{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:49:11Z","timestamp":1791845351160,"version":"4.3.4"},"reference-count":44,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bacterial sexually transmitted infections (STIs) disproportionately impact gay, bisexual and other men who have sex with men (GBMSM) in China. Doxycycline post-exposure prophylaxis (DoxyPEP) can prevent syphilis and chlamydia among GBMSM; however, it has not yet been officially endorsed in China. This study aims to investigate the perceptions and use of DoxyPEP among GBMSM in a nationwide sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide online cross-sectional survey in China between November 2024 and February 2025. Participants were recruited through community-based organizations and Centers for Disease Control offices using convenience and snowball sampling. Eligible participants were cisgender GBMSM aged \u226518\u00a0years living in China. The survey assessed sociodemographic characteristics, sexual behaviors, and DoxyPEP awareness, willingness and use. Modified Poisson regression with robust variance estimation was used to identify correlates of DoxyPEP awareness, willingness and use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1022 GBMSM completed the survey (mean age 29\u00a0years); 96.9% identified as gay\/bisexual. Most were unmarried (87.7%), had graduated college (87.8%) and had a monthly income &amp;gt;USD750 (68.3%). Overall, 55.1% had heard of DoxyPEP, 42.7% reported willingness to use it and 12.8% had previously used it. DoxyPEP awareness was associated with prior HIV pre-exposure prophylaxis (PrEP) use (aPR\u00a01.47, 95% CI: 1.31\u20131.65) and recent sexual activity with female partners (aPR\u00a01.42, 95% CI: 1.23\u20131.64). Willingness to use DoxyPEP was associated with multiple casual sexual partners (aPR\u00a01.41, 95% CI: 1.15\u20131.73), commercial sex (aPR\u00a01.31, 95% CI: 1.07\u20131.62), prior PrEP use (aPR\u00a01.22, 95% CI: 1.05\u20131.41) and DoxyPEP awareness (aPR\u00a02.12, 95% CI: 1.78\u20132.53). The most reported barriers were insufficient information (72.7%), concerns about side-effects (35.5%) and doubts about effectiveness (30.6%). DoxyPEP use was associated with multiple casual partners (aPR\u00a02.17, 95% CI: 1.22\u20133.85), commercial sex (aPR\u00a01.63, 95% CI: 1.07\u20132.47), prior PrEP use (aPR\u00a02.56, 95% CI: 1.75\u20133.74) and DoxyPEP awareness (aPR\u00a014.60, 95% CI: 6.12\u201334.80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DoxyPEP awareness and willingness among GBMSM in China were moderate; however, actual uptake remained low. Having multiple sexual partners, commercial sex history, and prior HIV PrEP experience were associated with DoxyPEP willingness and use. Targeted health education and integration of DoxyPEP into existing HIV and STI prevention services may facilitate scaled uptake of DoxyPEP in practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh26150","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:11:52Z","timestamp":1791843112000},"source":"Crossref","is-referenced-by-count":0,"title":["Awareness, willingness to use and use of doxycycline post-exposure prophylaxis among gay, bisexual and other men who have sex with men in China: a national cross-sectional survey"],"prefix":"10.1071","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7012-5986","authenticated-orcid":true,"given":"Zhuoheng","family":"Yin","sequence":"first","affiliation":[{"name":"AUNC Project-China, Guangzhou, Guangdong, China."},{"name":"BUniversity of Hong Kong, School of Nursing, Hongkong, Hong Kong, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojin","family":"Zhang","sequence":"additional","affiliation":[{"name":"CShanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Li","sequence":"additional","affiliation":[{"name":"AUNC Project-China, Guangzhou, Guangdong, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S.","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"DUniversity of Washington, Division of Allergy and Infectious Diseases, Seattle, WA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5399-3443","authenticated-orcid":true,"given":"Peipei","family":"Zhao","sequence":"additional","affiliation":[{"name":"ENanjing Medical University, Department of Social Medicine and Implementation Science, School of Public Health, Nanjing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiehu","family":"Yuan","sequence":"additional","affiliation":[{"name":"AUNC Project-China, Guangzhou, Guangdong, China."},{"name":"ENanjing Medical University, Department of Social Medicine and Implementation Science, School of Public Health, Nanjing, China."},{"name":"FGuangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peizhen","family":"Zhao","sequence":"additional","affiliation":[{"name":"GDermatology Hospital Southern Medical University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"GDermatology Hospital Southern Medical University, Guangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0319-2518","authenticated-orcid":true,"given":"Sean","family":"Conley","sequence":"additional","affiliation":[{"name":"HUniversity of Chicago, Section of Infectious Diseases and Global Health, Chicago, IL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-3540","authenticated-orcid":true,"given":"Edmond Pui Hang","family":"Choi","sequence":"additional","affiliation":[{"name":"BUniversity of Hong Kong, School of Nursing, Hongkong, Hong Kong, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3780-2675","authenticated-orcid":true,"given":"Renslow","family":"Sherer","sequence":"additional","affiliation":[{"name":"HUniversity of Chicago, Section of Infectious Diseases and Global Health, Chicago, IL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-707X","authenticated-orcid":true,"given":"Weiming","family":"Tang","sequence":"additional","affiliation":[{"name":"AUNC Project-China, Guangzhou, Guangdong, China."},{"name":"IUniversity of North Carolina at Chapel Hill, Institution of Global Health and Infectious Diseases, Chapel Hill, NC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"8","key":"2026101218114858400_R1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1177\/09564624251333489","article-title":"A global meta-analysis of gonorrhoea and chlamydia prevalence among men who have sex with men from 2000 to 2022.","volume":"36","author":"Davies","year":"2025","journal-title":"Int J STD 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Technical information: doxycycline post-exposure prophylaxis for sexually transmitted infections prevention; 2026. Available at https:\/\/www.who.int\/teams\/global-hiv-hepatitis-and-stis-programmes\/guidelines\/stis-guidelines\/doxypep"},{"key":"2026101218114858400_R10","unstructured":"Molina JM. Doxy PEP for STIs; 2022. Available at https:\/\/www.iasociety.org\/sites\/default\/files\/EduFund\/meeting-material\/brazil\/presentations\/Jean_Michel_Molina_Doxy_PEP_for_STIs.pdf"},{"issue":"13","key":"2026101218114858400_R11","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1177\/09564624241273801","article-title":"IUSTI Europe position statement on use of DoxyPEP: June 2024.","volume":"35","author":"Sherrard","year":"2024","journal-title":"Int J STD AIDS"},{"issue":"2","key":"2026101218114858400_R12","doi-asserted-by":"publisher","DOI":"10.1071\/SH25227","article-title":"Doxycycline prophylaxis is effective as pre-exposure and post-exposure regimens in the prevention of sexually transmitted infections: an updated systematic review and meta-analysis.","volume":"23","author":"Zhao","year":"2026","journal-title":"Sex Health"},{"issue":"1","key":"2026101218114858400_R13","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11290-x","article-title":"Willingness to accept Doxycycline post-exposure prophylaxis for bacterial stis prevention among men who have sex with men in Southern China: a cross-sectional analysis.","volume":"25","author":"Liang","year":"2025","journal-title":"BMC Infect Dis"},{"issue":"1","key":"2026101218114858400_R14","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-24067-3","article-title":"Doxycycline post-exposure prophylaxis in China: current utilized situation among men who have sex with men in a cross-sectional online survey from two cites.","volume":"25","author":"Zhang","year":"2025","journal-title":"BMC Public Health"},{"issue":"1","key":"2026101218114858400_R15","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05194-6","article-title":"Rural and urban differences in health system performance among older Chinese adults: cross-sectional analysis of a national sample.","volume":"20","author":"Qin","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"2026101218114858400_R16","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1071\/SH22025","article-title":"East-west disparities in safer sex inside China: a sociocultural perspective.","volume":"20","author":"Zhang","year":"2023","journal-title":"Sex Health"},{"issue":"11","key":"2026101218114858400_R17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312006","article-title":"Urban-rural disparity in risky sexual behavior, HIV knowledge, and healthy practices among men who have sex with men: a cross-sectional study in Southeast China.","volume":"19","author":"Chen","year":"2024","journal-title":"PLoS ONE"},{"issue":"1","key":"2026101218114858400_R18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-21","article-title":"Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio.","volume":"3","author":"Barros","year":"2003","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"2026101218114858400_R19","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-024-00709-w","article-title":"Doxycycline post-exposure prophylaxis for bacterial sexually transmitted infections: the current landscape and future directions.","volume":"22","author":"Allan-Blitz","year":"2025","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"7","key":"2026101218114858400_R20","doi-asserted-by":"publisher","first-page":"2043","DOI":"10.1007\/s10461-025-04728-5","article-title":"Rapid diffusion of awareness and uptake of doxy-PEP among men who have sex with men in San Francisco.","volume":"29","author":"Moscatelli","year":"2025","journal-title":"AIDS Behav"},{"issue":"1","key":"2026101218114858400_R21","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s15010-024-02321-x","article-title":"Is doxycycline post-exposure prophylaxis being utilised in Germany? 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