If your group chat is 50% memes and 50% “we should book a check-up,” this is your one stop, no judgement update for 2025. We’ve boiled the latest guidance into clear actions for gay, bi and other men who have sex with men (GBMSM) in the UK.
TL;DR (save this bit)
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PrEP is free via NHS sexual health clinics across the UK (daily or event-based). Scotland has also approved long-acting injectable cabotegravir for restricted use; England’s NICE appraisal is ongoing.
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Doxy-PEP (doxycycline after sex) now has a 2025 UK guideline for reducing syphilis in people at higher risk — typically 200 mg within 24–72 hours after sex; offered with clinical judgement and stewardship in mind.
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U=U: people with HIV who keep an undetectable viral load do not transmit HIV sexually. Spread the message, not the stigma.
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Mpox: a routine vaccination programme for higher-risk GBMSM is rolling out with eligibility similar to 2022; full programme launched 1 August 2025.
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Home HIV tests are easy to order and quick to use; 2025 campaigns expanded access and visibility.
1) PrEP in 2025: more ways to ‘yes’
Oral PrEP (tenofovir + emtricitabine) is free from NHS sexual health clinics across the UK. You can use it daily or event-based (2-1-1) under clinic guidance both are well-established options for many GBMSM.
Long-acting injectable PrEP (cabotegravir, “CAB-LA”):
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Scotland: accepted for restricted use within NHS Scotland (Apretude). Clinics are defining local pathways and capacity.
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England: NICE has not yet published a final decision; the appraisal remains in progress (update noted 19 Aug 2025). In plain English: not routinely commissioned yet, so watch this space or ask your clinic about trials/pilots.
Quick tip: If daily pills don’t fit your life, ask your clinic whether event-based PrEP or (in Scotland) CAB-LA could suit you. Clinics can help match dosing to your patterns.
2) Doxy-PEP: smart use, not a free-for-all
The 2025 UK guideline (BASHH/BHIVA) supports doxycycline post-exposure prophylaxis (Doxy-PEP) to reduce syphilis in people at higher risk, alongside routine STI screening and risk-reduction. Typical regimen: 200 mg within 24–72 hours after sex (not more than once every 24 hours). It’s not for everyone; clinicians weigh benefits vs antimicrobial resistance and your personal risk profile.
Bottom line: Don’t self-start. Ask your sexual health clinic if Doxy-PEP is appropriate for you, and follow their plan.
3) U=U: Undetectable = Untransmittable
The science is solid: people living with HIV who take treatment and keep an undetectable viral load do not transmit HIV through sex. Knowing this reduces stigma and anxiety, and helps everyone focus on what matters — routine care and joy.
4) Mpox: roll up, don’t panic
Mpox hasn’t disappeared, but we’re better prepared. The routine programme uses MVA-BN vaccine and prioritises higher-risk GBMSM assessed via markers like multiple partners or group sex. The UKHSA practitioner guidance and Green Book (June 2025) confirm the 1 August 2025 programme launch and outline eligibility. Check with your clinic for dose schedules and catch-up.
5) Testing made easy (and discreet)
Two no-brainers for 2025:
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Home HIV tests: Discreet kits are available (eligibility varies by area). Campaigns during National HIV Testing Week 2025 boosted access and awareness; even the PM publicly took a home test to destigmatise it. Results can be as fast as 15 minutes depending on the kit.
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Clinic testing: Sexual health clinics remain free and confidential — book screens for HIV and other STIs, especially when changing partners or after condomless sex.
6) Build your 2025 protection stack
Think layers, not either/or:
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Condoms + lube for STI protection and comfort.
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PrEP (daily or event-based) to slash HIV risk or CAB-LA where available.
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Doxy-PEP (if suitable) to curb syphilis risk via your clinic, not DIY.
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Mpox vaccination if you’re in a higher-risk group.
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Regular screens so surprises stay on birthdays only.
7) Where to go next (UK-friendly)
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Find an NHS sexual health clinic near you (for PrEP, Doxy-PEP advice, mpox vax, full STI screens).
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Order a home HIV test (area-dependent services are available).
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Scotland: check local pathways for CAB-LA and national PrEP info.
8) FAQs you were about to text the group
Is event-based (2-1-1) PrEP legit?
For many GBMSM it’s an accepted option when taken correctly; your clinic will check suitability and explain dosing.
When will injectable PrEP be in England?
NICE’s appraisal is still in progress as of 19 August 2025. Until then, it’s not routinely commissioned nationally. Scotland has already accepted it for restricted use.
Will Doxy-PEP give me side-effects or wreck my gut microbiome?
Clinics discuss side-effects and antibiotic stewardship with you. The 2025 guideline emphasises using Doxy-PEP for clearly defined higher-risk groups and with regular STI screening.
Do I still need condoms if I’m on PrEP or Doxy-PEP?
PrEP prevents HIV, not other STIs. Doxy-PEP targets syphilis risk reduction. Condoms still reduce risk of gonorrhoea, chlamydia, HSV and others. Mix methods to suit your life.
9) The take-home
Your 2025 toolkit is powerful and free at point of use. Pick the combo that matches your sex life, check in with a clinic, and keep the vibe fun, informed and drama-free.