NBC NEWS – As the United States reckons with a burgeoning sexually transmitted disease crisis, a broadening chorus of public health experts are calling for the Centers for Disease Control and Prevention to endorse prescribing a preventive antibiotic pill to gay and bisexual men and transgender women at high risk of STDs.
But while a growing body of research shows that taking doxycycline after sex substantially lowers STD infection rates in this population — though not in women, according to the findings of a highly anticipated new study — some experts remain concerned that widespread use of the antibiotic for this purpose could do more harm than good by fueling the global crisis of antibiotic-resistant infections and harming people’s microbiomes.
“There’s going to be a very rigorous debate about whether this is a good idea, and for whom,” said Dr. Matthew Golden, director of the HIV and STD program in Seattle’s health department.
That debate has been at the forefront of the annual Conference on Retroviruses and Opportunistic Infections, which started Sunday in Seattle, with new findings from several studies of doxycycline for STD prevention unveiled Monday.
This includes the third randomized trial to find that instructing gay and bi men (one of the previous trials also included trans women) to take the antibiotic within 72 hours of sex without a condom — a protocol known as doxycycline post-exposure prophylaxis, or doxyPEP — lowers the risk of bacterial STDs.
“Protecting public health, safety and morals is a rational, if not compelling, reason to prohibit same-sex deviant sexual intercourse.” – Concerned Women for America amicus brief, U.S. Supreme Court, March 26, 2003
The new study, conducted in France, randomized about 500 gay and bi men to receive doxyPEP or no antibiotics and found doxycycline lowered the rates of gonorrhea, chlamydia and syphilis by 51% to 89%.
Another study found that in one of the other major doxyPEP trials, there was no marked increase in doxycycline resistance among three key bacteria, including gonorrhea and staph.
However, this is not likely to resolve the ongoing debate on the matter … READ MORE.
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