BASHH publishes UK-first guidelines on doxyPEP for the prevention of syphilis
09 June 2025
- The UK becomes one of the first countries in the world to issue a national evidence-based doxyPEP guideline.
- The new guidance offers clear direction for healthcare professionals and marks a landmark step in targeted STI prevention.
- New UKHSA annual STI data reveals an increase in diagnoses of syphilis over the past year in England.
Monday 9 June 2025 – The British Association for Sexual Health and HIV (BASHH) has today published national clinical guidelines on the use of doxycycline post-exposure prophylaxis (doxyPEP), making the UK one of the first countries globally to offer formal clinical direction on this STI prevention strategy.
The UK National Guideline for the Use of DoxyPEP for the Prevention of Syphilis provides healthcare professionals with a clear, evidence-informed framework for prescribing doxyPEP to those at increased risk of syphilis – a serious and rising challenge within the UK’s sexual health landscape. The latest data from the UK Health Security Agency (UKHSA) shows that syphilis diagnoses in England increased by almost 5% over the past year, reaching their highest recorded level since 1948.
BASHH clinical guidelines are developed through a robust process including evidence review and open consultation. The doxyPEP guideline is also the result of broad stakeholder collaboration, including community groups, experts in antimicrobial resistance (AMR) and leading UK sexual health and infectious disease organisations. This rigorous process underscores BASHH’s commitment to evidence-based, pragmatic, and equitable approaches to tackling the UK’s STI burden.
Professor Matt Phillips, BASHH President, said:
“I’m proud that BASHH and the UK is at the forefront of supporting effective use of new technologies to advance sexual health. We want to ensure that those at highest risk of serious STIs such as Syphilis can benefit from evidence-based prevention strategies such as doxyPEP. The development of the doxyPEP guidelines has been an exemplar of stakeholder engagement and collaboration across a range of disciplines, ensuring the guidance is balanced, expert-led, and reflective of the real-world needs of patients and clinicians. With clear clinical guidelines now in place, we look forward to seeing the impact of its application, supporting improved sexual health outcomes and helping to ease pressure on sexual health services.”
Dr John Saunders, Deputy Head of Programme Delivery and Service Improvement for Blood Safety, Hepatitis, STI, and HIV Division at UKHSA, said:
"As one of the first countries in the world to issue a formal guideline on the use of doxyPEP, the UK is taking a bold step forward in addressing the continuing rise in syphilis cases.
This simple intervention has the potential to drastically reduce cases, lowering infection risk by 77%, and protect those at greatest risk from serious and irreversible harm.
This guideline will support clinicians and patients to feel confident about the use of doxyPEP, balancing antimicrobial stewardship with better sexual health outcomes."