Given recent data for use of doxycycline as post-exposure STD prophylaxis, how have you applied its use in clinical practice?

Doxycycline as POST-exposure prophylaxis for bacterial STI prevention is the hottest thing in STI prevention. It's good at preventing syphilis and chlamydia (approximately 80%) and okay at preventing gonorrhea (approximately 50% depending on background resistance). Here is the landmark study:

Luetkem...

I have some concerns, especially training with Bill Mc Cormack in the early 1980s when we were seeing high levels of tetracycline resistance by Chlamydia. We were moving to Erythromycin in those cases, so we need to treat it carefully so that we don't overprescribe and repeat the past.

The New York State Department of Health AIDS Institute Clinical Guidelines Program released comprehensive information/guidelines on DoxyPEP last year (9/25/2023).

https://www.hivguidelines.org/collection/sexual-health/

I help a non-clinical organization (no medical billing, relies on grants) that does STI screening and syringe access. We are aggressively offering everyone who undergoes routine STI screening doxyPEP and trying to figure how they are actually using it during follow up visits to refine counseling. Up...