Health officials with the Center for Disease Control and Prevention (CDC) are proposing the use of a common antibiotic to prevent some sexually transmitted diseases. The CDC plans to endorse the antibiotic as a sort of ‘morning after pill’ for at-risk groups within the LGBTQ+ community, specifically men who have sex with men (MSM) and trans women.
The proposal was announced Monday, October 2 and CDC officials plan to finalize it following a 45-day period for public comment. The report comes as the CDC continues to report record highs in STDs and STIs. With the rise of sexually transmitted diseases, the CDC continues to look for new tools to combat their spread.
The antibiotic in question, doxycycline post-exposure prophylaxis, is a relatively cheap and common medication that has been available for around 40 years. The CDC proposal comes after studies found that some people who took doxycycline within three days of having unprotected sex were less likely to contract chlamydia, gonorrhea, and syphilis compared to those who did not take the medication. San Francisco’s health department started to promote the drug as a preventative morning-after measure a year ago.
One of the studies cited by the CDC comes from the New England Journal of Medicine which specifically studied a group of 501 of participants who were either MSM or trans women who had contracted a bacterial STI within the last year. The study found that the incidence of the aforementioned STIs was lower by two-thirds in the group that took doxycycline within three days than those who used standard care.
Leandro Mena, director of the Division of STD Prevention at the CDC, says in a statement announcing the guidelines that: “STIs are pervasive and increasingly rapid in the U.S., and DOXY PEP has demonstrated substantial benefit in reducing new chlamydia, gonorrhea, and syphilis infections.” Dr. Mena adds that, “Doxy Pep can benefit the health of some gay, bisexual, and other men who have sex with men, and transgender women who have increased chances of getting an STI.” Mena also notes that the work surrounding doxycycline will continue after guidelines are finalized, citing questions about its effectiveness in other populations and long-term impacts on antimicrobial resistance and on the microbiome.
There is less evidence the treatment works as effectively in other groups, namely heterosexual men and women, which will likely lead to more research by the CDC. Some of the side effects of doxycycline include stomach problems and increased sensitivity to sun exposure. There is also concern that the widespread use of doxycycline as a preventative measure could contribute to mutations in bacteria leading to a drug-resistant strain. However, Dr. Stephanie Cohen, who oversees the CDC’s STD prevention work, notes that this type of antibiotic resistance hasn’t emerged in San Francisco where the drug has been recommended as a preventative measure.
The CDC is also calling for long-term monitoring and evaluation of this use of doxycycline as more data becomes available.
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