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Doxy-PEP and HIV PEP are both “post-exposure prophylaxis”: treatment taken after sex to lower the chance of an infection taking hold. They’re very different, though. HIV PEP is an urgent, month-long course of HIV medicine that must be started within 72 hours. Doxy-PEP is a single dose of an antibiotic taken after sex to reduce the risk of some bacterial STIs, and in Australia it’s recommended only for certain people.
If you think you’ve been exposed to HIV in the last 72 hours, don’t wait to finish reading. Go to your nearest hospital emergency department or sexual health clinic, or call your state PEP line (listed below).
Doxy-PEP and HIV PEP at a glance
| Doxy-PEP | HIV PEP | |
|---|---|---|
| What it helps prevent | Syphilis and chlamydia (much less effective against gonorrhoea) | HIV |
| Type of medicine | An antibiotic | A combination of HIV (antiretroviral) medicines |
| When to start | Ideally within 24 hours, and no later than 72 hours after sex | As soon as possible, ideally within 24 hours, and no later than 72 hours after exposure |
| How long | One dose after each episode of sex | Every day for 28 days |
| Who it’s for | Mainly gay, bisexual and other men who have sex with men, and trans women, at higher risk of syphilis | Anyone who may have been exposed to HIV |
| How urgent | Time-sensitive, usually planned ahead with your doctor | Urgent: treat it like a medical emergency |
What is HIV PEP?
HIV PEP is a 28-day course of HIV medicines taken by someone who doesn’t have HIV, after a possible exposure. It works by stopping the virus from establishing an infection. The sooner it’s started, the better it works, and it must be started within 72 hours.
When might HIV PEP be needed?
A doctor will assess your risk, but PEP may be considered after:
- anal or vaginal sex without a condom, or when a condom broke or slipped off, with a partner who has HIV and a detectable viral load, or whose HIV status you don’t know
- sharing needles or other injecting equipment
- a needlestick injury or other exposure to blood
- sexual assault
If your partner has HIV and has had an undetectable viral load for at least six months, the risk of sexual transmission is effectively zero, and PEP usually isn’t needed. Your doctor can talk this through with you.
Where to get HIV PEP
According to healthdirect’s guide to PEP, you can get it from public hospital emergency departments, sexual health clinics, HIV-specialist doctors and some community pharmacies. Each state also has a PEP phone line for advice:
- NSW: 1800 737 669
- Queensland: 13 43 25 84
- South Australia: 1800 022 226
- Tasmania: 1800 675 859
- Victoria: 1800 889 887
- Western Australia: 1300 767 161
After PEP you’ll need follow-up HIV tests, usually at about 6 and 12 weeks, to confirm you haven’t been infected. If you’re often in situations where HIV PEP might be needed, ask a doctor about PrEP (pre-exposure prophylaxis), which is taken before exposure.
What is Doxy-PEP?
Doxy-PEP means taking a single dose of a particular antibiotic within 72 hours of sex (ideally within 24 hours) to reduce the chance of getting a bacterial STI. Studies have found it reduces syphilis and chlamydia by around 80% in the groups studied, but it’s much less effective, or not effective, against gonorrhoea. It doesn’t protect against HIV, herpes, HPV or other viral infections.
Who is Doxy-PEP recommended for in Australia?
The Australian consensus statement on Doxy-PEP, led by ASHM (the national body for HIV and sexual health medicine), recommends offering it mainly to gay, bisexual and other men who have sex with men, and trans women, who are at higher risk of syphilis. This includes people who:
- have had syphilis or several bacterial STIs recently
- expect a period of higher risk, such as travel, events or holidays with new partners
- also have partners who could become pregnant, where syphilis can affect a baby
It isn’t currently recommended for cisgender women, or as a general measure for everyone, because studies haven’t shown the same benefit and because of concerns about antibiotic resistance.
Things to weigh up
- Antibiotic resistance: regular antibiotic use may lead to resistance in the bacteria that normally live in your body, and possibly in STIs such as gonorrhoea.
- Side effects: such as reflux, nausea and sensitivity to the sun. It’s not suitable for everyone, including people who are or could be pregnant.
- Testing still matters: anyone using Doxy-PEP should keep having regular STI tests (usually every three months), including HIV and syphilis blood tests.
- Regular review: your doctor should check every six months or so whether it’s still right for you.
Can you need both?
Sometimes. After a single higher-risk encounter, a doctor may recommend HIV PEP and, if you meet the criteria, Doxy-PEP as well. The priority is always HIV PEP, because of its strict time window. Getting an STI and HIV test at the time, and again afterwards, is important either way. See our article on how telehealth makes STI testing easier for what testing involves.
When to get urgent help
- If you may have been exposed to HIV in the past 72 hours, go to a hospital emergency department or sexual health clinic now, or call your state PEP line. Don’t wait for a routine appointment.
- If you’ve been sexually assaulted, go to an emergency department or call 1800RESPECT (1800 737 732) for support. In an emergency, call 000.
- If you have a severe allergic reaction to any medicine (swelling of the face or throat, or trouble breathing), call 000.
How Teldoc and STI Doctor can help
Our AHPRA-registered GPs can talk through STI risks, arrange STI testing and treatment and discuss prevention options by phone or video, 7 days a week from 9 am to 7 pm (Sydney time). Our sister service STI Doctor focuses only on sexual health and offers consultations about Doxy-PEP and HIV PEP. A doctor will check whether treatment is clinically appropriate for you and, if so, send an eScript to your phone. If HIV PEP can’t be arranged quickly enough, they’ll direct you to the nearest emergency department or sexual health clinic.
Sexual health consultations are bulk billed for eligible patients with a valid Medicare card. See our fees page for details.
Frequently asked questions
How soon after sex do I need to start HIV PEP?
As soon as possible, ideally within 24 hours, and no later than 72 hours after the possible exposure. After 72 hours it’s unlikely to work, so go to an emergency department or sexual health clinic straight away.
Does Doxy-PEP protect against HIV?
No. Doxy-PEP only reduces the risk of some bacterial STIs, mainly syphilis and chlamydia. It doesn’t protect against HIV, so you may still need HIV PEP or PrEP.
Can anyone get Doxy-PEP?
Not routinely. Australian guidance recommends it mainly for gay, bisexual and other men who have sex with men, and trans women, who are at higher risk of syphilis. A doctor will talk through whether it’s suitable for you.
Do I still need STI tests if I use Doxy-PEP?
Yes. Regular STI testing, usually every three months, is still recommended, including HIV and syphilis blood tests, because Doxy-PEP doesn’t prevent every infection.
Where can I get HIV PEP after hours?
Public hospital emergency departments provide HIV PEP at any time. Your state PEP phone line can also tell you the nearest place to get it.
This article is general health information and isn’t a substitute for advice from your own doctor. If you’re worried about your health, speak to a GP. In an emergency, call 000.
Medically reviewed by Dr Vafa Derakshan (MBBS, FRACGP), September 2026
