(P121) PERCEPTIONS ABOUT DOXYCYCLINE POST-EXPOSURE PROPHYLAXIS (DOXY-PEP) AS AN STI-PREVENTION STRATEGY AMONG SEXUAL MINORITY MEN (SMM) IN THE UNITED STATES: RESULTS FROM A QUALITATIVE STUDY

Background:
Bacterial sexually transmitted infections (STIs) are on the rise in the United States, with sexual minority men (SMM) experiencing disproportionately high rates of STIs. Doxycycline post-exposure prophylaxis (Doxy-PEP) is a novel biomedical STI-prevention strategy that involves taking one dose of 200-mg doxycycline within 24 hours (and no later than 72 hours) after condomless sex, effectively reducing the risk of acquiring bacterial STIs. The Centers of Disease Control and Prevention (CDC) released draft guidelines for Doxy-PEP as an STI-prevention strategy in October 2023; though official guidelines have not been released. Little is known about Doxy-PEP’s acceptability in the U.S., nor how best to engage those most vulnerable to STIs in taking up this nascent prevention strategy. To that end, this study leverages qualitative data to explore SMM’s perceptions about Doxy-PEP.

Methods:
Between July and September of 2023, twenty-four cisgender men from across the U.S. completed qualitative interviews about their perceptions regarding Doxy-PEP. Participants were asked if they knew about Doxy-PEP, if they would be interested in using Doxy-PEP, what they liked about Doxy-PEP, and their concerns regarding it as an STI-prevention strategy. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic approach.

Results:
The sample’s mean age was 34.58 years and nearly 70% of the sample were people of color. One participant had been prescribed Doxy-PEP. Participants were generally interested in using Doxy-PEP, but were concerned about the potential for antibiotic resistance, side-effects, medication interactions, along with the potential for stigmatizing discourse to occur around its use. Meanwhile, participants were motivated by Doxy-PEP’s simplicity, and the protection it could confer on both an individual and community-level— along with its potential to reduce STI-related anxiety. Finally, participants desired additional information on Doxy-PEP to address their concerns.

Conclusion:
There is a need for clearer guidelines and expanded public health messaging on Doxy-PEP in the United States.