Avoiding STIs: Doxycycline as post-exposure prophylaxis?

A recent study investigated whether the incidence of sexually transmitted infections can be reduced by post-exposure administration of doxycycline.

Can the effects of doxycycline help in STI prevention?

STIs: A problem for vulnerable groups

Sexually transmitted infections can affect anyone and everyone. Often, simple treatment by the family doctor or gynaecologist is enough, although the same does not always apply to risk groups. Especially for people living with HIV, an infection can sometimes have serious consequences.

Homosexual men and transgender women are still among the people who - at least in the western world - most frequently contract HIV and STIs. Experts have therefore been discussing for some time which methods make sense to limit transmission.

The antibiotic as a beacon of hope

The question of post-exposure prophylaxis is particularly interesting. After all, an infection can possibly be avoided in this way and the person affected does not get sick in the first place.

Doxycycline is considered a top candidate for this task. The antibiotic has long been used in the treatment of STIs and is usually well tolerated. A recent study has now investigated whether the drug is also effective as a post-exposure prophylaxis.

Doxycycline administration, or wait and see

The authors conducted their study in a 2:1 randomisation. Key details included:

Significant reduction in infections

The results are clear: while in the standard group without doxycycline 31.9% of patients with PrEP against HIV and 30.5% of those with HIV suffered an STI, this was the case in only 10.7% and 11.8% of participants in the doxycycline group, respectively. The results were statistically significant.

The antibiotic was well tolerated overall with only five cases of side effects (grade 3) and no serious side effects.

Doxycycline as effective STI prophylaxis

Post-exposure administration of doxycycline can significantly reduce the risk of sexually transmitted infections in men who have sex with men and transgender women. Overall, the intervention was well tolerated. The reduction in incidence for STIs is significant and postexposure prophylaxis should therefore be considered.