{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:31:17Z","timestamp":1790094677324,"version":"4.0.1"},"reference-count":10,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,11,13]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Doxycycline as bacterial sexually transmitted infection (STI) postexposure prophylaxis (DoxyPEP) has shown high efficacy in clinical trials. We evaluated the impact of DoxyPEP on chlamydia (CT), gonorrhoea (GC) and syphilis incidence among pre-exposure prophylaxis (PrEP) users in a sexual health clinic in San Francisco, California, USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>DoxyPEP was offered to all PrEP clients at routine clinical visits starting on 30 November 2022. We included PrEP clients who received DoxyPEP (DoxyPEP users) or never initiated DoxyPEP (non-DoxyPEP users). Among DoxyPEP users, the \u2018pre-DoxyPEP\u2019 period was from 1 June 2022 until DoxyPEP initiation, and the \u2018post-DoxyPEP\u2019 period started after DoxyPEP initiation through 7 September 2023. STI testing included three sites\u2014GC, CT and early syphilis testing. STI incidence rate ratios (IRRs) per quarter were evaluated using a pre-analysis, post-analysis and a controlled interrupted time series (CITS) analysis, with mixed-effects Poisson regression used to evaluate intervention effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3081 PrEP clients, 1209 (39%) initiated DoxyPEP. During the pre-DoxyPEP period, any STI, CT, GC and syphilis mean quarterly positivity was 18.1%, 9.2%, 8.1% and 2.2% among DoxyPEP users and 7%, 3.2%, 3% and 0.7% among non-DoxyPEP users, respectively. In pre-implementation and post-implementation analysis of DoxyPEP users, DoxyPEP was associated with lower STI incidence for any STI (IRR 0.42, 95% CI 0.24 to 0.74, p=0.003), CT (IRR 0.33, 95% CI 0.23 to 0.46, p&lt;0.001) and syphilis (IRR 0.22, 95% CI 0.07 to 0.54, p=0.001), but not GC (IRR 0.89, 95% CI 0.69 to 1.15, p=0.383). In a CITS analysis, DoxyPEP was associated with a significant decline in any STI incidence (0.67, 95% CI 0.46 to 0.96, p&lt;0.030).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Observed DoxyPEP uptake reflected strong demand among PrEP users when offered in a clinical setting. Overall, STI incidence declined rapidly after implementation, demonstrating the high impact of this intervention in a real-world setting. Continued evaluation of uptake, adherence and impact on bacterial STIs will be essential as DoxyPEP implementation expands.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056674","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:20:52Z","timestamp":1764786052000},"page":"322-324","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Sexually transmitted infections after implementation of doxycycline postexposure prophylaxis"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-7214","authenticated-orcid":false,"given":"Hyman M","family":"Scott","sequence":"first","affiliation":[{"name":"Bridge HIV, San Francisco Department of Public Health, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Roman","sequence":"additional","affiliation":[{"name":"San Francisco AIDS Foundation, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Spinelli","sequence":"additional","affiliation":[{"name":"University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Bena","sequence":"additional","affiliation":[{"name":"San Francisco AIDS Foundation, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago","family":"Torres","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Glidden","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics and Global Health Sciences, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Buchbinder","sequence":"additional","affiliation":[{"name":"Bridge HIV, San Francisco Department of Public Health, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"2026071602100834000_102.5.322.1","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted surveillance, 2022. 2024. Available: https:\/\/www.cdc.gov\/std\/statistics\/2022"},{"key":"2026071602100834000_102.5.322.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211934"},{"key":"2026071602100834000_102.5.322.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30725-9"},{"key":"2026071602100834000_102.5.322.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(24)00236-6"},{"key":"2026071602100834000_102.5.322.5","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1001\/jamainternmed.2024.7186","article-title":"Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV Preexposure Prophylaxis","volume":"185","author":"Traeger","year":"2025","journal-title":"JAMA Intern Med"},{"key":"2026071602100834000_102.5.322.6","unstructured":"San Francisco Department of Public Health . Health update: doxycycline post-exposure prophylaxis reduces incidence of sexually transmitted infections. 2022. Available: https:\/\/www.sfcityclinic.org\/sites\/default\/files\/2023-01\/Health%20update_DoxyPEP_FINAL.1.pdf"},{"key":"2026071602100834000_102.5.322.7","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1001\/jamainternmed.2024.7178","article-title":"Doxycycline Postexposure Prophylaxis and Sexually Transmitted Infection Trends","volume":"185","author":"Sankaran","year":"2025","journal-title":"JAMA Intern Med"},{"key":"2026071602100834000_102.5.322.8","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2024.29.10.2400113","article-title":"Sharp increase in gonorrhoea notifications among young people, EU\/EEA, July 2022 to June 2023","volume":"29","author":"Nerlander","year":"2024","journal-title":"Euro Surveill"},{"key":"2026071602100834000_102.5.322.9","doi-asserted-by":"crossref","unstructured":"Mortimer TD , Grad YH . A genomic perspective on the near-term impact of doxycycline postexposure prophylaxis on. medRxiv 2023. doi:10.1101\/2023.03.14.23287223","DOI":"10.1101\/2023.03.14.23287223"},{"key":"2026071602100834000_102.5.322.10","unstructured":"Haaland R , Fountain J , Dinh C , et al . Mucosal Pharmacology of Doxycycline for Bacterial STI Prevention in Men and Women. Conference on Retroviruss and Opportunistic Infections (CROI); Seattle, Washington. Abstract 118, 2023"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056674","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:10:21Z","timestamp":1784193021000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":10,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/sextrans-2025-056674"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056674","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]}}}