{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:10:53Z","timestamp":1787962253558,"version":"build-2784847793"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T00:00:00Z","timestamp":1685750400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T00:00:00Z","timestamp":1685750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and incidence of both curable STIs and HIV. The use of doxycycline as a prophylaxis to prevent STIs is promising; however, clinical trials, to date, have only been conducted among men who have sex with men (MSM) in high-income settings. We describe the characteristics of participants enrolled in the first trial to determine the efficacy of doxycycline post-exposure prophylaxis (PEP) to reduce STI incidence among women taking daily, oral HIV pre-exposure prophylaxis (PrEP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is an open-label 1:1 randomized clinical trial on the efficacy of doxycycline PEP compared with standard of care (e.g., quarterly STI screening and treatment) to reduce incident bacterial STIs \u2013\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      ,\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      , and\n                      <jats:italic>Treponema pallidum<\/jats:italic>\n                      \u2013 among Kenyan women aged \u226518 and \u226430 years. All were also taking HIV pre-exposure prophylaxis (PrEP). We describe the baseline characteristics, STI prevalence, and STI risk perception of participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between February 2020 and November 2021, 449 women were enrolled. The median age was 24 years (IQR 21\u201327), the majority were never married (66.1%), 370 women (82.4%) reported having a primary sex partner, and 33% had sex with new partners in the three months prior to enrolment. Two-thirds (67.5%, 268 women) did not use condoms, 36.7% reported transactional sex, and 43.2% suspected their male partners of having sex with other women. Slightly less than half (45.9%, 206 women) were recently concerned about being exposed to an STI. The prevalence of STIs was 17.9%, with\n                      <jats:italic>C. trachomatis<\/jats:italic>\n                      accounting for the majority of infections. Perceived risk of STIs was not associated with the detection of an STI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Young cisgender women using HIV PrEP in Kenya and enrolled in a trial of doxycycline postexposure prophylaxis had a high prevalence of curable STIs and represent a target population for an STI prevention intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12905-023-02413-0","type":"journal-article","created":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T13:01:18Z","timestamp":1685797278000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Characteristics of Kenyan women using HIV PrEP enrolled in a randomized trial on doxycycline postexposure prophylaxis for sexually transmitted infection prevention"],"prefix":"10.1186","volume":"23","author":[{"given":"Kevin","family":"Oware","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Adiema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Rono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Violette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Scott","family":"McClelland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin W.","family":"Scoville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Odoyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared M.","family":"Baeten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bukusi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenell","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,3]]},"reference":[{"key":"2413_CR1","unstructured":"Organization WH, World Health Organization. Global health sector strategy on sexually transmitted infections, 2016\u20132021: Towards ending STIs. WHO\/RHR\/1609 Geneva WHO; [Internet]. 2016 [cited 2022 Feb 22];20(1):58\u201363. Available from: https:\/\/www.who.int\/reproductivehealth\/publications\/rtis\/ghss-stis\/en\/."},{"key":"2413_CR2","doi-asserted-by":"crossref","unstructured":"Korenromp EL, Rowley J, Alonso M, Mello MB, Saman Wijesooriya N, Guy Mahian\u00e9 S et al. Global burden of maternal and congenital syphilis and associated adverse birth outcomes\u2014Estimates for 2016 and progress since 2012. PLoS One. 2019 Feb 1;14(2).","DOI":"10.1371\/journal.pone.0211720"},{"key":"2413_CR3","doi-asserted-by":"crossref","unstructured":"Unemo M, Lahra MM, Escher M, Eremin S, Cole MJ, Galarza P et al. WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017\u201318: a retrospective observational study. The Lancet Microbe. 2021 Nov 1;2(11):e627\u201336.","DOI":"10.1016\/S2666-5247(21)00171-3"},{"key":"2413_CR4","doi-asserted-by":"crossref","unstructured":"Amornkul PN, Vandenhoudt H, Nasokho P, Odhiambo F, Mwaengo D, Hightower A et al. HIV prevalence and associated risk factors among individuals aged 13\u201334 years in rural Western Kenya. PLoS ONE. 2009;4(7).","DOI":"10.1371\/journal.pone.0006470"},{"key":"2413_CR5","doi-asserted-by":"crossref","unstructured":"Stewart J, Bukusi E, Celum C, Delany-Moretlwe S, Baeten JM. Sexually transmitted infections among African women: an opportunity for combination sexually transmitted infection\/HIV prevention. AIDS [Internet]. 2020 Apr 1 [cited 2022 Feb 9];34(5):651\u20138. https:\/\/pubmed.ncbi.nlm.nih.gov\/32167988\/.","DOI":"10.1097\/QAD.0000000000002472"},{"key":"2413_CR6","doi-asserted-by":"crossref","unstructured":"Stephens AJ, Aubuchon M, Schust DJ. Antichlamydial antibodies, human fertility, and pregnancy wastage. Infect Dis Obstet Gynecol. 2011;2011.","DOI":"10.1155\/2011\/525182"},{"issue":"11","key":"2413_CR7","doi-asserted-by":"publisher","first-page":"858","DOI":"10.2471\/BLT.08.059212","volume":"87","author":"R Steen","year":"2009","unstructured":"Steen R, Wi TE, Kamali A, Ndowa F. Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm. Bull World Health Organ. 2009;87(11):858\u201365.","journal-title":"Bull World Health Organ"},{"issue":"2","key":"2413_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pmed.1002512","volume":"15","author":"SC Francis","year":"2018","unstructured":"Francis SC, Mthiyane TN, Baisley K, Mchunu SL, Ferguson JB, Smit T, et al. Prevalence of sexually transmitted infections among young people in South Africa: a nested survey in a health and demographic surveillance site. PLoS Med. 2018;15(2):1\u201325.","journal-title":"PLoS Med"},{"key":"2413_CR9","doi-asserted-by":"publisher","unstructured":"Torrone EA, Morrison CS, Chen P-L, Kwok C, Francis SC, Hayes RJ et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. London Sch Hyg Trop Med [Internet]. 360. https:\/\/doi.org\/10.1371\/journal.pmed.1002511.","DOI":"10.1371\/journal.pmed.1002511"},{"key":"2413_CR10","unstructured":"Molina J-M, Charreau I, Chidiac C, Pialoux G, Cua E, Delaugerre C et al. Post-exposure 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. Lancet Infect Dis [Internet]. 2018;18:308\u201317. http:\/\/dx.doi.org\/10.1016\/."},{"issue":"4","key":"2413_CR11","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1097\/QAD.0b013e32834ed991","volume":"26","author":"R Steen","year":"2012","unstructured":"Steen R, Chersich M, Gerbase A, Neilsen G, Wendland A, Ndowa F, et al. Periodic presumptive treatment of curable sexually transmitted infections among sex workers: a systematic review. Aids. 2012;26(4):437\u201345.","journal-title":"Aids"},{"issue":"12","key":"2413_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/jamanetworkopen.2019.17134","volume":"2","author":"JJ Ong","year":"2019","unstructured":"Ong JJ, Baggaley RC, Wi TE, Tucker JD, Fu H, Smith MK, et al. Global epidemiologic characteristics of sexually transmitted infections among individuals using preexposure Prophylaxis for the Prevention of HIV infection: a systematic review and Meta-analysis. JAMA Netw Open. 2019;2(12):1\u201316.","journal-title":"JAMA Netw Open"},{"key":"2413_CR13","doi-asserted-by":"crossref","unstructured":"Celum C, Luetkemeyer AF. Doxycycline for Sexually Transmitted Infection Prevention: Evolving Evidence and Implementation Perspectives. Sex Transm Dis [Internet]. 2021 Sep 1 [cited 2022 Feb 22];48(9):620\u20131. https:\/\/journals.lww.com\/stdjournal\/Fulltext\/2021\/09000\/Doxycycline_for_Sexually_Transmitted_Infection.2.aspx.","DOI":"10.1097\/OLQ.0000000000001501"},{"issue":"4","key":"2413_CR14","doi-asserted-by":"publisher","first-page":"517","DOI":"10.4269\/ajtmh.2011.10-0285","volume":"84","author":"KR Tan","year":"2011","unstructured":"Tan KR, Magill AJ, Parise ME, Arguin PM. Doxycycline for malaria chemoprophylaxis and treatment: report from the CDC expert meeting on malaria chemoprophylaxis. Am J Trop Med Hyg. 2011;84(4):517\u201331.","journal-title":"Am J Trop Med Hyg"},{"key":"2413_CR15","doi-asserted-by":"crossref","unstructured":"Chusri S, McNeil EB, Hortiwakul T, Charernmak B, Sritrairatchai S, Santimaleeworagun W, et al. Single dosage of doxycycline for prophylaxis against leptospiral infection and leptospirosis during urban flooding in southern Thailand: a non-randomized controlled trial. J Infect Chemother. 2014 Nov;20(1):709\u201315.","DOI":"10.1016\/j.jiac.2014.07.016"},{"issue":"3","key":"2413_CR16","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1097\/QAI.0b013e3182926795","volume":"63","author":"JS Santelli","year":"2013","unstructured":"Santelli JS, Edelstein ZR, Mathur S, Wei Y, Zhang W, Orr MG, et al. Behavioral, biological, and demographic risk and protective factors for new HIV infections among youth in Rakai, Uganda. J Acquir Immune Defic Syndr. 2013;63(3):393\u2013400.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"5","key":"2413_CR17","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1097\/QAI.0000000000000362","volume":"67","author":"A Corneli","year":"2014","unstructured":"Corneli A, Wang M, Agot K, Ahmed K, Lombaard J, Van Damme L. Perception of HIV risk and adherence to a daily, investigational pill for HIV prevention in FEM-PrEP. J Acquir Immune Defic Syndr. 2014;67(5):555\u201363.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"2413_CR18","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1097\/QAI.0000000000001567","volume":"77","author":"JT Price","year":"2018","unstructured":"Price JT, Rosenberg NE, Vansia D, Phanga T, Bhushan NL, Maseko B, et al. Predictors of HIV, HIV Risk Perception, and HIV worry among adolescent girls and Young Women in Lilongwe, Malawi. J Acquir Immune Defic Syndr. 2018;77(1):53\u201363.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"1","key":"2413_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2018-022510","volume":"9","author":"MM R\u00f6nn","year":"2019","unstructured":"R\u00f6nn MM, Mc Grath-Lone L, Davies B, Wilson JD, Ward H. Evaluation of the performance of nucleic acid amplification tests (NAATs) in detection of chlamydia and gonorrhoea infection in vaginal specimens relative to patient infection status: a systematic review. BMJ Open. 2019;9(1):1\u20139.","journal-title":"BMJ Open"},{"key":"2413_CR20","doi-asserted-by":"crossref","unstructured":"Nakku-Joloba E, Kiragga A, Mbariza J, Kambugu F, Jett-Goheen M, Ratanashi R. Clinical Evaluation of Two Point-Of-Care Lateral Flow Tests for the Diagnosis of Syphilis. Sex Transm Dis [Internet]. 2016;43(10):623\u20135. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5026394\/.","DOI":"10.1097\/OLQ.0000000000000498"},{"key":"2413_CR21","doi-asserted-by":"publisher","unstructured":"Stewart J, Bukusi E, Sesay FA et al. Doxycycline post-exposure prophylaxis for prevention of sexually transmitted infections among Kenyan women using HIV pre-exposure prophylaxis: study protocol for an open-label randomized trial. Trials. 2022;23:495 (2022). https:\/\/doi.org\/10.1186\/s13063-022-64.","DOI":"10.1186\/s13063-022-64"},{"key":"2413_CR22","doi-asserted-by":"crossref","unstructured":"Grant JS, Stafylis C, Celum C, Grennan T, Haire B, Kaldor J et al. Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections. Clin Infect Dis [Internet]. 2020 Mar 3 [cited 2022 Mar 11];70(6):1247\u201353. https:\/\/pubmed.ncbi.nlm.nih.gov\/31504345\/.","DOI":"10.1093\/cid\/ciz866"},{"issue":"S6","key":"2413_CR23","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1002\/jia2.25346","volume":"22","author":"R Mwatelah","year":"2019","unstructured":"Mwatelah R, McKinnon LR, Baxter C, Abdool Karim Q, Abdool Karim SS. Mechanisms of sexually transmitted infection-induced inflammation in women: implications for HIV risk. J Int AIDS Soc. 2019;22(S6):32\u20139.","journal-title":"J Int AIDS Soc"},{"key":"2413_CR24","doi-asserted-by":"crossref","unstructured":"Yuh T, Micheni M, Selke S, Oluoch L, Kiptinness C, Magaret A et al. Sexually Transmitted Infections Among Kenyan Adolescent Girls and Young Women With Limited Sexual Experience. Front Public Heal [Internet]. 2020 Jul 14 [cited 2022 Feb 9];8. https:\/\/www.readcube.com\/articles\/10.3389%2Ffpubh.2020.00303.","DOI":"10.3389\/fpubh.2020.00303"},{"key":"2413_CR25","doi-asserted-by":"publisher","unstructured":"Madiba S, Ngwenya N. Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa. https:\/\/doi.org\/101080\/1654971620171341597 [Internet]. 2017 [cited 2022 Feb 23];10(sup2). https:\/\/www.tandfonline.com\/doi\/abs\/https:\/\/doi.org\/10.1080\/16549716.2017.1341597.","DOI":"10.1080\/16549716.2017.1341597"},{"key":"2413_CR26","doi-asserted-by":"crossref","unstructured":"Chesson HW, Mayaud P, Aral SO. Sexually Transmitted Infections: Impact and Cost-Effectiveness of Prevention. Dis Control Priorities, Third Ed (Volume 6) Major Infect Dis [Internet]. 2017 Nov 6 [cited 2022 Feb 9];203\u201332. https:\/\/pubmed.ncbi.nlm.nih.gov\/30212101\/.","DOI":"10.1596\/978-1-4648-0524-0_ch10"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02413-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-023-02413-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02413-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T13:01:21Z","timestamp":1685797281000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-023-02413-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,3]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2413"],"URL":"https:\/\/doi.org\/10.1186\/s12905-023-02413-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2027989\/v1","asserted-by":"object"}]},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,3]]},"assertion":[{"value":"3 September 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. McClelland has received honoraria for consulting for Lupin Pharmaceuticals and research funding, paid to the University of Washington, from Hologic Corporation. Dr. Baeten is an employee of Gilead Sciences outside of the submitted work. The author and all other co-authors do not have any declared conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Ethics approval was received from all pertinent approving bodies in Kenya and the USA: University of Washington\u2019s Institutional Review Board (UW IRB STUDY00007487), Kenya Medical Research Institute Scientific Ethics Review Unit (KEMRI SERU P00122\/3915), and Pharmacy and Poisons Board (PPB ECCT 19\/11\/02\/2020(013). Written informed consent to participate in the study was obtained from all participants and legal guardians of the illiterate participants before enrolment. All methods were carried out in accordance with relevant guidelines and regulations of the Kenyan Ministry of Health.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable\u2014no identifying images or other personal or clinical details of participants are presented here or will be presented in reports of the trial results.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"296"}}