Every day, I wake up, brush my teeth, shower, eat breakfast and take my medication. No, I’m not sick. I take Pre-Exposure Prophylaxis (PrEP) and now sometimes DoxyPEP too. The former is a life-saving HIV prevention drug, while the latter is a brand new tool that can help prevent bacterial sexually transmitted infections (STIs). This is important to me as – being Black and gay – I’m in two categories disproportionately affected by STIs. I want to spread the word about why DoxyPEP in particular is so groundbreaking.
I first heard about it last year from my colleague Ben who also works at The Love Tank – a not-for-profit that promotes health and wellbeing of under-served communities. Ben did a presentation on it and how our work could have a focus on it going forward. Initially, I reacted exactly how I did when I first learned about PrEP – I thought it was amazing and everyone I know should know about it! ‘Doxy’ is short for doxycycline, which is an antibiotic. ‘PEP’ is short for post-exposure prophylaxis, with prophylaxis meaning treatment given or action taken to prevent disease. Two little pills are already having some resounding success. There have been a handful of clinical trials suggesting DoxyPEP can protect against 70-89% of chlamydia infections and 73-87% of syphilis infections. Studies show it can prevent over 51-57% of gonorrhoea infections and even lesser-known STIs like mycoplasma genitalium (another bacterial STI).
As it’s an antibiotic, it’s important to note that DoxyPEP can’t prevent viruses like HIV, or hepatitis B, or parasites like crabs or scabies. There are also some concerns that the drug could cause an increase in antimicrobial resistance (which is when antibiotics stop working against certain bacteria that develop resistance to them), which is something that will require careful monitoring. But I believe that doesn’t necessarily mean people who may benefit from DoxyPEP shouldn’t use it for either peace of mind or to relieve the strain on sexual health services if there are no direct issues at the moment.
Learning all of this made me decide to start taking DoxyPEP myself in August last year. I’m a single, gay man in London and I take it after having sex. Every time I’ve been tested for STIs since, everything has come back negative, which is incredible. I’ve been taking PrEP and haven’t been at risk of HIV for several years, so taking DoxyPEP makes me feel even more control over the sex I have. Before I started taking it, I worried about STIs when not using condoms (which still are an effective way of preventing STIs) but now I don’t have that same concern. I’ve had lots of conversations about my experiences and those positive experiences have inspired friends to take DoxyPEP too.
I’m so passionate about telling people how to take care of their sexual health that I did a six-part podcast across Pride month this June, called The Other Blue Pill. It’s about the largely unknown story of the fight to get PrEP in England – in which NHS England were taken to court twice in order for them to prescribe this life-changing drug. In the sixth episode of the podcast (which is out on Wednesday) we discussed DoxyPEP. I interviewed Ben about it for listeners to understand what it is and that it’s safe. It was important for me to highlight this because the seemingly constant barriers to queer healthcare need to stop. For more information about DoxyPEP, visit the Queer Health website here . To listen to The Other Blue Pill, visit the Queer AF website here .
Now, more than ever, a drug like this could be a gamechanger. In England in 2023, there was a 4.7% increase in diagnoses of STIs from the previous year. DoxyPEP could reduce this – especially to those most at risk. Recent data from the UK Health Security Agency shows the impact of STIs remains greatest in young people aged 15 to 24, Black people, and gay, bisexual and other men who have sex with men (GBMSM). This means it is especially important I take care of my sexual health and it’s partially why I started working in this sector.
Unfortunately, much like the fight to get PrEP available through the NHS, DoxyPEP is another uphill battle for campaigners like me too. While it is approved for use in some places – including San Francisco and Chicago in the US, or Australia – doxycycline has not been approved for use as DoxyPEP on the NHS in the UK. Policymakers are reviewing whether it should be commissioned for use and some NHS clinics are considering making it available soon. If comprehensive guidelines for DoxyPEP use are published at the end of the year, we will be one of the first in the world to implement this.
What I found interesting about making the podcast was seeing how much we haven’t learned from our past. History is repeating itself. Fighting for access to PrEP was reminiscent of fighting for access to HIV medication in the 90s. Similarly, people in the UK right now are forced to buy DoxyPEP online, mirroring what happened with PrEP for nearly five years before it was made available on the NHS. We won that fight and we need to win this one. We have the tools to better our sexual health but we’re not using them. For all of our sakes.
