(P119) IMPLEMENTING DOXYPEP: A NEW OPPORTUNITY FOR STI PREVENTION IN A HEALTH DEPARTMENT PREP CLINIC

Background:
For many years, HIV pre-exposure prophylaxis (PrEP) has been known as a safe and efficacious method of HIV prevention among populations at risk of HIV acquisition. However, rates of other STIs remain high among these same groups. Recent studies using doxycycline as post-exposure prophylaxis (PEP) have shown reduced incidence of the bacterial STIs chlamydia, gonorrhea, and syphilis.

Methods:
Patients receiving routine HIV PrEP services in a local county health department PrEP clinic were provided counseling on DoxyPEP as a method of prevention for chlamydia, gonorrhea, and syphilis. A retrospective chart review was conducted to evaluate multiple variables related to patients’ sites of exposure, use of DoxyPEP, and incidence of STIs before and after starting DoxyPEP.

Results:
Of the 95 patients seen for a PrEP visit from September 1 – November 30, 2023, 94 were eligible for and counseled on DoxyPEP. 85 (90%) chose to start DoxyPEP. In 2022, 60 of the 85 patients were tested for bacterial STIs at least once in the PrEP clinic and 26 (43%) had at least one positive result. In 2023, all 85 patients were tested at least once prior to starting DoxyPEP and 40 (47%) had at least one positive result. 72 (85%) patients returned for their 3-month follow-up. Of those, 68 (96%) had taken at least 1 dose of DoxyPEP. 7 of those 68 (11%) had at least one positive test result for a bacterial STI since starting DoxyPEP. There were no reported side effects. Anecdotal reports indicate both patient and provider acceptability.

Conclusion:
Overall, DoxyPEP was favorably received and there was a reduction in incidence of chlamydia, gonorrhea and syphilis. An existing relationship with the PrEP provider and categorical STD clinic likely facilitated DoxyPEP uptake. Ongoing surveillance should add further clarity to additional factors influencing uptake and reduction in bacterial STI acquisition.