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September 10, 2025Open Access

DoxyPEP: Opportunities for Expansion

EWEn‐Ling WuUniversity of Chicago JPJade Pagkas-BatherUniversity of Illinois Chicago AHAniruddha HazraHoward Brown Health Center

Key Points

DoxyPEP significantly reduces the risk of STIs like syphilis and chlamydia, especially in targeted populations.
Real-world evidence indicates that DoxyPEP may be effective for diverse groups at higher risk of STIs.
Review of clinical guidelines suggests broadening discussions of DoxyPEP to all eligible patients for preventive care.
Future research should focus on understanding DoxyPEP's impact across various populations and its implementation strategies.

Abstract

Clinical trials show that doxycycline post-exposure prophylaxis (DoxyPEP) significantly reduces the risk of bacterial sexually transmitted infections (STIs), especially syphilis and chlamydia, in cisgender men who have sex with men and transgender women. Real-world data suggest DoxyPEP may be beneficial for other populations disproportionately affected by STIs. Given the ongoing STI epidemic we recommend discussing DoxyPEP with all eligible patients. We review clinical guidelines and practical considerations surrounding DoxyPEP, highlight areas for future research, and propose strategies for implementation.

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