Public health experts have recommended taking a common, cheap antibiotic shortly after unprotected sex to reduce the risk of contracting a sexually transmitted infection.
The CDC recently proposed new guidance for “post-exposure prophylaxis” use of the antibiotic doxycycline. Also known as “doxy PEP,” the practice would involve taking a 200-mg pill of doxycycline within 72 hours of unprotected sex. It allegedly showed promise in reducing chlamydia, gonorrhea, and syphilis infections.
Such bacterial sexually transmitted infections (STIs) often have few or no symptoms, meaning they can go untreated for long periods of time and cause adverse effects, including infertility.
According to CDC data, 1 in 5 Americans has an STI, making for a total of approximately 68 million infections nationwide. Younger people are especially at risk, with 46% of all new STIs occurring among those between the ages of 15 and 24.
The human papillomavirus (HPV), which is viral, not bacterial, is currently the most common STI, accounting for approximately 14 million new infections each year. However, bacterial STI rates have risen significantly between 2014 and 2018. Hikes were recorded in the number of syphilis, gonorrhea, and chlamydia cases, logging increases of 71%, 63%, and 19%, respectively.
Cases of congenital syphilis — a preventable condition if expectant mothers are treated with rounds of penicillin before giving birth — also saw an alarming increase of 185%. Moreover, there was a 32% bump in cases in 2021 alone, as previously covered by The Dallas Express. Texas had the fourth-highest number of cases nationwide, with 182 congenital syphilis cases per 100,000 live births.
To address what the CDC calls an “STI epidemic,” the agency called for developing “novel approaches … especially for populations disproportionately affected.”
Alongside young people and pregnant women, the U.S. Department of Health and Human Services identified other groups impacted most by STIs as racial and ethnic minorities, men who have sex with men, and people living in the southern and western regions of the country.
Although the CDC had the chance to institute this guideline within its comprehensive sexual health approach back in 2021, it found that there had not been enough research to back doxycycline’s effectiveness post-exposure.
“Since that time, promising results from several randomized trials on doxycycline PEP indicated the need to re-address this topic,” the CDC’s recent proposal read.
For instance, one study in The New England Journal of Medicine revealed a two-thirds decline in STIs among gay and bisexual men and transgender women after taking doxy PEP. All of the subjects had previously battled an STI within the last year.
The public has until November 16 to weigh in on the proposed guidance. Some health experts have expressed support for the proposal.
“Doxy PEP is moving STI prevention efforts into the 21st century,” remarked Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention, according to The Hill. “We need game-changing innovations to turn the STI epidemic around, and this is a major step in the right direction.”
Others have suggested the guidance misses the mark by failing to address the high-risk behaviors fueling STI rates.
“There is a concern that such preventive therapies will make people comfortable in engaging in high-risk behavior, thinking that they will be protected,” cautioned Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau Hospital, according to Fox News.
