US health officials propose using a cheap antibiotic as a ‘morning-after pill’ against STDs

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U.S. health authorities are proposing the use of a commonly available antibiotic as a post-exposure prophylaxis, often referred to as a ‘morning-after pill,’ for gay and bisexual men in an effort to combat the increasing prevalence of sexually transmitted diseases (STDs).

The Centers for Disease Control and Prevention (CDC) unveiled this recommendation on Monday, and it will be subject to finalization following a 45-day period for public feedback. With STD rates reaching record highs, Dr. Jonathan Mermin, a representative of the CDC, stressed the urgent need for additional preventive measures.

The proposal is grounded in studies that have shown that individuals who took the antibiotic doxycycline within three days of unprotected sexual activity were significantly less likely to contract chlamydia, syphilis, or gonorrhea compared to those who did not use the medication post-sexual encounter.

It’s important to note that this guideline is specifically tailored to a demographic group that has been extensively studied—gay and bisexual men and transgender women who have previously had an STD within the past year and remain at high risk of reinfection.

While the evidence supporting this approach for other populations, such as heterosexual men and women, is limited, Dr. Mermin believes that more research could change this landscape. He oversees the CDC’s efforts in combatting STDs.

Nevertheless, this proposal represents one of the few significant advancements in disease prevention in recent decades within a field that has long awaited innovation. Other notable measures include the HPV vaccine and HIV prophylactic medications.

Doxycycline, a cost-effective antibiotic available for over four decades, is commonly used to treat various health conditions, including acne, chlamydia, and Rocky Mountain spotted fever.

The CDC’s recommendation is grounded in four studies examining doxycycline’s efficacy against bacterial STDs. Among them, a study published in the New England Journal of Medicine earlier this year found that individuals with prior STD infections who took doxycycline were approximately 90% less likely to contract chlamydia, roughly 80% less likely to contract syphilis, and over 50% less likely to contract gonorrhea compared to those who did not use the medication.

San Francisco’s health department began promoting doxycycline as a morning-after prevention measure a year ago, followed by other health departments primarily on the West Coast. Fenway Health, a Boston-based healthcare center serving LGBTQ+ clients, reports approximately 1,000 patients currently using doxycycline in this manner.

Dr. Taimur Khan, the associate medical research director at Fenway Health, anticipates that the CDC’s guidelines will significantly boost nationwide adoption. Many healthcare providers across the country had been hesitant to discuss this approach with patients until receiving guidance from the CDC.

However, it’s important to consider potential side effects of the drug, such as stomach problems and increased sensitivity to sunlight. Additionally, research has suggested its ineffectiveness in heterosexual women. Widespread use of doxycycline as a preventive measure could theoretically contribute to antibiotic resistance in bacteria, although this issue has not emerged in San Francisco thus far. Continuous monitoring will be essential to address this concern.

Frequently Asked Questions (FAQs) about STD Prevention

More about STD Prevention

• CDC Guidelines on STD Prevention
• New England Journal of Medicine Study
• San Francisco Department of Public Health