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Doxy-PEP for prevention of STDs

A morning after pill for men?  Yes, you heard that right….introducing DoxyPep!...

What is Doxy-PEP?

Doxycycline is an antibiotic that has already been used for many years to treat many different diseases such as acne, malaria, skin infections, and Lyme disease.  It also treats many different sexually transmitted diseases (STDs) such as syphilis, chlamydia, gonorrhea, and pelvic inflammatory disease, a complication that can develop from an STD.

DoxyPEP is the use of doxycycline for post exposure prophylaxis (PEP, preventing disease or infection after a possible exposure) to prevent bacterial sexually transmitted diseases such as syphilis, gonorrhea, and chlamydia.  DoxyPEP is indicated for gay men (MSM) and transgender women (TGW), especially those engaging in high risk sexual activity (frequent unprotected intercourse with more than one partner).  It is not recommended for cisgender women, transgender men, and gender diverse patients due to lack of studies.

The US FDA has not approved doxycycline for STD post exposure prophylaxis, however the CDC has released proposed guidelines for DoxyPEP as an STD prevention strategy for MSM and TGW.  Studies are still needed on the potential long term effects of DoxyPEP on individual and population health.

DoxyPEP is not recommended for individuals who already take doxycycline for treatment of other conditions (such as acne and Lyme disease)

Given all this, DoxyPEP IS NOT AN ALTERNATIVE TO USING PROTECTION (IE CONDOMS) DURING INTERCOURSE.  Protection should be USED AT ALL TIMES to decrease risk of STD infection and to decrease the need for using DoxyPEP.  DoxyPEP also does not prevent HIV infection, so PREP medication (Truvada or Descovy) should be taken daily.

The Pros of Doxy-PEP

Studies have shown that taking DoxyPEP reduces your chance of getting these diseases by about 66%.  Using DoxyPEP can be empowering, allowing you to take charge of your sexual health and reduce anxiety and stigma about STDs.

The Cons of Doxy-PEP

Frequent doxycycline use raises the risk of antibiotic resistance, where doxycycline would no longer be able to treat your infection since bacteria evolve and become resistant to a medication. It can also cause several gastrointestinal side effects such as abdominal pain, nausea, vomiting, and diarrhea.  Other side effects include increased skin sensitivity to the sun causing various rashes and burns, headaches, tooth discoloration, and possible weight gain.  Protection at all times and minimal usage is advised.

How to get Doxy-PEP

Schedule an in person appointment with a City Care Family Practice (CCFP) provider.  After taking a comprehensive sexual history, having a shared discussion and decision making with you learn about the treatment, and conducting routine STD and laboratory testing (complete blood counts, liver and kidney function tests), your provider can prescribe doxycycline for post exposure prophylaxis of bacterial sexually transmitted diseases such as syphilis, gonorrhea, and chlamydia.

After your initial DoxyPEP visit at CCFP, you will be seen every 3 months for follow up visits to assess treatment and conduct further routine STD and other laboratory testing.  If you are deemed to be taking an excessive amount of doxycycline, side effect risks may increase and you will need to be re-counselled on using protection for all sexual encounters.

…So what are you waiting for?  Get protected today!


  1. New York City Department of Health and Mental Hygiene. Doxycycline Post-Exposure Prophylaxis (Doxy-PEP) to Prevent Bacterial Sexually Transmitted Infections, November 9 2023. (
  2. Los Angeles County Department of Public Health, Division of HIV and STD Programs. DoxyPEP for STI Prevention, Revised May 2023. (
Dr. Karthik Karibandi Dr. Karthik Karibandi is a board-certified family physician at City Care Family Practice. He received his medical degree from Albany Medical College and did his training at Albany Medical Center. During his free time, he enjoys watching sports, live theater, visiting museums, and going to the gym.

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