The incidence of bacterial sexually transmitted infections (STIs) continues to rise, particularly among men who have sex with men (MSM). Doxycycline post-exposure prophylaxis (doxy-PEP) has emerged as a promising biomedical prevention strategy. This approach has been the focus of recent studies aiming to evaluate its effectiveness and potential impacts.
Recent findings from four randomized controlled trials and three real-world analyses have consistently demonstrated a reduction in Chlamydia trachomatis and Treponema pallidum infections among MSM. However, the efficacy of doxy-PEP for Neisseria gonorrhoeae infection and among cisgender women remains uncertain. Additionally, there are concerns regarding potential adverse effects, including an increase in antimicrobial resistance and alterations to the gut microbiome.
Despite these concerns, doxy-PEP is recognized as an effective strategy for preventing certain STIs among MSM. Further research is necessary to explore its benefits among other populations and to monitor for any adverse effects.
