October 13, 2023
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BOSTON — In this video from IDWeek, Annie Luetkemeyer, MD, discusses the CDC’s pending recommendations for prescribing doxycycline as post-exposure prophylaxis for sexually transmitted infections.
The CDC announced earlier this month that it had developed draft guidelines on what is being called doxy-PEP and would be accepting public comments on the draft through Nov. 16.
It is part of a larger public health effort to address a steady surge in STIs in the United States that has lasted for almost a decade — and continued even during the COVID-19 pandemic.
Multiple studies have shown that taking a single 200 mg dose of doxycycline within 3 days of having condomless sex can reduce new cases of the three nationally reportable STIs: chlamydia, gonorrhea and syphilis.
Luetkemeyer and colleagues from the DoxyPEP Study Team found that doxy-PEP lowered the combined incidence of the three infections by around two-thirds among transgender women and men who have sex with men (MSM) with a recorded bacterial STI in the previous year.
A French study, DOXYVAC, found that MSM were 84% less likely to contract chlamydia or syphilis and half as likely to contract gonorrhea if they took doxy-PEP.
The CDC’s draft guidance mentions only MSM and transgender women. A third study, conducted in Kenya, found that doxy-PEP did not significantly reduce STIs among cisgender women for reasons that were unclear.
Luetkemeyer, a professor of medicine at San Francisco General Hospital and the University of California, San Francisco, addresses these studies and more in the video, including additional groups that may benefit from doxy-PEP that are not included in the guidance.
References:
- CDC. Public comment period for doxy PEP guidelines. https://www.cdc.gov/std/dstdp/dcl/2023-october-2-doxy-pep-guidelines.htm. Published Oct. 2, 2023. Accessed Oct. 13, 2023.
- Federal Register. Guidelines for the use of doxycycline post-exposure prophylaxis for bacterial sexually transmitted infection (STI) prevention; request for comment and informational presentation. https://www.federalregister.gov/documents/2023/10/02/2023-21725/guidelines-for-the-use-of-doxycycline-post-exposure-prophylaxis-for-bacterial-sexually-transmitted. Published Oct. 2, 2023. Accessed Oct. 13, 2023.
- Luetkemeyer AF. Doxy post-exposure prophylaxis in the real world: Considerations for implementation. Presented at: IDWeek; Oct. 11-15, 2023; Boston.
- Luetkemeyer AF, et al. Abstract 120. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 19-22, 2023; Seattle.
- Luetkemeyer AF, et al N Engl J Med. 2023;doi:10.1056/NEJMoa2211934.
- Molina J-M, et al. Abstract 119. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 19-22, 2023; Seattle.
- Stewart J, et al. Abstract 121. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 19-22, 2023; Seattle.
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Sources/Disclosures
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Disclosures:
Luetkemeyer reports that the doxy-PEP study received medication support from Mayne pharma and lab diagnostic support from Cepheid and Hologic.
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