Taking a long-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 such as acne. But fifty 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 favor of promoting condom use when STIs began to decline and AIDS emerged.
“The problem with the idea of wearing a condom is that people don’t wear them,” said 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 against gonorrhea. It has been shown to be effective among trans women and among men who have sex with men, but no benefit has been seen among cisgender women.
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.
“What’s difficult for us caregivers is that despite all the education and all the training, they come every two or three months, then hurry up, clean that up and presto, we start again,” said- he lamented.
Despite information about risk, about the possibility of resistance, and about the possibility of infecting others, he continues, 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 said.
The presentation of doxycycline as a kind of “morning after pill” after unprotected sex obviously risks further trivializing the perception that some people already have of problems such as syphilis, gonorrhea or chlamydia.
The recent episode of monkey pox reminds us, however, that sexually transmitted viruses are also circulating against which antibiotics can do nothing, recalled Dr. Routy. We cannot rule out the possibility that new viruses will begin to spread and cause a new epidemic.
“So condom use is always recommended, even though it’s very little used and people are fed up with it,” Dr. Routy said.
