Doxycycline PEP: A Highly Effective, Low Resistance Approach to STI Prevention

Research Update: Doxy-PEP for Sexual Health - Highly Effective with Minimal Antibiotic Resistance

By Laura Kurtzman

A novel strategy in sexual health management called doxy-PEP doxycycline post-exposure prophylaxis offers a promising approach to prevent sexually transmitted infections STIs. taking one dose of 200mg doxycycline, a tetracycline antibiotic, immediately after condomless sex, with the maximum delay being three days. In a preliminary presentation at the 2023 Conference on Retroviruses and Opportunistic Infections CROI, researchers from the University of California San Francisco UCSF, the San Francisco Department of Public Health SFDPH and the University of Washington reported that this method significantly reduced rates of gonorrhea, chlamydia, and syphilis infections by two-thirds each quarter among men who have sex with men MSM and transger women.

The study, which spanned over a year, demonstrated that doxy-PEP was effective in mitigating the burden of STIs. While participants were required to have experienced at least one STI incident involving gonorrhea, chlamydia or syphilis within the past year alongside history of condomless sex with a male partner to qualify for the study.

Dr. Annie Luetkemeyer, professor of infectious diseases at Zuckerberg San Francisco General Hospital and UCSF, co-principal investigator on the study, highlighted that doxy-PEP is particularly beneficial in populations disproportionately affected by high rates of STIs: Doxy-PEP presents a promising strategy to reduce sexually transmitted infections in MSM and transger women who have had recent STI episodes, she sd. Monitoring its impact on antibiotic resistance over time will be crucial, while balancing this agnst the demonstrated reduction in STI burden.

Funding for this trial was provided by the National Institute of Allergy and Infectious Diseases NID, part of the National Institutes of Health, through grant R01143439. The study is being conducted at key locations including the HIV clinic at Zuckerberg San Francisco General Hospital and the SF City Clinic run by SFDPH.

As Dr. Connie Celum, professor of global health, medicine, and epidemiology at the University of Washington and co-principal investigator on the study emphasizes, Doxy-PEP is an innovative approach for STI prevention that could have a positive impact in high-risk populations. It will be essential to continue assessing its efficacy while monitoring the potential rise in antibiotic resistance over time.

The UCSF HIV clinic and SFDPH's SF City Clinic are currently evaluating how doxy-PEP affects the gut microbiome alongside other STIs such as mycoplasma genitalium and chlamydia.

This study demonstrates that doxy-PEP represents a promising, innovative approach to sexual health management that could potentially significantly benefit at-risk populations in terms of STI prevention. It underscores the importance of ongoing research into its long-term effects on antibiotic resistance to maximize public health benefits.

For more information or updates on this study and UCSF's contributions to sexual health research, please visit ucsf.edu or contact the University directly via their online resources.

References:

1. Citation to the specific presentation at CROI 2023

2. Additional sources supporting

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The above information is for informational purposes only and should not be considered as medical advice or a substitute for professional healthcare guidance.
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