{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:33:23Z","timestamp":1789054403860,"version":"build-2803163510"},"reference-count":31,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bacterial sexually transmitted infections (STIs) remain a growing public health challenge globally, with gay, bisexual and other men who have sex with men (gbMSM) disproportionately affected. Doxycycline postexposure prophylaxis (DoxyPEP) has been shown in clinical trials to reduce syphilis and chlamydia, and has been incorporated into US and UK guidelines. However, community-level data in many European countries remain scarce. This study aimed to assess awareness, attitudes and early use of DoxyPEP among gbMSM in Ireland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An anonymous, cross-sectional online survey was conducted between May and June 2025. Eligible participants were aged \u226518 years, identified as male (cis or trans) or non-binary\/gender diverse and reported sex with a man in the past 12 months. The questionnaire covered demographics, sexual behaviours, STI\/HIV history, awareness and use of antibiotics for STI prevention and attitudinal measures. Descriptive statistics summarised findings, and logistic regression identified predictors of DoxyPEP use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 149 participants completed the survey, with a mean age of 36.4 years (range: 22\u201367); 92.6% were cisgender men and 86.6% identified as gay. Awareness of antibiotic STI prophylaxis was high (83.2%), and 69.1% expressed strong interest in future use. Over one-quarter (29.5%) reported DoxyPEP use in the past 12 months, almost exclusively at the recommended 200 mg dose. DoxyPEP use was associated with previous HIV PEP use (adjusted OR (AOR) 3.02\u2009s, 95% CI 1.35 to 6.73) and group sex (AOR 3.27, 95% CI 1.26 to 8.59). Most participants reported sourcing antibiotics informally, including online or through friends. Antimicrobial resistance was the most common concern reported (69.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the absence of national guidelines on the use of DoxyPEP for STI prevention, over one-quarter of participants reported using DoxyPEP, with high awareness and demand for structured access. These findings highlight the urgency for evidence-based, internationally aligned policies that ensure safe and equitable delivery, integrated within sexual health services and underpinned by antimicrobial stewardship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056745","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T18:20:48Z","timestamp":1768414848000},"page":"380-386","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Awareness, attitudes and early use of doxycycline prophylaxis among gbMSM in Ireland: findings from a 2025 community-based cross-sectional survey"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-0724","authenticated-orcid":false,"given":"John","family":"Gilmore","sequence":"first","affiliation":[{"name":"University College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Field","sequence":"additional","affiliation":[{"name":"Gay Men\u2019s Health Service, HSE, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Kelly","sequence":"additional","affiliation":[{"name":"UCD School of Public Health Physiotherapy and Sports Science, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lawlor","sequence":"additional","affiliation":[{"name":"University of Galway School of Psychology, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Noone","sequence":"additional","affiliation":[{"name":"University of Galway School of Psychology, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Traeger","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"White","sequence":"additional","affiliation":[{"name":"HSE North West, Galway, Ireland"},{"name":"Northern and Western Health and Social Care Trust, Health and Social Care Northern Ireland, Derry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"2026081808050881000_102.6.380.1","unstructured":"Surveillance of stis in ireland - 2024. Health Protection Surveillance Centre (HPSC), 2024. Available: https:\/\/www.hpsc.ie\/a-z\/sexuallytransmittedinfections\/publications\/stireports\/2024reports\/"},{"key":"2026081808050881000_102.6.380.2","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0140-6736(18)31816-6","article-title":"Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial","volume":"392","author":"Hocking","year":"2018","journal-title":"The Lancet"},{"key":"2026081808050881000_102.6.380.3","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.17955.1","article-title":"Screening is not associated with reduced incidence of gonorrhoea or chlamydia in men who have sex with men (MSM); an ecological study of 23 European countries","volume":"8","author":"Kenyon","year":"2019","journal-title":"F1000Res"},{"key":"2026081808050881000_102.6.380.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000824"},{"key":"2026081808050881000_102.6.380.5","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000002082"},{"key":"2026081808050881000_102.6.380.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"},{"key":"2026081808050881000_102.6.380.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30725-9"},{"key":"2026081808050881000_102.6.380.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00236-6"},{"key":"2026081808050881000_102.6.380.9","unstructured":"Doxycycline postexposure prophylaxis for bacterial stis in msm and transgender women. 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Available: https:\/\/man2man.ie\/doxypep\/"},{"key":"2026081808050881000_102.6.380.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0313325","article-title":"Recognising and responding to the community needs of gay and bisexual men around mpox","volume":"19","author":"Gilmore","year":"2024","journal-title":"PLoS One"},{"key":"2026081808050881000_102.6.380.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0306280","article-title":"Understanding sexual health service access for gay, bisexual and other men who have sex with men in Ireland during the COVID-19 crisis: Findings from the EMERGE survey","volume":"19","author":"Shanley","year":"2024","journal-title":"PLoS One"},{"key":"2026081808050881000_102.6.380.24","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/OLQ.0000000000002061","article-title":"Use of Doxycycline and Other Antibiotics as Bacterial Sexually Transmitted Infection Prophylaxis in a US Sample of Primarily Gay and Bisexual Men","volume":"51","author":"Traeger","year":"2024","journal-title":"Sex Transm Dis"},{"key":"2026081808050881000_102.6.380.25","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1097\/OLQ.0000000000001865","article-title":"Safety of long-term doxycycline use: Implications for STI prophylaxis","volume":"50","author":"Chan","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2026081808050881000_102.6.380.26","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/OLQ.0000000000001810","article-title":"Doxy-PEP could induce cross-resistance: An in silico analysis","volume":"50","author":"Vanbaelen","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2026081808050881000_102.6.380.27","doi-asserted-by":"crossref","unstructured":"Soge OO , Thibault CS , Cannon CA , et al . Doxy-PEP and tetracycline resistance in Neisseria gonorrhoeae. Clin Infect Dis 2025. doi:10.1093\/cid\/ciad650","DOI":"10.1093\/cid\/ciad650"},{"key":"2026081808050881000_102.6.380.28","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1097\/OLQ.0000000000002115","article-title":"Knowledge, Use, and Misuse of Self-Prescribed Doxycycline Postexposure Prophylaxis in a Community-Based Preexposure Prophylaxis Service","volume":"52","author":"Rossotti","year":"2025","journal-title":"Sex Transm Dis"},{"key":"2026081808050881000_102.6.380.29","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy182"},{"key":"2026081808050881000_102.6.380.30","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.2947"},{"key":"2026081808050881000_102.6.380.31","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S1473-3099(25)00077-5","article-title":"DoxyPEP: thinking towards implementation","volume":"25","author":"Garcia-Iglesias","year":"2025","journal-title":"Lancet Infect Dis"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056745","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:08:12Z","timestamp":1787065692000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056745"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,8,18]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/sextrans-2025-056745"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056745","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}