DoxyPEP Implementation and Management Guidelines
Guidelines and considerations for implementing and managing DoxyPEP, including candidate selection, shared decision-making, prescribing practices, and follow-up protocols. Addressing potential barriers and final thoughts on the use of DoxyPEP for STI prophylaxis.
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Doxy PEP Implementation The Ratelle s A1 Team June 13,2023
https://www.sfcdcp.org/wp-content/uploads/2022/10/Health-Update- Doxycycline-Post-Exposure-Prophylaxis-Reduces-Incidence-of-Sexually- Transmitted-Infections-SFDPH-FINAL-10.20.2022.pdf
Who are doxyPEP candidates? With whom should doxyPEP be discussed? Should we offer it only, or should we recommend it for certain patients? Should we consider doxyPEP for people who have not been included in any trials to date (e.g., men who have sex with women only)? Does doxyPEP make sense for people who do not have HIV but who also do not want to take PrEP?
What information should be included in a discussion with patients about doxyPEP? What should shared decision-making with patients look like? What should be included in the conversation? Should we develop shared decision-making materials such as exist for other scenarios (e.g., prostate cancer screening)? Will there be handouts/patient friendly literature to review and give to patients explaining the purpose, dosage and administration of Doxy PEP
How should doxyPEP be prescribed? How many pills should we give people at one time? How many refills? How should patients take it if they have ongoing, daily exposures? Doxycycline monohydrate vs hyclate - is one preferred over the other
Management of people taking doxyPEP How often should follow-up and STI screening be performed? How should we manage confirmed exposures to STIs in people taking doxyPEP? Does this vary by the exposure (chlamydia versus gonorrhea versus syphilis)?
Barriers Awareness of doxyPEP across patients, providers, staff Concerns for development of antibiotic resistance
