Australia Consensus Statement on doxy-PEP proposes limited use in gay and bisexual men

Simon Collins, HIV i-Base

On 1 April 2024, ASHM published a consensus statement on the use of doxycycline post‐exposure prophylaxis (doxy‐PEP) in Australia.

The statement was the result of a large stakeholder meeting and consultation in March 2023.

It includes ten recommendations for community and clinicians and nine recommendations for research, guidelines, and policy.

These include:

• Doxy-PEP should be considered primarily for the prevention of syphilis in gay and bisexual men who are at risk of this STI.
• The reduction in chlamydia, and the lesser reduction of gonorrhoea, both or which are often asymptomatic, might also be important in some people.
• Some stakeholders thought doxy-PEP should be only be considered for the prevention of syphilis in this population.
• Concern over increasing high rates of tetracycline resistance against gonorrhoea was a reason for limiting wider use.
• Research priorities included the importance of tracking antimicrobial resistance as part of the programme to provide doxy-PEP.
• The impact of doxy-PEP on male and cisgender female sexual partners or other sexual partners with a uterus was also considered.

The Statement will have considered clinical results presented at CROI 2023.

Importantly, it will not reflect research presented at CROI 2024.

References

Cornelisse VJ et al. Australian consensus statement on doxycycline post‐exposure prophylaxis (doxy‐PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men. Med J Aust. doi: 10.5694/mja2.52258. (1 April 2024).
https://ashm.org.au/about/news/doxy-pep-statement/