Plain Language Summary
Bacterial STIs are rising globally, affecting MSM, TGW, and cisgender women, especially pregnant women. Behavioral changes haven't curbed this trend, and vaccines aren't available, so doxycycline postexposure prophylaxis (doxyPEP) is being explored. Clinical trials show doxyPEP effectively reduces Chlamydia and syphilis in MSM and TGW, but not in cisgender women, likely due to adherence issues. Concerns remain about antibiotic resistance, particularly in Neisseria gonorrheae, and effects on the microbiome. While doxyPEP lowers STI rates, challenges like acceptability and access persist. Guidelines vary internationally, highlighting the need for consistent STI prevention strategies.
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