All Things Doxy Pep-The New STI Preventive Drug That Could Change the Game
Over the past ten years, science has finally caught up to match the lifestyles of higher risk sexual explorers. In the past, STIs including syphilis and chlamydia were treated after transmission, resulting in two or more weeks without sex as a mix of antibiotics were administered to get rid of the infection. Since the introduction of Doxy PEP, the rules have changed with doctors now offering a means to prevent you from getting sick by preventing transmission.
We sat down with Jamey Bell, a board-certified Nurse Practitioner and the Medical Director for the Performer Availability Screening System (PASS), to get the full skinny on Doxy PEP and how it’s being used to protect performer safety.
What is Doxy PEP?
Doxy PEP (Doxycycline Post-Exposure Prophylaxis) is a strategy for preventing sexually transmitted infections (STIs), including syphilis and chlamydia, through the use of the antibiotic doxycycline shortly after potential exposure. Although it is not a method for preventing HIV transmission, Doxy PEP has been shown to reduce the incidence of bacterial STIs, particularly in certain high-risk populations.
Doxy PEP involves taking a single 200 mg dose of doxycycline within 72 hours after unprotected sexual contact to prevent bacterial STIs. While studies have shown its effectiveness up to 72 hours post-exposure, it is generally recommended to take the dose within 24 hours after unprotected sex, as earlier administration maximizes efficacy.
Effectiveness of Doxy PEP
Doxy PEP has the greatest efficacy for chlamydia and syphilis, reducing the likelihood of those infections by up to 88%. Its efficacy in preventing gonorrhea is lower, around 55%, due to doxycycline resistance in some strains of gonorrhea.
Initial studies establishing the efficacy of Doxy PEP were conducted with men who have sex with men (MSM) and transgender women who had been diagnosed with one or more STIs in the preceding 12 months. A study conducted in Kenya with cisgender women did not produce the same results due to adherence issues among participants. However, ongoing studies aim to further evaluate its efficacy in cisgender women and transgender men. Notably, a recent study measuring doxycycline levels in rectal, vaginal, cervical, and urethral tissues after a 200 mg dose showed comparable drug levels in these anatomical sites.
Other studies are ongoing to evaluate the potential effect of Doxy PEP on Mycoplasma genitalium, as well as looking at impacts on the gut microbiome.
Concerns About Antibiotic Resistance
Doxycycline has a long history of being prescribed for extended periods, such as for treating acne in dermatology. It has also been used as a preventative treatment for Lyme disease and malaria for decades, with resistance remaining uncommon in these instances. However, the potential impact of Doxy PEP on antibiotic resistance requires careful monitoring over time.
Using Doxy PEP intermittently in higher-risk sexual situations may help mitigate the risk of resistance while providing the benefit of reduced STI transmission. Balancing these risks and benefits will be critical as its use becomes more widespread.
How Can Doxy PEP Benefit Adult Industry Talent?
Given the rigorous STI testing standards within the adult industry, taking Doxy PEP after studio or content shoots with tested performers does not appear necessary and could increase the risk of
antibiotic resistance. However, Doxy PEP may be a valuable tool for talent engaging in sexual encounters outside the tested talent pool, whether for work, personal reasons, or both.
Additionally, there is often a window period between exposure to an STI and when it becomes detectable on a test. Performers may occasionally be notified that a scene partner tested positive for an STI after the fact. If this notification occurs within the 72-hour window, taking a dose of Doxy PEP can significantly reduce the likelihood of infection. By lowering the risk of infection, Doxy PEP can help performers avoid interruptions to their work schedule. Testing positive for an STI can result in two or more weeks of lost work due to treatment and re-testing, which can substantially impact income.
Who Should Not Take Doxycycline?
Doxycycline is contraindicated during pregnancy and for individuals planning to become pregnant. It should also not be taken with certain medications, such as the acne drug Accutane, due to the risk of major drug interactions. Additionally, doxycycline increases sensitivity to light and should be avoided during laser hair removal or other laser skin procedures to prevent burns and scarring. Be sure to inform medical or aesthetic providers of doxycycline use.
Some individuals may experience sun sensitivity with doxycycline, though this risk is lower with intermittent use. Allergies to doxycycline or other tetracycline antibiotics can occur, as can gastrointestinal upset, including nausea, vomiting, or diarrhea. Mild symptoms can often be prevented by taking doxycycline with food.
Accessibility
Doxycycline is a generic medication and is typically covered by insurance. For those paying out of pocket, a prescription for 30 tablets can cost around $20 with a pharmaceutical coupon. Many sexual health clinics now offer prescriptions for Doxy PEP, and several online platforms also provide access to it.
By weighing its benefits and potential risks, Doxy PEP offers a promising option for reducing STI transmission in specific contexts. However, proper usage and medical guidance remain essential to maximize its benefits while minimizing risks such as antibiotic resistance.
Jamey Bell is a board-certified Nurse Practitioner and the Medical Director for the Performer Availability Screening System (PASS); which oversees the health and wellness of the Adult Industry. Jamey is also the Medical Director of the Sexual Health Program at the Los Angeles LGBT Center.
