ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Potential impact of doxycycline post-exposure prophylaxis prescribing strategies on incidence of bacterial sexually transmitted infections.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- 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 · 2024Guideline
- Acceptability and use of doxyPEP among cisgender men who have sex with men, transgender women and non-binary persons assigned male sex at birth: results from a national online survey from the USA.Sexually transmitted infections · 2026Article
- Incidence and risk factors ofBMJ open · 2026Article
- Correlates of asymptomatic sexually transmitted infections among marginalized women in the Dominican Republic.International journal of STD & AIDS · 2026Article
- Evidence-Informed Provision of Doxycycline Postexposure Prophylaxis for Prevention of Bacterial Sexually Transmitted Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Impact and cost-effectiveness of doxycycline post-exposure prophylaxis in Australian men who have sex with men.Nature communications · 2026Article
- World Health Organization-Recommended Periodic Presumptive Treatment Versus Doxycycline Post-Exposure Prophylaxis for Sexually Transmitted Infection Control Among Men Who Have Sex With Men in Kenya: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Decreasing trends of syphilis among people with HIV at a university hospital before implementation of doxycycline prophylaxis for syphilis: implications for targeted syphilis prevention.Sexually transmitted infections · 2025Article
- HIV Pre-exposure Prophylaxis Does Not Increase Gonorrhea and Chlamydia Incidence in Young Black and Hispanic Men who Have Sex With Men: An Observational Cohort Study.Open forum infectious diseases · 2025Article
- Bacterial sexually transmitted infections and related antibiotic use among individuals eligible for doxycycline post-exposure prophylaxis in the United States.Nature communications · 2025Article
- High syphilis incidence among PrEP-adherent men who have sex with men and transgender women in Peru.Journal of the International AIDS Society · 2025Article
- Doxycycline post-exposure prophylaxis in China: current utilized situation among men who have sex with men in a cross-sectional online survey from two cites.BMC public health · 2025Article
- Interest and disparities in awareness and uptake of doxycycline postexposure prophylaxis among US MSM with HIV.AIDS (London, England) · 2025Article
- Factors associated with placement along the HIV prevention and care continuum among sexual minority men who use methamphetamine.AIDS care · 2025Article
- Emergent informal use of doxycycline post- and pre-exposure prophylaxis among men who have sex with men and transgender and gender diverse people, the Netherlands, 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Acceptability of Doxycycline Prophylaxis, Prior Antibiotic Use, and Knowledge of Antimicrobial Resistance Among Australian Gay and Bisexual Men and Nonbinary People.Sexually transmitted diseases · 2025Article
- Article
- Where we stand on doxyPEP depends on where we sit: a viewpoint.Frontiers in microbiology · 2025Article
- Syphilis testing, incidence, and reinfection among gay and bisexual men in Australia over a decade spanning HIV PrEP implementation: an analysis of surveillance data from 2012 to 2022.The Lancet regional health. Western Pacific · 2024Article
- Self-Reported PrEP Use and Risk of Bacterial STIs Among Ontarian Men Who Are Gay or Bisexual or Have Sex With Men.Annals of family medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundDoxycycline post-exposure prophylaxis (doxyPEP) reduces bacterial sexually transmitted infection (STI) incidence in people with HIV (PWH) or using HIV preexposure prophylaxis (PrEP). Given concerns about widespread antibiotic use, we identified doxyPEP prescribing strategies to minimize use while maximizing impact on STIs.
methodsWe used electronic health records of gay and bisexual men (GBM), transgender women, and non-binary people assigned male sex at birth with ≥2 STI tests (chlamydia, gonorrhea, syphilis) at an LGBTQ-focused health center during 2015-2020. We defined 10 hypothetical doxyPEP prescribing strategies based on PrEP use, HIV status, or STI history. We estimated doxyPEP use and STI diagnoses averted in counterfactual scenarios in which people meeting prescribing criteria received doxyPEP, assuming STI rates during use would have been reduced by clinical trial efficacy estimates.
resultsAmong 10,546 individuals (94% GBM), rate of any STI was 35.9/100 person-years. Prescribing doxyPEP to all individuals would have averted 71% of STI diagnoses (number needed to treat for one year to avert one STI diagnosis, NNT = 3.9); prescribing to PrEP users/PWH (52%/12% of individuals) would have averted 60% of STI diagnoses (NNT = 2.9). Prescribing doxyPEP for 12 months after STI diagnosis would have reduced the proportion using doxyPEP to 38% and averted 39% of STI diagnoses (NNT = 2.4). Prescribing after concurrent or repeated STIs would have maximized efficiency (lowest NNTs) but prevented fewer STIs.
conclusionsPrescribing doxyPEP to individuals with STIs, particularly concurrent or repeated STIs, could avert a substantial proportion of all STI diagnoses. The most efficient prescribing strategies are based on STI history rather than HIV status or PrEP use.
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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.