From the Guidelines
Doxycycline is not used for HIV post-exposure prophylaxis (PEP) or pre-exposure prophylaxis (PrEP). The primary use of doxycycline in the context of sexual health is for the prevention of bacterial sexually transmitted infections (STIs) such as syphilis, chlamydia, and gonorrhea, as outlined in the CDC's clinical guidelines on the use of doxycycline postexposure prophylaxis for bacterial STI prevention, United States, 2024 1. According to this guideline, doxycycline can be used as postexposure prophylaxis to prevent bacterial STIs in men who have sex with men (MSM) and transgender women (TGW) who have had a bacterial STI diagnosed in the past 12 months. The recommended dose of doxycycline for this purpose is 200 mg taken within 72 hours after sex, which has been shown to reduce syphilis and chlamydia infections by >70% and gonococcal infections by approximately 50% 1.
Key points to consider:
- Doxycycline is used for the prevention of bacterial STIs, not HIV.
- The CDC recommends doxycycline postexposure prophylaxis (doxy PEP) for MSM and TGW who have had a bacterial STI diagnosed in the past 12 months.
- Doxy PEP should be implemented in the context of a comprehensive sexual health approach, including risk reduction counseling, STI screening and treatment, recommended vaccination, and linkage to HIV PrEP, HIV care, or other services as appropriate 1.
- HIV screening should be performed for HIV-negative MSM and TGW according to current recommendations, and doxycycline may sometimes be prescribed alongside HIV PEP to prevent bacterial STIs, but it is not a substitute for antiretroviral medications in the treatment or prevention of HIV.
From the Research
Doxycycline for HIV Exposure
- There is no evidence to suggest that doxycycline is used for Human Immunodeficiency Virus (HIV) exposure 2, 3, 4, 5, 6.
- The studies provided focus on the use of antiretroviral medications such as tenofovir disoproxil fumarate, emtricitabine, and raltegravir for HIV post-exposure prophylaxis (PEP) 2, 3, 5, 6.
- Doxycycline is an antibiotic commonly used to treat bacterial infections, but it is not mentioned in the context of HIV exposure or PEP in the provided studies.
Alternative Treatments for HIV Exposure
- The preferred regimens for HIV PEP include combinations of antiretroviral medications such as tenofovir disoproxil fumarate, emtricitabine, and raltegravir 2, 3, 5, 6.
- These regimens have been shown to be effective in preventing HIV transmission when used as PEP 2, 3, 4, 5, 6.
- The choice of regimen may depend on factors such as tolerability, adherence, and potential side effects 2, 3, 5, 6.