there’s also a pill that can help prevent certain STDs and STIs? Meet DoxyPEP, a prescription antibiotic that can reduce your risk of chlamydia, gonorrhea, and syphilis if taken 24 to 72 hours after an unprotected sexual encounter (think of it as the morning-after pill but for STIs!). Here’s what you need to know.

What is DoxyPEP?

DoxyPEP is short for doxycycline post-exposure prophylaxis. That medical jargon might sound intimidating, so let’s dive into the details! Doxycycline is a long-standing antibiotic used to treat bacterial infections in different parts of the body—think: chest, dental, and skin infections, and now STIs, too. This antibiotic treats infections by killing bacteria or stopping them from growing, spreading, and messing up your day.

The “post-exposure” part of doxycycline PEP is a little more self-explanatory! It refers to when you’re taking the medication, in this case after potential exposure to an STD. We can do our best to come prepared with an overnight bag—filled with condoms, lube, cleanup wipes, and the works – but unprotected sex still happens, and that’s okay! DoxyPEP has your back if you think you’ve been exposed to an STD.

The last technical bit here, “prophylaxis” refers to taking action to prevent a disease. Fun fact: prophylaxis comes from the Greek word phalax, meaning “guard.” So we like to imagine DoxyPEP in action as a cute little pill wearing a helmet and a shield, working hard to keep you safe.

Put it all back together, and doxycycline post-exposure prophylaxis is your prescription antibiotic best friend for guarding against pesky bacterial STIs. Not so intimidating at all!

What is DoxyPEP used for?

Alright, now that our vocabulary lesson is finished, we can focus on the good stuff—like what does DoxyPEP do, anyway? We’re oh-so-glad you asked!

DoxyPEP is used to prevent bacterial STDs and STIs after having unprotected sex.

(And by unprotected sex, we mean oral, anal, and vaginal or front-hole sex where condoms or dental dams weren’t used during the entire event, so skin-to-skin contact was made and fluids were exchanged.)

So, we’ve covered that DoxyPEP is an antibiotic for STDs. That means it can reduce your risk of chlamydia, gonorrhea, and syphilis since bacteria cause those infections.

What doxycycline PEP doesn’t do is reduce the risk of viral infections—think herpes, HIV, or hepatitis B. But don’t panic if you’re feeling viral symptoms! Schedule a quick and easy STD consult with one of our licensed medical providers. (No embarrassment, no hassle—just treatment.)

Who should take DoxyPEP?

It’s easy to get excited after hearing about the potential benefits of DoxyPEP, especially if you think you might have recently been exposed to an STI. But before you run (or click!) to the pharmacy, it’s important to know who doxycycline PEP is for, according to the research.

Three clinical trials conducted within the last 10 years have shown DoxyPEP to be an effective STD prevention pill. But, these studies focused on doxycycline PEP’s efficacy within cisgender men and transgender women populations. A fourth clinical trial focused on the medication’s effectiveness for cisgender women, but the data came back without conclusive results. With all that in mind, here’s who can benefit most from DoxyPEP.

DoxyPEP can be most useful for: Transgender women Gay and bisexual cisgender men Other men who have sex with men People who can’t or don’t use condoms regularly People who have had a bacterial STI in the last 12 months

Here at Wisp, we’re committed to increasing access to sexual health services for every person and every body. And, doxycycline has long been prescribed as a low-risk antibiotic for various infections. For these reasons combined, our providers have made the decision to offer DoxyPEP to all our patients, including cisgender women.

And while we wait for more conclusive data, we’ll continue advocating for increased research around women’s health and we’ll keep you updated if our protocol changes. 😘

How effective is DoxyPEP?

What do you think, does an STD prevention pill sound too good to be true? We don’t think so! But, just to be safe, we’re reading and rereading every clinical trial out there (and still encouraging regular STI testing, of course 😉). And since we did all that technical reading, we’re here to give you the quick and exciting details about the effectiveness of doxycycline post-exposure prophylaxis.

Remember those three clinical trials we mentioned? The evidence from those (gold-standard!) studies showed that taking DoxyPEP within 24 to 72 hours after unprotected sex significantly reduced the risk of syphilis, chlamydia, and gonorrhea—we’re talking a 65 - 70% reduction!

As we mentioned, the participants and focus of those studies were gay and bisexual cisgender men and transgender women. This population bears the brunt of STI diagnoses in the US according to the CDC. And with nearly 2 million new cases of bacterial STIs in the US in 2021 alone, we’re happy to have DoxyPEP on our side!

The data shows that DoxyPEP can dramatically reduce rates of syphilis, gonorrhea, and chlamydia (amazing!), specifically in more at-risk populations (incredible!). This antibiotic is a powerful new advancement in sexual healthcare, but it’s still only one tool in our giant toolbox of STD prevention and treatment strategies. Regular STI testing, condoms and dental dams, and abstinence are tried and true methods of keeping you safe and sexy.

How often can you take DoxyPEP?

First things first, remember that the sooner you take DoxyPEP after unprotected sex, the better! Like the morning-after pill for pregnancy, the effectiveness of doxycycline as an antibiotic for STDs depends on timing. Let’s take a closer look at some important info about doxycycline post-exposure prophylaxis!

Things to keep in mind when taking DoxyPEP:

  • The prescribed DoxyPEP dose is two 100 mg tablets within 72 hours (three days) of condomless sex
  • DoxyPEP is most effective if taken within 24 hours
  • While it’s safe to take daily, don’t take more than 200 mg every 24 hours
  • Taking DoxyPEP with a glass of water and food will help you avoid potential side effects like upset stomach and headache
  • Don’t take DoxyPEP right before bed and wait at least 30 minutes before lying down to avoid esophagitis
  • Don’t take DoxyPEP with dairy, calcium, antacids, or isotretinoin
  • DoxyPEP can make you more sensitive to the sun, so make sure you wear sunscreen

One more thing! There’s a current public health concern about antibiotic and antimicrobial resistance. This resistance happens when infection-causing bacteria change their genes so the usual antibiotics no longer kill them. So far, the bacteria that cause syphilis and chlamydia have not shown any adaptations or resistance to doxycycline—meaning DoxyPEP remains a great strategy in STI prevention! However, about 25% of bacteria that cause gonorrhea in the US were already resistant to doxycycline, even before DoxyPEP was used as an STD prevention pill. This has the potential to limit DoxyPEP’s effectiveness against gonorrhea, but doxycycline is still considered a useful option in overall bacterial STI prevention.

Is DoxyPEP FDA approved?

The FDA and CDC have not officially approved DoxyPEP as an STD prevention pill, as they’re evaluating the available data and considering its implications. But, the Department of Public Health in California has recommended a doxycycline post-exposure prophylaxis treatment for high-risk individuals (like folks who have had a bacterial STI in the last year). Weighing the potential benefits of DoxyPEP against the low risk associated with a single dose of doxycycline, Wisp believes it’s important for all our patients to have access to this new preventative care.

How do I get DoxyPEP?

By clicking right here! Because time is of the essence with DoxyPEP, we make it quick and easy to get your hands on this prescription. Order online and your prescription will be available at your local pharmacy within 24 hours (but it’s usually faster!). Two 100 mg doxycycline tablets cost $22. DoxyPEP is an antibiotic for STD prevention with no waiting room or doctor’s visit required.

At Wisp, we’re glad to be offering new, innovative sexual healthcare so you can go on living your happiest, healthiest lives. We’ll keep you posted if the science around doxycycline changes or if there are any updates to the DoxyPEP regimen. Until then, we’re committed to providing your healthcare, on your time.

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