Presentation:
New strategies are needed to address persistently increasing rates of bacterial sexually transmitted infections (STI). Recent trials demonstrate that doxycycline post-exposure prophylaxis (doxy-PEP) significantly reduces the risk of chlamydia, syphilis, and gonorrhea in cisgender men and transgender women who have sex with men. One study found doxy-PEP did not reduce risk for STI in cisgender women, potentially due to low adherence to the intervention in the trial. Despite its potential benefits for STI risk reduction in some populations, several potential implications of doxy-PEP in the near and longer term merit consideration. This presentation will review current evidence to frame the knowns and unknowns about doxy-PEP, highlight the range of doxy-PEP guidance and position statements, discuss the basis for concerns about antimicrobial resistance, and introduce future considerations for implementation to maximize benefit and minimize harms related to doxy-PEP use.