DoxyPEP Tied to Decreases in Sexually Transmitted Infections

TUESDAY, Jan. 7, 2025 (HealthDay News) — Doxycycline postexposure prophylaxis (doxyPEP) initiation is associated with decreases in sexually transmitted infections (STIs), according to a study published online Jan. 6 in JAMA Internal Medicine.

Michael W. Traeger, Ph.D., from Harvard Pilgrim Health Care Institute in Boston, and colleagues described early uptake of doxyPEP and evaluated changes in STI incidence following doxyPEP initiation. The analysis included data from 11,551 adults dispensed HIV preexposure prophylaxis (PrEP) at Kaiser Permanente Northern California from Nov. 1, 2022, to Dec. 31, 2023.

The researchers found that 19.5 percent were dispensed doxyPEP, which was associated with older age (mean age, 40.4 versus 39.8 years), longer HIV PrEP use (mean, 4.2 versus 3.4 years), and a higher proportion of commercial insurance (92.8 versus 88.9 percent). Quarterly chlamydia positivity decreased from 9.6 percent before starting doxyPEP to 2.0 percent after starting doxyPEP (rate ratio [RR], 0.21), with significant declines for each anatomic site of infection. Similarly, quarterly gonorrhea positivity decreased from 10.2 percent before starting doxyPEP to 9.0 percent afterward (RR, 0.88), with significant site-specific declines seen for rectal (RR, 0.81) and urethral (RR, 0.56) gonorrhea. Lastly, quarterly syphilis positivity decreased from 1.7 percent before starting doxyPEP to 0.3 percent afterward (RR, 0.20). Among individuals not dispensed doxyPEP, positivity for STIs remained stable.

“These findings suggest that doxyPEP may offer substantial benefits for reducing population-level STI transmission with broader implementation,” the authors write.

Abstract/Full Text

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