Put Some (Doxy)PEP in Your Step: Can DoxyPEP Protect You From Mpox?
by Josh Brown (@meth.borrison)
It’s a rainy Sunday evening, and you and your favorite lover(s) are relaxing in bed. Lightning is splitting the sky open, the torrential rain is pounding against the walls, and you and your lover(s) are taking inspiration. It’s hot, it’s heavy, and in the split second after your moans blend with the thunder shaking the earth, all falls silent. In the sweaty, gooey aftermath, you have exchanged pleasure, trust, and … oral gonorrhea?
It’s no big deal; bacterial STIs are the most common form of sexually transmitted disease in the U.S., with an estimated 1–in-5 Americans currently infected. They’re easily treatable with a round of antibiotics and usually leave no lasting damage—if you catch them early enough, that is.
Bacterial STIs have very high asymptomatic rates, between 40–90%. This means that, out of the 20% of Americans currently infected with a bacterial STI, 10–18% of them may not even know because they have no symptoms. And if that one-in-five has some fun in the other four, you’ve got a problem. This is how your favorite lover(s) gave you oral gonorrhea—they didn’t know they had it, and now you might not know you have it either. These statistics can create a feeling of uncertainty. We can all do our part with routine STD/STI screenings, but as of October 2023, we have a more immediate option:
DoxyPEP is an oral antibiotic that, when taken within 72 hours of sex, can reduce the chance of contracting gonorrhea (~55% reduction), chlamydia (~74% reduction), and syphilis (~77% reduction). The medication has been tested thus far on gay & bisexual men and transgender women, but continued research is being conducted to confirm its ability to be generalized across the broader gender and sexual spectrum.
When asked about her DoxyPEP usage, Boston-based academic and drag performer Mixie gave a glowing recommendation:
“I’m a blow job queen, and you can still get STDs that way, so knowing I have this as an option is a huge relief.” Brooklyn-based event producer and designer, Stan, recounts a time when he was especially grateful for the PEP in his step: “I typically use it after group sex. When someone at the orgy followed up with ‘oh yeah, I just tested positive for an STI,’ I got tested and my results were negative.'”
If you’re already in-the-know about DoxyPEP, this is where the juicy cutting-edge stuff comes in: we’re talking Mpox (or, the-artist-formerly-known-as-Monkeypox). Didn’t we deal with that already? Well, just like COVID, it’s a gift that keeps on giving.
It’s back in the news again, now with a new coat of paint. Last month, the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, declared an international health emergency on the heels of novel Mpox infections across the globe, primary in the Democratic Republic of Congo, Sweden, and Pakistan. While mpox might seem like the new girl on the block, she’s been around since the ’80s.
What’s this got to do with me, you ask, still gunked up in the love-puddle you and your lover(s) created so painstakingly. While you clean yourself up, I’ll tell you. The 2022 outbreak of Mpox was caused by one variant—called a “clade,” which is biology jargon for “relative.” Clade II Mpox was the star of the show in 2022, where it terrorized the sexually adventurous with debilitatingly painful lesions. It is unclear whether Clade I Mpox—responsible for the current crisis—is significantly different from Clade II, but current data suggests it is deadlier.
Now that you’ve learned something, I’ll cut to the chase: no, DoxyPEP is not going to protect you from Mpox transmission. Mpox, like HIV or HPV, is a viral infection—not a bacterial one, like syphilis, gonorrhea, or chlamydia. Therefore, an antibiotic like DoxyPEP would have no effect. If you’re looking for protection against Mpox, the CDC still recommends both doses of the Jynneos vaccine, which was widely distributed in 2022 during the initial outbreak. Currently, a booster dose is not recommended, but that may change as we continue to learn about the virus, its variants, and how it may mutate as it spreads.
So in conclusion: DoxyPEP is just one part of a strong defense against the transmission of STIs. If you’re looking for more full-service coverage, preventative measures like vaccination, PrEP, and abstinence (if you’re into that) are all great options. As God famously said, be fruitful and multiply (but stay on top of your sexual health while you’re at it).
