Interim position statement on doxycycline post-exposure prophylaxis (Doxy-PEP) for the prevention of bacterial sexually transmissible infections in Australia and Aotearoa New Zealand – the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
Vincent J. Cornelisse
A B C D * , Jason J. Ong A B E F , Nathan Ryder A B G H , Catriona Ooi A I J , Arthur Wong B K , Penny Kenchington A L , Massimo Giola M , Basil Donovan B , Judith A. Dean A N , Jean-Michel Molina O and Nicholas A. Medland A B C
+ Author Affiliations
- Author Affiliations
A The Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM), Sydney, NSW, Australia.
B The Kirby Institute, University of NSW, Sydney, NSW, Australia.
C Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
D NSW Health, Sydney, NSW, Australia.
E Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.
F Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
G Centre for Population Health, NSW Health, Sydney, NSW, Australia.
H HNE Sexual Health, Hunter New England Health District, New Lambton, NSW, Australia.
I Northern Sydney Local Health District Sexual Health Service, NSW, Australia.
J Faculty of Health and Medicine, Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
K Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW 2001, Australia.
L Townsville Hospital and Health Service, Queensland Health, 100 Angus Smith Drive, Douglas, Qld 4814, Australia.
M Sexual Health Services, Te Whatu Ora Bay of Plenty and Lakes, Tauranga and Rotorua, New Zealand (Aotearoa).
N Faculty of Medicine, School of Public Health, The University of Queensland, 288 Herston Road, Herston, Qld 4006, Australia.
O Department of Infectious Diseases, University of Paris Cité, St-Louis and Lariboisière Hospitals, APHP, Paris, France.
Sexual Health 20(2) 99-104 https://doi.org/10.1071/SH23011
Submitted: 12 January 2023 Accepted: 2 March 2023 Published: 17 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Recent studies have provided evidence for the effectiveness of using doxycycline (Doxy-PEP) to prevent bacterial sexually transmissible infections (STI), namely chlamydia, gonorrhoea, and syphilis, among gay, bisexual, and other men who have sex with men who have experienced multiple STIs. However, there remain several unanswered questions around potential adverse outcomes from Doxy-PEP, including the possibility of inducing antimicrobial resistance in STIs and other organisms, and the possibility of disrupting the microbiome of people who choose to use Doxy-PEP. This interim position statement from the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine aims to outline the current evidence for Doxy-PEP, and to highlight potential adverse outcomes, to enable clinicians to conduct evidence-based conversations with patients in Australia and Aotearoa New Zealand who intend to use Doxy-PEP.
Keywords: Australia, chlamydia, doxycycline, gonorrhea, men who have sex with men, New Zealand, prevention, STIs, syphilis.
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