Recommend doxy-PEP for: Cisgender men and transgender women who are sexually active with cis male or trans female partners, didn't use protection with more than one partner in the past year, and have had a bacterial STI in the past year.

 

Offer doxy-PEP after shared decision making for: Cisgender men and transgender women, who have not had a bacterial STI in the past year, but have had unprotected sex with more than one cis male or trans female partner in the past year. Transgender men who don't use protection  with more than one cis male or trans female partner in the past year. Current studies did not include this group; counsel patients about this.

 

Can consider doxy-PEP on a case-by-case basis after shared decision making for: Cisgender men who are sexually active only with cisgender women, but who have unprotected sex with more than one partner in the past year, and have had a bacterial STI (particularly syphilis) in the past year. Current studies did not include this group; counsel patients about this.

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Patients are advised to take 200mg of doxycycline within 24hrs but no later than 72hrs after condomless oral, anal or vaginal sex. Doxycycline can be taken every day depending on frequency of sexual activity. However, patients should not take more than 200mg within a 24hr period.