Awareness, Attitudes, and Interest in Doxycycline Postexposure Prophylaxis as Bacterial Prophylaxis Against Sexually...

Increased incidence of bacterial sexually transmitted infections including chlamydia, gonorrhea, and syphilis dictates the need for novel prevention strategies. One such strategy, doxycycline prescribed prophylactically, has proven to be effective at reducing transmission among men who have sex with men and transgender women. We assessed awareness, attitudes, and interest in doxycycline preexposure/postexposure prophylaxis (doxyPrEP/doxyPEP) among New York City sexual health clinic patients, including men who have sex with men, other cisgender men, women, transgender persons, and patients identifying as gender nonconforming or nonbinary.

A self-administered survey was completed by 280 patients from 5 New York City sexual health clinics between June and August 2023 that collected information assessing their knowledge, concerns, and willingness to use doxyPrEP and doxyPEP. We used Poisson regression models to examine factors associated with willingness to use doxyPEP.

Of the 280 patients, 73% (205) and 55% (153) reported that they would take doxyPEP and doxyPrEP, respectively, if offered by their provider. Willingness to use doxyPEP was observed across gender groups and significantly associated with history or current use of HIV preexposure prophylaxis (adjusted risk ratio [aRR], 1.17; 95% confidence interval [CI], 1.07-1.27). Compared with non-Hispanic White participants, Hispanic (aRR, 1.27; 95% CI, 1.07-1.52) and non-Hispanic other (Alaskan Native, American Indian, Native Hawaiian, Pacific Islander, multiracial) group (aRR, 1.28; 95% CI, 1.06-1.56) participants were more likely to report willingness to use doxyPEP. Possible antibiotic resistance was of highest concern.

If offered by a provider, doxyPEP would likely be accepted by patients of all gender groups. Additional research on acceptability in other settings would help guide widespread implementation.