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. 2025 Jul;29(7):2043-2053.
doi: 10.1007/s10461-025-04728-5. Epub 2025 Apr 28.

Rapid Diffusion of Awareness and Uptake of Doxy-PEP among Men who Have Sex with Men in San Francisco

Antonio A M Moscatelli  1 , Paloma L Ramirez  1 , Bow Suprasert  2 , Moranda Tate  2 , Stephanie E Cohen  2 , Maria Amelia S M Veras  1 , Glenda Baguso  2   3 , Erin C Wilson  2   4 , Willi McFarland  5   6
Affiliations

Rapid Diffusion of Awareness and Uptake of Doxy-PEP among Men who Have Sex with Men in San Francisco

Antonio A M Moscatelli et al. AIDS Behav. 2025 Jul.

Abstract
in English, Spanish

In October 2022, the San Francisco Department of Public Health published guidelines for doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections (STI) among men who have sex with men (MSM). We evaluated awareness and use of doxy-PEP using data from the National HIV Behavioral Surveillance in 2023 in San Francisco (N = 533). In the year following the publication of the guidelines, 66.6% of MSM reported awareness of doxy-PEP, and 19.3% had used it. Among MSM who are not living with HIV, awareness of doxy-PEP was associated with higher educational levels, condomless sex, bacterial STI diagnoses, and PrEP use; use was associated with STI diagnoses and PrEP use. Among MSM living with HIV, both awareness and use were associated with younger age. These findings indicate rapid dissemination and early adoption of doxy-PEP in a priority population in a real-world setting.

En octubre de 2022, el Departamento de Salud Pública de San Francisco publicó directrices de profilaxis posexposición con doxiciclina (doxi-PEP) para la prevensión de infecciones de transmisión sexual (ITS) de origen bacterianas entre hombres que tienen sexo con hombres (HSH). Evaluamos el conocimiento y uso de doxi-PEP con los datos de la National HIV Behavioral Surveillance de 2023 en San Francisco (N=533). En el año que siguio la publicación de las directrices, el 66.6% de los HSH conocían doxi-PEP y el 19.3% lo había utilizado. Entre los HSH que no viven con VIH, el conocimiento de doxi-PEP se asoció con mayor nivel educativo, sexo sin preservativo, diagnóstico de ITS bacteriana y uso de PrEP; el uso se asoció con diagnóstico de ITS y uso de PrEP. Entre los HSH que vivem con VIH, el conocimiento y el uso se asociaron con menor edad. Estos datos indican una rápida diseminación y adopción temprana del doxi-PEP en una población prioritaria en un entorno real.

Keywords: Doxy-PEP; Men who have sex with men; Post-exposure prophylaxis; Sexually transmitted infections.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare they have no financial or non-financial interests that are directly or indirectly related to this work. Ethical Approval: The authors certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed Consent: Participation was anonymous. All participants provided verbal informed consent.

References

    1. World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections. 2021. https://www.who.int/publications/i/item/9789240027077 . Accessed December 14, 2024.
    1. European Centre for Disease Prevention and Control. Surveillance Atlas of Infectious Diseases. 2023. https://www.ecdc.europa.eu/en/surveillance-atlas-infectious-diseases . Accessed December 14, 2024.
    1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance. 2021. https://www.cdc.gov/sti-statistics/media/pdfs/2024/07/2021-STD-Surveilla... . Accessed December 14, 2024.
    1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance. 2023. https://www.cdc.gov/sti-statistics/annual/index.html . Accessed December 14, 2024.
    1. San Francisco Department of Public Health. Sexually Transmitted Infection Annual Summary. 2021. https://www.sf.gov/sites/default/files/2024-07/Annual%20Summary%202021.pdf . Accessed December 14, 2024.

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