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Doxycycline prophylaxis for bacterial sexually transmitted infection prevention in Vietnam: awareness, attitudes and willingness to use among men who have sex with men using HIV-PrEP
  1. Hao T M Bui1,
  2. Paul C Adamson2,
  3. Jeffrey D Klausner3,
  4. Giang M. Le4,
  5. Pamina M Gorbach5
  1. 1Center for Training and Research on Substance Abuse - HIV, Hanoi Medical University, Hanoi, Viet Nam
  2. 2Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA
  3. 3Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  4. 4Center for Training and Research on Substance Abuse - HIV, School of Preventive Medicine and Public Healthon HIV, Hanoi Medical University, Hanoi, Viet Nam
  5. 5Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
  1. Correspondence to Dr Hao T M Bui; buiminhhao{at}hmu.edu.vn

Abstract

Objectives Doxycycline prophylaxis shows promise for bacterial sexually transmitted infection (STI) prevention, but data primarily come from high-income countries. This study assessed awareness, willingness and factors associated with willingness to use doxycycline for bacterial STI prevention among men who have sex with men (MSM) using HIV pre-exposure prophylaxis (HIV-PrEP) in Vietnam.

Methods Between 25 January and 4 February 2024, a cross-sectional study recruited males aged ≥18 years who reported having sex with men in the past 12 months from 11 HIV-PrEP clinics in Hanoi and Ho Chi Minh City. Self-administered surveys were conducted, and multivariable logistic regression was applied to identify factors associated with willingness to use doxycycline prophylaxis.

Results Among 350 participants, the median age was 25 (IQR 21–30), and 10.6% self-reported a bacterial STI diagnosis in the past 12 months. In the previous 6 months, the median number of sex partners was 2 (IQR 1–4), 53.1% reported condomless anal sex. Awareness of doxycycline was low (20.2%; 65/322); however, 75.4% (264/350) expressed willingness to use it, with 63.6% (168/264) preferring doxyPrEP. Participants who disclosed HIV-PrEP use to all sex partners (adjusted OR (aOR) 4.17; 95% CI 1.84, 9.46) and those with higher perceived STI risk (aOR 1.12; 95% CI 1.03, 1.22) were more likely to report willingness to use doxycycline prophylaxis. Concerns about daily medication (aOR 0.43; 95% CI 0.24, 0.81) and fear of judgement from peers (aOR 0.41; 95% CI 0.21, 0.81) were associated with lower willingness.

Conclusions Knowledge of doxycycline prophylaxis among MSM on HIV-PrEP in Vietnam was low. However, most expressed willingness to use it, with two-thirds preferring doxyPrEP. Findings highlight the need to disseminate information on doxycycline prophylaxis for bacterial STI prevention, monitoring the usage and evaluating comparative effectiveness of doxyPEP and doxyPrEP to guide implementation efforts in Vietnam.

  • Chalmydia Trachomatis
  • Epidemiology
  • Homosexuality, Male
  • NEISSERIA GONORRHOEAE
  • SYPHILIS

Data availability statement

Data are available upon reasonable request. Data are available on reasonable request. Deidentified individual participant data and other supporting documents will be made available on reasonable requests made to the corresponding author.

https://doi.org/10.1136/sextrans-2024-056449

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    Data availability statement

    Data are available upon reasonable request. Data are available on reasonable request. Deidentified individual participant data and other supporting documents will be made available on reasonable requests made to the corresponding author.

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    Footnotes

    • Handling editor Adam DN Williams

    • Contributors Study conceptualisation and methodology: HTMB, PCA, KJD, GML, PMG. Data curation and analysis: HTMB. Writing—original draft preparation, editing and finalisation: HTMB. Writing: review and provide feedback with important intellectual contributions: PCA, KJD, PMG. All authors reviewed and approved the manuscript. HTMB accepted full responsibility for the finished work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding This study was supported by the Fogarty International Center and the Office of Disease Prevention of the National Institutes of Health (NIH) under Award Number D43TW009343, and the University of California Global Health Institute (UCGHI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or UCGHI.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.