[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-400468-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-400468-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","doxycycline-post-exposure-prophylaxis-doxy-pep-for-the-prevention-of-bacterial-sexually-transmitted-infections-stis","Doxycycline Post-Exposure Prophylaxis (doxy PEP) for the Prevention of Bacterial Sexually Transmitted Infections (STIs)","","April 28, 2023 guidance from the California Department of Public Health informs health care providers about using doxycycline post-exposure prophylaxis (doxy PEP) to prevent bacterial STIs. Evidence from a randomized trial in men who have sex with men and transgender women shows substantial reductions in chlamydia, gonorrhea, and syphilis after condomless oral, anal, or vaginal sex, alongside an emphasis on counseling, screening, and appropriate prescribing. Safety data report no grade 2+ adverse events in the doxy PEP RCT, while unknowns include antimicrobial resistance and microbiome effects.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/doxycycline-post-exposure-prophylaxis-doxy-pep-for-the-prevention-of-bacterial-sexually-transmitted-infections-stis/400468/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/doxycycline-post-exposure-prophylaxis-doxy-pep-for-the-prevention-of-bacterial-sexually-transmitted-infections-stis/400468.png","ImageObject",300,407,{"name":42,"@type":43},"Stanford","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-27",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Which patients does CDPH recommend for doxy PEP?","Question",{"text":63,"@type":64},"CDPH recommends doxy PEP for men who have sex with men (MSM) or transgender women (TGW) who had at least one bacterial STI in the past 12 months. It also supports offering doxy PEP to non-pregnant individuals at increased risk and to those requesting it using shared decision-making.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How should doxy PEP be taken after condomless sex?",{"text":68,"@type":64},"Prescribe 200 mg of doxycycline taken within 72 hours after condomless oral, anal, or vaginal sex (ideally within 24 hours). It may be taken daily depending on sexual activity, but not more than 200 mg every 24 hours.",{"name":70,"@type":61,"acceptedAnswer":71},"What screening and follow-up does the guidance require?",{"text":72,"@type":64},"Screen for GC and CT at all exposure anatomic sites and test for syphilis and HIV (if not already known as living with HIV) at initiation of doxy PEP and every three months. If an STI is diagnosed, treat according to standard CDPH and CDC STI treatment guidelines.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},400468,1790673519,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":124,"preview_page_count":4},2336477552062,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","April 28, 2023  \nDoxycycline Post-Exposure Prophylaxis (doxy PEP) for the Prevention of Bacterial Sexually Transmitted Infections (STIs)  \nDear Colleague,  \nThe California Department of Public Health (CDPH) would like to inform all health care providers of a compelling new biomedical intervention to prevent bacterial  \nSTIs. Evidence from a study among men who have sex with men (MSM) and transgender women (TGW) suggests doxycycline, when taken as doxy PEP after condomless oral, anal, or vaginal sex, significantly reduces acquisition of chlamydia (CT), gonorrhea (GC), and syphilis.1 Given the high rates of these STIs in California2 , CDPH recommends the following:  \n1. Recommend doxy PEP to men who have sex with men (MSM) or transgender women (TGW) who have had ≥1 bacterial STI in the past 12 months.  \n2. Offer doxy PEP using shared decision-making to all non-pregnant individuals (e.g. , cisgender women/men, transgender women/men, and non-binary persons) at increased risk for bacterial STIs and to those requesting doxy PEP, even if these individuals have not been previously diagnosed with an STI or have not disclosed their risk status. i  \n3. Provide comprehensive preventative sexual health counseling and education to all sexually-active individuals to include HIV/STI screening, doxy PEP, HIV pre-exposure prophylaxis ( PrEP )/HIV post-exposure prophylaxis ( PEP ), vaccinations (e.g. , Hepatitis A/B, Human Papilloma Virus, Mpox, Meningococcal/MenACWY ), expedited partner therapy, and/or contraception where warranted.  \ni Doxy PEP can be offered to all non-pregnant individuals at increased risk of STIs, including cisgender women and men, transgender women and men, and non-binary persons, but data is limited. In a randomized trial of 449 cisgender Kenyan women, doxy PEP was not shown to be protective against STIs, but hair analyses suggest that nonadherence may have been the reason for lack of efficacy.3 Pharmacologic studies suggest that doxycycline levels in vaginal fluid should be sufficient to provide such protection.4 Doxy PEP has not been studied in transgender men or non-binary persons.  \nEvidence:  \nA randomized controlled trial (RCT) using a single, oral dose of doxycycline 200mg within 72 hours after condomless oral, anal, or vaginal sex in MSM and TGW, who were either persons living with HIV (PLWH) or taking HIV PrEP, showed significant reductions in CT, GC, and syphilis per quarter of study follow up. In persons on HIV PrEP, taking doxy PEP reduced syphilis by 87 percent, CT by 88 percent, and GC by 55 percent while in PLWH doxy PEP reduced syphilis by 77 percent, CT by 74 percent, and GC by 57 percent.1  \nSafety:  \nTaking doxycycline is safe and well tolerated, with no reported doxycycline associated Grade 2 or higher adverse events (AEs) and no documented laboratory-related severe AEs in the DoxyPEP RCT. Long-term use of doxycycline has been prescribed safely for other medical indications (e.g. , acne treatment or malaria prophylaxis) .  \nUnknowns:  \nData continue to be collected and reviewed for possible antimicrobial resistance among bacterial STIs, commensal Neisseria (as a potential reservoir for tetracycline resistant plasmids), and Staphylococcus aureus. The effects of doxy PEP on the gut microbiome are also being studied.  \nPrescribing doxy PEP:  \nDoxycycline is not FDA approved for STI PEP and there is no national organizational guidance for its use as STI prevention. However, Centers for Disease Control and Prevention (CDC) has released considerations for doxy PEP as an STI preventative strategy5 and San Francisco Department of Public Health has released their own guidance, including counseling messages.6  \ni. Prescribe 200 mg of doxycycline taken within 72 hours (ideally within 24 hours or as soon as possible) after condomless oral, anal, or vaginal sex. Doxycycline can be taken daily depending on sexual activity, but no more than  \n200 mg every 24 hours.  \nii. Screen for GC and CT at all anatomic sites of ","cbCaid3yz7wTmZbI","https://ap.wps.com/l/cbCaid3yz7wTmZbI","pdf",355946,"English","# Recommendations\n## Who should receive doxy PEP\n## When and how to prescribe\n## Safety and unknowns\n## Evidence and monitoring\n# References","[{\"question\":\"Which patients does CDPH recommend for doxy PEP?\",\"answer\":\"CDPH recommends doxy PEP for men who have sex with men (MSM) or transgender women (TGW) who had at least one bacterial STI in the past 12 months. It also supports offering doxy PEP to non-pregnant individuals at increased risk and to those requesting it using shared decision-making.\"},{\"question\":\"How should doxy PEP be taken after condomless sex?\",\"answer\":\"Prescribe 200 mg of doxycycline taken within 72 hours after condomless oral, anal, or vaginal sex (ideally within 24 hours). It may be taken daily depending on sexual activity, but not more than 200 mg every 24 hours.\"},{\"question\":\"What screening and follow-up does the guidance require?\",\"answer\":\"Screen for GC and CT at all exposure anatomic sites and test for syphilis and HIV (if not already known as living with HIV) at initiation of doxy PEP and every three months. If an STI is diagnosed, treat according to standard CDPH and CDC STI treatment guidelines.\"}]","Doxycycline Post-Exposure Prophylaxis (doxy PEP) for the Prevention of Bacterial Sexually Transmitted Infections (STIs) | PDF",1790511664]