A morning-after pill treatment for sexually transmitted infections may not be effective at preventing disease in biological women, according to a new publication from the National Institute of Allergy and Infectious Diseases.
The prophylactic treatment with the antibiotic doxycycline had been recommended in October by the Centers for Disease Control and Prevention for biological males who have sex with other men to prevent the spread of gonorrhea, chlamydia, and syphilis.
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But a NIAID-funded study published Wednesday in the New England Journal of Medicine found that the treatment, known as DoxyPREP, did not prevent STIs in biological women. This contrasts with the findings in United States studies that found the treatment to be successful among males engaging in homosexual intercourse.
The study was conducted among Kenyan women at high risk for contracting HIV. Researchers postulate several reasons for the findings, including low compliance with taking the medication as instructed and antibiotic-resistant strains of bacteria that cause gonorrhea.
Doxycycline was developed first by Pfizer in the early 1960s and has been used to treat a variety of diseases, including malaria, Lyme disease, and severe acne. The powerful antibiotic is also the first-line treatment for chlamydia and an alternative treatment for syphilis for those who are allergic to penicillin.
CDC documentation from October indicated that at least one randomized trial of females taking DoxyPREP failed to show the benefits of the medication for biological women.
NIAID Director Jeanne Marrazzo published an editorial accompanying the study stressing the importance of better incorporating biological women into further studies on STI acquisition and treatment.
In her editorial, Marrazzo specifically highlighted the need to examine how different treatments “perform in cervicovaginal versus rectal tissues” and take into account sexual activity preferences and power dynamics in heterosexual relationships.
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Marrazzo, appointed to the position in August, is the first female director of one of the largest branches of the National Institutes of Health. Newly sworn-in NIH Director Monica Bertagnolli is also the first woman to lead the agency in a permanent capacity.
“NIH strives to increase the meaningful inclusion of diverse and representative populations in the planning, conduct, and translation of clinical research so that everyone can enjoy the benefits of scientific progress and its applications,” according to the agency’s press statement.
