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RESEARCH ARTICLE (Open Access)
Contents Vol 22(3)

Awareness and willingness toward doxycycline post-exposure prophylaxis use for bacterial sexually transmitted infections among men who have sex with men

Yi-Ting Chen https://orcid.org/0009-0001-6734-1593 A , Kuan-Yin Lin A B , Hsin-Yun Sun B , Yu-Shan Huang B , Wang-Da Liu B C , Yu-Chung Chuang B , Po-Hsien Kuo D , Sung-Hsi Huang D , Kai-Hsiang Chen D , Aristine Cheng B , Wang-Huei Sheng B , Szu-Min Hsieh B , Sung-Ching Pan A B , Un-In Wu B C , Szu-Ting Huang D , Tzong-Yow Wu E , Wen-Chun Liu B , Pei-Ying Wu A , Yu-Zhen Luo A , Hsi-Yen Chang A , Ling-Ya Chen https://orcid.org/0000-0001-8271-6595 A , An-Ting Peng F , Pei-Yu Wang F , Guei-Chi Li B and Chien-Ching Hung https://orcid.org/0000-0001-7345-0836 B E G *
+ Author Affiliations
- Author Affiliations

A Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan.

B Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

C Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.

D Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.

E Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.

F Center for Infection Control, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.

G Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.

* Correspondence to: hcc0401@ntu.edu.tw

Handling Editor: Cheng Wang

Sexual Health 22, SH24136 https://doi.org/10.1071/SH24136
Submitted: 2 July 2024  Accepted: 8 May 2025  Published: 26 May 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Doxycycline post-exposure prophylaxis (doxy-PEP) has shown efficacy in preventing bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM). We aimed to investigate the awareness and willingness toward doxy-PEP among MSM in the real-world setting.

Methods

From October 2023 to March 2024, we enrolled MSM aged ≥18 years, including people with HIV and PrEP users in Taiwan. Participants completed a questionnaire interview on sexual behaviors, STI history, and awareness and willingness to use doxy-PEP. Factors associated with willingness and doxy-PEP prescription were identified.

Results

Of 1100 participants (median age, 36 years), 75.5% were people with HIV and 24.5% were PrEP users. Among them, 29.8% (328/1100) had heard of doxy-PEP. After education and counseling, 85.9% (945/1100) expressed willingness to use doxy-PEP and 45.6% (431/945) received prescriptions for doxy-PEP. In multivariable analysis, willingness to use doxy-PEP was associated with engaging in anal sex (AOR 2.98, 95% CI 1.01–8.78), having fixed sexual partners (AOR 0.53, 95% CI 0.34–0.82), using recreational drugs (AOR 1.59, 95% CI 1.01–2.50) and receiving suggestions from healthcare providers (AOR 1.89, 95% CI 1.22–2.91). Starting doxy-PEP was associated with having a bachelor’s degree or higher (AOR 1.47, 95% CI 1.03–2.09), more than five sexual partners (AOR 1.97, 95% CI 1.18–3.27), chlamydia history (AOR 1.92, 95% CI 1.23–2.99), suggestions from healthcare providers (AOR 1.64, 95% CI 1.10–2.45) and information from scientific research papers (AOR 1.34, 95% CI 1.01–1.79).

Conclusions

MSM in Taiwan had high willingness toward doxy-PEP, which was correlated with their at-risk sexual behavior. Understanding factors influencing willingness and counseling from healthcare providers may guide doxy-PEP implementation.

Keywords: chlamydia, gonorrhea, health literacy, people with HIV, pre-exposure prophylaxis, syphilis, tetracycline, unprotected sex.

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