Response to the ASHM 2023 statement on the use of doxy‐PEP in Australia: considerations and recommendations

Abstract

Response to the ASHM 2023 statement on the use of doxy-PEP in Australia: considerations and recommendations I n September 2023, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) released the 2023 Consensus statement on doxycycline prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual, and other men who have sex with men in Australia, 1 which appears in this issue of the MJA. 2 The Statement addresses important considerations for the use of doxy-PEP to reduce acquisition, potential transmission, and negative sequalae primarily for syphilis, while noting its clinical benefit, albeit to a lesser extent, for chlamydial and gonococcal infection for gay and bisexual men who have sex with men (GBMSM). We commend ASHM on this timely and important statement, with people already requesting or using doxy-PEP, with or without clinical oversight. In response, we wish to further emphasise two important considerations for doxy-PEP implementation, notably, the potential threat of increasing antimicrobial resistance (AMR) and the urgent need to implement measures to effectively monitor doxy-PEP use and its impact.