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Sexual health prevention has evolved significantly in recent years. Alongside PrEP — which has been transforming HIV prevention since 2012 — a newer tool called DoxyPEP has emerged as a promising way to reduce bacterial STIs. At Spectrum by Equalis Health, we offer both, and we get a lot of questions about how they differ and who should consider each one.
Here's a clear, jargon-free breakdown.
PrEP (pre-exposure prophylaxis) is a daily oral medication taken by HIV-negative individuals to prevent HIV infection. The most commonly prescribed forms in Canada are Truvada and Descovy. When taken consistently and correctly, PrEP reduces the risk of getting HIV from sex by more than 99%.
PrEP is taken every day, regardless of whether you've been exposed. It builds up a protective level of medication in your bloodstream over time — reaching full effectiveness after about 7 days of consistent use for receptive anal sex, and 21 days for receptive vaginal sex or injection drug use.
PrEP requires a prescription from a licensed clinician and routine follow-up visits every three months that include HIV testing, STI screening, and kidney function monitoring.
DoxyPEP (doxycycline post-exposure prophylaxis) is a different kind of prevention strategy. Rather than taking a daily pill, DoxyPEP is taken within 72 hours after a potential sexual exposure to reduce the risk of bacterial sexually transmitted infections — specifically chlamydia, gonorrhea, and syphilis.
The medication is doxycycline, a common antibiotic. When taken as a single 200mg dose within 72 hours of sex, clinical trials — including a landmark 2023 study published in the New England Journal of Medicine — have shown it reduces bacterial STIs by around 65% to 80%.
DoxyPEP does not prevent HIV. It also does not prevent viral STIs like herpes or HPV. It is specifically effective against the three most common bacterial STIs.
PrEP is recommended for people who are at ongoing, regular risk of HIV exposure. This typically includes:
Gay and bisexual men with multiple or concurrent sexual partners, trans women and trans men who have sex with men, people with HIV-positive partners who are not virally suppressed, people who have recently been treated for a bacterial STI (which is a marker of HIV risk), and anyone who does not consistently use condoms and has concerns about HIV exposure.
If HIV prevention is a primary concern for you, PrEP is one of the most powerful tools available.
DoxyPEP is most appropriate for people who have frequent bacterial STIs — particularly those who have been diagnosed with chlamydia, gonorrhea, or syphilis in the past year, or who have multiple partners and inconsistent condom use. It's also relevant for people on PrEP who are already engaged in sexual health care and want additional protection against bacterial infections.
DoxyPEP is not a first-line option for everyone. Its use is more targeted, and there are considerations around antibiotic resistance that your clinician will discuss with you when determining whether it's appropriate.
Yes. Many of the patients we see at Spectrum by Equalis Health take both PrEP daily and use DoxyPEP after specific exposures. The two are complementary — PrEP handles HIV prevention continuously, while DoxyPEP provides a tactical layer of protection against bacterial STIs when you've had a sexual encounter.
Your clinician will assess your individual situation, sexual health history, and risk profile to determine the right combination for you.
Both medications require a prescription in Canada. At Spectrum by Equalis Health, you can access both through a fully virtual consultation with a licensed Nurse Practitioner. There's no referral needed, no in-person visit required, and for most patients, PrEP costs $0 through coverage programs available in Alberta.
If you're curious about whether PrEP, DoxyPEP, or both might be right for you, the best first step is a consultation with one of our clinicians. We'll walk you through your options without judgment.
Book your free virtual consultation today and take the next step in protecting your health on your own terms.
Teagan L, Calgary Downtown Resident
Calgary, AB
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