{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:39:01Z","timestamp":1772725141623,"version":"3.50.1"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"unspecified","delay-in-days":63,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Health and Care Research Health Protection Research Unit","award":["NIHR200911"],"award-info":[{"award-number":["NIHR200911"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,1,16]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>HIV pre-exposure prophylaxis (PrEP) demonstrates the value of biomedical interventions as part of combination prevention. Some gay, bisexual and other men who have sex with men (GBMSM) use antibiotics to prevent sexually transmitted infections (STIs), primarily as post-exposure prophylaxis (PEP). We aimed to understand variations in awareness and use of HIV PrEP and STI PEP\/PrEP among people attending specialist sexual health services (SHSs) in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected data from 1732 SHS attendees aged &gt;16 years in London and the East of England using an online questionnaire between April 2022 and December 2023, including awareness and use of HIV-PrEP and STI PEP\/PrEP. We ran regression analyses: one to identify demographic factors associated with STI PEP\/PrEP use among all SHS attendees, and a second to identify behavioural factors (controlling for sociodemographic factors) associated with antibiotic prophylaxis use among GBMSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study recruited 1732 participants (50% GBMSM, 12% men who had reported sex with women only (MSW), 31%\u2009women). 74% had heard of HIV-PrEP but this varied by group (GBMSM: 98%, MSW: 39%, women: 49%). 34% of GBMSM had heard of STI PEP\/PrEP and 11% reported using it (MSW: 15%\/5%, women: 18%\/4%). 61% of STI PEP\/PrEP users reported taking doxycycline, mostly to prevent chlamydia, gonorrhoea and syphilis. 80% of all participants reported being somewhat\/very likely to use event-based STI PEP\/PrEP, with a higher proportion of GBMSM saying they would be likely to use STI PEP\/PrEP in this way. In the behavioural regression model of GBMSM, use was independently associated with reporting higher-risk sexual behaviour (OR: 2.11, 95%\u2009CI 1.29 to 3.48).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found that a sizeable minority of GBMSM already use STI PEP\/PrEP, but some MSW and women also use or have an interest in antibiotic prophylaxis, suggesting potential benefits may exist for populations other than GBMSM. Communication should therefore emphasise appropriate antibiotic use and the risks of antibiotic resistance among all populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003695","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:40:26Z","timestamp":1772721626000},"page":"e003695","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and factors associated with use of prophylaxis for HIV and sexually transmitted infections among sexual health service attendees in England: findings from a cross-sectional observational study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-1205","authenticated-orcid":false,"given":"James","family":"Bell","sequence":"first","affiliation":[{"name":"Blood Safety, Hepatitis, HIV and STI Division, UK Health Security Agency, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manik","family":"Kohli","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"},{"name":"Central and North West London NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caisey","family":"Pulford","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, HIV and STI Division, UK Health Security Agency, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Ogaz","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, HIV and STI Division, UK Health Security Agency, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Williams","sequence":"additional","affiliation":[{"name":"Homerton University Hospital, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Apea","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"David","sequence":"additional","affiliation":[{"name":"Cambridgeshire Community Services NHS Trust, Saint Ives, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmi","family":"Suonpera","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9572-193X","authenticated-orcid":false,"given":"Richard","family":"Gilson","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"},{"name":"Central and North West London NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine H","family":"Mercer","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"},{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with (UKHSA), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwenda","family":"Hughes","sequence":"additional","affiliation":[{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with (UKHSA), London, UK"},{"name":"London School of Hygiene and Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1836-4446","authenticated-orcid":false,"given":"David","family":"Dunn","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Showler","sequence":"additional","affiliation":[{"name":"University College London Institute for Global Health, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2060-7286","authenticated-orcid":false,"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, HIV and STI Division, UK Health Security Agency, London, UK"},{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with (UKHSA), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Saunders","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, HIV and STI Division, UK Health Security Agency, London, UK"},{"name":"University College London Institute for Global Health, London, England, UK"},{"name":"National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Blood Borne and Sexually Transmitted Infections at UCL in partnership with (UKHSA), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"2026030506401458000_4.1.e003695.1","unstructured":"Hannah Kitt AS , Chau C , Okumu-Camerra K , et al . HIV testing, prep, new hiv diagnoses and care outcomes for people accessing hiv services: 2024 report.the annual official statistics data release (data to end of december 2023). London UK Health Security Agency; 2024."},{"key":"2026030506401458000_4.1.e003695.2","unstructured":"Shah A , Mackay N , Ratna N , et al . HIV testing, prep, new hiv diagnoses and care outcomes for people accessing hiv services: 2023 report. London UK Health Security Agency; 2023."},{"key":"2026030506401458000_4.1.e003695.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30725-9"},{"key":"2026030506401458000_4.1.e003695.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"},{"key":"2026030506401458000_4.1.e003695.5","unstructured":"Molina J-M , Bercot B , Assoumou L , et al . In: ANRS 174 DOXYVAC: AN OPEN-LABEL RANDOMIZED TRIAL TO PREVENT STIs IN MSM ON PrEP. Seattle, Washington2023: CROI,"},{"key":"2026030506401458000_4.1.e003695.6","unstructured":"Stewart J , Oware K , Donnell D , et al . In: DOXYCYCLINE POSTEXPOSURE PROPHYLAXIS FOR PREVENTION OF STIs AMONG CISGENDER WOMEN. Seattle, Washington2023: CROI,"},{"key":"2026030506401458000_4.1.e003695.7","first-page":"466","article-title":"Position statement of the German STI Society on the prophylactic use of doxycycline to prevent STIs (Doxy-PEP, Doxy-PrEP)","volume":"22","author":"Werner","year":"2024","journal-title":"J Dtsch Dermatol Ges"},{"key":"2026030506401458000_4.1.e003695.8","unstructured":"ASHM . 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. 2023."},{"key":"2026030506401458000_4.1.e003695.9","unstructured":"Ublic health seattle and king county. guidelines, june 2023: doxycycline post-exposure prophylaxis (doxy-pep) to prevent bacterial stis in men who have sex with men (msm) and transgender persons who have sex with men. In: Clinic HSHPSH. Seattle, Washington, 2023."},{"key":"2026030506401458000_4.1.e003695.10","unstructured":"Health update: doxycycline post-exposure prophylaxis reduces incidence of sexually transmitted infections. 2022."},{"key":"2026030506401458000_4.1.e003695.11","unstructured":"Centers for Disease Control and Prevention . Guidelines for the use of doxycycline post-exposure prophylaxis for bacterial sexually transmitted infection (sti) prevention; request for comment and informational presentation. 2023."},{"key":"2026030506401458000_4.1.e003695.12","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1177\/09564624251352053","article-title":"British Association for Sexual Health and HIV (BASHH) UK national guideline for the use of doxycycline post-exposure prophylaxis (DoxyPEP) for the prevention of syphilis, 2025","volume":"36","author":"Saunders","year":"2025","journal-title":"Int J STD AIDS"},{"key":"2026030506401458000_4.1.e003695.13","doi-asserted-by":"crossref","unstructured":"Carveth-Johnson T , Stingone C , Nwokolo N , et al . Doxycycline use in MSM taking PrEP. Lancet HIV 2018;5. doi:10.1016\/S2352-3018(18)30210-8","DOI":"10.1016\/S2352-3018(18)30210-8"},{"key":"2026030506401458000_4.1.e003695.14","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054592"},{"key":"2026030506401458000_4.1.e003695.15","doi-asserted-by":"crossref","DOI":"10.1136\/sextrans-2021-055310","article-title":"Choice of antibiotics for prophylaxis of bacterial STIs among individuals currently self-sourcing","volume":"98","author":"Kohli","year":"2022","journal-title":"Sex Transm Infect"},{"key":"2026030506401458000_4.1.e003695.16","article-title":"Chemsex, sexual behaviour and STI-PrEP use among HIV-PrEP users during the COVID-19 pandemic in Brighton, UK","volume":"98","author":"Ringshall","year":"2022","journal-title":"Sex Transm Infect"},{"key":"2026030506401458000_4.1.e003695.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003807","article-title":"Knowledge, uptake and intention to use antibiotic post-exposure prophylaxis and meningococcal B vaccine (4CMenB) for gonorrhoea among a large, online community sample of men and gender-diverse individuals who have sex with men in the UK","volume":"4","author":"Ogaz","year":"2024","journal-title":"PLOS Glob Public Health"},{"key":"2026030506401458000_4.1.e003695.18","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1007\/s15010-023-02086-9","article-title":"Already current practice? A snapshot survey on doxycycline use for prevention of sexually transmitted infections in parts of the German MSM community","volume":"51","author":"Hornuss","year":"2023","journal-title":"Infection"},{"key":"2026030506401458000_4.1.e003695.19","unstructured":"Traeger M , Karkower D , Mayer K , et al . National Survey on the Use of Antibiotics as Sexually Transmitted Infection Prophylaxis in the US. Denver, Colorado2024: CROI,"},{"key":"2026030506401458000_4.1.e003695.20","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.drugpo.2018.02.002","article-title":"Sexualised drug use in the United Kingdom (UK): A review of the literature","volume":"55","author":"Edmundson","year":"2018","journal-title":"Int J Drug Policy"},{"key":"2026030506401458000_4.1.e003695.21","doi-asserted-by":"publisher","DOI":"10.1111\/HIV.12498"},{"key":"2026030506401458000_4.1.e003695.22","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052719"},{"key":"2026030506401458000_4.1.e003695.23","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.15585\/mmwr.mm7047a3","article-title":"Racial, Ethnic, and Gender Disparities in Awareness of Preexposure Prophylaxis Among HIV-Negative Heterosexually Active Adults at Increased Risk for HIV Infection - 23 Urban Areas, United States, 2019","volume":"70","author":"Baugher","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026030506401458000_4.1.e003695.24","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/hiv.13458","article-title":"PrEP for women in Europe: a systematic literature review","volume":"24","author":"Fitzgerald","year":"2023","journal-title":"HIV Med"},{"key":"2026030506401458000_4.1.e003695.25","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2023-055989"},{"key":"2026030506401458000_4.1.e003695.26","doi-asserted-by":"crossref","first-page":"e790","DOI":"10.1016\/S2352-3018(23)00256-4","article-title":"HIV pre-exposure prophylaxis and its implementation in the PrEP Impact Trial in England: a pragmatic health technology assessment","volume":"10","author":"Sullivan","year":"2023","journal-title":"Lancet HIV"},{"key":"2026030506401458000_4.1.e003695.27","unstructured":"Bell J , Pulford C , Ogaz D , et al . A systematic review and meta-analysis to understand the prevalence of antibiotic use for the prevention of bacterial sexually transmitted infections in multiple countries. BASHH; 2024."},{"key":"2026030506401458000_4.1.e003695.28","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-053986"},{"key":"2026030506401458000_4.1.e003695.29","unstructured":"Ogaz D , Mullen D , Phillips D , et al . Knowledge and Use of Sti Prophylaxis Reported in the \u2019Reducing Inequalities in Sexual Health (Riish) Survey, a Large, Online Community Sample of Gay, Bisexual and Other MSM (GBMSM) in UK,2023. Bournemouth, UK: BASHH, 2024."}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:40:33Z","timestamp":1772721633000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3,5]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjph-2025-003695"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003695","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}