Does doxycycline post exposure prophylaxis prevent sexually transmitted Infections in women and achieve minimum Inhibitory concentrations in vaginal Mucosa?: a population - based prospective cohort

Prieto Sánchez, Paula
BACKGROUND: Sexually transmitted infections (STIs) present an increasing public health concern. The incidence of these diseases has risen markedly in recent decades due to unprotected sexual activity. One of the main problems with STIs is that a large number of cases go untreated and undiagnosed, which contributes to the spread of new cases. Moreover, STIs can lead to significant health complications, including those related to childbirth, and can have permanent effects such as infertility. Currently, there are two studies investigating the use of Doxycycline for postexposure treatment against sexually transmitted infections, namely Syphilis, Chlamydia, and Gonorrhoea. These studies demonstrate the effectiveness of Doxycycline against these pathogens. However, it should be noted that while Doxy-PEP effectively reduces infection rates in men, it is less effective for women as illustrated in the study involving Kenian cisgender women. OBJECTIVE: The aim of this research is to demonstrate the efficacy of postexposure doxycycline against chlamydia, syphilis and gonorrhoea in sexually active women and to assess the concentration of doxycycline in different tissues. DESIGN AND SETTINGS: The study is a single-arm prospective cohort study carried out in ten hospitals to investigate the incidence of STIs and tissue concentration of doxycycline. PARTICIPANTS: The research project will include adult women who have experienced an STI in the past year and attend the clinic for an annual screening while continuing to engage in unprotected sexual activity. Additionally, the study will involve women who use HIV-PrEP (pre-exposure prophylaxis). METHODS: Over the course of one year, 353 participants will be enrolled using a non-probability consecutive sampling technique. These participants will undergo STI and pregnancy screening at the clinic and will be given a 200mg dose of doxycycline to take at home. Patients will be instructed to take Doxy-PEP within 72 hours of engaging in unprotected sexual intercourse. Participants will be asked to return to the clinic within 48 hours of taking the tablet for swabs and biopsies to measure doxycycline levels in different tissues. They will also be tested for sexually transmitted infections at their clinic visit 3 weeks later ​
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