CDC Endorses Doxy PEP for STI Prevention: Key Updates and What You Need to Know
In October of last year, I shared news about a potential “morning-after pill” for reducing STI transmissions.
Yesterday, @cdcgov finalized its position and guidance. Here’s what you need to know:
The CDC recommends doxycycline, an antibiotic, be prescribed within 72 hours of unprotected sex with a new or recurring partner. They’re calling it “doxy PEP” (short for doxycycline postexposure prophylaxis). It aims to specifically reduce STI transmissions of gonorrhea, chlamydia, and syphilis among gay and bisexual men and transgender women.
While the CDC says it can’t recommend this for ALL sexually active groups due to a lack of supporting data, it encourages providers to “use their best judgement” when prescribing to others. So it’s possible that doxy PEP could be useful to other sexually active folks, too.
The treatment aims to reduce gonorrhea, chlamydia, and syphilis. Data suggests this regimen could prevent up to 70% of chlamydia and syphilis infections and up to 50% of gonorrhea infections (CDC, 2024). And yes they’re taking potential drug-resistance into account.
Changes from the October 2023 draft guidance include language clarifications and reassessing treatment with patients every 3-6 months.
This new approach comes when STIs are reaching high counts across the country. Notably, with syphilis cases being the highest since the 1950s. The CDC has high hopes for doxy PEP, noting this is “the first new prevention tool against STIs in decades.”
I am, obviously, in support of new approaches to reduce STI transmissions and help providers in supporting disproportionately affected communities, but…it feels like a bandaid when it comes to collective STI stigma.
Ultimately, in order to change overall behaviors when it comes to safer sex, we need better education to reduce stigma around testing and treatment. In addition to normalizing not only talking to partners about STIs and their screening histories, but also teaching them how to have “the talk.”