Campaigns and Hubs Trans+ Sexual Wellbeing DoxyPEP | Trans+ Sexual Wellbeing Talking about STI prevention can feel awkward, but having clear information helps you make choices that feel right for you. Trans people are often left out of sexual health conversations. This guide is here to help close that gap. Data released by Sexual Health London (SHL), based on home STI testing kits sampled between 2018 and 2022, found that trans people were more likely to test positive for chlamydia and syphilis than cisgender people. Data from the UK Health Security Agency (UKHSA) also highlighted that syphilis disproportionately affects trans communities. This could be due to a range of factors, including limited access to inclusive healthcare services, barriers to prevention methods, gaps in knowledge about treatment, and potentially higher rates of STI testing. One newer STI prevention approach that may be helpful for some trans people is DoxyPEP What is DoxyPEP? DoxyPEP (Doxycycline Post-Exposure Prophylaxis) is a medication that helps reduce your chances of getting bacterial STIs like syphilis, chlamydia, and gonorrhoea. It works by taking an antibiotic after sex to prevent infections before they take hold. Think of it as an extra layer of protection for your sexual health. Who is DoxyPEP for? DoxyPEP is mainly recommended for gay, bi, and other men who have sex with men (MSM), as well as trans women who have had an STI in the past year. I If you have an active sex life and want additional protection against STIs, this could be an option worth discussing with a healthcare professional. How do you take DoxyPEP? Remember 3…2…1: Within 3 days, or 72 hours, of a sexual encounter Take 2 tablets, or 200 mg, of Doxycycline Just 1 time, or no more than one dose per day It will be most effective if you take it within the first 24 hours, so treat it like a morning-after medication. If you have sex on consecutive days, you can continue taking one dose per day until up to 72 hours after your last sexual encounter. Although it is safe to take daily, do not take more than 200mg in one day. Take it with water and food, if possible, to help decrease any potential side effects like nausea or headaches. Always follow medical advice, as overuse of antibiotics can cause resistance. Does It work? Here’s what the research says: San Francisco Study: Found that DoxyPEP reduced syphilis and chlamydia cases by 50% among MSM and trans women. Kaiser Permanente Study: Showed that DoxyPEP reduced chlamydia by 79%, syphilis by 80%, and gonorrhoea by 12% in people taking HIV PrEP. While it’s not perfect, it’s a significant step in reducing STIs and keeping your health in check. Are there any side effects? Like any medication, DoxyPEP has potential side effects, including: Stomach upset (nausea, diarrhoea, or bloating) Sensitivity to sunlight (wear sunscreen if you’re taking it) Risk of antibiotic resistance if overused It’s always best to check in with a healthcare professional to see if it’s the right choice for you. Being trans and taking DoxyPEP DoxyPEP for trans women who have sex with men and are at higher risk of STIs (specifically syphilis and chlamydia) is generally recommended. It’s effective regardless of whether you’ve had gender-affirming surgeries (such as vaginoplasty). For trans men, specific studies are currently limited, but DoxyPEP is considered safe to use. For those with a vagina/front hole, there’s limited evidence on its effectiveness for STIs acquired through vaginal/frontal sex. DoxyPEP does not negatively interact with hormone treatments (testosterone, oestrogen). What else should I know before starting DoxyPEP? It's safe to take PrEP for HIV and DoxyPEP at the same time. Since this treatment method is relatively new, we are still learning about the effects of DoxyPEP on the ‘good’ bacteria of the gut, the bacteria that live on our skin (for example, staph), and possible resistance to STIs such as gonorrhoea. Doxycycline is not a new medication, but this use of it is. Doxycycline has long been used as a common antibiotic due to its safety, mild potential side effects, and low cost. How does DoxyPEP fit into your sexual health routine? DoxyPEP isn’t a replacement for other sexual health strategies but works best alongside: Regular STI check-ups PrEP or condoms for HIV prevention Vaccinations for hep A, hep B, and HPV Open conversations about testing with partners Can you get DoxyPEP in the UK? At the moment, DoxyPEP isn’t widely available on the NHS, but there are ways to access it: Private Clinics: Some sexual health clinics and online pharmacies may prescribe it. Online Pharmacies: Certain sites allow you to order a personal supply legally — check reliable sources like The Love Tank’s Queer Health for guidance. Always consult a healthcare provider before starting any new medication. The future of DoxyPEP in the UK UK health authorities are still reviewing DoxyPEP, particularly around concerns of antibiotic resistance. Research is ongoing, so keep an eye out for updates. Is DoxyPEP right for you? If you frequently get STIs and want an extra layer of protection, DoxyPEP might be a good fit. Talk to a doctor or sexual health professional to see if it’s suitable for you. You’re in control of your sexual health choices, and different options work for different people. Find out more For more information, check out: 56 Dean Street Your local sexual health clinic Queer Health THT Manage Cookie Preferences