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Position statement on doxycycline post-exposure prophylaxis (Doxy-PEP) for the prevention of bacterial sexually transmissible infections in Aotearoa New Zealand – the New Zealand Sexual Health Society

Julia Scott , Massimo Giola , Jeannie Oliphant

Abstract

Recent studies have demonstrated that doxycycline post-exposure prophylaxis (doxy-PEP) reduces the risk of syphilis and chlamydia in men who have sex with men (MSM) and transgender women who have sex with men who are at risk of sexually transmitted infections (STIs). With several international organisations publishing guidance regarding doxy-PEP use, and substantial community and sector interest, the New Zealand Sexual Health Society (NZSHS) drafted an interim statement and then convened a cross-sectoral meeting to discuss doxy-PEP benefits and risks, review and revise the statement. There was strong agreement that doxy-PEP be considered as part of a comprehensive STI prevention approach to people assigned male sex at birth who have sex with men who are at risk of syphilis, primarily as an intervention to prevent syphilis. NZSHS advises that doxy-PEP be proactively offered to people assigned male sex at birth who have sex with men with a diagnosis of syphilis or two other bacterial STIs in the past 12 months, and considered for others as outlined in the statement. Prescription of doxy-PEP should include counselling on the benefits and harms including side effects and antimicrobial resistance, with users assisted to maximise the benefits of doxy-PEP while minimising overall antibiotic use. STI diagnostic considerations and monitoring and surveillance are discussed.

SH25017  Accepted 13 May 2025

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