In a bid to combat the rising rates of sexually transmitted diseases (STDs), U.S. health officials are contemplating endorsing a common antibiotic as a morning-after pill for use by gay and bisexual men. The proposed guideline, released recently by the Centers for Disease Control and Prevention (CDC), is now open for a 45-day public comment period. Dr. Jonathan Mermin of the CDC stressed the urgency, stating, “With STD rates rising to record levels, more tools are desperately needed.”
Studies have revealed that individuals who took the antibiotic doxycycline within three days of unprotected sex had significantly lower chances of contracting chlamydia, syphilis, or gonorrhea compared to those who did not take the pills after sexual encounters. However, the guideline primarily targets gay and bisexual men and transgender women who had an STD in the previous year and are at high risk of recurrence. While there’s less evidence for its effectiveness in heterosexual individuals, further research is ongoing.
Dr. Mermin acknowledges that this approach marks a significant development in a field that has lacked innovation for some time. It joins a shortlist of major prevention measures, including an HPV vaccine and HIV prevention pills. Doxycycline, an affordable antibiotic available for over 40 years, has traditionally been used to treat various health issues, including acne, chlamydia, and Rocky Mountain spotted fever.
The CDC’s recommendation stems from four studies on the use of doxycycline against bacterial STDs, with one particularly influential study in the New England Journal of Medicine showing a substantial decrease in STD transmission among gay and bisexual men and transgender women who previously contracted STDs and took the pills as a preventive measure.
San Francisco’s health department began promoting doxycycline as a morning-after prevention measure a year ago, and several other health departments, primarily on the West Coast, followed suit. Dr. Stephanie Cohen, overseeing STD prevention work in San Francisco, emphasized the urgency of action due to rising infection rates.
Dr. Taimur Khan, from Fenway Health in Boston, a health center serving many LGBTQ clients, reported approximately 1,000 patients currently using doxycycline as a morning-after option. The CDC’s endorsement is expected to encourage more doctors to discuss this approach with their patients.
However, it’s essential to consider potential side effects of doxycycline, which include stomach problems and sun sensitivity. Additionally, some research suggests its ineffectiveness in heterosexual women. There is also concern that widespread use could contribute to antibiotic resistance, although such resistance has not yet materialized in San Francisco. Vigilance will be necessary to monitor this aspect moving forward.