Interest, concerns, and attitutdes among men who have sex with men and healthcare providers toward prophylactic use of doxycycline against Chlamydia trachomatis infections and syphilis

Abstract

Introduction: Prophylactic administration of doxycycline is regarded as a potential new public
health strategy to combat the rising rates of Chlamydial trachomatis infections and syphilis among men who have sex with men (MSM). We conducted a survey-based study to evaluate how community members and healthcare providers in Southern California would perceive doxycycline pre-exposure/post-exposure prophylaxis (PrEP/PEP) to predict its acceptability and identify potential areas of concern.

Methods: We conducted an online cross-sectional survey among community members who identify as MSM and healthcare providers with prescribing authority in Southern California to investigate the current attitudes toward doxycycline PrEP/PEP, including their willingness to accept. We analyzed the data using descriptive statistics and binary logistic regression.

Results: Among 212 enrolled community member participants, 67.5% indicated they would take doxycycline PrEP/PEP if offered by their provider. Higher acceptability was significantly associated with several characteristics, including recent history of bacterial sexually transmitted infection diagnosis and current use of HIV PrEP. For healthcare providers, 89.5% of 76 enrolled participants expressed willingness to prescribe doxycycline PrEP/PEP to their patients if recommended by the Centers for Disease Control and Prevention, but only 43.4% were willing if not. Both community members and healthcare providers demonstrated high levels of concern
toward possible drug resistance.

Conclusion: Doxycycline PrEP/PEP as a preventive strategy against chlamydial infections and syphilis would likely be accepted among community members and healthcare providers. Clear guidelines from public health officials and further clarification on the strategy’s potential impact on developing drug resistance may be necessary to ensure successful implementation.