(PL2) WHERE CAN I GET DOXY PEP? AVAILABILITY OF DOXY PEP VIA WEB-BASED TELEHEALTH PLATFORMS

Background:
The CDC released final guidance for the use of doxycycline as postexposure prophylaxis (doxy PEP) on June 4, 2024. Telehealth platforms have the potential to improve access to doxy PEP, but information on its availability is limited. Equitable access to doxy PEP is crucial for success. We aimed to describe the availability of doxy PEP via online telehealth platforms.

Methods:
In May 2024, we conducted a web-based scan of doxy PEP telehealth providers before the official release of CDC’s guidelines. We used common search terms such as "doxy PEP online," "doxy PEP telehealth," "STI treatment online," and "how to get doxy PEP online" and reviewed the first page of web results (n=40). We also cross-referenced an HIV PrEP telehealth directory and KFF’s sexual health telemedicine environmental scan (n=22 sites) for doxy PEP prescribing. Of 46 sites (16 duplicates excluded), five specifically advertised doxy PEP for STIs, while four offered general sexual health services with educational information about doxy PEP.

Results:
Most (n=7/9) sites require a virtual consultation to determine patient eligibility. Four platforms include the prescription cost in the consult fee, while five charge separate costs based on the individual’s pharmacy and insurance. Six platforms accept insurance, with an average prescription cost of $30 with insurance and $83 without. Two platforms offer their services for free, and two provide subscriptions with automatic prescription renewals every three months. Options include local pharmacy pick-up (n=4), delivery (n=3), or both (n=2). Seven platforms state that prescriptions are at the practitioner's discretion, and two only prescribe doxy PEP to established HIV PrEP patients.

Conclusion:
Prior to CDC's final guidance release, some telehealth platforms were prescribing doxy PEP with unclear eligibility criteria and varying prices. Post-guidance release, further investigation is needed to monitor prescribing trends, costs, and assess variability in care models across platforms to ensure equitable access.