Can Postexposure Prophylaxis Prevent STIs in Cisgender Women?

In a trial in Kenyan women, doxycycline within 72 hours after sexual intercourse did not appear to protect against bacterial sexually transmitted infections.

Among men who have sex with men and transgender women, doxycycline taken after intercourse substantially reduces risk for bacterial sexually transmitted infections (STIs). Does postexposure prophylaxis (PEP) also work among cisgender women, who bear a disproportional burden of STI sequelae — including pregnancy complications and infertility? Investigators randomized 449 Kenyan women aged 18 to 30 to receive either 200-mg doxycycline within 72 hours of intercourse or standard care. All women were receiving HIV preexposure prophylaxis (PrEP) with tenofovir-emtricitabine and were seen quarterly to evaluate for chlamydia, gonorrhea, and syphilis infections.

The rate of incident infections did not differ by study arm, with 50 infections among wom…

Reviewing Author

Anna Wald, MD, MPH

Disclosures

Consultant/Advisory BoardAicuris; Bayer; GSK; Innovative Molecules; Merck; MAPP Biopharmaceutical (Safety Monitoring Committee)

RoyaltiesUpToDate

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; GSK; Moderna; Assembly Biomedical; Aicuris

Editorial BoardsSexually Transmitted Diseases; Sexually Transmitted Infections; Journal of Infectious Diseases

Leadership PositionsID Division Chiefs Community of Practice (At-Large Member)