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DoxyPEP, morning after pill sees STIs incidence going down

By Catherine Murombedzi

The Choice Agenda notes a decline in sexually transmitted infections (STIs) in San Francisco, USA. This was reported at the Conference on Retroviruses and Opportunistic Infections (CROI 2024) in
Denver, Colorado yesterday.

Taking the antibiotic doxycycline after sex appears to have lowered the incidence of sexually transmitted infections (STIs) in San Francisco, according to researchers who presented some of the earliest real-world data yesterday at the Conference on Retroviruses and Opportunistic Infections (CROI 2024).

In October 2022, San Francisco was the first city to recommend doxycycline post-exposure prophylaxis, or doxyPEP, for gay and bisexual men and transgender people. Over the ensuing year, chlamydia cases dropped steeply, and syphilis also fell, but there was little decline in gonorrhoea.

Results from clinical practice and population-wide analyses are consistent with findings from recent clinical trials, suggesting that doxyPEP is in demand and is already making an impact on STI incidence.

“It’s not often in public health that you have population-level surveillance in concordance with clinical service delivery in concordance with clinical trial results, all at the same time,” CROI chair Professor Landon Myer of the University of Cape Town said at a media briefing. “This, to my mind, seals the case,” posted Jim Pickett, Consulting at The Choice Agenda.

Doxy PEP (like HIV PEP) is about taking 200 mg of Doxycycline 24-72 hours after a potential exposure to an STI (i.e. oral, anal, or vaginal/frontal condomless sex).


While Doxy PrEP (like HIV PrEP) means taking Doxycycline daily to stop a sexually transmitted infection from developing.

PEP involves taking medication after sex where there is a risk to contact with STIs. It also involves taking medication regularly, so it is already in the system when one comes into contact with STIs.


The novel (CAB LA) PrEP injectable is another game changer to HIV infections as the jab will be given once every eight weeks. It is safe and superior to daily oral pill taken for HIV prevention.
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