CDC Proposes Antibiotic After Sex to Prevent STIs

The Centers for Disease Control and Prevention (CDC) is considering new guidelines suggesting the use of antibiotics as a prophylactic measure to prevent sexually transmitted infections (STIs).

The CDC has opened the opportunity for public comment on these guidelines.

The proposed guidelines recommend the use of the common antibiotic doxycycline as a preventive treatment against bacterial STIs like chlamydia, gonorrhea, and syphilis.

Under these new guidelines, doxycycline, originally developed in the 1960s, would be encouraged as a post-exposure prophylactic (PEP). In this context, it would be taken within 72 hours of sexual intercourse, in conjunction with additional tests and resources.

The current recommendation applies solely to men who have sex with men and transgender women who have had a similar infection within the last 12 months.

However, experts emphasize that addressing healthcare disparities in underserved communities is vital for the effectiveness of this policy change. Systemic barriers such as limited healthcare infrastructure, affordability, and health insurance gaps disproportionately affect Black, Latinx, and Tribal communities.

The research accompanying the proposal did not find significant indicators at this stage that prescribing the medication poses a significant risk of antibiotic resistance.

The recommendations also highlight that individuals prescribed this antibiotic should be retested in three to six months. Continuous monitoring of resistance and infection rates remains crucial.

The CDC based its proposed recommendation on data from four studies and in-person consultations. The proposed guidelines suggest taking 200 mg of doxycycline up to 72 hours after unprotected intercourse, regardless of whether it was vaginal, anal, or oral.

Adrienne Ton, Director of Clinical Operations at TBD Health, noted that the recommendations provide clinicians with concrete guidance to recommend this treatment, thereby facilitating its use. Ton emphasized that the change could benefit those who protect themselves after an unwanted sexual encounter.

Dr. Kecia Gaither MPH, from NYC Hospitals and Health, highlighted that negative pregnancy tests should be an integral part of the algorithm before administering antibiotics, as they are contraindicated during pregnancy.

Also Read: Gonorrhea Cases Surge in the UK, Public Urged to Wear Condoms

“Black, Latinx and Tribal communities often face disparities in healthcare access, which includes limited access to essential medications, including drugs for STI prevention,” Christie said. “This lack of access directly results from systemic barriers, such as limited healthcare infrastructure, affordability, and health insurance gaps. Without some of these broader systemic considerations that center on deliberately marginalized communities, it will not be an effective population-level strategy.”

In addition to medication options, experts stressed the importance of sexual education and equipping individuals with medically accurate sexual knowledge to make informed decisions, develop sexual communication skills, challenge STI myths, and ensure access to testing and safer-sex tools.