Doctors are now prescribing doxy-PEP, a morning-after pill that helps prevent STIs like gonorrhea, chlamydia, or syphilis
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- STIs are on the rise, but there's a morning-after pill called doxy-PEP that may help.
- CDC recommendations for doxy-PEP are under review through mid-November.
- Some doctors aren't waiting for the CDC and already prescribing doxy-PEP to help patients.
The CDC could soon make it easier for a common antibiotic to be used as a morning-after pill to prevent sexually transmitted infections in high-risk people.
Earlier this month, the agency released a proposed guideline that outlines how groups with a high risk of STIs can use doxycycline to prevent STIs after unprotected sex.
This prescribed treatment protocol is called doxycycline post-exposure prophylaxis, or doxy-PEP. It involves taking a single dose of doxycycline within 72 hours of having unprotected sex.
Some doctors are already prescribing doxy-PEP
The San Francisco Department of Public Health began recommending doxy-PEP to some groups last December.
Dr. Stephanie Cohen, the medical director of San Francisco City Clinic, told the Associated Press, "we didn't feel like we could wait," for the CDC to formalize its recommendation since STIs are on the rise.
Taking doxy-PEP within 72 hours of unprotected sex has the potential to help anyone concerned about their risk of bacterial STIs, including chlamydia, gonorrhea, and syphilis, doctors say.
Since this summer, Dr. Laura Purdy, chief medical officer at Wisp, has been offering the antibiotic to patients of all genders and orientations who are concerned about contracting a bacterial STI after unprotected sex.
"This treatment is crucial in reducing bacterial STI rates," Purdy told Insider by email.
STI reduction in high-risk groups
Doxycycline was approved in 1967 and has since been used to treat bacterial infections ranging from acne to malaria.
More recently, studies have found it can reduce STI risk in certain groups.
A study published in The New England Journal of Medicine earlier this year found that doxy-PEP reduced the risk for STIs like chlamydia.
The combined risk for chlamydia, syphilis, and gonorrhea was reduced by two-thirds in participants who took doxy-PEP compared to those who did not, the researchers reported in the study.
But it's worth noting the study focused on high-risk populations, including trans women and men who have sex with men who were already on PrEP (an HIV preventative regimen) or living with HIV, and who had gonorrhea, chlamydia, or syphilis within the past year.
Doctors say anyone who has unprotected sex could benefit
While the CDC recommendation focuses on high-risk populations, the science shows "that doxycycline would be effective regardless of gender identity or sexual preference," said Dr. Dahlia Philips, an infectious disease physician and medical director for Partnership in Care at MetroPlusHealth.
An estimated 2.5 million cases of syphilis, gonorrhea, and chlamydia were recorded in the US in 2021.
Research looking at how doxy-PEP reduces STIs for cisgender women and cisgender heterosexual men is ongoing, Purdy said.
Despite that, Purdy emphasized anyone can talk to their doctor today about using doxycycline to prevent STIs.
The medication is already approved for use in anyone 12 or older, and an updated CDC recommendation isn't necessary for doctors to prescribe it.
Condoms are still important
The CDC recommendation is in what's called a public comment period, which will last through mid-November.
This gives doctors, healthcare providers, and the public the chance to recommend what should be included in the CDC guidelines and explain what their experience has been if they're already prescribing doxy-PEP.
After that, if the CDC adopts the recommendation, it could help increase doxy-PEP use, since many healthcare providers and patients follow CDC guidelines to understand best practices in health, ranging from COVID quarantine times to how to responsibly prescribe opioids.
Widespread access to medical options to reduce STIs, like doxy-PEP and PrEP, are important, Philips said. But they're only one piece of the puzzle when it comes to sexual health.
Regular STI tests and the use of barriers like condoms "must not be forgotten and should also be a part of sexual health discussions," she said.
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