Factors Associated with DoxyPEP Familiarity Amongst Pediatric Providers
Sebastian Otero, Jose Luis Paredes, Trenton Lam, Aniruddha Hazra, John FloresAbstract
Background
Over half of all newly diagnosed sexually transmitted infections (STIs) occur in adolescents and young adults (AYAs) aged 15-24. The Center of Disease Control (CDC) suggested that the rates of STIs in the United States may slowing down based on data from 2023, but AYAs remain a suggested high priority group given disparities in reduction. Doxycycline postexposure prophylaxis (doxyPEP), a recently described novel chemoprophylaxis of STIs, has been proven efficacious in certain patient populations 18 years of age or older. While data suggest its efficacy amongst adult men who have sex with men (MSM) and transgender women (TGW), few studies have examined doxyPEP familiarity and utilization amongst AYAs and those who provide their care. This study aimed to establish a baseline understanding of factors associated with familiarity with doxyPEP amongst pediatric providers.
Methods
We conducted a cross-sectional national survey of general pediatric and specialty pediatric providers in the United States (USA). The survey included questions about current practice, diagnostic and treatment perspectives and choices with regards to sexual health practices, including STIs and doxyPEP, and demographic attributes. Data was collected anonymously through purpose driven sampling through a nationwide pediatric medical organization directory, with a Likert scale measurement of the questions related to clinical practices and perspectives. Descriptive statistics and logistic regression were performed both between pediatrics infectious disease (ID) and non-ID providers, and those with and without reported familiarity of doxyPEP. using STATA.
Results
167 pediatric providers completed the survey, which resulted in a 9% response rate. (Table 1). Amongst all pediatric providers, familiarity with doxyPEP was associated with comfort with discussing sexual orientation (11.6 (5.30-25.40) and comfort with discussing gender identity (9.36 (4.47-19.60)). Other factors include working with individuals 18 and older (2.33 (1.10-4.94)), familiarity with screening and treating STIs (12.14 (5.46-26.99) and 15.20 (6.67-34.70), respectively), and discussing sexual activity with and without parent involvement (10.8 (5.09-22.69) and (12.75 (5.95-27.28), respectively). No significant differences were noted between ID and non-ID providers.
Conclusion
Our survey demonstrated that pediatric providers who are more familiar with caring for sexual health and wellness are more likely to be familiar with doxyPEP. While these data reflect the priority areas of ensuring MSM and TGW have access to prevention measures such as doxyPEP, our data suggest that there is potential to increase familiarity amongst pediatric providers in clinics that do not focus on sexual health and wellness.