The new CDC guideline was issued on Monday, and after a 45-day public comment period, officials will seek to finalize it. “More tools are desperately needed,” said Dr. Jonathan Mermin of the Centers for Disease Control and Prevention, as STD rates reach historic highs.
The idea follows research that found that those who took the antibiotic doxycycline within three days of unprotected sex were considerably less likely to get chlamydia, syphilis, or gonorrhea than those who did not take the pills after sex.
The advice is tailored to the most researched population: gay and bisexual men and transgender women who had an STD in the preceding 12 months and were at high risk of becoming infected again.
There is less evidence that the strategy is effective for other people, such as heterosexual men and women. That may change when more study is conducted, according to Mermin, who supervises the CDC’s STD activities.
Nonetheless, the concept is one of only a handful important prevention strategies in recent decades in “a field that’s lacked innovation for so long,” according to Mermin. He also mentioned a vaccination against the HPV virus and tablets to prevent HIV.
Doxycycline, a low-cost antibiotic that has been available for over 40 years, is used to treat conditions such as acne, chlamydia, and Rocky Mountain spotted fever.
The CDC recommendations were based on four trials of doxycycline use against bacterial STDs.
A research published earlier this year in the New England Journal of Medicine was one of the most important. It discovered that gay males, bisexual men, and transgender women who took the tablets after intercourse were around 90% less likely to have chlamydia, 80% less likely to receive syphilis, and more than 50% less likely to get gonorrhea than persons who didn’t take the pills after sex.
San Francisco’s health department began recommending doxycycline as a morning-after preventive tactic a year ago.
With infection rates rising, “we didn’t feel like we could wait,” said Dr. Stephanie Cohen, the department’s STD prevention coordinator.
Other city, county, and state health authorities followed suit, mostly on the West Coast.
Dr. Taimur Khan, the organization’s associate medical research director, stated that roughly 1,000 individuals at Fenway Health, a Boston-based health center that serves many gay, lesbian, and transgender clients, are currently taking doxycycline in this manner.
The guideline should have a significant impact because many doctors were hesitant to discuss it with patients until they heard from the CDC, according to Khan.
Side effects of the medication include stomach problems and rashes after sun exposure. According to certain studies, it is unsuccessful in heterosexual women. Furthermore, extensive use of doxycycline as a prophylactic measure could conceivably contribute to changes that render bacteria resistant to the antibiotic.
That type of antibiotic resistance hasn’t appeared in San Francisco yet, but Cohen says it’s something to keep an eye out for.