Note: This blog details some of the steps involved with getting a DoxyPEP prescription from the Auckland Sexual Health Service. This service is currently free and available for certain priority populations - Māori and Pasifika, and young people under 30. If you don’t fall into these demographics, and you want to organise a DoxyPEP prescription, we recommend you go through this process with your GP or health provider. More info here. 

(This blog was written by a cis gay 30 year old Māori man)

How I mustered the courage to bring up DoxyPEP for the first time

Tuesday 11.49am

I had just walked into the gym, ready for a quick workout on my lunch break.

I dodged the Yoga Mums chatting at the cubby holes, and mumbled the usual Hi to the staff. I prepared myself to beeline toward the treadmills when my hand started buzzing. I looked down at my phone and saw the familiar phone number. I knew what was coming.

I rushed into one of the bathrooms and locked the door behind me. I answered the phone, acting like I didn’t know who it was or why I was being called.

“Hi, it’s Anyonymous speaking”, I croaked out, wondering how sound-proof these bathroom walls were.

“Hey Anonymous, it’s Anonymous Nurse from Auckland Sexual Health”

I wondered which STI I had won from the lottery this time.

See, I had my tests taken at Awanui Labtests (as is usual when you get tested through Auckland Sexual Health Service) on the Saturday before. It was now Tuesday. That was a pretty quick turnaround! I was impressed. I didn’t necessarily have any symptoms (at least, not that I knew of at the time), but my PrEP prescription was running out so it was just a routine STI test in order to get my next 3-month PrEP supply.

“Just wanted to let you know that we’ve found chlamydia in your bottom. Did you have any symptoms when you got tested? Any discomfort, or itching, any discharge?

I thought back to last week. Did I go for a couple rounds of Taco Bell, drink my bodyweight in coffee and fall asleep surrounded by crumbs of fried chicken and chocolate bar wrappers multiple nights last week? And, did I end up paying for it every morning in the bathroom?

Yeah, you could say there was some discomfort back there.

“Uh, yeah, perhaps a bit of umm, discomfort when going to the toilet? I didn’t think that was related though-”, I stammered.

“That’s all good, it’s just important that you do tell us if you have any symptoms when you’re getting tested so that we can make sure we get you treated as soon as possible if we do find something”

Phew. The nurse was very friendly and reassuring. They reminded me of the process from here, that I would have my PrEP phone call appointment on Thursday at 3.30pm, and they’d also sort my treatment for chlamydia at the same time. They asked if I had any questions.

I decided to finally bite the bullet. “Yeah, I was thinking it might be a good idea to go on DoxyPEP?”

“Sure, so the nurse can talk to you about that as well, at the same they do your PrEP stuff. To be eligible, you just need to have had an STI more than once in the last 12 months, and… I can see you had chlamydia in December. So, yup, you’re definitely eligible.”

I thanked the nurse, and I agreed that I’d tell my recent hook-ups, friends with benefits and ex-boyfriend that they needed to get tested too.

Professional foreplay: The DoxyPEP discussion

Thursday 3.43pm

Like any anxious 90’s millennial, I had spent the last couple of days mentally preparing for this phone call. I imagined what I would say as soon as I picked up the phone, I tried my best to recount how many hook-ups I had had in the last three months, and I read through some of the information online about DoxyPEP.

That’s why I was immediately flustered when the phone rang and it was completely silent. For a moment, I was the awkward colleague joining a Teams call with ‘tech issues’ as I fumbled around the volume buttons on my phone and mumbled ‘Hi?'s and ‘Hello?’s and ‘Are you there?’s - only for me to realise the sound was coming through my bluetooth headphones and not my phone the entire time.

Well. We’re off to some kind of start.

The nurse ran through the usual questions concerning my PrEP prescription - how many sexual partners I had had recently, whether I’m on more of a dom top or sloppy bottom vibe currently, and how many bottles of PrEP I had left. As usual, I had waited until the last minute to get this sorted, and so I sheepishly admitted that I had about three pills left. The nurse very kindly reminded me that in the future, it’s best to call as soon as I opened my third bottle of PrEP, in case there was any waiting time or stock issues, so I wouldn’t need to go without a supply in between prescriptions.

Next, we moved on to the chlamydia talk.

It wasn’t my first time contracting chlamydia (I’m a single gay man in my early 30s on PrEP after all) so I knew all the beats of this chat - and I could answer the nurse’s questions before being asked. “Yep, doxycycline is fine - I have no allergies to it”, “Yep, I’ve taken it before, I’ll stay out of the sun and make sure I eat with each dose,” and “Please send the prescription to the Chemist Warehouse at Redacted Auckland suburb, thank you”

I rubbed my hands together like a housefly - piece of cake! (or should I have clapped my hands? Get it? The Clap? OK anyway…). The next part of the phone call, though, was the one I was most nervous and curious about.

DoxyPEP.

The nurse began by asking me what I knew about it, and why I was interested in getting on it. I tried my best at summarising what I had read online:

“So… I know that it’s basically doxycycline - the same antibiotic you’re currently prescribing me for chlamydia - and that it’s mostly effective at reducing the risk of chlamydia and syphilis. I know that you need to take it within a certain amount of time after having condomless sex. And the reason I’m interested in it, is because I’m in my slut era at the moment, and I think I’m at a higher risk of STIs right now.”

The nurse practically shoved a gold star sticker through the phone and into my ear.

“Wow, that’s actually a great explanation!”

They went on to add a little more context and info on to my summary:

• Yep, it’s effective at reducing the risk of chlamydia and syphilis, but not so much for gonorrhoea - so to keep that in mind and to keep up the regular STI testing

• I needed to take specifically two pills within 72 hours after condomless sex

• And, finally, that I could only take a maximum of three doses of DoxyPEP per week - so I needed to think about how I would make that work around my hook-ups

The nurse asked me whether I was more of a ‘spontaneous hook-up' kind of person, or if I’m more of a ‘let me get that dick appointment scheduled in Outlook’ type. I replied that I’m kinda in between.

For me personally, if I’m meeting a regular friends-with-benefit, I would most likely schedule it and work my day around it. On the other hand… if I’m in that mood (…you know, the one where you’re recklessly scrolling Grindr, firing off the ‘Hey Handsome’ messages left and right until you finally get a bite) in that case, it’s probably going to be more spontaneous.

The nurse explained that, either way, as I can only take DoxyPEP a maximum of three times a week - that it’s a good idea to keep track of my hook-ups and how I’m spacing them out, so I can make the most of the effectiveness of the DoxyPEP.

There were a few more simple questions around my sexual health and wellbeing, and before I knew it, we were done! The nurse added DoxyPEP to my prescription pick-up at Chemist Warehouse at Redacted Auckland suburb. And, that was that!

"Is That a Prescription in Your Pocket, or Are You Just Happy to Be Here?"

Saturday 11.38am

“Hey, it’s Anonymous First Name, Anonymous Last Name and I have a prescription to pick-up”

The pharmacist click-clacked her fabulous nails on the keyboard as she stared at the computer screen, asked me to confirm my home address, and let me know my medication would be ready in about 10 minutes.

Naturally, I walked over to the Sexual Health aisle while I waited.

Did you know that Chemist Warehouse sell a douche (they call it a rectal syringe) for only $22? Plus, they have ZIP or Afterpay Pay-in-4-instalments available if you’re in a pinch - just a tip for my fellow bottoms on a budget.

After what felt like less than five minutes of inspecting all the varieties of lube they had on offer, my prescription was ready to go! I sauntered over to the counter, where a different pharmacist was about to hand me my giant pack of PrEP, doxycycline and DoxyPEP… when she glanced at the label on the package, gave me a curious side-eye, muttered ‘Hang on…’ and walked over to another pharmacist behind the counter for a chat, holding my prescription hostage.

I was confused. Was my name wrong? My address? Did they mess up the dosage somehow?

After about a minute of me awkwardly standing at the counter with a rectal syringe in my hand, acutely aware of the elderly customers piling up behind me, the pharmacist came back and said:

“Okay, so, for some reason you’ve been prescribed two treatments of the same antibiotic, doxycycline”

Now it was my turn to give the pharmacist some side-eye back. Should I explain to her why I had two different prescriptions for doxycycline? Internally I weighed up how brave I was feeling on this Saturday morning at my local chemist. I decided to bite my tongue.

The pharmacist continued: “So, each of the antibiotic has a different dosage and different instructions, so just make sure you read them properly and follow the directions. Do you know why you’ve been prescribed them?”

I nodded my head. I telepathically tried to send her a message that I’m a S.L.U.T and that these antibiotics are helping me achieve my wildest sexual fantasies (while staying as safe and protected as possible).

She didn’t get the message, so I just thanked her and walked away with my new prescription.

And on I went. A new man, a new ‘On DoxyPEP’ line added to my bio on Grindr, with a brand new douche, and a dream.

(Well, once I had finished the week of Chlamydia doxy pills, that is)