Taking a regular antibiotic within 72 hours of unprotected sex can lower the risk of sexually transmitted infections (STDs), especially among the LGBTQ+ community.
On Monday, the Centers for Disease Control and Prevention (CDC) announced that it will seek input from the general public on its proposal to offer the low-cost antibiotic doxycycline as part of a regimen called doxy-PEP to gay men, men who have sex have with men. and transgender women having unprotected sex.
The agency believes the antibiotic could potentially prevent 40 percent of STDs, such as chlamydia, gonorrhea and syphilis, that have exploded into epidemics in the US.
Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), said, “Doxy PEP moves STD prevention efforts into the 21st century. We need breakthrough innovations to reverse the STD epidemic, and this is a big step in the right direction.”
The recommended dose is not specified in the proposal. The agency will seek public comment on its proposal until November 16.
Doxycycline is an inexpensive antibiotic that has been sold in the US for more than 50 years. Research shows it may show promise in reducing the risk of STDs
In 2021, Mississippi topped the list with a total of 1,266 STDs per 100,000 people. Gonorrhea rates were the highest in the country, with 427.7 infections per 100,000
Doxy-PEP is only intended to lower the risk of STDs, and the traditional morning-after pill, Plan B, should still be taken within 72 hours of unprotected sex to prevent unwanted pregnancy.
Someone can be at risk of contracting an STD if they have unprotected sex with someone who is already infected with an STD.
Earlier this year, the CDC warned that the US is in the midst of an “STD epidemic” that “shows no signs of slowing.”
The latest CDC figures show that there were 176,713 cases of syphilis in 2021, the most since 1950 and a third more than in 2020.
The report also noted an increase in congenital syphilis, which occurs when a baby is born with the infection after contracting it from the mother during pregnancy.
The number of cases of this disease increased by 32 percent, from 2,148 in 2020 to more than 2,800 in 2021. This resulted in 220 stillbirths and infant deaths in 2021, the CDC said.
The number of cases of gonorrhea also increased, by almost five percent, from 677,769 cases in 2020 to more than 710,000 in 2021, the highest annual total in four years.
Chlamydia cases, initially the most common STD with 1.58 million cases in 2020, skyrocketed to 1.64 million in 2021.
Despite this increase of approximately four percent, the total number of annual cases of chlamydia has decreased since 2019, when more than 1.8 million cases were reported. This may be due to Covid social distancing and fewer tests being conducted during the pandemic.
Doxycycline is an inexpensive antibiotic that has been sold in the US for more than 50 years. It is most commonly used to treat bacterial infections, such as urinary tract infections and respiratory infections, as well as skin conditions such as rosacea, which cause red skin and rashes.
However, research shows that it may show promise in reducing the risk of STDs.
A study in the New England Journal of MedicineThe study, funded by the National Institutes of Health (NIH), involved 501 gay men, bisexual men and transgender women in Seattle and San Francisco with a history of STD infections. The participants each took one 200 mg doxycycline pill within 72 hours after unprotected sex.
Participants who took the pills were about 90 percent less likely to get chlamydia, 80 percent less likely to get syphilis and more than 50 percent less likely to get gonorrhea, compared to people who didn’t take the drugs after sex.
There is less evidence that doxy-PEP is effective in cisgender and heterosexual men and women, although experts believe this may change as more studies are conducted.
The total number of cases of STDs – chlamydia, gonorrhea and syphilis – has been on an upward trend over the past seven years. Infections fell in 2020, but CDC officials said it was likely that cases were in fact continuing to rise but not being detected because of a drop in testing during the Covid-19 pandemic.
Doctors from the University of California, San Francisco and the University of Washington said: ‘The combined incidence of gonorrhea, chlamydia and syphilis was two-thirds lower with post-exposure prophylaxis than with standard care, a finding that supports its use among men who having sex with men) with recent bacterial STDs.’
There is less evidence that doxy-PEP is effective in cisgender and heterosexual men and women. Dr. However, Mermin said this may change as more research is done.
Citing ongoing research in this area, the San Francisco Department of Public Health approved the use of doxycycline as a prophylactic last October.
The Department said: ‘Doxy-PEP is the first biomedical prevention tool that has been shown to be effective and well tolerated. Community awareness is growing and many providers in SF are already prescribing doxy-PEP for their patients at risk for STDs.”
State statistics from the CDC show that Mississippi and Louisiana have the highest rates of sexually transmitted infections (STDs) in the US.
The most recent data is available in 2021, Mississippi was at the top of the list for the highest gonorrhea rates in the country, with 427.7 infections per 100,000 people.
The rate of chlamydia, a bacterial infection, was also high: 750 per 100,000. And the cumulative syphilis rate that year was 88.3 per 100,000.
After Mississippi, Louisiana was the state with the second highest STD rate. The The state’s chlamydia rate was 730.1 per 100,000, while the gonorrhea rate was 354.5 per 100,000 residents.
Alaska had the third highest rate of STDs overall, but rates of gonorrhea and syphilis have been rising there for years, according to the state’s Department of Health and Human Services.
And in 2021, state health officials counted 447 cases of syphilis, an increase of 24 percent above the 2020 total.
The likely contributors include a relatively young population – which accounts for more than 50 percent of all STD cases in the US. Much of Alaska is also remote, limiting the availability of health care, and public health infrastructure is severely lacking.
After Alaska came South Carolina, which recorded 1,052 STDs per capita in 2021. The country recorded the fourth highest rate of chlamydia, with 703 cases per capita.
The state had the lowest number of syphilis cases on the list, with 40.1 cases per capita.
In South Dakota, which rounded out the top five states, there is limited access to health care in rural and tribal areas. There, syphilis has exploded by more than 1,800 percent, from 41 cases in 2016 to 785 in 2021.
When the CDC will formally recommend doxycycline as the de facto morning-after pill remains to be seen, but officials will have to consider many factors before then, including the drug’s adverse health risks.
For example, when combined with the blood thinner warfarin to treat or prevent blood clots, doxycycline can further thin the blood, increasing the risk of serious bleeding and bruising.
Other medications, including over-the-counter antacids and some barbiturates, sedative medications commonly used to treat seizures and insomnia, make the medication less effective.
Doxycycline can also cause nausea and vomiting, bloating, dizziness, chills, constipation and, in more severe cases, rash, swelling and hives, and blurred vision.