Syphilis Drop: New Antibiotic Use by Gay Men May Be the Key

It seems like the tide might be turning for sexually transmitted infections (STIs). After years of seeing record highs, the top three bacterial STIs have started to drop since the Covid pandemic. Syphilis, which is one of the most infectious STIs, went down by 10% in 2023. This is a big deal, especially for gay and bisexual men, who have historically made up about half of all syphilis cases, even though they only make up 2% of the adult population. Why is this happening? Experts think it might be because of a new way to prevent STIs using the antibiotic doxycycline. This method, called doxyPEP, has been shown to lower cases of chlamydia and syphilis by more than 70% and gonorrhea by about 50%. It’s been recommended in cities like San Francisco, Chicago, and New York.

But it’s not all good news. While syphilis cases are going down among gay and bisexual men, they’re still high among young people and racial minorities. Gonorrhea and chlamydia cases are also still pretty high. There’s also a concern that doxyPEP might not be reaching everyone who needs it. Just like with HIV prevention pills, it might be more popular among white people, which could make racial disparities in STI transmission even worse. The fight against STIs is far from over. But this new strategy using doxycycline gives hope that we might be able to turn the tide.

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