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A examine performed at a sexual well being clinic in San Francisco discovered sustained vital declines in instances of chlamydia and syphilis amongst those that used doxycycline post-exposure prophylaxis (doxy-PEP) almost 2 years after it was launched, with a smaller impact on gonorrhea, researchers reported yesterday in Scientific Infectious Illnesses.
Within the examine, researchers with the College of California, San Francisco and the San Francisco Division of Public Well being analyzed information on 2,524 doxy-PEP customers and a pair of,068 non–doxy-PEP customers in San Francisco over 96 weeks after the intervention—which includes taking a dose of doxycycline inside 72 hours of unprotected intercourse—was provided to all sufferers at a big sexual well being clinic within the metropolis. Implementation of the intervention was based mostly on a randomized trial, performed in San Francisco and Seattle, that in 2023 confirmed vital declines in chlamydia, syphilis, and gonorrhea amongst doxy-PEP customers in contrast with those that acquired customary care.
Utilizing an interrupted time sequence evaluation, the researchers in contrast sexually transmitted an infection (STI) charges within the 5 quarters earlier than and after the introduction of doxy-PEP to find out whether or not the massive declines initially noticed after the discharge of citywide doxy-PEP tips have been sustained.
Dramatic decline in charges of chlamydia, syphilis
The evaluation confirmed a big decline in all particular person STIs within the doxy-PEP group, most notably (83%) for mixed charges of chlamydia and syphilis (adjusted odds ratio [AOR]0.17; 95% confidence interval [CI]0.12 to 0.25) and fewer for gonorrhea (AOR, 0.56; 95% CI, 0.44 to 0.71). STI charges in doxy-PEP customers after initiation have been statistically just like these in sufferers who by no means took doxy-PEP, regardless of a better variety of condomless intercourse companions over the identical interval.
The examine authors observe that whereas gonorrhea charges did initially decline in customers after beginning doxy-PEP, they started to extend once more towards the tip of the evaluation, which might point out that gonorrhea resistance to doxycycline is growing.
“As doxy-PEP uptake will increase globally, future research ought to look at doxy-PEP adherence, effectiveness, and affect on antimicrobial resistance,” they wrote.
