2272. High interest in doxycycline for sexually transmitted infection post-exposure prophylaxis (doxy-PEP) in a multi-city survey of men having sex with men (MSM) using a social-networking app
Session: Poster Abstract Session: HIV: Sexually Transmitted Infections
Saturday, October 6, 2018
Room: S Poster Hall
  • IDWeek Doxy-PEP.pdf (276.7 kB)
  • Background:

    Sexually transmitted infections (STI) in people living with HIV (PLWH) and HIV-uninfected men who have sex with men (MSM) are increasing. Doxycycline post-exposure prophylaxis (doxy-PEP) showed partial efficacy against STI acquisition in a small population of HIV-uninfected MSM using pre-exposure prophylaxis (PrEP). Acceptability in a larger, diverse population of MSM is unknown.


    We conducted a survey of doxycycline for STI PEP among users of a gay social networking app in 6 US cities: Atlanta, Birmingham, Chicago, New York City, San Francisco, and Seattle. In adjusted analyses using logistic regression, we examined factors associated with bacterial STI in the last year and willingness to use doxy-PEP. Predictors included: demographics, city, risk behaviors, and bacterial STI.


    Overall, 1301 individuals, 80% HIV-uninfected, 16% PLWH, and 4% status unknown responded to the survey. The median age was 33 and the sample was racially/ethnically diverse: 7% Asian, 21% Black, 24% Latinx, and 44% White. Most (80%), reported condomless sex in the last 6 months; 39% reported an STI in the last year. Of the HIV-uninfected, 44% were on PrEP. In adjusted analysis, age per ten years was inversely associated with an STI in the last year (AOR 0.8; 95% CI: 0.7-0.9 and AOR 0.2; 0.0-0.8 respectively), while number of partners in the last 6 months and condomless anal sex were associated with STI (AOR 1.1 per 5 partners; 1.0-1.1 and AOR 3.8; 2.5-5.8 respectively). There was no difference by race/ethnicity, or when comparing PrEP users to PLWH, however not using PrEP was inversely associated with STI (AOR 0.2; 0.2-0.3). Overall, 84% of respondents were interested in trying doxy-PEP. The factors associated with higher interest were: older age per ten years (1.2; 95% CI 1.0-1.4), Black race and Latinx ethnicity vs. White race (AOR 2.0; 1.2-3.5 and 1.9; 1.2-3.0 respectively), prior STI (AOR 1.7; 1.1-2.5), and having condomless sex (AOR 1.6; 1.1-2.4). Interest did not differ by city, number of partners, serostatus, or PrEP use.


    Interest in doxy-PEP was high among a diverse population of MSM in the U.S. Differences in reported STI prevalence may be related to increased detection through screening in PLWH and on PrEP. Additional research to evaluate efficacy/safety of doxy-PEP is needed to potentially reduce STIs among MSM.

    Matthew A. Spinelli, MD1, Hyman Scott, MD2, Eric Vittinghoff, PhD3, Albert Y. Liu, MD2, Kenneth Coleman, MA2, Monica Gandhi, MD, MPH4 and Susan P. Buchbinder, MD2, (1)Infectious Diseases, University of California, San Francisco, San Francisco, CA, (2)Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, (3)Epidemiology, University of California, San Francisco, San Francisco, CA, (4)Medicine, Division of HIV, Infectious Diseases and Global Medicine, UCSF, San Francisco, CA


    M. A. Spinelli, None

    H. Scott, None

    E. Vittinghoff, None

    A. Y. Liu, None

    K. Coleman, None

    M. Gandhi, None

    S. P. Buchbinder, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.