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Awareness and acceptability of doxycycline post-exposure prophylaxis among men who have sex with men
- Uncategorized
- Published: July 3, 2026
Awareness and acceptability of doxycycline post-exposure prophylaxis among men who have sex with men
José A. Ramos 1 
, Joana Reis 2 , Marcelo Silva 2 , Hugo Leme 1 , Frederico Bonito 1, Katarina Rodrigues 1 , João Alves 2
1 Serviço de Dermatovenereologia, Unidade Local de Saúde de Almada-Seixal, EPE, Almada, Portugal; 2 Centro de Responsabilidade Integrada de Dermatovenereologia, Unidade Local de Saúde Almada-Seixal, Av. Torrado da Silva, Pragal 2801-951 Almada, Portugal
José A. Ramos, Joana Reis, Marcelo Silva, Hugo Leme, Frederico Bonito, Katarina Rodrigues, João Alves
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: José A. Ramos. Email: jalramos@campus.ul.pt
Abstract
Objectives: Doxycycline post-exposure prophylaxis (Doxy-PEP) has emerged as a complementary strategy for the prevention of bacterial sexually transmitted infections (STIs). In Portugal, data regarding awareness and acceptability of Doxy-PEP among men who have sex with men (MSM) are scarce. This study aimed to assess awareness and acceptability of Doxy-PEP among MSM attending a hospital-based STI clinic, describe sexual and preventive practices, and explore the relationship between human immunodeficiency virus (HIV) pre-exposure prophylaxis (HIV-PrEP), previous bacterial STIs, and willingness to use Doxy-PEP. Methods: A cross-sectional single-center study was conducted using an anonymous questionnaire administered to MSM attending a hospital-based STIs clinic between April and September 2025. Statistical analysis was performed using the Statistical Package for the Social Sciences version 29.0.1. Results: Fifty-four valid questionnaires were included. Participants had a median age of 31.5 years (range: 19-57 years). HIV infection was present in 20.4% (11/54) of participants. Among HIV-negative participants, 44.2% (19/43) were using HIV-PrEP. Overall, 66.7% (36/54) reported at least one bacterial STI episode in the previous 12 months. Previous awareness of Doxy-PEP was reported by 57.4% (31/54), mainly through peers (51.6%). After a brief explanation regarding Doxy-PEP, 83.3% (45/54) stated that they would be willing to use it if available. A statistically significant association was found between the number of sexual partners during the previous 6 months and Doxy-PEP acceptability (Spearman’s correlation coefficient = 0.395; p = 0.0054). Among HIV-negative participants, bacterial STI burden and Doxy-PEP acceptability were higher among HIV-PrEP users compared with non-users. Conclusion: Doxy-PEP acceptability among MSM attending an STI clinic was high, despite limited baseline awareness. HIV-PrEP users represented a subgroup with higher STI burden and greater acceptability of Doxy-PEP, suggesting that implementation strategies may be particularly relevant within HIV-PrEP clinics. Educational interventions, regular STI screening, antimicrobial stewardship, and antimicrobial resistance surveillance should accompany this prophylactic strategy.
Keywords: Doxycycline. Doxy-post-exposure prophylaxis. Sexually transmitted infections. Men who have sex with men. Sexually transmitted infections prevention.
