Understanding PrEP and Doxy

Modern Strategies in Sexual Health

In recent years, advancements in medical science have provided us with effective tools to prevent sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Among these, Pre-Exposure Prophylaxis (PrEP) and Doxycycline Post-Exposure Prophylaxis (Doxy-PEP) have emerged as significant preventive measures. These strategies are particularly impactful within marginalized communities, such as the LGBTQ+ population, who have historically faced higher risks and unique challenges related to sexual health.

The introduction of PrEP marked a turning point in HIV prevention, offering individuals at high risk a means to significantly reduce their chances of contracting the virus. Similarly, Doxy-PEP has shown promise in decreasing the incidence of certain bacterial STIs. While these medical advancements are commendable, they also bring forth discussions about adherence, potential side effects, and the importance of comprehensive sexual health education.

Defining PrEP and Doxy-PEP

PrEP (Pre-Exposure Prophylaxis):

PrEP involves the daily intake of antiretroviral medications by HIV-negative individuals to prevent HIV infection. The most commonly prescribed PrEP medications are combinations of tenofovir and emtricitabine, which work by inhibiting the virus’s ability to replicate within the body. When taken consistently, PrEP has been shown to reduce the risk of HIV transmission through sexual contact by approximately 99%. 

Doxy-PEP (Doxycycline Post-Exposure Prophylaxis):

Doxy-PEP entails taking a dose of the antibiotic doxycycline shortly after potential exposure to bacterial STIs, such as syphilis, chlamydia, and gonorrhea. Research indicates that taking doxycycline within 72 hours after unprotected sex can reduce the likelihood of contracting these infections. This approach is particularly recommended for individuals at elevated risk, including gay, bisexual, and other men who have sex with men, as well as transgender women with a history of bacterial STIs. 

Administration and Adherence

PrEP:

• Dosage: PrEP is typically taken as a once-daily pill.
• Adherence: Consistent daily intake is crucial for maintaining optimal levels of protection against HIV. Missing doses can compromise the medication’s efficacy.
• Routine Monitoring: Regular follow-ups with healthcare providers are essential to monitor kidney function and ensure overall health while on PrEP.

Doxy-PEP:

• Dosage: A single 200 mg dose of doxycycline is taken within 72 hours after unprotected sexual activity.
• Adherence: Timely administration post-exposure is vital for effectiveness. It’s important to note that Doxy-PEP is not intended for daily use but rather as needed based on exposure.
• Routine Monitoring: Regular STI screenings are recommended to ensure the continued effectiveness of the prophylaxis and to monitor for potential antibiotic resistance.

Possible Side Effects

PrEP:

Common Side Effects:

• Nausea
• Headaches
• Weight loss

Less Common Side Effects:

• Kidney function alterations
• Bone density reduction

Most side effects are mild and tend to resolve over time. Regular medical check-ups help in early detection and management of any adverse effects.

Doxy-PEP:

Common Side Effects:

• Gastrointestinal discomfort
• Photosensitivity (increased sensitivity to sunlight)

Less Common Side Effects:

• Esophageal irritation
• Yeast infections

It’s essential to discuss any side effects with a healthcare provider to determine the best course of action.

Risk Factors and Considerations

Interruption and Resumption:

Interrupting PrEP can reduce its protective benefits. If an individual stops taking PrEP and is exposed to HIV, they are at risk of infection. Before resuming PrEP, it’s advisable to get tested for HIV to ensure a negative status.

For Doxy-PEP, inconsistent use may lead to reduced effectiveness and contribute to antibiotic resistance. It’s crucial to use Doxy-PEP as directed and only when necessary.

Activities Increasing the Need for Doxy-PEP:

• Engaging in unprotected sex with multiple partners
• Participating in sexual activities in high-prevalence STI settings
• Involvement in chemsex (the use of drugs to enhance sexual experience)

It’s important to approach these topics without judgment and provide individuals with the information they need to make informed decisions about their health.

Testing and Monitoring

Regular testing is a cornerstone of effective use of both PrEP and Doxy-PEP. For individuals on PrEP, HIV testing is recommended every three months, along with assessments of kidney function. For those using Doxy-PEP, routine STI screenings are essential to monitor for potential infections and assess the continued effectiveness of the prophylaxis.

Prevention and Health Strategies

While PrEP and Doxy-PEP are effective tools in preventing HIV and certain bacterial STIs, they should be part of a comprehensive sexual health strategy that includes:

• Condom Use: Condoms remain effective in preventing a wide range of STIs and should be used consistently.
• Vaccinations: Vaccines are available for infections like hepatitis A and B and human papillomavirus (HPV). 

PrEP Near you

We will at soon publish the direct links, but on our GUIDES Page we include PrEP information for almost all countries in EU