sexually transmitted diseases

Doxycycline postexposure prophylaxis to prevent bacterial sexually transmitted infections

Alex Haga — Tue, 27 May 2025 13:12:27 +0000

Date Added:

May 27, 2025

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

May 20, 2025

Issue:

Volume:

197

Pages:

E534-E535

URL:

Doxycycline postexposure prophylaxis to prevent bacterial sexually transmitted infections

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.250128

Keywords

doxycycline

prophylaxis

sexually transmitted diseases

Chlamydia

PMID (1):

40393712

MeSH

Doxycycline

sexually transmitted diseases

chlamydia

A concise review of the use of doxycycline for STI prevention following unprotected intercourse. James W. Mold, MD, MPH

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No abstract available.

Author/s:

Victor Leung, Junine Toy, Peter Phillips, Julio S G Montaner

Doxycycline Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infection

Alex Haga — Sun, 05 Jan 2025 21:47:03 +0000

Date Added:

January 5, 2025

Journal/Publication:

JAMA

Publication Date:

January 19, 2025

URL:

Doxycycline Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infection

Type:

Meta-analyses, Reviews, and Guidelines, Public Health Announcements

Format:

Article

DOI (1):

10.1001/jama.2024.24540

Keywords

sexually transmitted diseases

doxycycline

PMID (1):

39699880

MeSH

sexually transmitted diseases

Doxycycline

A guideline from the CDC regarding the use of doxycycline post exposure to STIs to prevent infection. James W. Mold, MD, MPH

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This JAMA Guidelines Synopsis summarizes the 2024 Centers for Disease Control and Prevention guidelines on use of doxycycline postexposure prophylaxis (doxyPEP) for bacterial sexually transmitted infection prevention.

Author/s:

John Flores, Andrew M Davis, Aniruddha Hazra

Adolescent-Centered Sexual and Reproductive Health Communication

Alex Haga — Sun, 05 Jan 2025 21:43:38 +0000

Date Added:

January 5, 2025

Journal/Publication:

JAMA

Publication Date:

December 18, 2024

URL:

Adolescent-Centered Sexual and Reproductive Health Communication

Type:

Clinical Decision Aids, Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2024.24246

Keywords

adolescent

sexuality

sexually transmitted diseases

PMID (1):

39693089

MeSH

sexually transmitted diseases

A useful list of internet sources for clinicians, parents, and adolescents regarding sexual and reproductive health concerns. James W. Mold, MD, MPH

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This JAMA Insights explores how clinicians can effectively communicate person-centered health care information to adolescents regarding sexual and reproductive health, contraception, and sexually transmitted infection testing and treatment.

Author/s:

Bianca A Allison, Tracey A Wilkinson, Julie Maslowsky

Antiretroviral Drugs for Treatment and Prevention of HIV in Adults: 2024 Recommendations of the International Antiviral Society-USA Panel

Alex Haga — Sun, 08 Dec 2024 20:41:28 +0000

Date Added:

December 8, 2024

Journal/Publication:

JAMA

Publication Date:

December 1, 2024

URL:

Antiretroviral Drugs for Treatment and Prevention of HIV in Adults: 2024 Recommendations of the International Antiviral Society-USA Panel

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.24543

Keywords

HIV Infections

HIV

sexually transmitted diseases

PMID (1):

39616604

MeSH

HIV infections

sexually transmitted diseases

2024 guidelines for the use of anti-retrovirals for prevention and treatment of HIV infections. James W. Mold, MD, MPH

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Importance: New data and new antiretroviral drugs and formulations continue to become available for the prevention and management of HIV infection.

Objective: To provide updated recommendations for HIV treatment and clinical management and HIV prevention.

Methods: A panel of volunteer expert physician scientists were appointed to provide updated consensus recommendations for 2024. Relevant evidence in the literature since the last report was identified from PubMed and Embase searches (which initially yielded 3998 unique citations, of which 249 were considered relevant); from ongoing monitoring of the literature by the panel members; from data submitted by product manufacturers; and from studies presented at peer-reviewed scientific conferences between June 2022 and October 2024.

Findings: Antiretroviral therapy continues to be recommended for all individuals with HIV. For most people with HIV, initial regimens composed of an integrase strand transfer inhibitor (InSTI), specifically bictegravir or dolutegravir, with 2 (and in some cases 1) nucleoside or nucleotide reverse transcriptase inhibitors are recommended. Recommendations are made for those with particular clinical circumstances, such as pregnancy and active opportunistic diseases, as well as for those unable to take InSTIs. Regimens may need to be changed for virologic failure, adverse effects, convenience, or cost, among other reasons. Long-acting injectable therapy is available for those who prefer not to take daily oral medications and for people struggling with adherence to daily therapy. Recommendations are provided for laboratory monitoring, management of substance use disorders and weight changes, as well as use of statins for cardiovascular disease prevention. For HIV prevention, oral (daily or intermittent) and injectable long-acting medications are effective options for people at increased likelihood of HIV exposure. Further, new tools for maintaining health and well-being among people with HIV, such as doxycycline postexposure prophylaxis to avert sexually transmitted infection, and strategies to treat substance use disorders, are recommended. Disparities in HIV acquisition and care access are discussed and solutions proposed.

Conclusions: New approaches for treating and preventing HIV offer additional tools to help end the HIV epidemic, but achieving this goal depends on addressing disparities and inequities in access to care.

Author/s:

Rajesh T Gandhi, Raphael J Landovitz, Paul E Sax, Davey M Smith

Genital Herpes

Alex Haga — Tue, 20 Aug 2024 20:03:33 +0000

Date Added:

August 20, 2024

Journal/Publication:

JAMA

Publication Date:

August 14, 2024

URL:

Genital Herpes

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.12743

Keywords

sexually transmitted diseases

urinary tract infections

herpes

genital herpes

PMID (1):

39141407

MeSH

sexually transmitted diseases

urinary tract infections

Genitalia

A review of what we currently understand about genital herpes simplex infections. James W Mold, MD, MPH

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This JAMA Insights examines the history, diagnosis, prevention, and stigma of genital herpes infection in the US and explores treatments such as suppressive therapy.

Author/s:

Christine Johnston, Anna Wald

Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections

Aubrey Delammermore — Wed, 26 Apr 2023 05:00:00 +0000

Date Added:

April 26, 2023

Journal/Publication:

New England Journal of Medicine

Publisher:

Massachusetts Medical Society

Publication Date:

April 6, 2023

Issue:

Volume:

388

Pages:

1296-1306

URL:

Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1056/NEJMoa2211934

Keywords

sexually transmitted diseases

sexual and gender minorities

primary prevention

HIV prevention

doxycycline

PMID (1):

37018493

MeSH

Anti-Bacterial Agents / administration & dosage

Anti-Infective Agents* / administration & dosage

Chlamydia Infections / prevention & control

Doxycycline* / administration & dosage

Pre-Exposure Prophylaxis

Transgender Persons

Doxycycline prophylaxis after unprotected sex seems to dramatically reduce the incidence of STIs. James W. Mold, MD, MPH

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Background: Interventions to reduce sexually transmitted infections (STIs) among men who have sex with men (MSM) are needed.

Methods: We conducted an open-label, randomized study involving MSM and transgender women who were taking preexposure prophylaxis (PrEP) against human immunodeficiency virus (HIV) infection (PrEP cohort) or living with HIV infection (persons living with HIV infection [PLWH] cohort) and who had had Neisseria gonorrhoeae (gonorrhea), Chlamydia trachomatis (chlamydia), or syphilis in the past year. Participants were randomly assigned in a 2:1 ratio to take 200 mg of doxycycline within 72 hours after condomless sex (doxycycline postexposure prophylaxis) or receive standard care without doxycycline. STI testing was performed quarterly. The primary end point was the incidence of at least one STI per follow-up quarter.

Results: Of 501 participants (327 in the PrEP cohort and 174 in the PLWH cohort), 67% were White, 7% Black, 11% Asian or Pacific Islander, and 30% Hispanic or Latino. In the PrEP cohort, an STI was diagnosed in 61 of 570 quarterly visits (10.7%) in the doxycycline group and 82 of 257 quarterly visits (31.9%) in the standard-care group, for an absolute difference of -21.2 percentage points and a relative risk of 0.34 (95% confidence interval [CI], 0.24 to 0.46; P<0.001). In the PLWH cohort, an STI was diagnosed in 36 of 305 quarterly visits (11.8%) in the doxycycline group and 39 of 128 quarterly visits (30.5%) in the standard-care group, for an absolute difference of -18.7 percentage points and a relative risk of 0.38 (95% CI, 0.24 to 0.60; P<0.001). The incidences of the three evaluated STIs were lower with doxycycline than with standard care; in the PrEP cohort, the relative risks were 0.45 (95% CI, 0.32 to 0.65) for gonorrhea, 0.12 (95% CI, 0.05 to 0.25) for chlamydia, and 0.13 (95% CI, 0.03 to 0.59) for syphilis, and in the PLWH cohort, the relative risks were 0.43 (95% CI, 0.26 to 0.71), 0.26 (95% CI, 0.12 to 0.57), and 0.23 (95% CI, 0.04 to 1.29), respectively. Five grade 3 adverse events and no serious adverse events were attributed to doxycycline. Of the participants with gonorrhea culture available, tetracycline-resistant gonorrhea occurred in 5 of 13 in the doxycycline groups and 2 of 16 in the standard-care groups.

Conclusions: The combined incidence of gonorrhea, chlamydia, and syphilis was lower by two thirds with doxycycline postexposure prophylaxis than with standard care, a finding that supports its use among MSM with recent bacterial STIs. (Funded by the National Institutes of Health; DoxyPEP ClinicalTrials.gov number, NCT03980223.).

Author/s:

Luetkemeyer, A. F., Donnell, D., Dombrowski, J. C., Cohen, S., Grabow, C., Brown, C. E., Malinski, C., Perkins, R., Nasser, M., Lopez, C., Vittinghoff, E., Buchbinder, S. P., Scott, H., Charlebois, E. D., Havlir, D. V., Soge, O. O., Celum, C., DoxyPEP Study Team

Penicillin allergy delabelling of patients at risk of sexually transmitted infections in primary care

Aubrey Delammermore — Thu, 30 Mar 2023 05:00:00 +0000

Date Added:

March 30, 2023

Journal/Publication:

Canadian Medical Association Journal

Publisher:

CMA Impact

Publication Date:

March 27, 2023

Issue:

Volume:

195

Pages:

E449-E451

URL:

Penicillin allergy delabelling of patients at risk of sexually transmitted infections in primary care

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.221266

Keywords

Penicillins

Anti-Bacterial Agents

primary health care

sexually transmitted diseases

hypersensitivity

PMID (1):

36972911

MeSH

Anti-Bacterial Agents / adverse effects

Drug Hypersensitivity* / epidemiology

Penicillins / adverse effects

Sexually Transmitted Diseases* / epidemiology

Hypersensitivity*

A concise review and algorithm for evaluating and delabelling "penicillin-allergic"
patients. James W. Mold, MD, MPH

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KEY POINTS
Most patients who report a penicillin allergy do not have a serious allergy.

Penicillin allergy delabelling enables patients to receive penicillin and β-lactam antibiotics when indicated.

A simple algorithm allows for stratification of allergy risk for patients.

Patients at low risk of a serious allergic reaction can undergo an oral penicillin challenge in sexual health clinics and other primary care settings.

Author/s:

Wittmer, R., Vincent-Boulay, O., Barrios, J. L.

Pre-exposure prophylaxis for HIV: effective and underused

Aubrey Delammermore — Sat, 10 Sep 2022 05:00:00 +0000

Date Added:

September 10, 2022

Journal/Publication:

CMAJ

Publisher:

CMA Impact Inc

Publication Date:

September 6, 2022

Issue:

Volume:

194

Pages:

E1164-E1170

URL:

Pre-exposure prophylaxis for HIV: effective and underused

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1503/cmaj.220645

Keywords

Follow-Up Studies

Substance Abuse, intravenous

Canada

sexually transmitted diseases

Drug users

MeSH

Pre-Exposure Prophylaxis

Sexual and Gender Minorities

HIV infections

Tenofovir

fumarates

Pre-exposure prophylaxis should be offered to those at high risk for HIV. James W. Mold, MD, MPH

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Pre-exposure prophylaxis (PrEP) is a highly effective modality for HIV prevention that can be prescribed by generalists.

Pre-exposure prophylaxis should be offered to patients who are at high risk of HIV exposure, including gay, bisexual and other men who have sex with men (GBM), women reporting condomless intercourse with partners of confirmed or unknown transmissible HIV status and persons who inject drugs and share injection equipment.

Once daily PrEP (tenofovir disoproxil fumarate/emtricitabine [TDF/FTC] or tenofovir alafenamide fumarate/emtricitabine tablets) is approved by Health Canada.

On-demand TDF/FTC can be prescribed to gay, bisexual and other men who have sex with men and has similar efficacy.

The Canadian guideline details protocolized monitoring for PrEP follow-up including HIV screening, screening for sexually transmitted infection and renal monitoring.

Author/s:

Hempel, A., Biondi, M. J., Baril, J., Tan, D. H. S.