Doxycycline Prophylaxis for Bacterial STIs: Implementation Challenges, Innovations, and Equity for Priority Populations

The emergence of doxycycline prophylaxis (Doxy-PEP and Doxy-PrEP) potentially represents one of the most significant developments in bacterial sexually transmitted infection (STI) prevention after the introduction of HIV-PrEP. While growing evidence demonstrates the effectiveness of doxycycline prophylaxis, important questions remain particularly its implementation, acceptability, antimicrobial resistance, equitable access and integration into existing models of sexual healthcare.This Research Topic aims to advance understanding of how doxycycline prophylaxis can be implemented effectively, safely, and equitably as it moves from clinical evidence into routine sexual healthcare. Implementation of doxycycline prophylaxis extends beyond questions of clinical efficacy and requires attention to the social and structural contexts in which prevention technologies are adopted and experienced. Uptake, acceptability and sustained use are shaped by interacting influences operating across multiple levels, including individual beliefs and risk perceptions, interpersonal relationships and sexual networks, community norms and stigma, healthcare provider attitudes, organisational practices and broader policy and regulatory environments. These processes are further mediated by issues of trust, health literacy, access to care and the unequal distribution of social and material resources. Understanding doxycycline prophylaxis therefore requires moving beyond a narrowly biomedical lens to consider how prevention technologies are embedded within everyday practices and broader systems of power, and how these dynamics influence who benefits, who remains excluded, and how sexual health innovations are translated into routine care. Quantitative, qualitative, mixed-methods, implementation science, and policy perspectives each have an important role in advancing understanding of the barriers, enablers, innovations and emerging challenges associated with doxycycline prophylaxis.A particular focus is placed on priority populations who may experience disproportionate burdens of bacterial STIs or inequities in access to prevention strategies. These include gay, bisexual and other men who have sex with men, transgender and gender-diverse populations, people living with HIV, individuals using HIV pre-exposure prophylaxis, young people, culturally and linguistically diverse communities, Indigenous populations, sex workers, and people living in rural and regional settings. Understanding how doxycycline prophylaxis can be implemented in ways that are acceptable, culturally safe, and responsive to diverse needs is critical to ensuring that benefits are realised equitably.We welcome contributions addressing (but not limited to):• Clinical effectiveness and real-world outcomes of Doxy-PEP/Doxy-PrEP• Antimicrobial resistance surveillance and stewardship implications• Acceptability, uptake, and sustained use across priority populations• Healthcare provider attitudes and organisational/health-system integration• Equity of access and structural barriers to implementation• Policy, regulatory, and guideline developmentWe invite Original Research, Reviews, Systematic Reviews, Policy Briefs, Perspectives, and Study Protocols employing quantitative, qualitative, mixed-methods, implementation science, or policy analysis approaches. Topic editors: Amy B. Mullens, Daniel Demant Source: https://www.frontiersin.org/research-topics/84756/doxycycline-prophylaxis-for-bacterial-stis-implementation-challenges-innovations-and-equity-for-priority-populations