DoxyPEP Is Changing Sexual Health — Here’s How

Globally, some gay, bi, queer, and trans people experience sexually transmitted infections (STIs) more frequently compared to straight and cisgender people, so prevention strategies lower infection rates for HIV and sexually transmit infection concerns such as syphilis. As a solution, researchers recommend doxyPEP (doxycycline post-exposure prophylaxis) as a newer tool to protect us from bacterial STIs, like syphilis, chlamydia, and gonorrhea.

Using an antibiotic such as doxycycline (sometimes called doxy) can reduce STIs risk. But, despite its branding as a “morning-after pill” and “Plan B,” doxyPEP does not prevent pregnancy. It does not reduce our risk of contracting HIV, hepatitis, herpes, or mpox. Other methods, like condom usage, remain critical to combat infection. Condoms, PrEP (pre-exposure prophylaxis), and U=U (undetectable equals untransmittable) most effectively prevent us from acquiring and transmitting HIV and viral STIs.

Readers of the Grindr Blog unfamiliar with doxyPEP should not feel badly: my health care provider, a board-certified optometrist, had not heard of it, either. This highlights how awareness of antibiotic prophylaxis for bacterial STIs (like gonorrhea and chlamydia) can lag behind community needs.

Last year, during my annual eye exam, the optometrist asked me if I ever hear ringing in my ears. Hoping she might help treat me, I answered affirmatively because I convinced myself a health care provider should diagnose me with pulsatile tinnitus after scouring WebMD for weeks like a hypochondriac. The optometrist then asked me to list my medications. When I mentioned doxyPEP, she admitted she did not know about it and then proceeded to explain that the overprescription of this antibiotic caused the ringing in my ears. I questioned her assessment, as did my primary care provider — who prescribes my doxyPEP — when I told the story to him.

It concerned me that a health care provider looking after queer and trans people did not recognize doxyPEP. Even so, doxycycline is a common antibiotic used for post exposure prophylaxis in sexually transmit infection scenarios. However, after leaving the exam with the optometrist, I acknowledged that even well-meaning health care providers may need a little help keeping up with advancements in LGBTQ+ health and that we can play a role in bridging that gap.

One Quick Step, Remember DoxyPEP

I first sought a prescription of doxyPEP from my primary care provider after three bouts of syphilis following unprotected sex. Repeated syphilis or chlamydia infection can sometimes be prevented by a timely PEP approach with doxy. The treatment for syphilis calls for a penicillin injection using a large needle in your buttock, and it caused me such pain that I accidentally kicked the nurse — perhaps as a reflex or as a trauma response — before she injected me during my second bout of syphilis. No one should learn about new STI prevention tools only after experiencing painful treatments. The more we openly discuss doxyPEP — on Grindr, with our friends, and with our health care providers — the more we empower each other to make informed decisions before an STI happens.

As an expert in public health, I knew another option to reduce my risk of experiencing STIs and the pain that followed during treatment must exist. Enter: doxyPEP. My primary care provider instructed me to take two 100-milligram pills of doxycycline within 72 hours after condomless sex, though best to take it within 24 hours. This post exposure prophylaxis approach with doxycycline (an antibiotic) helps lower bacterial STIs risk—such as gonorrhea and chlamydia—following sex without a condom. A prescription delivery service sends doxyPEP every few months to my apartment after I order it on their app.

Empower Hour

I met my friend and neighbor, Davon Wise, on Grindr. For these same reasons — frustration with the treatment that follows acquiring an STI — Davon, who lives down the street from me in Harlem, asked his health care provider for a prescription of doxyPEP. He pays $10 to refill his prescription because his private insurance mostly covers the cost, though Medicare, Medicaid, Planned Parenthood, and some telehealth services offer free or low-cost options. “I am really grateful to have doctors who are very open with me about sex,” Davon said.

Like many in our community, Davon first heard about doxyPEP from his LGBTQ+ friends in New York City, another example of queer and trans people looking out for one another when it comes to sexual health. By adding the “I’m on DoxyPEP” and “Condoms” profile field and tag, Grindr makes those conversations even easier, helping us build a culture where prevention is both accessible and free of stigma. This culture shift can reduce infection rates of gonorrhea, chlamydia, and syphilis while also supporting HIV prevention efforts.

Davon realized he should find creative reminders to take doxyPEP after unprotected sex, like during morning and evening routines when you might take PrEP for HIV prevention or ART (antiretroviral therapy) for HIV treatment. “This may sound funny, but it’s routine for me,” he said. “If there is someone new who I am having unprotected sex with, I like to have it in my pocket after I leave their house or once they leave mine.” Staying consistent with antibiotic prophylaxis helps fight bacterial STIs (including chlamydia and gonorrhea), underscoring the value of doxy after sex.

Jeff Day, DNP, AGPCNP-BC, serves an adult-gerontology primary care nurse practitioner at Callen-Lorde Community Health Center and an adjunct clinical professor at New York University Rory Meyers College of Nursing. Similar to Davon, he recommends finding creative reminders to take doxyPEP after unprotected sex.

“I encourage my patients to keep it simple by remembering the 3:2:1 rule – within three days, take two tablets, one time,” Dr. Day said. “I also recommend making a sexual health ‘goody bag.’ Include your PrEP and doxyPEP bottles, lube, condoms, toys, and any other supplies you might need for a satisfying, healthy, sexual encounter.” This practical approach helps reduce infection by using antibiotic (such as doxycycline) for PEP, alongside condom use to prevent sexually transmit infection spread.

Some health care providers lack knowledge about doxyPEP, but that does not make it experimental or uncommon. In fact, most health care providers supporting queer and trans people in STI prevention would recommend it as a promising tool. For those who find themselves in situations where they need to educate their health care providers, like my optometrist, Dr. Day reminds us to take charge of our own well-being.

“Regional LGBTQ-focused health centers, like Callen-Lorde Community Health Center here in New York City, have guidance online,” he said. “Print out this information to bring with you to your health care provider or have a tab open on your phone to show your provider in the office. It may be uncomfortable to describe your concerns and ask for doxyPEP, but remember that your health is the most important resource that you have, and advocating for yourself is always worth it.” Being proactive about sex health, post exposure prophylaxis, and doxycycline ensures fewer STIs like gonorrhea, chlamydia, and syphilis take hold.

Gay, bi, queer, and trans people always lead the way in building supportive sexual health networks. By adding the “I’m on DoxyPEP” and “Condoms” profile field and tag, Grindr strengthens that tradition, making it easier to share prevention strategies without fear of judgment. Dr. Day reminds us to ignore the stigma that others may associate with doxyPEP.

“I counsel my patients not to let other people’s opinions interfere with seeking healthcare and living their best lives,” he said. “It’s true that, as with PrEP, some people may have misperceptions about those who use these treatments, but get the care you need and deserve anyway — you are worth it.” Combating stigma around antibiotic usage for PEP can help reduce HIV and other infection risks in sex-positive communities.

The Path Forward with Doxy

Grindr’s new additions to its Sexual Health Practice section excite Dr. Day, who notes that it could activate those who do not know much about doxyPEP to discover it. Additionally, the “I’m on DoxyPEP” and “Condoms” profile field and tag bridge the gap between medical systems and our community by making conversations about STI prevention more visible and accessible.

When more people share their prevention choices, we collectively shift the narrative toward empowerment. The new additions to Grindr’s Sexual Health Practice section excite Davon, too.

“I would definitely add the tag,” he said. “That already allows us to have a transparent and honest conversation about sex without it feeling too awkward, but I respect people who decide to leave it off and disclose within a private chat.”

For more information on DoxyPEP, check out our new series, The Equality Spotlight, produced in tandem with Grindr for Equality—our social justice initiative dedicated to uplifting LGBTQ+ issues worldwide.

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