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Emergency Medicine

Doxycycline Postexposure Prophylaxis and Sexually Transmitted Infections

To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: September 22, 2023

JAMA Insights

Article Information and Disclosures

Kenneth H. Mayer, MD^1,2;

Michael Traeger, PhD^3,4;

Julia L. Marcus, PhD^1,4

Author Affiliations

¹The Fenway Institute, Fenway Health, Boston, Massachusetts
²Harvard Medical School, Harvard University, Boston, Massachusetts
³Burnet Institute, Melbourne, Victoria, Australia
⁴Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts

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Bacterial and protozoal sexually transmitted infections (STIs) cause more than 1 million treatable STIs daily worldwide.¹ Bacterial STIs can cause significant morbidity. Syphilis can cause meningitis, deafness, blindness, and congenital sequelae, including stillbirth and neonatal death. Chlamydia or gonorrheal infection can cause infertility. Although most bacterial STIs are treatable with accessible and inexpensive antibiotics, challenges to effective STI prevention remain.²^,3 Asymptomatic infections are common and may be more prevalent among individuals with low health literacy and among those who have difficulty accessing care and/or avoid medical treatment because of anticipated stigma. STI control programs have traditionally used contact tracing to identify partners of newly diagnosed individuals, but this approach is challenging when individuals meet anonymous partners and public health programs have limited resources.⁴

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Article Information

Corresponding Author: Kenneth H. Mayer, MD, Fenway Health, 1340 Boylston St, Boston, MA 02215 (kmayer@fenwayhealth.org).

Published Online: September 22, 2023. doi:10.1001/jama.2023.16416

Conflict of Interest Disclosures: Dr Traeger reported receiving grants and personal fees from Gilead Sciences outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by the Harvard University Center for AIDS Research (NIAID R24, AI067039).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: The authors wish to recognize the thoughtful comments of Douglas Krakower, MD (Beth Israel Deaconess Medical Center and Harvard Medical School), in reviewing the manuscript and the assistance of Whitney Crebase, MPH (Fenway Health), in the preparation of the manuscript, neither of whom received compensation.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.