Sexually Transmitted Infections (STI) (like syphilis, chlamydia, and gonorrhea) rates are increasing, and have been since 2019. Left untreated, these bacterial infections can lead to lifelong medical issues. For example, untreated syphilis during pregnancy can lead to congenital syphilis, which can lead to miscarriage and infant death, or lifelong health problems for babies.
Preventing STIs with a Daily Dose
Although programs like Get Checked Online have helped communities in BC get access to STI testing and treatment, there is still much work to do to help curb the increase of STI in BC and throughout Canada. Dr Troy Grennan, physician lead for the Provincial HIV/STI Program at BCCDC, is researching a new approach to bacterial STI prevention: pre-and post-exposure prophylaxis (PrEP) using the common antibiotic doxycycline (doxyPEP and doxyPrEP).
Doxycycline as an Intervention for bacterial STI ChemOprophylaxis (DISCO) is the name of the research study conducted by Dr Grennan and his team. Previous studies – including two pilot studies led by Dr Grennan – have found a notable decrease in bacterial Sexually Transmitted Infections (STI) for people taking daily doxycycline. In the latest pilot study examining the use of doxyPrEP in gay, bisexual, and other men who have sex with men (GBM) with HIV, there was a 92% reduction in chlamydia, a 79% reduction in syphilis, and a 68% reduction in gonorrhea.
An Easily Accessible Treatment Option
Not only is Doxycycline shown to be effective at reducing bacterial STI, but it is readily available, and easy to access. “There are not huge barriers to prescribing doxycycline,” says Dr Grennan. “It’s not a niche medication that you need special access to, and most providers would be able to prescribe it and counsel patients on its proper use.”
The DISCO team is looking to further explore the tolerability and safety of doxycycline therapy, with vigilant monitoring for the potential risk of antibiotic resistance. Thankfully, there has been no evidence thus far to show persisting resistance with doxycycline, but this warrants further study.
A Public Health Improvement
This breakthrough study has the potential to arm healthcare providers with an additional tool to help those at increased likelihood of STIs, providing an opportunity to change the trajectory of the STI epidemic. Preventing the occurrence of STIs — rather than treating them — is public health in action!
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