Doxycycline does not prevent STIs among cisgender women
2023-02-20
(Press-News.org) February 20, 2023 – Researchers from the University of Washington (UW), Kenya Medical Research Institute (KEMRI), and Hennepin Healthcare Research Institute (HHRI) announced results at CROI from a clinical trial demonstrating that doxycycline taken after sex does not prevent bacterial sexually transmitted infections (STIs) – chlamydia or gonorrhea – among cisgender women. The dPEP Kenya Trial was conducted in Kisumu, Kenya, to evaluate the effectiveness of doxycycline postexposure prophylaxis (PEP) to prevent bacterial STIs. The results of the study have been highly anticipated, as this is the first study of doxycycline PEP among cisgender women, following multiple studies that showed a high level of STI protection with doxycycline use among cisgender men and transgender women in France and the United States.
Differences in anatomy, antibiotic resistance, and adherence offer possible explanations for the lack of efficacy among cisgender women when it worked for cisgender men and transgender women, and the research team is working to understand the potential role of these differences. “Doxycycline PEP didn’t work for cisgender women in Kenya, but the need for STI prevention is increasing around the world,” said Dr. Jenell Stewart, the dPEP Kenya Study Director, Infectious Disease Physician at Hennepin Healthcare and University of Minnesota.
Biological differences between the vagina/cervix and rectum may explain why doxycycline didn’t prevent STIs in cisgender women; however, the approach to treatment of STIs doesn’t differ by sex. Antibiotic resistance offers an explanation for why gonorrhea wasn’t prevented, but it doesn’t explain why chlamydia wasn’t prevented. There are no known cases of antibiotic resistant chlamydia; however, the rate of doxycycline resistant gonorrhea was very high, including 100% of the infections acquired prior to starting the study. Self-reported adherence was high but imperfect and frequency and timing of doxycycline use among cisgender women in the trial is being evaluated further. All participants were also taking daily HIV PrEP pills (a medicine to prevent HIV), and none of the participants got HIV during the year they were in the study.
At a single site in Kisumu, Kenya, the study enrolled 449 cisgender women who were taking daily oral HIV pre-exposure prophylaxis (PrEP) and were randomized to receive doxycycline or standard of care. 18% of participants had an STI at the time they entered the study and over the course of the study the rate of STIs remained high – an annual incidence of 27%, which is comparable to rates among men who have sex with men in high income countries. There were 109 new STIs diagnosed, 50 among those using doxycycline PEP compared to 59 among those randomized to no doxycycline and standard of care, during the course of the 12-month follow-up. Most, 78%, of the new STIs diagnosed were chlamydia, 35 among people taking doxycycline PEP and 50 among standard of care, which was not statistically different. Only one new case of syphilis was diagnosed in this study, consistent with other studies in the region, and therefore, the impact of doxycycline PEP on preventing syphilis among cisgender women could not be evaluated.
“The results from the study are deeply disappointing, and we are committed to understanding why doxycycline PEP did not work in this population and also determining the next steps for how to identify prevention tools that will work for and can be used by women,” said Prof. Elizabeth Bukusi, a Principal Investigator of the dPEP Kenya Trial and Senior Principal Clinical Research Scientist at the Kenya Medical Research Institute.
Bacterial STIs in women can lead to lasting and severe consequences including pelvic inflammatory disease, chronic pain, infertility, pregnancy complications, and increased susceptibility to HIV. While the study team continues to investigate the potential role of biological and behavioral differences to explain why doxycycline PEP did not work, it is clear that cisgender women need primary STI prevention strategies.
The trial was funded by the National Institutes of Health (R01AI145971, P30AI027757, K23MH124466) and was conducted at the KEMRI Lumumba site in Kisumu, Kenya. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
###
About Hennepin Healthcare Research Institute
Founded in 1952, Hennepin Healthcare Research Institute (HHRI) supports and administers the medical research conducted at HCMC, the acute care research and teaching hospital of the Hennepin Healthcare System. HHRI supports the work of more than 250 researchers and staff, including MDs, MD/PhDs, PhDs, and PharmDs, and consistently ranks in the top 10 percent of all institutions receiving research funds from the National Institutes of Health. For more information about research at HHRI, visit www.hhrinstitute.org or Twitter @hhrinstitute.
Media Contact
Susan O’Reilly
Corporate Communications Director
Hennepin Healthcare Research Institute
soreilly@hhrinstitute.org
612.873.5321
END
ELSE PRESS RELEASES FROM THIS DATE:
2023-02-20
Geckos can use their tongue to differentiate their own odor from that of other members of their species, as researchers from the University of Bern have shown in a new experimental study. The findings show that geckos are able to communicate socially, meaning that they are more intelligent than was previously assumed.
Self-recognition is the ability to detect stimuli which come from oneself. We as people, and also some animals, can identify ourselves visually when we look in the mirror. However, not all animals rely on their sense of sight, first and foremost. Geckos, and also other lizards ...
2021-07-26
Government officials and policymakers have tried to use numbers to grasp COVID-19's impact. Figures like the number of hospitalizations or deaths reflect part of this burden. Each datapoint tells only part of the story. But no one figure describes the true pervasiveness of the novel coronavirus by revealing the number of people actually infected at a given time -- an important figure to help scientists understand if herd immunity can be reached, even with vaccinations.
Now, two University of Washington scientists have developed a statistical framework that incorporates key COVID-19 data -- such as case counts and deaths due to COVID-19 -- to model the true prevalence of this disease in the United States and individual states. Their approach, published the ...
2021-07-26
New research has identified potential treatment that could improve the human immune system's ability to search out and destroy cancer cells within the body. Scientists have identified a way to restrict the activity of a group of cells which regulate the immune system, which in turn can unleash other immune cells to attack tumours in cancer patients.
"A patient's immune system is more than able to detect and remove cancer cells and immunotherapy has recently emerged as a novel therapy for many different types of cancers." Explained Nullin Divecha, Professor of Cell Signalling at the University of Southampton who led the study. "However, cancer cells can generate a microenvironment ...
2021-07-26
Research published in the Proceedings of the National Academy of Sciences describes a new type of liquid in thin films, which forms a high-density glass. Results generated in this study, conducted by researchers in Penn's Department of Chemistry, demonstrate how these glasses and other similar materials can be fabricated to be denser and more stable, providing a framework for developing new applications and devices through better design.
Glass is typically created through solidification, or falling out of equilibrium, of a liquid when it is cooled to a temperature where its motion arrests. The structure of a glass closely ...
2021-07-26
Mice exposed to the opioid oxycodone before birth experience permanent changes in behavior and gene expression. The new research published in eNeuro highlights a need to develop safer types of painkillers for pregnant women.
Opioids like oxycodone are prescribed to pregnant women to treat pain, but the drugs may affect the fetus, too. Opioids can pass through the placenta, binding to receptors in the fetal brain, which can lead to opioid withdrawal in newborn babies. The long-term consequences of prenatal opioid exposure haven't been fully studied, however.
To explore this, Martin et al. administered oxycodone to female mice every day for the two weeks prior ...
2021-07-26
A new MIT study of how a mammalian brain remembers what it sees shows that while individual images are stored in the visual cortex, the ability to recognize a sequence of sights critically depends on guidance from the hippocampus, a deeper structure strongly associated with memory but shrouded in mystery about exactly how.
By suggesting that the hippocampus isn't needed for basic storage of images so much as identifying the chronological relationship they may have, the new research published in Current Biology can bring neuroscientists closer to understanding how the brain coordinates long-term visual memory across key regions.
"This offers the ...
2021-07-26
What The Study Did: Researchers examined the safety of the second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccines in patients who experienced an allergic reaction to the first dose.
Authors: Kimberly G. Blumenthal, M.D., M.Sc., of Massachusetts General Hospital in Boston, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamainternmed.2021.3779)
Editor's Note: The article includes conflicts of interest and funding and support disclosures. ...
2021-07-26
What The Study Did: The association between Medicare eligibility at age 65 and changes in racial and ethnic disparities in access to care and self-reported health was evaluated in this study.
Authors: Jacob Wallace, Ph.D., of the Yale School of Public Health in New Haven, Connecticut, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamainternmed.2021.3922)
Editor's Note: The article includes conflicts of interest and funding and support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
INFORMATION:
Media advisory: The full study and ...
2021-07-26
What The Study Did: Survey data were used to investigate the relationship between loneliness and high-risk medication use in adults older than age 65.
Authors: Ashwin A. Kotwal, M.D., M.S., of the University of California, San Francisco School of Medicine, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamainternmed.2021.3775)
Editor's Note: The article includes conflicts of interest and funding and support disclosures. Please see the article for additional information, including other authors, author contributions ...
2021-07-26
Lonely, older adults are nearly twice as likely to use opioids to ease pain and two-and-a-half times more likely to use sedatives and anti-anxiety medications, putting themselves at risk for drug dependency, impaired attention, falls and other accidents, and further cognitive impairment, according to a study by researchers at UC San Francisco.
The study found that just over half of 6,000 respondents in a nationally representative survey of seniors living independently were not lonely, while 40 percent were moderately lonely, and 7 percent were highly lonely.
The proportion of seniors ...
LAST 30 PRESS RELEASES:
[Press-News.org] Doxycycline does not prevent STIs among cisgender women
