MISTR's Free DoxyPEP Leads to Huge Drop in STI Rates (2025)

MISTR says that its efforts to provide free DoxyPEP to patients across the United States has resulted in a drop in STI positivity rates by more than 50% among its more than 500,000 patients.

The news from the nation’s largest LGBTQ-focused sexual health platform coincided with the commemoration of STI Awareness Week, April 14 to 18.

Starting last year, MISTR, which utilizes telehealth to connect patients to free online PrEP, DoxyPEP, long-term HIV treatments, and at-home STI testing, said it would enable patients to receive DoxyPEP, free of charge.

Past studies of DoxyPEP, in which a person takes one 200-milligram dose of doxycycline within 72 hours of condomless sex, has shown that the regiment helps reduce STI rates among sexually active people.

An NIH-funded study published by the New England Journal of Medicinein 2023 showed that DoxyPEP helped reduce syphilis and chlamydia infections by 87% and 88%, respectively, and reduced gonorrhea infections by 55%, among people taking pre-exposure prophylaxis, a separate biomedical intervention to prevent transmission of HIV.

Additionally, the regiment helped reduce syphilis, chlamydia, and gonorrhea infections by 77%, 74%, and 57% among people living with HIV.

Due to the medication’s efficacy, MISTR sought to connect its patients — 30% of whom are uninsured — with the medication as a way to reduce STI rates among vulnerable populations without incurring significant out-of-pocket costs.

In the 12 months since the initiative launched, MISTR reports that over 74% of its patients have begun requesting DoxyPEP bundled with their PrEP prescriptions or other medications, demonstrating an underlying need for this prevention tool.

“The science is clear — DoxyPEP works. PrEP works. The problem isn’t awareness, it’s access,” Tristan Schukraft, the founder and CEO of MISTR, said in a statement. “We’ve built a platform that patients actually want to use. We’ve removed the stigma, the waiting rooms, the paperwork — and we’re seeing real results.”

MISTR’s efforts have been praised by some HIV prevention advocates, including Carl Schmid, executive director of the HIV + Hepatitis Policy Institute.

“MISTR’sresults show what happens when we remove barriers and bring prevention to where people actually are,” Schmid said in a statement. “This is the kind of innovation we need — community-driven, tech-enabled, and stigma-free. We applaud MISTR’s leadership and look forward to continuing the work ahead to ensure everyone at risk can access tools that keep them healthy.”

According to data from the Centers for Disease Control and Prevention, over 68 million people in the United States have an STI at any given time. Yet only 2.4 million cases were officially diagnosed in 2023, the last year for which there was data.

Additionally, only 1 in 4 people at risk of acquiring HIV have been prescribed PrEP, and that rate drops to 13% among Black Americans, who are the group most impacted by new HIV diagnoses.

While still having some room for improvement, MISTR has been able to make some inroads into vulnerable communities, with Black patients representing 18% of its patient base.

The telehealth platform has future plans to integrate long-acting injectable PrEP into its offerings to provide alternative ways of preventing HIV transmission.

“We’re scaling to reach every person who wants protection but can’t — or won’t — navigate a broken healthcare system,” Schukraft said in a statement. “We’re showing what’s possible when prevention is stigma-free, community-rooted, and actually convenient.”