Americans should take a pill after sex to deal with the US explosion of sexually transmitted infections (STDs), health officials say.
The Centers for Disease Control and Prevention (CDC) is urging singletons to use doxycycline as a “morning-after pill” to prevent bacteria from reproducing and developing into an infection.
The inexpensive antibiotic — which costs about $1.18 per pill — has been used for more than 50 years to treat dental infections and skin conditions.
It comes in response to what the CDC has described as an “STD epidemic,” with a record 2.53 million cases of chlamydia, gonorrhea and syphilis in 2021.
Dr. Philip Andrew Chan, who consults with the CDC on doxycycline recommendations, said using an antibiotic to prevent STDs won’t be a “magic bullet” but it will be “another tool”
The figures for 2021 – revealed in a report this week – mark a 6 percent increase from the 2020 figure and a 7 percent increase from 2017.
Some STIs, such as syphilis, are seeing the highest numbers in more than 70 years.
Dr. Leandro Mena, director of the CDC’s STD prevention division, believes that doxycycline could work as a “morning after” pill for sexually transmitted diseases, capable of preventing STDs within 72 hours of unprotected sex.
The antibiotic is used to treat other bacterial infections such as acne and malaria.
When taken within three days of unprotected sex, it reduces infections by more than 60 percent by preventing bacteria from reproducing.
It does this by inhibiting bacterial protein synthesis, which means amino acids cannot be linked together. Bacteria cannot function without proteins.
Currently, the drug is not available over the counter and patients need a prescription from their doctor to get the tablets for $1.18 each.
Dr. Mena said the CDC is making recommendations to use doxycycline in this way.
New data published in the New England Journal of Medicine last week regarding doxycycline gives doctors some hope that the epidemic of STIs can be contained.
In the National Institutes of Health-funded study, 501 gay men, bisexual men and transgender women in Seattle and San Francisco with a history of STD infections took one doxycycline pill within 72 hours of having unprotected sex.
Researchers refer to this course of treatment in the study as doxycycline postexposure prophylaxis, or doxyPEP for short.
In the period 2020 to 2021, the rate of gonorrhea has increased by more than six percent in men (from 234.8 to 249.7 per 100,000) and by more than two percent in women (from 173.8 to 177.9 per 100,000). .
Chlamydia was unreportable in all 50 states and the District of Columbia until 2000. Steady rise in chlamydia cases since 1996 is due in part to improved reporting and testing infrastructure
In 2021, a total of 2,855 cases of congenital syphilis were reported, representing approximately 78 per 100,000 live births. Between 2020 and 2021, the number of reported congenital syphilis has increased by more than 30 percent
Participants who took the pills were about 90 percent less likely to get chlamydia, 80 percent less likely to get syphilis, and more than 50 percent less likely to get gonorrhea compared to people who didn’t take the pills after sex.
Physicians from the University of California, San Francisco and the University of Washington said: ‘The combined incidence of gonorrhea, chlamydia and syphilis was two-thirds lower with post-exposure doxycycline prophylaxis than with standard care, a finding that confirms use among [men who have sex with men] with recent bacterial STDs.’
Dr. Philip Andrew Chan, who consults with the CDC on the doxycycline recommendations, said using an antibiotic to prevent STDs will not be a “miracle drug,” but “another tool.”
The San Francisco Department of Public Health approved the use of doxycycline as a prophylactic last October, citing research conducted in Washington and California.
The Department said last fall: ‘Doxy-PEP is the first biomedical preventive that has been shown to be effective and well tolerated. Community awareness is growing and many providers in SF are already prescribing doxy-PEP to their patients at risk for STDs.”
Meanwhile, the CDC’s Dr. Mena said there are no signs of the STD trend slowing.
Officials have blamed limited access to healthcare during the pandemic and an increasingly lax attitude towards contraception.
According to the CDC, there were 2.53 million cases of chlamydia, gonorrhea and syphilis in 2021, nearly 6 percent more than in 2020 and an increase of 7 percent from 2017.
While certain STDs are still not as high in 2021 and in pre-pandemic years, others, such as syphilis, are seeing the highest numbers in more than 70 years.
Half (50.5 percent) of reported STD cases in 2021 were among adolescents and young adults aged 15-24.
Those aged 20-24 had the highest rates of gonorrhea (873 and 844 per 100,000 population, respectively), followed by men aged 25-29 and 30-34.
For chlamydia, women aged 20-24 and 15-19 had the highest rates (3798 and 2697 per 100,000 population), followed by men aged 20-24.
With primary and secondary syphilis, men had a higher rate than women in every age group, with the highest in men aged 25-29 with a rate of 68 per 100,000 population.
CDC figures show there were 176,713 cases of syphilis in 2021, the highest since the 217,558 cases reported in 1950 and a third more than in 2020.
The report also found an increase in congenital syphilis, which happens when a baby is born with the infection after contracting it from her mother during pregnancy.
The number of cases rose 32 percent from 2,148 in 2020 to more than 2,800 in 2021. This resulted in 220 stillbirths and infant deaths in 2021, the CDC said.
Cases of gonnhorea rose nearly five percent from 2020 to 2021, from 677,769 cases to more than 710,000, the highest annual total in four years.
Chlamydia cases, which were more common at the start with 1,579,885 in 2020, skyrocketed to 1,644,416 in 2021.
Despite this about four percent increase, total annual cases of chlamydia have declined since 2019, when more than 1.8 million cases were reported.