The World Health Organization (WHO) has issued its first recommendation on the use of doxycycline post-exposure prophylaxis (PEP) – commonly referred to as doxyPEP – for the prevention of bacterial sexually transmitted infections (STIs) among men who have sex with men and transgender women.

The new recommendation, issued following a WHO guideline development process, reflects growing evidence that doxycycline taken after sexual exposure can reduce the risk of syphilis and chlamydia, and may also reduce gonorrhoea in some settings. These infections continue to rise in many regions worldwide, disproportionately affecting key populations.

“This new WHO recommendation marks an important step forward in expanding STI prevention options,” said Dr Tereza Kasaeva, Director of WHO’s Department for HIV, TB, Hepatitis & STIs. “WHO encourages countries and partners to work together to scale up implementation of this recommendation to ensure that these important key populations at increased risk can benefit from evidence-based prevention options”. WHO emphasizes that implementation should be part of a comprehensive sexual health approach, prioritize people with recent or recurrent STIs, particularly syphilis, and include context-appropriate monitoring of antimicrobial resistance.