Evidence map›Paper›PMID 37018493›Full record

Trial reportThe New England journal of medicine2023

Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections.

Anne F Luetkemeyer, Deborah Donnell, Julia C Dombrowski, Stephanie Cohen, Cole Grabow, Clare E Brown, Cheryl Malinski, Rodney Perkins, Melody Nasser, Carolina Lopez and 8 more

3 registry-linked trialsOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 196 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
196citing papers in PubMed, 3 pooled it
73.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03980223 phase4completednot on this map

Evaluation of Doxycycline Post-exposure Prophylaxis to Reduce Sexually Transmitted Infections in PrEP Users and HIV-infected Men Who Have Sex With Men

TypeinterventionalSponsorUniversity of California, San FranciscoRan2019 to 2023Enrolled641ConditionsGonorrhea, Chlamydia, SyphilisArmsDoxycycline Hyclate Delayed-Release 200 mg
NCT06778083 recruitingnot on this mapstarted 2025, after this paper: background citation

STI Prophylaxis and Emergence of Antimicrobial Resistance

TypeobservationalSponsorUniversity College, LondonRan2025 to 2027Enrolled108ConditionsSexually Transmitted Infection (STI) Prevention, Antibiotic Prophylaxis, Antibiotic Resistance, Bacterial, Microbiome
NCT07397403 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

The Efficacy of Doxycycline Post Exposure Prophylaxis for Preventing Sexually Transmitted Diseases (Gonorrhea, Chlamydia, Syphilis) Among Men Who Have Sex With Men in Bangkok, Thailand.

TypeinterventionalSponsorBangrak STIs CenterRan2025 to 2027Enrolled400ConditionsSyphilis Infection, Gonorrhea, ChlamydiaArmsDoxycycline (200mg/day)
3 · Its place in the literature

Who cites it

196 citing papers in PubMed, 3 syntheses or guidelines pooled it, 398 citations in OpenAlex.

  1. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025
    Guideline
  2. CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024
    Guideline
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Perceptions of DoxyPEP use Among Racial & Ethnic Minority Patients.Journal of racial and ethnic health disparities · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Should we still treat asymptomaticSexually transmitted infections · 2026
    Article
  19. Article
  20. Review

136 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 2 countries.

Anne F LuetkemeyerFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Deborah DonnellFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Julia C DombrowskiFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Stephanie CohenFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Cole GrabowFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Clare E BrownFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Cheryl MalinskiFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Rodney PerkinsFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Melody NasserFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Carolina LopezFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Eric VittinghoffFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Susan P BuchbinderFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Hyman ScottFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Edwin D CharleboisFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Diane V HavlirFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Olusegun O SogeFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
Connie CelumFrom Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle.
DoxyPEP Study Team
San Francisco General Hospital · USPublic Health – Seattle & King County · USSan Francisco Department of Public Health · USUniversity of California, San Francisco · USCape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa · ZA

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI EDWIN ROBERTO ORELLANA · 1988 to 2026
$104.9M
Evaluation of doxycycline post-exposure prophylaxis to reduce sexually transmitted infections in PrEP users and HIV-infected men who have sex with menR01AI143439 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CELUM, CONNIE L, LUETKEMEYER, ANNE FREY · 2019 to 2023
$8.3M
University of Washington Developmental AIDS Research Center for Mental Health (UW ARCH)P30MH123248 · NIMH · UNIVERSITY OF WASHINGTON · PI SIMONI, JANE M. · 2021 to 2024
$5.8M
RiNGH (Research in Nursing & Global Health) Training ProgramT32NR019761 · NINR · UNIVERSITY OF WASHINGTON · PI KOHLER, PAMELA, PINTYE, JILLIAN · 2021 to 2025
$1.4M
NIAID NIH HHS P30 AI027757NIAID NIH HHS R01 AI143439NIMH NIH HHS P30 MH123248NINR NIH HHS T32 NR019761
6 · The paper itself

Abstract

backgroundInterventions to reduce sexually transmitted infections (STIs) among men who have sex with men (MSM) are needed.

methodsWe conducted an open-label, randomized study involving MSM and transgender women who were taking preexposure prophylaxis (PrEP) against human immunodeficiency virus (HIV) infection (PrEP cohort) or living with HIV infection (persons living with HIV infection [PLWH] cohort) and who had had

resultsOf 501 participants (327 in the PrEP cohort and 174 in the PLWH cohort), 67% were White, 7% Black, 11% Asian or Pacific Islander, and 30% Hispanic or Latino. In the PrEP cohort, an STI was diagnosed in 61 of 570 quarterly visits (10.7%) in the doxycycline group and 82 of 257 quarterly visits (31.9%) in the standard-care group, for an absolute difference of -21.2 percentage points and a relative risk of 0.34 (95% confidence interval [CI], 0.24 to 0.46; P<0.001). In the PLWH cohort, an STI was diagnosed in 36 of 305 quarterly visits (11.8%) in the doxycycline group and 39 of 128 quarterly visits (30.5%) in the standard-care group, for an absolute difference of -18.7 percentage points and a relative risk of 0.38 (95% CI, 0.24 to 0.60; P<0.001). The incidences of the three evaluated STIs were lower with doxycycline than with standard care; in the PrEP cohort, the relative risks were 0.45 (95% CI, 0.32 to 0.65) for gonorrhea, 0.12 (95% CI, 0.05 to 0.25) for chlamydia, and 0.13 (95% CI, 0.03 to 0.59) for syphilis, and in the PLWH cohort, the relative risks were 0.43 (95% CI, 0.26 to 0.71), 0.26 (95% CI, 0.12 to 0.57), and 0.23 (95% CI, 0.04 to 1.29), respectively. Five grade 3 adverse events and no serious adverse events were attributed to doxycycline. Of the participants with gonorrhea culture available, tetracycline-resistant gonorrhea occurred in 5 of 13 in the doxycycline groups and 2 of 16 in the standard-care groups.

conclusionsThe combined incidence of gonorrhea, chlamydia, and syphilis was lower by two thirds with doxycycline postexposure prophylaxis than with standard care, a finding that supports its use among MSM with recent bacterial STIs. (Funded by the National Institutes of Health; DoxyPEP ClinicalTrials.gov number, NCT03980223.).

Indexed as

Anti-Infective AgentsDoxycyclinePrimary PreventionSexual and Gender MinoritiesSexually Transmitted DiseasesAnti-Bacterial AgentsChlamydia InfectionsFemaleGonorrheaHIV InfectionsHomosexuality, MaleHumansMalePre-Exposure ProphylaxisSyphilisTransgender PersonsAnti-Bacterial AgentsAnti-Infective AgentsDoxycycline

Identifiers

PMID37018493
PMCPMC10140182
OpenAlexW4362640977

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.