Beyond the doxy PEP Script: A Call for Longitudinal STI Screening and Follow-up – Lessons Learned from HIV Outpatient Program
Document Type
Abstract
Location
Virtual
Start Date
24-4-2026 9:00 AM
End Date
24-4-2026 3:00 PM
Description
Authors: Mary Katherine Moore, Emma Allemond, Jared Barrilleaux, Kaitlyn Calabresi, Mason Calico, Ross Hightower, Ivan Nguyen, Thoung Dien Nguyen-Bui, Meredith Clement, Tat Yau Background: The Centers for Disease Control and Prevention (CDC) recommends that gay, bisexual, and other men who have sex with men (MSM) and transgender women (TGW) who have had a bacterial sexually transmitted infection (STI) diagnosed in the past 12 months should receive counseling and engage in shared decision-making with their provider regarding doxycycline post-exposure prophylaxis (doxy PEP). The purpose of this study is to evaluate the eligibility for and utilization of doxy PEP among people with HIV (PWH) at the HIV Outpatient Program (HOP) at the University Medical Center New Orleans (UMCNO). Methods: The target population (MSM and TGW) was identified among all PWH clients served at HOP in 2023. Patient characteristics were evaluated over a two-year period to determine doxy PEP eligibility, utilization, subsequent STI monitoring, and barriers to doxy PEP. Results: Of the 456 clients identified, 426 were male, 29 were transgender female, and 1 was gender non-binary. 67 clients received doxy PEP during the study period: 32 had an STI within the previous 12 months, 30 had a history of an STI more than 12 months prior, and 5 had no documented history of STIs. Most clients (96%) had a CD4 count above 200 and virally suppressed (91%). Among the 46 clients who had follow-up STI testing within 6 months of initiating doxy PEP, 6 tested positive (1 syphilis, 3 gonorrhea, 2 chlamydia). Beyond the 6-month mark, 9 clients tested positive (3 syphilis, 8 gonorrhea, 3 chlamydia). Non-adherence to the doxy PEP regimen was the most common factor associated with subsequent positive tests. Among the 389 clients who never received doxy PEP, 44 met the eligibility criteria in 2023. An additional 45 clients tested positive for an STI during the follow-up period. While 75 total clients were eligible for doxy PEP during the study, documented provider counseling was offered to only 6. Furthermore, 24 clients were lost to follow-up, and 41 had no documentation acknowledging their eligibility for the intervention. Conclusion: Non-adherence is the primary reason for STI detection following doxy PEP initiation, while loss to follow-up remains the most significant barrier to discussing the intervention with eligible patients. This study highlights the urgent need to increase provider awareness of doxy PEP criteria, improve clinical documentation, and maintain longitudinal STI monitoring to effectively combat the STI epidemic. Patient
Recommended Citation
Moore, Mary Katherine, "Beyond the doxy PEP Script: A Call for Longitudinal STI Screening and Follow-up – Lessons Learned from HIV Outpatient Program" (2026). Medicine Research Day. 15.
https://digitalscholar.lsuhsc.edu/mrd/2026/tr/15
Beyond the doxy PEP Script: A Call for Longitudinal STI Screening and Follow-up – Lessons Learned from HIV Outpatient Program
Virtual
Authors: Mary Katherine Moore, Emma Allemond, Jared Barrilleaux, Kaitlyn Calabresi, Mason Calico, Ross Hightower, Ivan Nguyen, Thoung Dien Nguyen-Bui, Meredith Clement, Tat Yau Background: The Centers for Disease Control and Prevention (CDC) recommends that gay, bisexual, and other men who have sex with men (MSM) and transgender women (TGW) who have had a bacterial sexually transmitted infection (STI) diagnosed in the past 12 months should receive counseling and engage in shared decision-making with their provider regarding doxycycline post-exposure prophylaxis (doxy PEP). The purpose of this study is to evaluate the eligibility for and utilization of doxy PEP among people with HIV (PWH) at the HIV Outpatient Program (HOP) at the University Medical Center New Orleans (UMCNO). Methods: The target population (MSM and TGW) was identified among all PWH clients served at HOP in 2023. Patient characteristics were evaluated over a two-year period to determine doxy PEP eligibility, utilization, subsequent STI monitoring, and barriers to doxy PEP. Results: Of the 456 clients identified, 426 were male, 29 were transgender female, and 1 was gender non-binary. 67 clients received doxy PEP during the study period: 32 had an STI within the previous 12 months, 30 had a history of an STI more than 12 months prior, and 5 had no documented history of STIs. Most clients (96%) had a CD4 count above 200 and virally suppressed (91%). Among the 46 clients who had follow-up STI testing within 6 months of initiating doxy PEP, 6 tested positive (1 syphilis, 3 gonorrhea, 2 chlamydia). Beyond the 6-month mark, 9 clients tested positive (3 syphilis, 8 gonorrhea, 3 chlamydia). Non-adherence to the doxy PEP regimen was the most common factor associated with subsequent positive tests. Among the 389 clients who never received doxy PEP, 44 met the eligibility criteria in 2023. An additional 45 clients tested positive for an STI during the follow-up period. While 75 total clients were eligible for doxy PEP during the study, documented provider counseling was offered to only 6. Furthermore, 24 clients were lost to follow-up, and 41 had no documentation acknowledging their eligibility for the intervention. Conclusion: Non-adherence is the primary reason for STI detection following doxy PEP initiation, while loss to follow-up remains the most significant barrier to discussing the intervention with eligible patients. This study highlights the urgent need to increase provider awareness of doxy PEP criteria, improve clinical documentation, and maintain longitudinal STI monitoring to effectively combat the STI epidemic. Patient