{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:44:23Z","timestamp":1792651463682,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001058","name":"Australian-American Fulbright Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Doxycycline post-exposure prophylaxis (doxyPEP) reduces bacterial sexually transmitted infection (STI) incidence in people with HIV (PWH) or using HIV pre-exposure prophylaxis (PrEP). Given concerns about widespread antibiotic use, we identified doxyPEP prescribing strategies to minimize use while maximizing impact on STIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used electronic health records of gay and bisexual men (GBM), transgender women, and nonbinary people assigned male sex at birth with \u22652 STI tests (chlamydia, gonorrhea, syphilis) at an LGBTQ-focused health center during 2015\u20132020. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 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 maximized efficiency (lowest NNTs) but prevented fewer STIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prescribing 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad488","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T16:16:58Z","timestamp":1692289018000},"page":"304-311","source":"Crossref","is-referenced-by-count":52,"title":["Potential Impact of Doxycycline Post-exposure Prophylaxis Prescribing Strategies on Incidence of Bacterial Sexually Transmitted Infections"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3452-350X","authenticated-orcid":false,"given":"Michael W","family":"Traeger","sequence":"first","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts ,","place":["USA"]},{"name":"The Fenway Institute, Fenway Health , Boston, Massachusetts ,","place":["USA"]},{"name":"Disease Elimination Program, Burnet Institute, Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth H","family":"Mayer","sequence":"additional","affiliation":[{"name":"The Fenway Institute, Fenway Health , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S","family":"Krakower","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts ,","place":["USA"]},{"name":"The Fenway Institute, Fenway Health , Boston, Massachusetts ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sy","family":"Gitin","sequence":"additional","affiliation":[{"name":"The Fenway Institute, Fenway Health , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel M","family":"Jenness","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Emory University , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia L","family":"Marcus","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts ,","place":["USA"]},{"name":"The Fenway Institute, Fenway Health , Boston, Massachusetts 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prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial","volume":"18","author":"Molina","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2026031306480236500_ciad488-B8","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa2211934","article-title":"Postexposure doxycycline to prevent bacterial sexually transmitted infections","volume":"388","author":"Luetkemeyer","year":"2023","journal-title":"N Engl J Med"},{"key":"2026031306480236500_ciad488-B9","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1093\/cid\/ciz866","article-title":"Doxycycline prophylaxis for bacterial sexually transmitted infections","volume":"70","author":"Grant","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2026031306480236500_ciad488-B10","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofx214","article-title":"Sociodemographic and clinical factors associated with increasing bacterial sexually transmitted infection diagnoses in men who have sex with men accessing care at a Boston community health center (2005\u20132015)","volume":"4","author":"Mayer","year":"2017","journal-title":"Open Forum Infect Dis"},{"key":"2026031306480236500_ciad488-B11","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1097\/01.qai.0000144444.44518.a3","article-title":"Comparison of three methods to measure HIV incidence among persons seeking voluntary, anonymous counseling and testing","volume":"39","author":"Kellogg","year":"2005","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2026031306480236500_ciad488-B12","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/cid\/ciab944","article-title":"Syphilis testing and diagnosis among people with human immunodeficiency virus (HIV) engaged in care at 4 US clinical sites, 2014\u20132018","volume":"75","author":"Menza","year":"2022","journal-title":"Clin Infect 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