High Willingness to Use and Recommend Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted...

Area of Science:

• Public Health
• Infectious Diseases
• Sexual Health

Background:

• Bacterial sexually transmitted infections (STIs) are a significant concern for men who have sex with men (MSM) and transgender women (TGW) in Peru.
• Doxycycline postexposure prophylaxis (doxy-PEP) presents a potential prevention strategy, yet data from Latin America are scarce.

Purpose of the Study:

• To assess the willingness of MSM and TGW to use doxy-PEP in Lima, Peru.
• To evaluate healthcare providers' (HCPs) willingness to recommend doxy-PEP.
• To identify factors associated with willingness to use doxy-PEP.

Main Methods:

• Two online surveys were conducted in Lima, Peru, in September-October 2024.
• One survey targeted MSM and TGW regarding doxy-PEP use.
• The second survey focused on HCPs' willingness to recommend doxy-PEP, with logistic regression used to analyze correlates of willingness.

Main Results:

• 82.1% of MSM and TGW expressed willingness to use doxy-PEP, with 34.2% showing high willingness. Factors associated with high willingness included higher numbers of sexual partners, prior HIV pre-exposure prophylaxis (HIV-PrEP) use, and living with HIV.
• Participants preferred doxy-PEP over daily doxycycline (64.0% vs 28.6%).
• Among HCPs involved in HIV/STI care, 87.1% were willing to recommend doxy-PEP, especially if included in national guidelines. Concerns included diagnostic capacity and unofficial use.

Conclusions:

• Significant willingness to use and recommend doxy-PEP was observed among both clients and HCPs in Peru.
• These findings support the integration of doxy-PEP into sexual health services in Latin America.
• Further research should address HCPs' concerns regarding diagnostic capacity and unofficial use.