Doxycycline for the prevention of STIs

Doxycycline for the prevention of STIs
Doxycycline for the prevention of STIs

The French ANRS DOXYVAC clinical trial carried out on 500 volunteers had already established last March the effectiveness of doxycycline post-exposure in reducing the risk of occurrence of chlamydia infections and syphilis (-83% for both) and, to a lesser degree, gonococcal infections (- 33%), versus placebo.

The American studies used real-life data. One measured monthly cases of chlamydia, gonorrhea, and early syphilis in the city of San Francisco, before and after the implementation of guidelines recommending doxyPEP (200 mg of doxycycline per os within 72 hours after sex without a condom) to men who have sex with men (MSM) and certain transgender women. In one year, cases of chlamydia and early syphilis decreased by 49.64% and 51.39% compared to expected projections, but a 25% increase in gonorrhea cases was observed. The other study analyzed medical records of patients who received HIV pre-exposure prophylaxis at a California hospital. Comparing those who additionally received doxyPEP to those who did not take doxycycline, the researchers found a significant drop in the incidence of chlamydia infections (-79%) and syphilis (80%). The results are less convincing for gonococcal infections (-12%), especially in the pharyngeal form. “DoxyPEP may offer substantial benefits in reducing STI transmission at the population level with broader implementation”conclude the authors.

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