Doxycycline prophylaxis for sexually transmitted infections prevention among men who have sex with men in China

Background: Men who have sex with men (MSM) have a high prevalence of sexually transmitted infections (STIs). The efficacy of doxycycline prophylaxis in STIs prevention has been demonstrated. This study aimed to examine the utilization of doxycycline prophylaxis among MSM in China, providing evidence to inform future policies and guidelines. Methods: Between June and July 2025, a cross-sectional survey was conducted in China, using a convenience sampling method to recruit eligible MSM. Sociodemographic characteristics, behavioral information, and doxycycline prophylaxis utilization experience were collected from the participants. Logistic regression analysis was performed to identify factors associated with doxycycline prophylaxis utilization among MSM. Results: A total of 508 MSM were recruited, with a median age of 31.5 (28.0-64.0) years. The utilization proportion of doxycycline prophylaxis was 13.4% (68/508). Multivariate logistic regression analysis indicated that age >35 years (aOR = 0.393, 95%CI: 0.172-0.898), engagement in casual sex (aOR = 2.187, 95%CI: 1.045-4.578), engagement in commercial sex (aOR = 3.986, 95%CI: 1.622-9.794) and HIV PrEP/PEP experience (aOR = 20.220, 95%CI: 9.061-45.123) were significantly associated with doxycycline prophylaxis use. Conclusions: As an effective strategy for STIs prevention, doxycycline prophylaxis use among MSM in China remains at a relatively low level. Age and sexual behaviors are associated with its use. Future efforts should focus on strengthening STIs-related education, enhancing MSM's risks awareness, and promoting the appropriate use of doxycycline prophylaxis for STIs prevention within this population.