DoxyPEP (doxycycline post-exposure prophylaxis) is a single 200mg dose of doxycycline taken within 72 hours of unprotected sex. Clinical trial evidence shows 70–80% reduction in syphilis and chlamydia risk among gay and bisexual men and trans women.
DoxyPEP in the French Context
France is one of the most advanced countries in Europe for HIV and sexual health policy. The ANRS MIE (the French national HIV research agency) and clinicians at the major Paris CeGIDDs have been actively following DoxyPEP evidence since the key trials published in 2023.
DoxyPEP is not yet officially part of Assurance Maladie standard guidelines, but:
- CeGIDD doctors, particularly in Paris (Saint-Louis, Tenon, Bichat) and Lyon, are increasingly comfortable prescribing it
- Your médecin référent (HIV/PrEP specialist) is the right person to ask
- Doxycycline is inexpensive — approximately €5–10 per course at any pharmacie
- Some CeGIDDs include DoxyPEP counselling as part of their PrEP follow-up appointments
How to Get It
Ask at your next CeGIDD appointment or PrEP follow-up:
"J'ai lu des études sur le DoxyPEP — la doxycycline en prophylaxie post-exposition. Est-ce quelque chose que vous proposez ici?" ("I've read studies on DoxyPEP — doxycycline as post-exposure prophylaxis. Is that something you offer here?")
AIDES (aides.org) stays current with HIV prevention evidence and can advise on which doctors in your area are prescribing DoxyPEP and what to say.
Reimbursement
Because DoxyPEP is not in official guidelines, it is typically prescribed as a standard antibiotic (doxycycline has many licensed uses). Assurance Maladie may partially reimburse doxycycline as a standard medication — even without DoxyPEP-specific indication — through standard antibiotic prescribing. With Mutuelle top-up, your cost may be minimal.
Regardless: doxycycline is one of the cheapest antibiotics in France. The out-of-pocket cost is low even if there's no reimbursement.
What DoxyPEP Covers and Doesn't
Strong evidence:
- Syphilis — major risk reduction
- Chlamydia — major risk reduction
Partial or uncertain:
- Gonorrhoea — partial effectiveness; antibiotic resistance is a concern
No effect:
- HIV — DoxyPEP does not replace PrEP or PEP
- HPV, herpes, hepatitis
Dosing
200mg doxycycline (two 100mg tablets) as a single dose within 72 hours of unprotected sex — the sooner the better.
Take with food and plenty of water. Avoid lying down for 30 minutes after taking. Avoid sun exposure during a doxycycline course.
Cost at the Pharmacie
Doxycycline at a French pharmacie is inexpensive regardless of reimbursement:
- 10 × 100mg capsules: approximately €5–10
- Enough for 5 DoxyPEP doses
Regular Testing Still Essential
DoxyPEP works best alongside continued regular testing. If you're using DoxyPEP, maintain three-monthly testing: HIV, syphilis serology, and three-site gonorrhoea/chlamydia panels. The CeGIDD or your médecin référent can continue managing this as part of your PrEP monitoring.