How to prevent STIs after unprotected sex
By Kathleen Morrison
July 23, 2023
Medically reviewed by Andrea Sleeth, WHNP-BC
🎉 We are so excited to announce that Wisp is offering DoxyPEP, the morning after pill for STDs! 🎉
Have you ever had a spur-of-the-moment sexual encounter that didn’t quite go as planned? Maybe you didn’t have a condom on hand, or the condom broke or slipped before you were finished with your partner. Emergency contraception is available if you’re concerned about pregnancy, but it doesn’t protect against STDs or STIs—how can you protect your sexual health? DoxyPEP may be your answer! This antibiotic regimen helps reduce your risk of contracting certain STIs, and helps protect your sexual health when accidents happen!
What is DoxyPEP?
DoxyPEP is a one-time, 200mg dose of doxycycline, which acts as a preventive measure against STIs when taken as soon as possible, but no later than three days after having unprotected sex. Studies have shown that DoxyPEP can reduce the risk of contracting gonorrhea, chlamydia, and syphilis, by two-thirds.
How does DoxyPEP work?
DoxyPEP stands for Doxycycline Post-Exposure Prophylaxis. Let’s break that down: Doxycycline is a type of antibiotic that is used to treat multiple types of bacterial infections (including STDs and STIs). “Post-exposure” refers to the period of time after the possibility of exposure to an STD (such as after a sexual encounter where condoms weren’t used). “Prophylaxis” is an action taken to prevent disease. If you’ve engaged in sexual activity and are concerned about your STI risk, you can take DoxyPEP the following day to prevent certain STI bacteria from taking hold in your system.
Is DoxyPEP safe?
Yes! The DoxyPEP regimen consists of doxycycline, a commonly prescribed antibiotic that’s used to treat a variety of conditions, including acne. Researchers have conducted studies on the use of taking doxycycline 200 mg within 72 hours of oral, anal, or vaginal sex in specific populations, such as men who have sex with men and transgender women living with HIV or taking HIV prophylaxis. The data from these studies revealed a reduction rate of 62-66% in STI acquisition per quarter of follow-up.
Currently, the FDA and CDC have not yet officially approved the DoxyPEP regimen for its use in reducing the risk of STDs, as they are evaluating the available data and considering its implications. However, the Department of Public Health in California has recommended the use of this regimen for high-risk individuals, and many Infectious Disease Clinics have begun to prescribe this off-label treatment as research continues.
Considering the potential impact of this treatment and the low risk associated with a single dose of doxycycline, Wisp doctors have made the decision to offer this treatment to all our patients. We believe it’s important for our patients, especially those without access to regular healthcare, to have access to this preventative treatment.
Will taking DoxyPEP increase antibiotic resistance?
Resistance is always a potential risk with antibiotics, however it's important to weigh the risks against the benefits as you would with any potential treatment. There is evidence to show that DoxyPEP works to prevent STIs that we are already seeing antibiotic resistance in (like gonorrhea). Drug resistance with DoxyPEP is currently being studied in individuals that use this treatment for STI prevention, but given the increase in STI incidence in the US over the past few years, this treatment is highly valuable in preventing their spread.
Does DoxyPEP have side effects?
Doxycycline is considered a very safe and common antibiotic with mild side effects. If your stomach is upset by antibiotics, taking it with food may help. Doxycycline can cause esophagitis, so be sure to drink plenty of water when taking it and avoid lying down for 30 minutes afterwards. Some people are more sensitive to the sun when they take doxycycline, so apply sunscreen (which you should be doing anyway!).
Be mindful not to take DoxyPEP with dairy, calcium, antacids, or isotretinoin, and speak with your provider if you are currently taking anticoagulants like Warfarin, penicillins, barbiturates, and antiepileptic medications like carbamazepine and phenytoin.
Can DoxyPEP be taken with emergency contraception?
Yes! If you are concerned about your risk of pregnancy following a sexual encounter, you can add on emergency contraception to your Wisp DoxyPEP order to be picked up at your local pharmacy at the same time. Accidents happen and we want to make sure you’re taken care of, no matter what! Remember: using condoms correctly and consistently is still the best way to protect against both pregnancy and STDs.
Where can I find DoxyPEP?
You can order DoxyPEP through Wisp and pick it up at your local pharmacy! A single dose is available for $22 and you can add on the emergency contraceptive Ella during the checkout process. You’ll also have the option to add on a lab slip for STD testing at a local lab so you can ensure you are negative for STDs following your treatment. Please wait 90 days after your dose of DoxyPEP to complete your STD testing to be sure of your results.
Disclaimer: DoxyPEP doesn’t protect against Mpox, HIV, herpes, or other viral infections. At this time, there is insufficient evidence to recommend DoxyPEP for STD prevention for individuals who report receptive vaginal sex. The CDC has released off-label treatment considerations for DoxyPEP as an STD prevention strategy, and is continuing to evaluate available data in order to make a clinical recommendation in the future. Current efficacy data on DoxyPEP applies to gay and bisexual cisgender men and transgender women. Research on DoxyPEP conducted with cisgender women is ongoing, per the CDC. Please continue to get tested for STIs every 3 months and whenever you have symptoms.
