{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:09:01Z","timestamp":1791468541939,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2024,4,15]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Doxycycline post\u2010exposure prophylaxis (doxy\u2010PEP) involves consuming 200\u2009mg of doxycycline up to 72 hours after a condomless sex act to reduce the risk of bacterial sexually transmitted infections (STIs). Recent clinical trials of doxy\u2010PEP have demonstrated significant reductions in syphilis, chlamydia and, to a lesser degree, gonorrhoea among gay, bisexual and other men who have sex with men (GBMSM). There is a high level of interest in doxy\u2010PEP in the GBMSM community and, in response, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) held a national consensus conference with the aim of creating preliminary guidance for clinicians, community, researchers and policy makers.<\/jats:p><\/jats:sec>Main recommendations<\/jats:title>There was broad agreement that doxy\u2010PEP should be considered primarily<\/jats:italic> for the prevention of syphilis in GBMSM who are at risk of this STI, with a secondary benefit of reductions in other bacterial STIs. At the end of the consensus process, there remained some disagreement, as some stakeholders felt strongly that doxy\u2010PEP should be considered only<\/jats:italic> for the prevention of syphilis in GBMSM, and that the risk of increasing antimicrobial resistance outweighed any potential benefit from reductions in other bacterial STIs in the target population. The national roundtable made several other recommendations for clinicians, community, researchers and policy makers, as detailed in this article. ASHM will support the development of detailed clinical guidelines and education materials on doxy\u2010PEP (www.ashm.org.au\/doxy\u2010pep<\/jats:ext-link>).<\/jats:p><\/jats:sec>Changes in management as a result of this consensus statement<\/jats:title>For GBMSM at high risk of syphilis, and perhaps other bacterial STIs, clinicians may consider prescribing doxy\u2010PEP for a limited period of time, followed by a review of ongoing need. Unlike human immunodeficiency virus (HIV) pre\u2010exposure prophylaxis (PrEP), doxy\u2010PEP may not be suitable as a population\u2010level intervention and should instead be used more selectively.<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52258","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:20:07Z","timestamp":1710375607000},"page":"381-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Australian consensus statement on doxycycline post\u2010exposure prophylaxis (doxy\u2010PEP<\/scp>) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men"],"prefix":"10.5694","volume":"220","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0657-9677","authenticated-orcid":false,"given":"Vincent J","family":"Cornelisse","sequence":"first","affiliation":[{"name":"Monash University Melbourne VIC"},{"name":"Kirby Institute, University of New South Wales Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Riley","sequence":"additional","affiliation":[{"name":"Australasian Society for HIV Medicine Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A","family":"Medland","sequence":"additional","affiliation":[{"name":"Kirby Institute, University of New South Wales Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"e_1_2_10_1_1","volume-title":"HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2023","author":"King J","year":"2023"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH22134"},{"key":"e_1_2_10_3_1","volume-title":"Monitoring HIV pre\u2010exposure prophylaxis (PrEP) uptake in Australia","author":"Fraser 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sexually transmitted infections [23 Aug 2023].https:\/\/www.nmhealth.org\/publication\/view\/general\/8411\/(viewed Jan 2024)."},{"key":"e_1_2_10_22_1","unstructured":"New York City Department of Health and Mental Hygiene.Doxycycline post\u2010exposure prophylaxis (doxy\u2010PEP) to prevent bacterial sexually transmitted infections [9 Nov 2023].https:\/\/www.nyc.gov\/assets\/doh\/downloads\/pdf\/std\/dear\u2010colleague\u2010doxy\u2010PEP\u2010to\u2010prevent\u2010bacterial\u2010STI\u201011092023.pdf(viewed Jan 2024)."},{"key":"e_1_2_10_23_1","unstructured":"Public Health Seattle and King County.Doxycycline post\u2010exposure prophylaxis (doxy\u2010PEP) to prevent bacterial STIs in men who have sex with men (MSM) and transgender persons who have sex with men [June 2023].https:\/\/kingcounty.gov\/en\/\u2010\/media\/depts\/health\/communicable\u2010diseases\/documents\/hivstd\/DoxyPEP\u2010Guidelines.ashx(viewed Jan 2024)."},{"key":"e_1_2_10_24_1","unstructured":"San Francisco Department 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