A different kind of 'morning after pill': An antibiotic to prevent certain STIs?

Taking a well-known antibiotic within hours of unprotected sex could help stop the spread of certain sexually transmitted bacterial infections (STIs), new studies show. Doxycycline is used today to treat health problems like acne. But 50 years ago, it was prescribed to American sailors who disembarked in a port in anticipation of the encounters they would make there. The practice was abandoned in favour of promoting condom use when STIs began to decline and AIDS emerged. Read: Let's talk about sex: Calgary research lab providing information for disabled "The problem with wearing a condom is that people don't wear them," says Dr. Jean-Pierre Routy, clinical director of the Chronic Viral Diseases Service at the MUHC. “So, it's like accepting that some strategies don't work, despite years of information and education." New research now shows that a single dose of doxycycline taken within 72 hours of unprotected sex can reduce the risk of STIs by up to 80% in some cases. The strategy seems particularly effective against chlamydia and syphilis, and a little less so against gonorrhea. It has been shown to be effective among trans women and among cisgender men who have sex with men, but no benefit has been seen among cisgender women. Read: Could a vaccine for UTIs be coming to Canada? Some STIs, like chlamydia, are increasingly resistant to antibiotics, but doxycycline doesn't seem to be contributing to the problem at this time. The drug also does not appear to interfere with the intestinal flora of patients. In recent years, there has been an upsurge in cases of STIs, says Dr. Routy, particularly within a sub-group of the population who are particularly uninterested in the constraint of a condom. “What is difficult for us and the nursing staff, is that despite all the education and all the training, [patients] come every two or three months [to say] there you go, clean it up and presto, we start again,” he says. Despite the information about risk, the possibility of resistance and the chance of infecting others, he says this subgroup has a “very emotional claim” to be able to live out their sexuality as they see fit. "That's how it is today, like it or not," he says. The presentation of doxycycline as a kind of "morning after pill" after unprotected sex risks further trivializing the perception of problems such as syphilis, gonorrhea or chlamydia. Plus, the recent episode of mpox (simian pox) reminds us that there are STIs circulating for which antibiotics can do nothing, says Dr. Routy. “We cannot rule out the possibility of new viruses starting to spread and causing a new epidemic,” he says. "So, we always recommend the use of condoms, even if they are used very little and people are fed up with them.” This article has been translated from its original French and originally appeared on our sister site Profession Santé.

A different kind of 'morning after pill': An antibiotic to prevent certain STIs?

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