New research published in Eurosurveillance reveals a 15% recent use of doxycycline post- and pre-exposure prophylaxis (doxyPEP/PrEP) among men who have sex with men (MSM), transgender, and gender-diverse individuals in the Netherlands. The study, which analyzed data from an online survey of 1,633 respondents, highlights an increase in the informal use of doxyPEP/PrEP, with 65% of participants expressing intent to use it in the future.
Although doxyPEP has shown effectiveness in preventing sexually transmitted infections (STIs) in these populations, its informal use without a prescription poses risks of antimicrobial resistance (AMR) and changes in the microbiome. The study also points out potential public health implications of widespread doxyPEP use, including increased antibiotic consumption and AMR.
Researchers led by Teker Buhari conducted a cross-sectional study using data from an online survey targeting MSM, transgender, and gender-diverse individuals. Results showed that recent doxyPEP/PrEP users were more likely to have a history of STIs, use oral HIV PrEP, engage in risky sexual behaviors, and live with HIV.
The study also found a high intention to use doxyPEP/PrEP among participants, with many willing to pay for the drug if it became formally available. However, concerns about AMR and potential adverse effects of long-term doxyPEP/PrEP use highlight the importance of monitoring individual and population-level resistance to doxycycline.
The lack of awareness about the extent of informal doxyPEP/PrEP use makes it challenging to implement appropriate public health stewardship and monitor for overuse, misuse, and adverse effects. Monitoring and addressing these issues are crucial in preventing the development of AMR and impacts on microbiome composition.
For more information, you can refer to the original study published in Eurosurveillance titled “Emergent informal use of doxycycline post- and pre-exposure prophylaxis among men who have sex with men and transgender and gender diverse people, the Netherlands, 2024.”
