ACT’s Online Outreach program’s volunteers and staff have noticed more and more men asking them about Doxy PrEP & PEP. So, they decided to put together a quick explanation for anyone who might be curious about what exactly Doxy PrEP & PEP are.

Doxy PrEP & PEP are a pharmaceutical intervention to prevent STIs – similar to the idea of PEP and PrEP for HIV, except this intervention is to avoid STIs using an antibiotic called Doxycycline. 

Doxy PEP (like HIV PEP) is about taking 200 mg of Doxycycline 24-72 hours after a potential exposure to an STI (i.e. oral, anal, or vaginal/frontal condomless sex). 

Doxy PrEP (like HIV PrEP) means taking Doxycycline daily to stop a sexually transmitted infection from developing.

However, Doxycycline is on the market to treat bacterial infections and adult acne (rosacea).  Health Canada does not authorize it for STI PrEP & PEP purposes, meaning doctors would be prescribing off-label.  Prescribing off-label happens in the medical world, but what this practically means is:

  • doctors may be hesitant to give it to patients, and
  • public and private insurance will likely not cover their cost.

Is it effective?

According to NAM Aidsmap (a respected HIV knowledge clearinghouse from the UK), the DoxyPrEP study that happened in the US involving gay and bisexual men, trans women, and people living with HIV was getting such good results it had to be stopped and redesigned. It was later reported at the 2022 International AIDS Conference as having “reduced the risk of acquiring chlamydia by 74%, and syphilis by 77% for people with HIV.”

Is it available in Toronto? 

  • Talk to your doctor  (It’s worth talking to the HIV PrEP-providing clinics and pharmacies about whether they can get you a prescription with their interdisciplinary teams.)
  • Get into a drug trial. Currently, Canadian researchers are running a trail called “disco” comparing Doxy PrEP with Doxy PEP – you can find it here:  Note: getting into a drug trail means you are part of a study with a need to answer questions and attend appointments and you would be accessing Doxycycline at no cost. -Sexual Health News from the ACT Online Outreach Team