1887
  1. Home
  2. Eurosurveillance
  3. Volume 30, Issue 26, 03/Jul/2025
  4. Article
Research Open Access
Like 0
Download

SDG 3: STI

Abstract

BACKGROUND

Doxycycline post-exposure and pre-exposure prophylaxis (doxyPEP/PrEP) to prevent sexually transmitted infections (STIs) is not part of standard practice in the Netherlands but may be used informally (without prescription).

AIM

We assessed informal use and intention to use doxyPEP/PrEP among men who have sex with men (MSM) and transgender and gender diverse people in the Netherlands.

METHODS

Between 26 February and 6 May 2024, we conducted an online survey on informal doxyPEP/PrEP use in the preceding 6 months and intention to use. We assessed the determinants of recent informal use and high intention to use using risk ratio regression.

RESULTS

Of the 1,633 participating individuals (96.7% MSM) 246 (15%) reported doxyPEP/PrEP use in the preceding 6 months. Informal use was more common among participants who used HIV PrEP or were living with HIV, had ≥ 15 anonymous sexual partners, engaged in chemsex, wanted to protect themselves, got advice from others to use doxyPEP/PrEP and believed doxyPEP/PrEP is safe. High intention to use (n = 1,063 (65%) participants) was more common among participants using HIV PrEP or living with HIV, who wanted to have condomless sex, who wanted to protect others from STIs and who perceived doxyPEP/PrEP as effective and safe.

CONCLUSION

Although doxyPEP/PrEP is not formally recommended in the Netherlands, survey participants reported informal use and a high intention to use. These findings, combined with the global increase of antimicrobial resistance (AMR), stress the need for close monitoring and further research on the AMR effects of doxyPEP/PrEP use.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2025.30.26.2400707
2025-07-03
2025-07-19
/content/10.2807/1560-7917.ES.2025.30.26.2400707
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/30/26/eurosurv-30-26-6.html?itemId=/content/10.2807/1560-7917.ES.2025.30.26.2400707&mimeType=html&fmt=ahah

References

  1. Sokoll PR, Migliavaca CB, Döring S, Traub U, Stark K, Sardeli AV. Efficacy of postexposure prophylaxis with doxycycline (Doxy-PEP) in reducing sexually transmitted infections: a systematic review and meta-analysis. Sex Transm Infect. 2025;101(1):59-67.  https://doi.org/10.1136/sextrans-2024-056208  PMID: 39097410 
  2. Luetkemeyer AF, Donnell D, Dombrowski JC, Cohen S, Grabow C, Brown CE, et al. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. N Engl J Med. 2023;388(14):1296-306.  https://doi.org/10.1056/NEJMoa2211934  PMID: 37018493 
  3. Molina JM, Bercot B, Assoumou L, Rubenstein E, Algarte-Genin M, Pialoux G, et al. Doxycycline prophylaxis and meningococcal group B vaccine to prevent bacterial sexually transmitted infections in France (ANRS 174 DOXYVAC): a multicentre, open-label, randomised trial with a 2 × 2 factorial design. Lancet Infect Dis. 2024;24(10):1093-104.  https://doi.org/10.1016/S1473-3099(24)00236-6  PMID: 38797183 
  4. Szondy I, Meznerics FA, Lőrincz K, Kemény LV, Walter A, Mohammed AA, et al. Doxycycline prophylaxis for the prevention of sexually transmitted infections: A systematic review and meta-analysis of randomized controlled trials. Int J Infect Dis. 2024;147:107186.  https://doi.org/10.1016/j.ijid.2024.107186  PMID: 39122208 
  5. Unemo M, Cole MJ, Kodmon C, Day M, Jacobsson S, Balla E, et al. High tetracycline resistance percentages in Neisseria gonorrhoeae in Europe: is doxycycline post-exposure prophylaxis unlikely to reduce the incident gonorrhoea cases? Lancet Reg Health Eur. 2024;38:100871.  https://doi.org/10.1016/j.lanepe.2024.100871  PMID: 38476738 
  6. Traeger MW, Mayer KH, Krakower DS, Gitin S, Jenness SM, Marcus JL. Potential impact of doxycycline post-exposure prophylaxis prescribing strategies on incidence of bacterial sexually transmitted infections. Clin Infect Dis. 2023;ciad488.  https://doi.org/10.1093/cid/ciad488  PMID: 37595139 
  7. Truong R, Tang V, Grennan T, Tan DHS. A systematic review of the impacts of oral tetracycline class antibiotics on antimicrobial resistance in normal human flora. JAC Antimicrob Resist. 2022;4(1):dlac009.  https://doi.org/10.1093/jacamr/dlac009  PMID: 35198979 
  8. Chu VT, Glascock A, Donnell D, Grabow C, Brown CE, Ward R, et al. Impact of doxycycline post-exposure prophylaxis for sexually transmitted infections on the gut microbiome and antimicrobial resistome. Nat Med. 2025;31(1):207-17.  https://doi.org/10.1038/s41591-024-03274-2  PMID: 39363100 
  9. Cornelisse VJ, Riley B, Medland NA. 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. 2024;220(7):381-6.  https://doi.org/10.5694/mja2.52258  PMID: 38479437 
  10. Werner RN, Schmidt AJ, Potthoff A, Spornraft-Ragaller P, Brockmeyer NH, German STI, German STI Society (DSTIG). Position statement of the German STI Society on the prophylactic use of doxycycline to prevent STIs (Doxy-PEP, Doxy-PrEP). J Dtsch Dermatol Ges. 2024;22(3):466-78.  https://doi.org/10.1111/ddg.15282  PMID: 38123738 
  11. Bachmann LH, Barbee LA, Chan P, Reno H, Workowski KA, Hoover K, et al. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR Recomm Rep. 2024;73(2):1-8.  https://doi.org/10.15585/mmwr.rr7302a1  PMID: 38833414 
  12. Kohli M, Medland N, Fifer H, Saunders J. BASHH updated position statement on doxycycline as prophylaxis for sexually transmitted infections. Sex Transm Infect. 2022;98(3):235-6.  https://doi.org/10.1136/sextrans-2022-055425  PMID: 35414633 
  13. Hermanussen R, van Bokhoven-Rombouts CAJ, de Vries HJC, Gisolf J, Hoornenborg E, de Stoppelaar S, et al. Nederlandse stellingname inzake doxyPEP december 2024. [Dutch position statement on doxyPEP, December 2024]. Amsterdam: Soa Aids Nederland; 2025. Dutch. Available from: https://www.soaaids.nl/files/2025-01/Nederlandse%20stellingname%20DoxyPEP%20jan2025%20DEFINITIEF%20webversie.pdf
  14. Chan PA, Malyuta Y, Parent H, Tao J, Erbe M, Salhaney P, et al. Early adopters of doxycycline as post-exposure prophylaxis to prevent bacterial sexually transmitted infections in a real-world clinical setting. Sex Transm Infect. 2024;100(6):339-42.  https://doi.org/10.1136/sextrans-2024-056152  PMID: 38821877 
  15. Wagner L, Boesecke C, Baumgarten A, Scholten S, Schellberg S, Hoffmann C, et al. Is doxycycline post-exposure prophylaxis being utilised in Germany? Insights from an online survey among German men who have sex with men. Infection. 2025;53(1):61-70.  https://doi.org/10.1007/s15010-024-02321-x  PMID: 39042326 
  16. Villanueva Baselga S, Ruben M, Luis V. A practice already in use: a snapshot survey on the use of doxycycline as a preventive strategy (Doxy-PEP and Doxy-PrEP) in the GBMSM population in Spain. Infection. 2025;53(1):437-41.  https://doi.org/10.1007/s15010-024-02320-y  PMID: 39060908 
  17. Matser A, Hulstein B, de Vries HJC, Hoornenborg E, Prins M, Davidovich U, et al. What do men who have sex with men think of the use of antibiotics as pre- and post-exposure prophylaxis to prevent sexually transmitted infections? medRxiv. 2023:23295017 https://doi.org/10.1101/2023.09.06.23295017 
  18. Blomaard CM, Jongen VW, Achterbergh RC, van der Loeff MFS, de Vries HJ. Sexualized drug use and STD and HIV incidence among men who have sex with men in Amsterdam, the Netherlands. Int J STD AIDS. 2023;34(11):795-802.  https://doi.org/10.1177/09564624231180781  PMID: 37279926 
  19. Mårdh O, Plachouras D. Using doxycycline for prophylaxis of bacterial sexually transmitted infections: considerations for the European Union and European Economic Area. Euro Surveill. 2023;28(46):2300621.  https://doi.org/10.2807/1560-7917.ES.2023.28.46.2300621  PMID: 37971658 
  20. Samuel KD, Ellis MS, Buttram ME. The impact of socio-environmental factors on doxycycline post-exposure prophylaxis awareness in the US: a cross-sectional study. Sex Health. 2024;21(3).  https://doi.org/10.2807/1560-7917.ES.2023.28.46.2300621  PMID: 37971658 
  21. Traeger MW, Mayer KH, Krakower DS, Gitin S, Jenness SM, Marcus JL. Potential impact of doxycycline post-exposure prophylaxis prescribing strategies on incidence of bacterial sexually transmitted infections. Clin Infect Dis. 2023;ciad488.  https://doi.org/10.1093/cid/ciad488  PMID: 37595139 
  22. King BM. The Influence of Social Desirability on Sexual Behavior Surveys: A Review. Arch Sex Behav. 2022;51(3):1495-501.  https://doi.org/10.1007/s10508-021-02197-0  PMID: 35142972 
Emergent informal use of doxycycline post- and pre-exposure prophylaxis among men who have sex with men and transgender and gender diverse people, the Netherlands, 2024
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Buhari+Teker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Teker Buhari</a>, <a href="/search?value1=Elske+Hoornenborg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoornenborg Elske</a>, <a href="/search?value1=Maarten+F+Schim+van+der+Loeff&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schim van der Loeff Maarten F</a>, <a href="/search?value1=Anders+Boyd&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boyd Anders</a>, <a href="/search?value1=Janneke+CM+Heijne&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Heijne Janneke CM</a>, <a href="/search?value1=Maria+Prins&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Prins Maria</a>, <a href="/search?value1=Udi+Davidovich&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Davidovich Udi</a>, <a href="/search?value1=Henry+JC+de+Vries&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Vries Henry JC</a>, <a href="/search?value1=Vita+W+Jongen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jongen Vita W</a></span>. Emergent informal use of doxycycline post- and pre-exposure prophylaxis among men who have sex with men and transgender and gender diverse people, the Netherlands, 2024. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(26):pii=2400707. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.26.2400707" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.26.2400707</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 25 Oct 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 05 Feb 2025 </span> </p>
/content/10.2807/1560-7917.ES.2025.30.26.2400707
/content/10.2807/1560-7917.ES.2025.30.26.2400707
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error