NEW YORK (AP) — U.S. health officials are planning to endorse the use of a common antibiotic as a morning-after pill for gay and bisexual men as a preventive measure against sexually transmitted diseases (STDs). The Centers for Disease Control and Prevention (CDC) released a proposed guideline on Monday, with finalization to occur following a 45-day public comment period. Dr. Jonathan Mermin of the CDC stated that “more tools are desperately needed” due to the rising rates of STDs.
Recent studies have shown that individuals who took the antibiotic doxycycline within three days of unprotected sex were significantly less likely to acquire chlamydia, syphilis, or gonorrhea compared to those who did not take the pills. The proposed guideline specifically targets gay and bisexual men and transgender women who had previously contracted an STD within the last year and are at high risk of reinfection. While evidence for the effectiveness of this approach is limited to this particular group, more research may yield positive results for other populations, according to Dr. Mermin.
Dr. Mermin described the endorsement of doxycycline as a preventive measure as a major step forward for STD prevention. Only a few significant measures have been introduced in recent decades, including the HPV vaccine and HIV prevention pills. Doxycycline is a low-cost antibiotic that has been available for over 40 years and is commonly used to treat acne, chlamydia, and Rocky Mountain spotted fever.
CDC guidelines were based on four studies that examined the use of doxycycline for bacterial STDs. One of the most influential studies, published in the New England Journal of Medicine earlier this year, found that gay men, bisexual men, and transgender women who took doxycycline were about 90% less likely to contract chlamydia, 80% less likely to acquire syphilis, and over 50% less likely to get gonorrhea compared to those who did not use the antibiotic as a preventive measure.
San Francisco’s health department began promoting doxycycline as a morning-after prevention measure last year. Several other city, county, and state health departments, primarily on the West Coast, have followed suit. Dr. Taimur Khan from Fenway Health, a Boston-based health center serving numerous LGBTQ+ clients, stated that approximately 1,000 patients are currently utilizing doxycycline in this way. Dr. Khan mentioned that the endorsement from the CDC will significantly impact the adoption of this preventive measure, as many doctors were hesitant to discuss it without official guidance.
Side effects of the drug include stomach problems and increased sensitivity to sun exposure. Some research has indicated its ineffectiveness in heterosexual women. While widespread use of doxycycline as a preventive measure has yet to result in antibiotic resistance in San Francisco, monitoring for potential resistance is crucial, according to Dr. Stephanie Cohen.
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