The prevention campaign based on doxy-PEP, a dose of the antibiotic doxycycline to be taken after unprotected sexual intercourse, implemented in the city of San Francisco has reduced the number of STIs by half.
- Doxy-PEP is taking a dose of the antibiotic doxycycline after unprotected sex to protect against STIs.
- A targeted prevention campaign based on doxy-PEP was implemented in San Francisco in October 2022 for gay, bisexual men and transgender women with a history of STIs or with multiple sexual partners.
- The results of this campaign are positive: the number of cases of early syphilis and chlamydia has been reduced by half.
Since October 2022, the city of San Francisco in the United States has implemented a campaign to prevent sexually transmitted infections (STIs) which has made it possible to reduce “cases of early syphilis and chlamydia in gay and bisexual men and transgender women halved“, city health officials said at the Conference on Retroviruses and Opportunistic Infections (CROI) in Denver, reported by 20 minutes.
An antibiotic to take after sex
The preventive strategy proposed by the American city, called Doxy-PEP, consists of taking a dose of doxycycline, an antibiotic, after unprotected sex to reduce the risk of STIs.
As part of this campaign, the target audiences – gay, bisexual men and transgender women with a history of STIs or with multiple sexual partners – therefore received doses of doxycycline. If they had unprotected sex, they had to take two 100-milligram tablets within 24 to 72 hours.
“Wearing a condom is the most effective way to protect yourself from STIs. assures Dr Nicolas Dupin, dermatologist-venerologist responsible for the Sexual Health Center at Hôtel-Dieu (AP-HP), to 20 Minutes. But doxy-PEP constitutes one of the chemical approaches to the prevention of STIs. A part of the population at risk does not systematically use condoms. In addition, many of these STIs can be contracted through orogenital contamination: sexual intercourse which is less at risk of contracting HIV, and therefore even less protected within these populations. Which makes doxy-PEP an interesting prevention tool.“
Doxycycline against STIs: unknown side effects
Doxycycline is an antibiotic used for many diseases, according to the Vidal, including cholera, periodontitis, Lyme disease or anthrax, etc. But this new use has not been known for a long time. “We therefore do not know if there are possible long-term effects, underline the New York public health services. We don’t yet know if taking doxy-PEP will affect the “good” bacteria in the gut, or if other bacteria that cause STIs or other infections will become resistant. [à cet antibiotique]therefore more complicated to treat.”
For the moment, doxy-PEP is not planned in France. “I do not think that the recommendations of the health authorities are going in this direction for the moment, because there are still unknowns about the risk of emergence of antibiotic resistance, believes Dr Dupin. This is the whole problem that this treatment poses, already in France there is an increase in the resistance of gonorrhea to cyclins. [cette classe d’antibiotiques à large spectre] quite important. This also raises the question of the long-term risks of potentially seeing the emergence of resistance in syphilis, chlamydia or other germs to this family of antibiotics. However, to date, there is a lack of perspective on the possible risks of antibiotic resistance.“
In 2015, there were 125,000 infections caused by multi-resistant bacteria according to Public Health France. According to a study by European Center for Disease Prevention and Control (ECDC)infections caused by resistant bacteria are associated with more than 5,500 deaths in France.
