Sexually transmitted diseases (STDs) are a major public health concern, especially among men who have sex with men (MSM) and transgender women (TW). According to the Centers for Disease Control and Prevention (CDC), cases of chlamydia, gonorrhea and syphilis have reached record highs in the United States, with MSM and TW accounting for most of the infections.
While condoms and pre-exposure prophylaxis (PrEP) are effective ways to prevent STDs, they are not always used consistently or correctly. Moreover, some STDs can be transmitted through oral sex, which is often not protected by condoms. Therefore, there is a need for new strategies to reduce the risk of STDs after unprotected sex.
One such strategy is post-exposure prophylaxis (PEP), which involves taking an antibiotic within a short time after a potential exposure to an STD. PEP has been shown to be effective for preventing HIV infection, but its role for other STDs is less clear.
Is This Morning After STD Prevention Pill the Solution?
A recent study published in the New England Journal of Medicine suggests that doxycycline hyclate, a common antibiotic, may be a promising PEP option for chlamydia, gonorrhea and syphilis. Doxycycline hyclate is a tetracycline antibiotic that works by stopping the growth of bacteria in the body. It is used to treat various bacterial infections, including acne, periodontitis, malaria and some types of anthrax.
The study involved about 500 gay men, bisexual men, and transgender women in Seattle and San Francisco who had a history of STDs in the past year. They were randomly assigned to either receive doxycycline hyclate pills to take within 72 hours of unprotected sex (up to 40 pills per month), or no pills. They were followed for up to one year, with regular testing for chlamydia, gonorrhea and syphilis.
The results showed that the doxycycline hyclate group had significantly lower rates of STDs than the no-pill group. Specifically, they were about 90% less likely to get chlamydia, about 80% less likely to get syphilis, and more than 50% less likely to get gonorrhea compared with the no-pill group. The doxycycline hyclate group also had fewer adverse events than the no-pill group, such as nausea, vomiting and diarrhea.
The study was led by researchers from the University of California, San Francisco, and was funded by the National Institutes of Health. It was based on a similar French study that also found a benefit of doxycycline hyclate PEP for STDs.
The authors of the study concluded that doxycycline hyclate PEP may be a feasible and effective morning after pill to prevent STDs, especially among people at high risk. They suggested that further research is needed to confirm the findings and to evaluate the long-term safety and efficacy of this approach. They also cautioned that doxycycline hyclate PEP should not replace condoms or PrEP, but rather complement them as part of a comprehensive prevention package.
The CDC has not yet issued any official recommendations on using doxycycline hyclate PEP as a morning after pill for STDs, but they are currently drafting recommendations according to Dr. Leandro Mena who is acting director of the agency’s STD prevention division.
CDC has stated that it is reviewing the evidence, and will update its guidance as needed. In the meantime, it advises people who are sexually active to use condoms consistently and correctly, get tested regularly for STDs, and talk to their health care providers about PrEP if they are at high risk for HIV.
