PrEP and DoxyPEP in Australia, Explained Without the Jargon

You've probably heard about PrEP, and if you're in the right circles, you may have heard about doxyPEP as well. They sound similar, and they do completely different things. So here's what each one is in plain English, and how to get them in Australia.

What is PrEP?

PrEP stands for pre-exposure prophylaxis. It's medication that HIV-negative people take to stop themselves getting HIV. Taken as directed, it's very effective at preventing HIV through sex.

It's usually a pill. Some people take it daily, and some men who have sex with men use an on-demand schedule around the times they have sex, which needs to be done exactly right, so talk to your doctor about what suits you. It only protects against HIV. It won't stop chlamydia, gonorrhoea, syphilis, herpes or pregnancy.

Who's PrEP for?

It's for people who could be exposed to HIV. In Australia, that's commonly gay and bisexual men, but it's not only for them. It can suit anyone who has a partner living with HIV whose viral load isn't undetectable, people who have condomless sex with partners whose status they don't know, and people who've recently had certain STIs. If you think it might be for you, you don't have to justify yourself. Just ask.

How do I get PrEP in Australia?

1. See a GP or sexual health clinic. Many GPs can prescribe it. If yours isn't confident, a sexual health clinic is a good place to go. HIV and sexual health organisations in your state can point you to a PrEP-friendly doctor.
2. Get tested first. You'll need an HIV test, plus other STI tests, and a kidney function check.
3. Fill the script. PrEP's been on the Pharmaceutical Benefits Scheme since 2018, so if you have Medicare, you'll pay the standard PBS price at a pharmacy, and less with a concession card.
4. Keep going back. You'll need regular check-ups and testing, usually every three months, to stay on it safely.

No Medicare card? You can still get PrEP, usually by importing a generic for personal use, or through a clinic. A sexual health clinic can walk you through it.

What is doxyPEP?

DoxyPEP means taking a single dose of the antibiotic doxycycline after sex, ideally within 24 hours and no later than 72 hours, to reduce your chance of catching some bacterial STIs.

The research has mostly been in gay and bisexual men and trans women, and it showed large reductions in syphilis and chlamydia. It doesn't work as reliably for gonorrhoea, because resistance is a growing problem. It doesn't prevent any viruses, like HIV, herpes or HPV. Trials in women who have sex with men didn't show the same benefit.

Who's doxyPEP for in Australia?

This one's more restricted, and for good reason. A 2024 Australian consensus statement from ASHM, the country's clinical HIV and sexual health body, recommends considering it mainly to prevent syphilis in gay, bisexual and other men who have sex with men. It's most likely to be suggested if you've recently had syphilis, or have had several bacterial STIs lately.

It isn't for everyone who's having a lot of sex, as using antibiotics a lot can lead to resistance and may affect your gut bacteria. There are also side effects, including nausea and sun sensitivity, which is a real problem in this country. Guidance in this area keeps changing, so ask your clinic what's current. It's a conversation you should have with a doctor, and you shouldn't use someone else's pills.

Which is which: a quick summary

• PrEP is taken before and around sex to prevent HIV. Antiviral. Ongoing check-ups. Subsidised on the PBS.
• PEP is a 28-day course you start within 72 hours after a possible exposure to HIV. It's an emergency measure. Our guide to broken condoms covers it.
• DoxyPEP is one antibiotic dose after sex to reduce syphilis and chlamydia. Mostly for gay and bisexual men at higher risk.

What about condoms?

Condoms are still the only one of these that helps against pretty much all STIs at once, as well as pregnancy. Plenty of people use them along with PrEP. If you find they don't feel great, you may be in the wrong size or material. Our condom size guide and materials guide can help, and here's which lubes work with which condoms. And keep up your regular checks, whichever you use. Our STI testing guide explains how.

This is general information, not medical advice. Check with a GP or sexual health clinic about what's right for you, as subsidies and guidelines can change.