They recommend pills to prevent sexually transmitted diseases

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Amid rising rates of chlamydia, gonorrhea and syphilis, US health officials proposed Monday that doctors begin prescribing a morning-after pill to reduce sexually transmitted diseases (STDs), despite concerns about the possibility that more resistant strains are generated.

DoxyPEP, or doxycycline, used as post-exposure prevention, reduces the risk of developing these infections, according to a study involving men who have sex with men and transgender women who had sex without a condom.

The project, with guidelines developed by the Center for Disease Control (CDC), targets only these groups, which it considers to be at highest risk, for fear that a broader recommendation could fuel the rise of superbugs.

"Innovation and creativity are important in public health, and more tools are desperately needed," Jonathan Mermin, director of STD prevention at the CDC, told AFP before the announcement.

The guidelines recommend a single 200 mg pill taken by mouth within 72 hours of a sexual encounter.

– Less condom use –

Reported cases of chlamydia, gonorrhea and syphilis increased to 2.5 million in the United States in 2021, new growth after about a decade of increases.

Several problems are behind this trend: fewer and fewer people are using condoms since the advent of PrEP, daily pills that significantly reduce the chances of contracting HIV.

Another possible driver of the increase is that people taking PrEP are recommended to undergo health screenings every three months, which is likely to increase the identification of infections. There is also the basic epidemiological fact that the greater the number of infected people, the more they can infect.

Researchers have found DoxyPEP to be effective in three of four trials.

"What we found was that there was about a two-thirds reduction in sexually transmitted infections every three months," Annie Luetkemeyer, co-leader of a trial in the United States, told AFP.

The doctor and scientist at the University of California, San Francisco, recruited about 500 people in San Francisco and Seattle among communities of men who have sex with men and transgender women. The drug's effectiveness was greatest against chlamydia and syphilis, which were reduced by approximately 80%, while for gonorrhea it was approximately 55%. There were few side effects.

Expanded access to doxycycline has raised concerns about the possibility of it causing antibiotic resistance, particularly in gonorrhea, which is rapidly mutating.

But initial investigations have found no cause for alarm.

Connie Celum of the University of Washington, who co-led the US study, told AFP that they analyzed gonorrhea samples from breakthrough infections (when people got the disease despite taking the antibiotic) in the DoxyPEP group and compared them. with the group that did not receive the pill.

Although they found that the rate of resistant gonorrhea was slightly higher in the DoxyPEP group, he said the finding could simply mean that the pill is less effective against strains that are already resistant, rather than causing that resistance.

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