A New Tool for STI Prevention

April is Sexually Transmitted Infection (STI) Awareness Month—a great time to reflect on what you are doing to help prevent the spread of STIs for yourself and for others. Being educated about the resources out there is one way of doing that. And a new treatment, DoxyPEP may help further curb transmission of STIs.

Most of us are familiar with the effectiveness of condoms in preventing most STIs, or the success that PrEP has had in preventing HIV. Now DoxyPEP has been shown to be very effective in preventing some bacterial-based STIs like chlamydia and syphilis. It is apparently less effective at preventing gonorrhea, and it will not prevent non-bacterial infections like hepatitis. 

DoxyPEP (or doxycycline post-exposure prophylaxis) is a low dosage of the antibiotic doxycycline that, if taken within 24 hours after having unprotected sex, has been effective in preventing some (but not all) bacterial STI infections. A statement released by the Centers for Disease Control in July 2022 revealed encouraging results:

“The first look at the data presented at the 2022 International AIDS Conference showed doxy-PEP demonstrated significant effectiveness and tolerability against these common STIs (gonorrhea, chlamydia, and syphilis) in gay and bisexual men and transgender women with HIV or taking HIV pre-exposure prophylaxis (PrEP) over the course of this study.”

Dr. Vandana Shrikanth is the medical director for adult services at Legacy Community Health, the Montrose-based clinic that provides services to a large swath of the LGBTQ population in Houston. She has been with Legacy for eight years. She explains that DoxyPEP is not a necessary treatment for everyone, but it may be effective for some gay and bisexual men or transgender women.

“It’s important to first say that treatments like DoxyPEP or PrEP, although effective, should not be viewed as a license to have unprotected sex,” Dr. Shrikanth notes. “Condoms are still one of the most effective ways to prevent STIs. Also, DoxyPEP is not recommended as a routine. It is intended for only out-of-the-ordinary encounters you might be having. If you know that you are not sexually active or if you are only active with one partner, then DoxyPEP may not be necessary for you. If you know that you might have a vacation or a party and you want to be more prepared just in case, then you should speak to your doctor about your options.” 

There has been some concern lately about the over-prescription of antibiotics that have caused some bacterial infections to become more resistant to antibiotics. Although the CDC is still looking into the data relating to the use of DoxyPEP, Dr. Shrikanth says that infrequent or occasional usage should be OK.

She also cautions that DoxyPEP should not be confused with HIV PrEP. “PrEP is for HIV only. It protects against HIV infection, whereas DoxyPEP is effective at preventing you from acquiring syphilis and chlamydia. It is not as effective at preventing gonorrhea. If you think that DoxyPEP will also protect you from HIV, that is not the case.” 

Dr. Shrikanth recommends talking to your healthcare provider about your options regarding DoxyPEP. You should also get regularly tested for STIs if you are sexually active. And remember that condoms are always a good first line of defense. 

DoxyPEP is another available tool in the doctor’s toolkit to prescribe to prevent some STIs,” she concludes.