Sexual health

Discovering the magic of Doxy PEP – one hook-up at a time

After my fourth STI in a year, I was ready to try out this new way to prevent infections. Here’s a NSFW chronicle of my experience.
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My syphilis shot hurt so badly that I curled up on the exam table like Sydney Sweeney in Maddie’s bathroom on Season 2 of Euphoria and cried.

It was my fourth STI diagnosis that year, and I was frustrated by the infections interfering with my quality of life. (One time I had contracted oral gonorrhea the day I was to begin rehearsals for a production of Hedwig and the Angry Inch, which turned out to be perfectly in-character, though inconvenient by all accounts).

Quite a few people (thankfully not my medical providers!) tried to blame my frequent need for treatment on the fact that I had been raw-dogging my way through half the men in New York City, and while there is merit to those allegations, it felt particularly anti-feminist to claim the sole antidote to STIs was to scale back my enthusiastic sex life. People deserve pleasure! 

Plus, as queer people well know, STI spread is a failing of public health policy, not a failing of our moral character. Not to mention this particular syphilis contraction happened during a time where I’d been intimate with exactly one (1) person, and used a condom. Damned if you do, damned if you don’t.

Later that week I was sulking on Sniffies, waiting out my week-long contagion period, when I saw an acronym I didn’t recognize underneath a headless torso:

“Neg, on PrEP and Doxy PEP”

The first two referred to STI status and HIV preventative medication, just like the one I took, but I had never heard of “Doxy PEP”. Unfamiliar shorthand on hookup apps has happened to me before — famously, I learned the hard way the capital “T” in parTy did not mean everyone was just really excited — so I looked it up.

The results astounded me; I could take 2 doxycycline pills within 72 hours of sex and possibly prevent contracting an STI? I had to know more. I fell down a Google rabbit hole the way I would’ve usually fallen for the headless torso.

At the time, nearly a year ago, there wasn’t wide reaching guidance on Doxy PEP’s efficacy, though studies showed it reduces bacterial infection by 66% among people on PrEP, and 62% for people living with HIV. Most of the places prescribing it were local, progressive health care centers (San Francisco AIDS Foundation among them!). Luckily mine, the AIDS Healthcare Foundation, offered prescriptions, and at my next appointment I inquired. The conversation went something like this:

ME: I’ve been thinking about 
going on DoxyPEP.

DR: I think you’re a great 
candidate for that.

ME: How does it work?

DR: Take 2 doxy pills within 
24 but no later than 72 hours 
of a sexual encounter, and make 
sure you keep up with your 
testing so you don’t accidentally 
take DoxyPEP when you’re positive 
for an STI, as that could lead 
to antibiotic resistance.

*prescription filled at pharmacy*

In the coming weeks (once I was cleared to get back in action!) I started talking to my hook-ups about the little blue pill I would take as soon as I got home. It made for excellent pillow talk, (sexual health is sexy!!) and I found quite a few people were also taking Doxy PEP; cisgender men, trans women, and nonbinary folks alike.

It was especially popular amongst the cruising crew, circuit queens, those with anonymous kinks (who weren’t discussing STI status with partners they were, well, anonymous), sex workers, and play party regulars. This made sense, these were the folks with the most exposure to STIs due to their lifestyles, interests, and behaviors, but it still left the majority of the population vulnerable.

Most people I talk to (then and now) don’t know Doxy PEP exists, nor its benefits. Like the headless torso before me I added it to my own bio, hoping to spread the word, not STIs.

It has been seven, nearly eight months of my using Doxy PEP, and multiple partners have messaged me letting me know they’ve tested positive for an STI, fulfilling their ethical duties so I can also get tested and treated if necessary.

Each time my results have come back negative. (One of them was even for syphilis!). As of June 2024, the month this article was published, the CDC has officially released official guidelines for DoxyPEP, hopefully increasing its accessibility for sexually active people. We all deserve to raw-dog through the other half of New York, should we so desire! 

Thanks to Doxy PEP I’ve avoided the exam table without forfeiting pleasure. In fact, Doxy PEP allows me to approach intimate connections with more confidence around my sexual health. Now I’m doing a lot less crying and a lot more, well, you get the point.

How to get Doxy PEP

If you’re a client at SFAF’s Magnet clinic and have an appointment with a nurse, ask your nurse for a prescription.

If you’re a client at SFAF’s Magnet clinic and don’t have an appointment or don’t have an appointment with a nurse (e.g. have an Express appointment), call 415-487-3131 and leave a message. A member of our nursing team will call you back with more information.

More info

About the author

James Rose

James Rose (they/she) is an award-winning actress, author, and content creator based in New York City. On their account @jamesissmiling they discuss transgender rights, sexual health, reproductive justice, progressive politics, and sexual violence. She currently serves as an Ambassador for Planned Parenthood, and has consulted for META, Instagram, Tik Tok, and regional theaters across the country. Her debut memoir, SORRY I KEEP CRYING DURING SEX, will be published in 2025.