It is unclear whether GPs are willingly prescribing the doxycycline for STI prophylaxis or whether patients are lying to their doctors by claiming the medication is for other purposes, such as their skin. Regardless of how they are obtaining the doxycycline, doctors and the wider sexual health community should be vigilant and take steps to discourage doxycycline use amongst the MSM community until we get more evidence of its safety and efficacy as STI prophylaxis. As doxycycline does not have antimicrobial activity against every STI, its use as PEP or PrEP could lead to increases in condomless anal sex and dangerous sexual practices, leading to increased transmission of STIs.
Christopher Marr is a clinical pharmacist with a Bachelor of Pharmacy from Curtin University, a Graduate Diploma in Clinical Pharmacy from the University of Tasmania, and a background in both hospital and community pharmacy in Perth. Currently he works closely with General Practitioners in a non-dispensing role at View Street Medical as a consultant pharmacist. The practice specialises in sexual health and delivers an optimised and collaborative healthcare service to our patients through our dedicated multidisciplinary team.