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<p class="MsoNormal"><span class="acr-preheader"><span style="font-family:"Arial",sans-serif">The public comment period for Doxy PEP is now open</span></span><span style="font-family:"Arial",sans-serif"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" align="right" style="text-align:right"><span style="font-family:"Arial",sans-serif">October 2, 2023<o:p></o:p></span></p>
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<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">Dear Colleagues,
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">CDC has developed draft guidelines on the use of sexually transmitted infection (STI) post-exposure prophylaxis with doxycycline (Doxy PEP) for preventing some bacterial
STIs. Beginning Monday, October 2, the agency will request public input on the draft. Comments can be shared for 45 days on
<a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea015&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=B_8SHfuoyL37Yc4eB2YdskVY8Ed3sN8gNPNirJsffUo">
Guidelines for the Use of Doxycycline Post-Exposure Prophylaxis for Bacterial Sexually Transmitted Infection (STI) Prevention</a>. An
<a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea016&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=e5Kq6IslFvO-9LHKCgvDa0oo5oKM49-AJMBf-eRMc8M">
informational presentation</a> about the draft guidelines is available online. <o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea017&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=m-KYLKf0N17sbndJy9u_iV5d1woxbo4ezG3VT9IqTM0">The
2021 CDC STI Treatment Guidelines</a> included a systematic review of the available literature on STI PEP and concluded that further studies were necessary to determine whether it would be an effective strategy for bacterial STI prevention. Since that time,
promising results from several randomized trials on STI PEP indicated the need to re-address this topic. The new guidelines will offer an important resource for healthcare providers to inform the use of Doxy PEP for preventing bacterial STI infections.
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">STIs are pervasive and increasing rapidly in the U.S., and Doxy PEP has demonstrated substantial benefit in reducing new chlamydia, gonorrhea, and syphilis infections.
Doxy PEP can benefit the health of some gay, bisexual, and other men who have sex with men, and transgender women who have increased chances of getting an STI. When offered, Doxy PEP should be implemented in the context of comprehensive sexual health. These
draft guidelines represent a new approach to addressing STI prevention. <o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">Once complete, the updated clinical guidelines for healthcare providers will inform the use of Doxy PEP for preventing bacterial STI infections. However, our work isn’t
over after the guidelines are finalized. Important questions remain about the effectiveness of this approach for other populations, as well as potential long-term development of antimicrobial resistance and impacts on the microbiome. Given potential unknowns,
CDC is calling for long-term monitoring and evaluation as more data become available.
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">Transparency and public feedback are crucial for effective public health and clinical guidelines, and broad, diverse perspectives will strengthen and improve the quality
and use of the first new STI prevention tool in decades. <o:p></o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="text-align:justify"><span style="font-family:"Arial",sans-serif">This step is part of a comprehensive process for ensuring the best possible guidelines, which has included:<o:p></o:p></span></p>
<ul type="disc">
<li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo3">
<span style="font-family:"Arial",sans-serif">Development of <a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea018&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=Y0de5cySeuUaq5DPRFEOiHcdhkwyS-0pvpGAsgQ6hLY">
immediate considerations</a> for the use of Doxy PEP in July 2022.<o:p></o:p></span></li><li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo3">
<span style="font-family:"Arial",sans-serif">External and internal <a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea019&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=C3a4vwxiYjkT9jjXNEmF42ZkhRJzfmTuprsp3pbkCS8">
consultations</a> with experts.<o:p></o:p></span></li><li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo3">
<span style="font-family:"Arial",sans-serif">Review of the <a href="https://t.emailupdates.cdc.gov/r/?id=h81d1f415,1a173e14,1a1ea01a&e=QUNTVHJhY2tpbmdJRD1VU0NEQ05QSU5fMTIyLURNMTE0MTExJkFDU1RyYWNraW5nTGFiZWw9UHVibGljJTIwSW5wdXQlMjBSZXF1ZXN0ZWQlM0ElMjBEcmFmdCUyMERveHljeWNsaW5lJTIwYXMlMjBTVEklMjBQb3N0LUV4cG9zdXJlJTIwUHJvcGh5bGF4aXMlMjBHdWlkZWxpbmVz&s=owUwbXK8frgWQ2DtkrCyHLOVIFRJ9L8Sw-DQzQUw-C0">
DoxyPEP trial results</a> published in April 2023.<o:p></o:p></span></li><li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo3">
<span style="font-family:"Arial",sans-serif">Cross-agency review of proposed guidelines.<o:p></o:p></span></li></ul>
<div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">CDC now needs your input on the guidelines, and we are listening during this public comment period.
<o:p></o:p></span></p>
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<div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Thank you for your continued support.
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Leandro Mena, MD, MPH, FIDSA
<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Director<o:p></o:p></span></p>
</div>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Division of STD Prevention<o:p></o:p></span></p>
</div>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">National Center for HIV, Viral Hepatitis, STD and TB Prevention<o:p></o:p></span></p>
</div>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Centers for Disease Control and Prevention<o:p></o:p></span></p>
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