Doxy-PEP
Post-Exposure Prophylaxis
⚠️ PEP must be taken within 72 hours after risk of exposure to HIV
🧑 Who is it for?
Most people who have had a risk of HIV exposure. Especially sex workers when a condom breaks, condomless/bb sex or have been sexually assaulted.
⚠️ Do not use if you have Hepatitis B (it can make the virus more active).
🔍 What is it called?
The most common brand names you'll hear for PEP, which contain the same active ingredients often used in PrEP, are:
💊 Truvada
Generic name:
Emtricitabine/Tenofovir Disoproxil Fumarate
Generic name:
Emtricitabine/Tenofovir Alafenamide
Generic name:
Raltegravir
💉 Yeztugo
Generic name:
Lenacapavir
⏰ When to take it?
Take it as soon as possible after a possible HIV risk/exposure (like a condom breaking or sexual assault etc).
👉As soon as possible, within 72 hours/3 days
Please note: When exposure risk is outside 72 hours contact a nurse/doctor.
🏥 Where to get it?
👉 Urgent Care Facilities
👉 Emergency Departments at hospitals
👉 Sexual Health Clinics
👉 Online Doctors
👉 Doctors Surgeries
👉 Some Pharmacies
⚙️ How to take it?
👉 You start with 2/3 pills right away
👉 Then take 1 pill daily for 28 days.
Reduces the chance of HIV infection by at least 80% Visit a sexual health clinic or doctor for a STI/STD check up.
Note: Always follow what the doctors prescribes.
🤔 Why should you consider PEP?
It's an emergency treatment to stop HIV from taking hold in your body, but you must start it within 72 hours of exposure.
👉 It reduces the chance of HIV infection by at least 80%
The sooner you start PEP sooner the better chance of it working.
🚨 Emergency PEP
In cases of emergencies you can use you can take 2 of your medication PrEP medication (Truvada/Descovy), then continue taking 1 pill for 28 days - this can offer some protection from HIV.
⚠️ Allergic Reaction Signs:
Rash, Itching , Swelling - face/tongue/throat, Dizziness, Trouble breathing
🚨Seek medical help immediately
Most Common Side Effects
Usually mild & temporary
👉 Truvada:
Abnormal dreams, Dizziness, Insomnia and
Hyperpigmentation (skin discolouration)
👉 Both Truvada and Descovy:
Diarrhoea, Nausea, Headache, Fatigue, Rash, Stomach cramps and Tiredness.
Less common (rare) Side Effects:
👉Truvada:
Bone loss, Depression, High cholesterol.
👉 Both Truvada and Descovy:
Allergic reaction*
Liver problems, eg severe Hepatomegaly with Steatosis
Kidney problems, eg acute renal failure
Worsening of Hepatitis B infection†
Lactic acidosis
Immune reconstitution syndrome (flare-ups of past infections, such as pneumonia, fungal infections, or tuberculosis)
Taken Before HIV Exposure Risk
🔍 What is PreP ?
PrEP is a medication that HIV-negative people can take to significantly reduce their risk of getting HIV.
The most common brand names you'll hear for PrEP:
Generic name:
Emtricitabine/Tenofovir Disoproxil Fumarate
Generic name:
Emtricitabine/Tenofovir Alafenamide
Generic name:
Cabotegravir
Generic name:
Cabotegravir
👉 Apretude
Generic name:
Cabotegravir
Long-Term Use: You can take PrEP long-term with regular tests.
🧑 Who Can Take PrEP ?
Anyone HIV negative* who might engage in unprotected/condomless sex.
👉 People with multiple sexual partners
👉 Men who have sex with men
👉 People that use/share needles
⚠️ Do not use if you have Hepatitis B, it can make the HIV virus more active.
** People that have severe liver or kidney problems PrEP may not be suitable for PrEP. Talk to a medical professional for advice.
🤔 Why Take PrEP?
It builds up protection in your body, ready to stop HIV if it shows up.
Protection Level:
PrEP daily: If you've been taking PrEP daily for 7 days, you're protected. For daily PrEP, you need at least 6 doses in the past week for full protection*.
PrEP on-demand can offer up to 99% protection
**Reduces the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%
🚨 Can be used as emergency PEP:
In an absolute emergency, taking your PrEP pills after a potential exposure can offer some immediate protection, as they contain two of the three drugs used in full PEP. While not ideal because it's missing the crucial third drug like dolutegravir (or raltegravir) for maximum effectiveness, this could be a vital stopgap if immediate access to proper PEP isn't possible, but always seek full PEP as soon as you can.
⏰ When To Take PrEP?
PrEP Options:
💊 Daily PrEP Pill
👉 Take 1 pill every day around the same time.
⏰ Wait 7 days after starting before sex for full protection
💊 💊 PrEP On-Demand*
2-1-1 method
👉 Take 2 pills between 2 and 24 hours before anal sex. At least 20 minutes before sex*.
👉 Take 1 pill 24 hours later.
👉 Take 1 pill 24 hours after that.
If having sex over a period of time, keep taking 1 pill every 24 hours until you've had no sex for 2 days.
** At least 20 minutes before is what the NHS states, different organisations say slightly different - some say at least 2 hours before risky sex.
💉🗓️ Bimonthly PrEP Injection
Long-acting injectable PrEP, Apretude (cabotegravir), is typically given every two months
⚙️ How To Get PrEP?
📍 Find a Local Sexual Health Clinic or Doctor Surgery*
**PrEP is only available at sexual health clinics in the UK. PrEP is not available in every country yet.
🧑⚕️ Talk to a doctor or nurse:
👉 They will ask you about your medical and sexual history.
👉 Discuss what PrEP option is best for you.
🏥 Get Blood/Urine Tests:
🧪 HIV and other STI tests (every 3 months)
🔬 Hepatitis B test (negative result)
🩸 Kidney function test (PrEP can affect kidneys, especially if over 40 or with existing issues).
📍Find a PrEP Pharmacy:
Not all pharmacies stock PrEP medication as a standard medication.
📞 Call Before You Go:
Before visiting, it's best to call the pharmacy to confirm they have PrEP in stock.
📆 Ordering Options:
If the pharmacy don't have it on hand, ask if they can order it in for you.
Alternative Pharmacies:
If ordering isn't an option or is too slow, try another pharmacy in your area. Some countries have PrEP pharmacy finders.
✈️💊 Buying PrEP from Overseas:
🧑⚖️📝 Check Local Laws:
While often legal for personal use, always confirm the specific rules in your country regarding importing prescription medications.
🧑⚕️ Local Prescription Needed:
You will almost certainly require a valid prescription from a doctor in your own country to legally import PrEP.
⚠️ 🔢 Quantity & Safety:
Be aware of quantity limits (often a 1-3 month supply) and remember that regular medical check-ups and tests are still essential for your safety and PrEP's effectiveness.
😮 How to Take PrEP Pill:
🍽️ Best with or after food
🤢 If you throw up within 1 hour, take another pill. If after 1 hour, no need
💉 How to Inject PrEP:
Apretude Dosing and Administration
🏥 Where to Get PrEP:
PrEP access varies greatly worldwide; it's widely in high-income countries like the US and Australia, parts of Southern and Eastern Africa and some countries in Asia, but remains limited or unofficial in many other regions, often due to concerns about cost and antibiotic resistance.
PrEP may be found in:
👉 Sexual Health Clinics
👉 Doctors Surgeries
👉 Online Doctors
👉 Some Pharmacies
🔍 What is Doxy-PEP?
Doxy-PEP, short for Doxycycline Post-Exposure Prophylaxis, is a short term strategy that involves taking the antibiotic doxycycline after condomless sex to reduce the risk of getting certain bacterial sexually transmitted infections (STIs) like Syphilis and Chlamydia.
🦠 Antibiotic Resistance Risk:
Using Doxy-PEP too often could make antibiotics less effective in the future for treating infections
🩹 Not a Replacement:
Doxy-PEP is an extra tool, not a replacement for condoms or other safer sex practices.
Doxy PEP has limited effectiveness against gonorrhea. It doesn't protect against HIV or all other STIs such as herpes. Always use condoms for safer sex
🧑 Who can take Doxy PEP?
👉 Gay, Bisexual, and other Men who have Sex with Men (GBMSM)
👉 Transgender Women
👉 People with a Recent History of STIs
👉 People with Ongoing High-Risk Exposure:
Please note: This is the primary group for whom Doxy-PEP has shown significant efficacy in clinical trials is Gay, Bisexual, and other Men who have Sex with Men (GBMSM) and Transgender Women
🤔 Why Take Doxy PEP?
Doxy-PEP is to significantly reduce the risk of acquiring certain bacterial sexually transmitted infections (STIs).
Reduction Rates:
⬇️ Effective Against Syphilis:
Can reduce the risk of getting 70-90% when taken within 72 hours after exposure.
⬇️ Effective Against Chlamydia:
Can reduce the risk of getting by 70-90% when taken within 72 hours after exposure.
⚠️ Doxy-PEP Gonorrhoea Concerns:
👉 Neisseria gonorrhoeae (the bacteria causing gonorrhoea) already has significant resistance to various antibiotics.
👉 Doxy-PEP's lower and variable efficacy against gonorrhoea, coupled with its widespread use, is a major concern because it can increase the prevalence of doxycycline-resistant gonorrhoea strains, making future treatment harder.
⏰ When Do I Take Doxy PEP?
Doxy-PEP is designed to be taken after a potential exposure to certain bacterial STIs. The timing is critical for its effectiveness.
👉 As Soon as Possible:
The medication should be taken as soon as possible after a condomless sexual encounter (oral, anal, or vaginal/front-hole sex).
👉 Within 72 Hours:
To be effective, Doxy-PEP must be taken no later than 72 hours (3 days) after the potential exposure. While ideally taken within 24 hours, the 72-hour window is the maximum timeframe for it to work.
👉 Single Dose per 24 Hours:
A single dose for a specific exposure or series of close exposures is the general approach.
Regardless of multiple exposures within a day, only one 200 mg dose of doxycycline should be taken within a 24-hour period.
😮 How do I take Doxy PEP?
Doxy-PEP is an on-demand post-exposure prophylaxis. It is short term and the typical dosing regimen after condomless oral/anal/vaginal sex is:
👉 Dosage:
Two 100 mg tablets (total 200 mg) of doxycycline after condomless sex.
👉 With Food and Water:
Take with a full glass of water and with food to minimise stomach upset and to prevent the pill from getting stuck in the oesophagus , which can cause irritation
👉 Stay upright for 30 minutes to 1 hour after dosing
⚠️ Avoid:
Dairy products, calcium supplements, antacids, or multivitamins should ideally be avoided for 2 hours before or after taking doxycycline, as they can interfere with absorption.
🧪 Regular Testing is Key:
Keep getting tested for HIV and other STIs regularly, even if you're using Doxy-PEP.
🏥 How to Get Doxy-PEP?
Doxy-PEP is a prescription medication, and access pathways depend heavily on national health guidelines and regulatory approvals
Countries Where Doxy PEP is Widely Available/Recommended:
🇺🇸 United States:
Officially recommended by the CDC for specific high-risk groups (gay, bisexual, and other men who have sex with men, and transgender women with a recent STI history).
Find Doxy PEP: Typically through doctors (GPs/PCPs), sexual health clinics, and specialised Telehealth services.
🇦🇺 Australia & 🇳🇿 New Zealand:
Strong consensus statements and emerging guidelines support its use for similar high-risk populations.
Find Doxy PEP: Typically through doctors (GPs), sexual health clinics, and some local Telehealth providers.
🇫🇷 France:
Key research has driven its use,
Find Doxy PEP: Available through certain clinics and providers, particularly within sexual health networks.
⚠️ Doxy-PEP Side Effects
🦠 Antibiotic Resistance Risk:
Using Doxy-PEP too often could make antibiotics less effective in the future for treating infections.
☀️ Sun Sensitivity:
Doxycycline can increase sensitivity to the sun (photosensitivity), so wearing sunscreen and protective clothing is recommended Be extra cautious during peak sun hours (usually 10 am to 4 pm)
🤢 Nausea and Stomach Upset:
Some people experience mild nausea, indigestion, or stomach cramps. This is often temporary and may improve after a few doses.
Suggestion: Taking Doxy-PEP with food or a full glass of water might help reduce stomach upset. Avoid lying down immediately after taking it.
😵 Headaches:
Mild headaches can occur in some individuals.
Suggestion: Over-the-counter pain relievers like paracetamol (acetaminophen) may help. Stay hydrated.
🚽 Diarrhoea:
Changes in bowel habits, including mild diarrhoea, are possible.
Suggestion: Stay hydrated. If diarrhoea is severe or persists, consult a healthcare provider.
🍄 Yeast Infections (Thrush):
Although less common with a single dose, repeated use of antibiotics can sometimes lead to yeast infections in the mouth or genitals.
Suggestion: Be aware of symptoms like itching, burning, or unusual discharge. If you suspect a yeast infection, see a healthcare provider for treatment.
⚠️ Rare but Serious Side Effects:
😓 Kidney or Liver Issues:
This is why regular blood tests are recommended if you are taking PrEP, and your doctor will assess your kidney and liver function before prescribing Doxy-PEP.
🚨 Allergic Reactions Signs:
Rash, Itching, Swelling (especially of the face, tongue, or throat), Dizziness, Trouble breathing
Urgently seek emergency medical help if you experience any signs of an allergic reaction.
🗣️ Talk to a Doctor:
Doxy-PEP isn't for everyone. Chat with a healthcare provider to see if it's right for you and to get a prescription.
PEP
Quizzes
Please Note:
The information provided in this quiz is for general educational and informational purposes only, and does not constitute medical advice. You will be redirected to google forms quiz.
Always consult with a doctor or other qualified health provider for any questions regarding a medical condition or before making any decisions about your health.
📋 Medium Quiz
A 10-question quiz on Post-Exposure Prophylaxis (PEP), specifically tailored to scenarios relevant for male sex workers and their clients.
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Doxy-PEP
Quizzes
Please Note:
The information provided in this quiz is for general educational and informational purposes only, and does not constitute medical advice. You will be redirected to google forms quiz.
Always consult with a doctor or other qualified health provider for any questions regarding a medical condition or before making any decisions about your health.
Privacy Disclaimer:
Find PPD understand the importance of your privacy. Any information collected will be stored responsibly and securely. Rest assured, no personal identifying information will be released to third parties. Your responses are used solely to help us understand general trends and improve our resources.
PrEP
Quizzes
Please Note:
The information provided in this quiz is for general educational and informational purposes only, and does not constitute medical advice. You will be redirected to google forms quiz.
Always consult with a doctor or other qualified health provider for any questions regarding a medical condition or before making any decisions about your health.
Privacy Disclaimer:
Find PPD understand the importance of your privacy. Any information collected will be stored responsibly and securely. Rest assured, no personal identifying information will be released to third parties. Your responses are used solely to help us understand general trends and improve our resources.
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