Awareness of HIV PrEP, HIV PEP, and Doxy-PEP Among Adults Recruited Through Social Media in Poland: Differences According to Self-Reported Sexual Orientation

Introduction: HIV pre-exposure prophylaxis (HIV PrEP) and HIV post-exposure prophylaxis (HIV PEP) are established preventive strategies against HIV, while doxycycline post-exposure prophylaxis (doxy-PEP) is used to prevent bacterial sexually transmitted infections (STIs). Awareness, access, and use of these methods may differ between heterosexual persons and sexual minority individuals (SMIs). This study aimed to assess awareness of HIV PrEP, HIV PEP, and doxy-PEP among adults in Poland recruited through social media and to compare awareness according to self-reported sexual orientation. Materials and methods: We conducted a cross-sectional survey of Polish adults recruited through social media platforms. Collected data included demographic characteristics, sexual behavior, awareness and knowledge of HIV PrEP, HIV PEP, and doxy-PEP, willingness to use preventive measures, and access-related knowledge. Comparative analyses were performed between heterosexual persons and SMIs. Results: We collected 204 questionnaires. Of these, 196 were included in the final analysis, while 8 (3.9%) respondents with missing or unspecified sexual orientation were excluded. The majority of participants were heterosexual 59.7%, with 31.1% identifying as homosexual and 9.2% as bisexual. Of the 196 participants, 54.6% were male, and 45.4% were female. The median respondent age was 29.5 years (IQR: 25.0–36.8 years), and most respondents had higher education (61.7%). Compared to heterosexual respondents, SMIs reported more sexual partners (median 4 vs. 1; p < 0.001), more often reported condomless sexual intercourse or condom failure with a partner of unknown serological status (69.6% vs. 26.5%; p < 0.001), and more often had been tested for HIV (74.7% vs. 31.6%; p < 0.001). Moreover, SMIs were more likely to report STIs, particularly syphilis (p = 0.004), chlamydia (p = 0.004), gonorrhea (p < 0.001), and pubic lice (p = 0.028). SMIs were more aware of HIV prevention strategies, including being more familiar with HIV PEP (77.2% vs. 30.8%; p < 0.001) and doxy-PEP (54.4% vs. 18%; p < 0.001). In univariable analyses, SMI participants had higher prevalence of doxy-PEP awareness (PR 3.03, 95% CI: 1.96–4.69; p < 0.001) and self-reported STI history (PR 9.43, 95% CI: 3.90–22.83; p < 0.001). In multivariable analyses, previous HIV testing was independently associated with awareness of HIV PrEP (aPR 1.97, 95% CI: 1.32–2.93; p < 0.001), HIV PEP (aPR 1.89, 95% CI: 1.20–2.96; p = 0.006), and doxy-PEP (aPR 2.12, 95% CI: 1.10–4.07; p = 0.025), while SMIs remained independently associated with HIV PEP awareness (aPR 1.60, 95% CI: 1.04–2.45; p = 0.031). Conclusions: Despite greater awareness of HIV and prevention of bacterial STIs, SMIs reported more frequent sexual encounters associated with potential exposure to STIs and a higher self-reported history of STI diagnoses. Previous HIV testing was consistently associated with greater awareness of HIV PrEP, HIV PEP, and doxy-PEP, highlighting HIV testing encounters as an important opportunity for integrated prevention education. These findings highlight the need for further research on the clinical eligibility, acceptability, and implementation of doxy-PEP among individuals meeting guideline-defined eligibility criteria in Poland.