{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:10:38Z","timestamp":1792649438556,"version":"4.5.0"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Viatris","award":["BEL3882"],"award-info":[{"award-number":["BEL3882"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,8,18]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to assess the awareness, willingness to use and use of doxycycline post-exposure prophylaxis (doxyPEP) among men who have sex with men (MSM) and transgender women (TGW) in Belgium. Additionally, we aimed to identify factors associated with doxyPEP use and concerns regarding antimicrobial resistance (AMR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross-sectional online survey among MSM and TGW in Belgium in April 2024. Participants were recruited through sexual networking applications and social media of community-based organisations. Numerical variables were compared with Wilcoxon rank-sum test and categorical variables with \u03c7<jats:sup>2<\/jats:sup>or Fisher\u2019s exact tests. Factors associated with doxyPEP use were assessed using logistic regression. Willingness to use doxyPEP and concerns about side effects\/AMR were assessed before and after presenting a brief paragraph on the potential effects of doxyPEP on AMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>875 individuals initiated the survey. Almost all identified as men (860\/875, 98.3%) with a median age of 40 years (IQR 32\u201348), 40.4% (n=352\/875) had heard of doxyPEP and 9.4% (n=82\/875) had used it, among whom the majority used it within the previous 6\u2009months (70\/81, 86.4%). In multivariable logistic regression, doxyPEP use was associated with reporting \u22651\u2009sexually transmitted infection (STI) in the previous 12 months, engagement in chemsex, HIV status and pre-exposure prophylaxis use, and education level.<\/jats:p><jats:p>About 80% of the participants initially reported being willing to use doxyPEP, and about 50% reported being concerned about side effects. After reading about the potential effects of doxyPEP on AMR, willingness to use decreased to 60% and concerns of side effects\/AMR increased to around 70%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately 1 in 10 MSM in Belgium reported using doxyPEP. A recent history of STIs and STI risk factors were positively associated with doxyPEP use. Importantly, concerns about AMR and side effect influenced willingness to use doxyPEP. If doxyPEP is introduced, informing patients about doxyPEP benefits and risks is crucial to enable informed decision-making.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2024-056261","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T17:21:47Z","timestamp":1724952107000},"page":"34-40","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Doxycycline post-exposure prophylaxis among men who have sex with men and transgender women in Belgium: awareness, use and antimicrobial resistance concerns in a cross-sectional online survey"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5541-6041","authenticated-orcid":false,"given":"Thibaut","family":"Vanbaelen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Rotsaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-252X","authenticated-orcid":false,"given":"Irith","family":"De Baetselier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5906-4530","authenticated-orcid":false,"given":"Tom","family":"Platteau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Hensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-921X","authenticated-orcid":false,"given":"Thijs","family":"Reyniers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-8998","authenticated-orcid":false,"given":"Chris","family":"Kenyon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"2025012910100558000_101.1.34.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30725-9"},{"key":"2025012910100558000_101.1.34.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"},{"key":"2025012910100558000_101.1.34.3","article-title":"ANRS 174 DOXYVAC: an open-label randomized trial to prevent STIs in MSM on PrEP (CROI abstract 119)","volume":"31","author":"Molina","year":"2023","journal-title":"Top Antivir Med"},{"key":"2025012910100558000_101.1.34.4","doi-asserted-by":"crossref","unstructured":"Molina J-M , Bercot B , Assoumou L , et al . Doxycycline prophylaxis and meningococcal group B vaccine to prevent bacterial sexually transmitted infections in France (ANRS 174 DOXYVAC): a multicentre, open-label, randomised trial with a 2\u2008\u00d7\u20082 factorial design. Lancet Infect Dis 2024. doi:10.1016\/S1473-3099(24)00236-6","DOI":"10.1016\/S1473-3099(24)00236-6"},{"key":"2025012910100558000_101.1.34.5","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad129"},{"key":"2025012910100558000_101.1.34.6","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055425"},{"key":"2025012910100558000_101.1.34.7","unstructured":"De\u00a0Scheerder M-A , Libois A , Van\u00a0Praet J , et al . Doxycycline post-exposure prophylaxis for stis not endorsed by breach. 2024. Available: https:\/\/breach-hiv.be\/uncategorized\/doxy-post-exposure-prophylaxis-for-sti-not-endorsed-by-breach\/"},{"key":"2025012910100558000_101.1.34.8","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054325"},{"key":"2025012910100558000_101.1.34.9","doi-asserted-by":"crossref","DOI":"10.1016\/S2352-3018(18)30210-8","article-title":"Doxycycline use in MSM taking PrEP","volume":"5","author":"Carveth-Johnson","year":"2018","journal-title":"Lancet HIV"},{"key":"2025012910100558000_101.1.34.10","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30186-9"},{"key":"2025012910100558000_101.1.34.11","doi-asserted-by":"crossref","DOI":"10.1136\/sextrans-2022-055511","article-title":"Prophylactic use of antibiotics for sexually transmitted infections: awareness and use among HIV PrEP users in Belgium","volume":"98","author":"Vanbaelen","year":"2022","journal-title":"Sex Transm Infect"},{"key":"2025012910100558000_101.1.34.12","unstructured":"Bacon O , Levy M , Kohn R , et al . Implementation of a doxy-pep program at a municipal sti clinic in san francisco. Chicago: HIV & STI World Congress; 2023."},{"key":"2025012910100558000_101.1.34.13","unstructured":"R Core Team . R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing, 2022."},{"key":"2025012910100558000_101.1.34.14","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054592"},{"key":"2025012910100558000_101.1.34.15","doi-asserted-by":"crossref","unstructured":"Wagner L , Boesecke C , Baumgarten A , et al . Is doxycycline post-exposure prophylaxis being utilised in Germany? Insights from an online survey among German men who have sex with men. Infection 2024. doi:10.1007\/s15010-024-02321-x","DOI":"10.1007\/s15010-024-02321-x"},{"key":"2025012910100558000_101.1.34.16","doi-asserted-by":"crossref","DOI":"10.1071\/SH23176","article-title":"The impact of socio-environmental factors on doxycycline post-exposure prophylaxis awareness in the US: a cross-sectional study","volume":"21","author":"Samuel","year":"2024","journal-title":"Sex Health"},{"key":"2025012910100558000_101.1.34.17","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000942"},{"key":"2025012910100558000_101.1.34.18","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003837"},{"key":"2025012910100558000_101.1.34.19","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000753"},{"key":"2025012910100558000_101.1.34.20","doi-asserted-by":"crossref","first-page":"iv47","DOI":"10.1136\/sextrans-2013-051020","article-title":"The role of core groups in the emergence and dissemination of antimicrobial-resistant N gonorrhoeae","volume":"89 Suppl 4","author":"Lewis","year":"2013","journal-title":"Sex Transm Infect"},{"key":"2025012910100558000_101.1.34.21","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad553"},{"key":"2025012910100558000_101.1.34.22","doi-asserted-by":"crossref","unstructured":"Roster KIO , Grad YH . Estimating changes in antibiotic consumption in the USA with the introduction of doxycycline post-exposure prophylaxis. Lancet Microbe 2024;5. doi:10.1016\/S2666-5247(23)00314-2","DOI":"10.1016\/S2666-5247(23)00314-2"},{"key":"2025012910100558000_101.1.34.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.02.017"},{"key":"2025012910100558000_101.1.34.24","first-page":"490","article-title":"Doxycycline Postexposure Prophylaxis Could Induce Cross-Resistance to Other Classes of Antimicrobials in Neisseria gonorrhoeae\u202f: An In Silico Analysis","volume":"50","author":"Vanbaelen","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025012910100558000_101.1.34.25","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad279"},{"key":"2025012910100558000_101.1.34.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2024.107977"},{"key":"2025012910100558000_101.1.34.27","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2023.0289"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2024-056261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T18:14:59Z","timestamp":1738174499000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2024-056261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,29]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/sextrans-2024-056261"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2024-056261","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}