Doxycycline prophylaxis for sexually transmitted infections prevention among men who have sex with men in China

TL;DR

This study examines how often men who have sex with men in China use doxycycline to prevent STIs and finds that usage is low, with factors like age and sexual behavior playing a role.

Contribution

The study provides new evidence on doxycycline prophylaxis use and associated factors among MSM in China.

Findings

Only 13.4% of participants used doxycycline prophylaxis for STI prevention.

Older age and certain sexual behaviors were linked to higher usage.

HIV PrEP/PEP experience strongly predicted doxycycline use.

Abstract

Men who have sex with men (MSM) have a high prevalence of sexually transmitted infections (STIs). The efficacy of doxycycline prophylaxis in STIs prevention has been demonstrated. This study aimed to examine the utilization of doxycycline prophylaxis among MSM in China, providing evidence to inform future policies and guidelines.

Between June and July 2025, a cross-sectional survey was conducted in China, using a convenience sampling method to recruit eligible MSM. Sociodemographic characteristics, behavioral information, and doxycycline prophylaxis utilization experience were collected from the participants. Logistic regression analysis was performed to identify factors associated with doxycycline prophylaxis utilization among MSM.

A total of 508 MSM were recruited, with a median age of 31.5 (28.0–64.0) years. The utilization proportion of doxycycline prophylaxis was 13.4% (68/508). Multivariate logistic regression analysis indicated that age >35 years (aOR = 0.393, 95%CI: 0.172–0.898), engagement in casual sex (aOR = 2.187, 95%CI: 1.045–4.578), engagement in commercial sex (aOR = 3.986, 95%CI: 1.622–9.794) and HIV PrEP/PEP experience (aOR = 20.220, 95%CI: 9.061–45.123) were significantly associated with doxycycline prophylaxis use.

As an effective strategy for STIs prevention, doxycycline prophylaxis use among MSM in China remains at a relatively low level. Age and sexual behaviors are associated with its use. Future efforts should focus on strengthening STIs-related education, enhancing MSM's risks awareness, and promoting the appropriate use of doxycycline prophylaxis for STIs prevention within this population.