Study Shows DoxyPEP Reduces STIs in San Francisco’s Gay Community
San Francisco, known for its vibrant LGBTQ+ community, has been at the forefront of implementing new strategies to combat sexually transmitted infections (STIs). A recent study has shed light on the impact of a preventive treatment called DoxyPEP in reducing STI rates among the city’s gay community. DoxyPEP, short for Doxycycline Post-Exposure Prophylaxis, involves taking a single 200 mg dose of the antibiotic doxycycline within 72 hours of a sexual encounter to minimize the chances of acquiring STIs such as gonorrhea, chlamydia, or syphilis.
San Francisco took the lead in late 2022 by allowing health providers to distribute DoxyPEP to high-risk individuals, particularly gay men with multiple partners and trans women. The city’s progressive approach has been met with enthusiasm, with around 40% of people taking pre-exposure prophylaxis (PrEP) also trying DoxyPEP. This indicates a strong willingness among the gay community to adopt additional preventive measures.
The Centers for Disease Control and Prevention (CDC) issued its first official guidelines on DoxyPEP last October, giving the treatment its approval. The CDC recognizes the urgent need to address the soaring STI rates in the United States and is exploring various strategies. However, concerns about over-prescribing antibiotics have previously delayed the endorsement of DoxyPEP. Fortunately, trials have shown little evidence of the treatment contributing to antibiotic resistance in targeted bacteria.
While the CDC guidelines were slightly more conservative than those in San Francisco, which required a positive STI diagnosis within the past year, the city’s approach allows individuals to access DoxyPEP without an STI diagnosis. This flexibility ensures that those at high risk can take proactive steps to protect their sexual health.
At the Conference on Retroviruses and Opportunistic Infections (CROI 2024), researchers presented the results of the study conducted in San Francisco. The findings revealed a significant decrease in STI cases, particularly chlamydia and syphilis, following the introduction of DoxyPEP. However, the reduction in gonorrhea cases was less pronounced. Overall, there was a remarkable 58% decrease in STIs among individuals taking DoxyPEP. These results have been hailed as a positive development for the nation’s sexual health.
Experts have welcomed the real-world results from San Francisco, which align with data from clinical trials. Professor Landon Myer of the University of Cape Town, chair of CROI, expressed his satisfaction with the findings, stating that having population-level surveillance, clinical service delivery, and clinical trial results all corroborating each other is a rare occurrence in public health. This convergence of evidence solidifies the case for DoxyPEP as an effective preventive tool.
In addition to the San Francisco study, the conference also presented results from a trial conducted in France. The initial study reported a remarkable 70% reduction in STIs among gay men on DoxyPEP. The trial was extended, and participants were informed whether they received DoxyPEP or a placebo. The results showed a similar decline in STIs to that observed in San Francisco, further supporting the efficacy of DoxyPEP.
However, not all studies have yielded the same results. A study conducted in Kenya among young cisgender women failed to replicate the positive outcomes seen in other populations. While syphilis is rare among this group in Kenya, DoxyPEP did not show a significant reduction in chlamydia levels. The reasons behind these discrepancies remain unclear and warrant further investigation.
Jorge Roman, Senior Director of Clinical Services at the San Francisco AIDS Foundation, has been actively involved in prescribing DoxyPEP since its introduction. He expressed his satisfaction with the study results, emphasizing the need for additional strategies to combat rising STI rates. Roman highlighted the limitations of relying solely on condoms for prevention, as they may not be suitable for everyone. The availability of DoxyPEP as a new tool for STI prevention is an exciting development that can make a significant impact in San Francisco and across the United States.
The study on DoxyPEP’s effectiveness in reducing STIs among San Francisco’s gay community provides valuable insights into the potential of this preventive treatment. While further research is needed to address the discrepancies observed in different populations, the overall findings offer hope for improved sexual health outcomes. As cities and healthcare providers explore innovative approaches to tackle STIs, DoxyPEP emerges as a promising addition to the arsenal of preventive measures. With continued efforts and a comprehensive approach, it is possible to create a safer and healthier future for all.
