Breaking News: Doxycycline After Sex Reduces STIs (DoxyPEP)

[BootmanLA]

8 hours ago, bluewind said:

Doesn't it completely wreck your bowel biome? 

As I understand the studies that have been done, if you take doxycycline at the doses recommend for treating active infections, it can indeed impact some (though not all) of the bacteria normally present in the digestive tract. When taken at lower doses - which may or may not be what is prescribed off-label for prophylactic use - the changes were less dramatic.  See, for instance, [think before following links] https://bmjopen.bmj.com/content/10/9/e035677 for a summation of studies of various antibiotics and their effect on bacteria in the human gut.

But in general: yes, this is another concern with overuse of antibiotics prophylactically. 

[Guest]

16 hours ago, BootmanLA said:

As I understand the studies that have been done, if you take doxycycline at the doses recommend for treating active infections, it can indeed impact some (though not all) of the bacteria normally present in the digestive tract. When taken at lower doses - which may or may not be what is prescribed off-label for prophylactic use - the changes were less dramatic.  See, for instance, [think before following links] [think before following links] https://bmjopen.bmj.com/content/10/9/e035677 for a summation of studies of various antibiotics and their effect on bacteria in the human gut.

But in general: yes, this is another concern with overuse of antibiotics prophylactically. 

Thanks for your detailed answer.

Note I'm not against the procedure per se (I'm on Prep after all, which has side effects like everything in this world), it's just that the biome is so important to someone's health and wellbeing in ways we probably don't fully realize. Tough choice.

 

 

 

[cx2117]

I started doing this with some leftover doxy pills that I have, they expired in September so less than a month. I know there’s a lot of info out there that says never use expired pills but im thinking they’re talking about expired for over a few months. It helps i saw that the FDA signed some extension for 6 months on using expired doxy pills when there was a shortage a while ago.

anyway, I have enough to try this for about a month, getting seeded twice a week with as many loads as possible. this first weekend I took 20 raw loads at the bathhouse with most of them being anonymous, sucked countless cocks and rimmed a few freshly seeded holes. 
 

Sorta excited to see if this actually works or not. I take the 2x100mg the same night after I get home right before bed

the only question is if this does work, how do I tell my doctor I’ve been experimenting with doxy lol

[Pozpunk]

Even though some of it is really stupid, like the doxy for skin breakouts should not be a permanent medicine taken, it’s not good long term as it kills good bacteria as well as bad, can’t imagine it being used for prep, why are we talking about prep!! How you expect to get knocked up on prep?😆

[cx2117]

On 3/16/2020 at 3:49 AM, Spunkinmyarse said:

Anecdotally, I would agree that it works.  After a heavy session at a cruise club or sex party, I wait 24 hours and then take 2 x 100mg pills of doxy together.  Since I started this approach, I haven’t had syph or chlamydia at all, though I have had gonno twice.  I’ve just recently tested again after the 6 ‘busiest’ months of my life (including party trips to New York/Montreal and Gran Canaria, as well as the usual London merry-go-round) and have somewhat miraculously come away with no infections at all.

Just out of curiosity why do you wait 24 hours before taking it? I’ve been taking it immediately after (the night of a big sex party before bed)

[fskn]

"[O]n May 13, 2022 our Data Safety Monitoring Board (DSMB) had a scheduled review at the midway point of the study, and the results showed that participants in the DoxyPEP study who were randomized to take doxycycline as a single dose after condomless sex were much less likely to be diagnosed with a new sexually transmitted infection (STI), compared with participants who were not assigned to take doxycycline PEP. This level of efficacy is exciting news."

Enrollment is closing early. Current participants who didn't get doxycycline now have the option. Everyone will continue to be monitored for the planned 12-month period, because...

"[W]e also need to learn about antimicrobial resistance which is part of the DoxyPEP study aims, specifically about the impact of intermittent doxycycline on the risk for drug resistance in bacterial STIs, on bacteria that often live on the body like Staph aureus and Neisseria and on the bacteria that live in the gut. This information is not yet available and will be important to understand the pros and cons of taking doxycycline as post-exposure prophylaxis."

As a study participant I received the announcement a few hours ago. I'll update this thread when a public announcement comes out.

• PEP means Post-Exposure Prophylaxis, in other words, taking protective medication after a risky activity.

• PrEP means Pre-Exposure Prophylaxis, in other words, taking protective medication before a risky activity.

PEP for HIV has been available for more than two decades, and is for emergencies like needlesticks or unusually risky sex. PrEP for HIV has been available for a decade and is familiar by now.

DoxyPEP and other research might lead to PEP for bacterial STIs someday.

[BBBxCumDumpster]

Thank you for sharing that information!

[Oldercumslut]

Official publication date is in July but here is original release 

 

[think before following links] https://www.ucsf.edu/news/2022/05/422911/doxycycline-after-unprotected-sex-significantly-reduced-stis

[fskn]

Many thanks, @Oldercumslut!

[blackrobe]

How do you get access to Doxy if you want to begin taking it?

It requires a prescription and doctors are still catching up on PrEP (which has been long approved). Anyone doing this already?

[fskn]

On 6/1/2022 at 6:48 AM, blackrobe said:

How do you get access to Doxy if you want to begin taking it?

It requires a prescription and doctors are still catching up on PrEP (which has been long approved). Anyone doing this already?

It would require a discussion with your doctor (or other professional licensed in your state to prescribe medications, perhaps a nurse practitioner or physician's assistant). Discussion is especially important because this would be an "off-label" use.

If your medical provider is aware of gay (and trans) sexual behavior, is humble enough to seek new information, perhaps by contacting one of the DoxyPEP principal investigators, and is flexible, you might be able to move to a conversation about whether this approach is right for you. If you receive a flat-out refusal, see if you can find a doctor who has experience serving GLBT patients, or go to a community clinic with that focus.

Here is the "provider letter" being given to study participants, for us to pass on to our regular doctors. My doctor was happy to prescribe doxycycline. I'd love to hear, via this thread, from other people who have asked for and/or received doxycycline for STI PEP.

The evidence of efficacy from the DoxyPEP study was so strong that the experiment ended early, and participants not assigned to receive doxycycline will have the option. Separately, because doxycycline has been available for so many decades and is so widely used, there is plenty of evidence about its safety, side effects, and risks. There is also lots of evidence about the risks of antibiotics generally. (The DoxyPEP researchers are continuing to monitor study participants, to look for any antibiotic resistance patterns.)

A recommendation to use doxycycline for STI PEP would take a long time and a label change, even longer — if either outcome ever happens.

This doesn't mean access should be or will be impossible. For example, intermittent or "2-1-1" Truvada for HIV PrEP is supported by research and has been added to the CDC PrEP guidelines, even though the product hasn't been relabeled. When Truvada for PrEP is prescribed with less than daily dosing, that's an evidence-based but nevertheless off-label use.

Good luck!

[kinkatx]

On 6/1/2022 at 8:48 AM, blackrobe said:

How do you get access to Doxy if you want to begin taking it?

It requires a prescription and doctors are still catching up on PrEP (which has been long approved). Anyone doing this already?

I’ve ordered it from All Day Chemist before  and took care of an STI myself with test to confirm. Bloodwork showed antibodies but no infection… my doctor was like “so what did you do?” 

[leaker30]

mmm. I'm on 50mg of it now for an unrelated condition.

So if I went to the bath house, and took 4 pills after (50mg x4=200mg) I would most likely avoid an STI?

I'm going to be away from home for 6 months for training for a new job and I wanted to check out the bathhouse there while I'm gone. But I've been hesitant b/c I can't afford the time to go to a health clinic in a different city if I got something

 

[ErosWired]

On 5/20/2022 at 9:22 PM, fskn said:

"[W]e also need to learn about antimicrobial resistance which is part of the DoxyPEP study aims, specifically about the impact of intermittent doxycycline on the risk for drug resistance in bacterial STIs, on bacteria that often live on the body like Staph aureus and Neisseria and on the bacteria that live in the gut. This information is not yet available and will be important to understand the pros and cons of taking doxycycline as post-exposure prophylaxis."

This is the part that concerns me. The evidence that overuse of antibiotics in general for many purposes may be leading to a rise in antimicrobial resistant “superbugs” has been in the news for several years. The fact that the information is lacking on the potential for a widespread prophylactic use of doxycycline to generate doxycycline resistance should counsel prudence on adopting it as a strategy. If it ends up creating strains that render it useless, then jumping on board with it because it is effective for the short term would be short-sighted.

[fskn]

19 hours ago, kinkatx said:

I’ve ordered it from All Day Chemist before  and took care of an STI myself with test to confirm. Bloodwork showed antibodies but no infection… my doctor was like “so what did you do?” 

That is totally different. It's treatment rather than prevention, and one-time rather than routine.

Self-treatment is risky because even if a person could be certain of having a particular infection, appropriate treatment for bacterial STIs is complex and ever-changing.

The US guidelines for treating gonorrhea have changed within recent memory, for example.

This is not to say that treatment strategies that give patients more control are bad, when used in cooperation with medical professionals.

For example, US guidelines have long recommended "expedited partner therapy" (EPT). A patient can ask for extra doses of STI treatment medication to hand directly to sexual partners. That's a great way to reach people who do not have access to medical care or who simply would not go in for testing and treatment. A new California law specifically encourages partner treatment.

US guidelines also recommend treatment for presumed infections, especially when available diagnostic tools are limited. The risk that a patient who has to wait days or weeks won't receive the test result, let alone return for treatment, is high. Once again, though, a medical professional is involved.

Last but not least, the role of telemedicine is growing, but medical professionals must still arrange for patients to get tested, whether by going to a laboratory, by collecting specimens at home and mailing them in, by taking rapid self-tests under observation, or by taking rapid self-tests without online supervision.

References:

• See "Antimicrobial-Resistant N. gonorrhoeae" in [think before following links] https://www.cdc.gov/std/treatment-guidelines/gonorrhea-adults.htm

• [think before following links] https://www.cdc.gov/std/treatment-guidelines/clinical-EPT.htm

• [think before following links] https://sd06.senate.ca.gov/news/2021-10-05-governor-signs-sb-306-tackle-sti-crisis

• Search for "presumptive" in [think before following links] https://www.cdc.gov/std/treatment-guidelines/urethritis-and-cervicitis.htm

• See "Providing PrEP by Telehealth" on p. 40 of [think before following links] https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf