Rapid Diffusion of Awareness and Uptake of Doxy-PEP among Men who Have Sex with Men in San Francisco.

In October 2022, the San Francisco Department of Public Health published guidelines for doxycycline post-exposure prophylaxis (doxy-PEP) to prevent bacterial sexually transmitted infections (STI) among men who have sex with men (MSM). We evaluated awareness and use of doxy-PEP using data from the National HIV Behavioral Surveillance in 2023 in San Francisco (N = 533). In the year following the publication of the guidelines, 66.6% of MSM reported awareness of doxy-PEP, and 19.3% had used it. Among MSM who are not living with HIV, awareness of doxy-PEP was associated with higher educational levels, condomless sex, bacterial STI diagnoses, and PrEP use; use was associated with STI diagnoses and PrEP use. Among MSM living with HIV, both awareness and use were associated with younger age. These findings indicate rapid dissemination and early adoption of doxy-PEP in a priority population in a real-world setting.