Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections

This randomized, open-label study evaluated the effectiveness of doxycycline postexposure prophylaxis (DoxyPEP) in reducing bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women, either taking HIV preexposure prophylaxis (PrEP) or living with HIV. A total of 501 participants were enrolled across cohorts. Doxycycline (200 mg) taken within 72 hours of condomless sex reduced the combined quarterly incidence of gonorrhea, chlamydia, and syphilis by approximately two-thirds compared to standard care. Specific relative risks for chlamydia and syphilis were as low as 0.12 and 0.13, respectively, in the PrEP cohort. Adherence to the regimen was high, with no serious adverse events reported. Antimicrobial resistance monitoring revealed a modest increase in tetracycline-resistant gonorrhea and doxycycline-resistant Staphylococcus aureus. Authors conclude doxy-PEP is highly effective for STI prevention among high-risk MSM and transgender women with recent STI history.

This randomized, open-label study evaluated the effectiveness of doxycycline postexposure prophylaxis (DoxyPEP) in reducing bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women, either taking HIV preexposure prophylaxis (PrEP) or living with HIV. A total of 501 participants were enrolled across cohorts. Doxycycline (200 mg) taken within 72 hours of condomless sex reduced the combined quarterly incidence of gonorrhea, chlamydia, and syphilis by approximately two-thirds compared to standard care. Specific relative risks for chlamydia and syphilis were as low as 0.12 and 0.13, respectively, in the PrEP cohort. Adherence to the regimen was high, with no serious adverse events reported. Antimicrobial resistance monitoring revealed a modest increase in tetracycline-resistant gonorrhea and doxycycline-resistant Staphylococcus aureus. Authors conclude doxy-PEP is highly effective for STI prevention among high-risk MSM and transgender women with recent STI history.