Will doxyPEP create antibiotic resistant STDs?

[marylander1940]

There’s a morning-after pill to prevent sexually transmitted infections

WWW.VOX.COM

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Why aren’t more doctors prescribing it?

OP note: I don't think antibiotics should be taken unless they're needed. 

Edited April 18, 2023 by marylander1940

[+ BenjaminNicholas]

Bottom line, this is yet another tool in an arsenal.  And options are always a good thing.

As to resistance (as per Annie Luetkemeyer, M.D., a professor of medicine at University of California-San Francisco)

Quote

'Regarding antimicrobial resistance, Luetkemeyer reiterated that clinicians do not use doxycycline to treat gonorrhea, and there is no evidence of reduced efficacy against syphilis or chlamydia despite years of use. Krakower warned that increased antimicrobial resistance in the wake of doxyPEP might have a negative impact on clinicians’ ability to treat Neisseria and Staphylococcus infections, but Luetkemeyer pointed out that doxycycline is not used to treat serious Neisseria and Staphylococcus infections.'

The original article from TheBodyPro...

https://www.thebodypro.com/article/doxypep-stis-prophylactic-doxycycline-msm-hiv-prep

[Guest]

There are diseases, such as gonorrhea, which doxycycline won't treat. And doxycycline increases the risk of sun damage (including, probably cancer). Taking this for years on end hasn't been well-studied. People who sleep around a lot would be wisest to use to use PrEP and condoms, and get tested periodically. I haven't heard of any national advisory agency (comprised of public health officials), such as the USPSTF or CDC, recommending this. 

[+ BenjaminNicholas]

7 hours ago, Unicorn said:

There are diseases, such as gonorrhea, which doxycycline won't treat.

I literally already quoted this from the article, verbatim. 

But there are other drugs, like Ceftriaxone, which work quickly and easily on those who have contracted it. 

You don't have to practice DoxyPrep, but to say it's not useful as yet another choice would be fucking ridiculous. 

As for recommending agencies, the CDC has currently released formal considerations about it, while the San Francisco Department of Health has fully recommended it. 

That said, whether you're taking this as DoxyPrep or DoxyPep, it's not a regime that's right for everyone. 

Edited April 18, 2023 by BenjaminNicholas

[surferguy_1]

More people are getting on Doxypep. That's interesting since doctors in NY are still cautious about it. 

[+ KensingtonHomo]

It will contribute to antibiotic resistance. PreP for HIV makes sense to me, and I use it. But this is dangerous and, frankly, unnecessary. All the STIs are treatable, and if you're on Doxyprep, you're 99% likely to be on PreP. So why contribute to antibiotic resistance? We're not making new antibiotics and treatment-resistant gonorrhea is on the rise. 

[+ BenjaminNicholas]

2 hours ago, KensingtonHomo said:

It will contribute to antibiotic resistance. PreP for HIV makes sense to me, and I use it. But this is dangerous and, frankly, unnecessary. All the STIs are treatable, and if you're on Doxyprep, you're 99% likely to be on PreP. So why contribute to antibiotic resistance? We're not making new antibiotics and treatment-resistant gonorrhea is on the rise. 

Did you not read what was posted above?  Gonorrhea isn't even treated with the class of antibiotic that doxy is in.  It's really a moot point.

Antibiotic resistance is per class of specific drug.  At longer-term low dosage doxy, the resistance level is incredibly low.  It's nearly zero when you follow a more conservative doxyprep regime of only taking it post-72 hours from last sexual activity.

This is a shades of grey discussion.  Blanket statements are harmful to those who could benefit from this regime.  You're in a sex-worker/sex-positive forum here and for many of us, this is a helpful medical discussion to have with our doctors.

[+ KensingtonHomo]

7 minutes ago, BenjaminNicholas said:

Antibiotic resistance is per class of specific drug.  At longer-term low dosage doxy, the resistance level is incredibly low.  It's nearly zero when you follow a more conservative doxyprep regime of only taking it post-72 hours from last sexual activity.

I am incredibly pro-sex worker, but you do not understand antibiotic resistance. We have a massive overuse of antibiotics in this country (and globally), 20-60 percent of which are not medically necessary. Resistance does not happen in our bodies. It happens to the bacteria as they are exposed to drugs and evolve to survive them. All antibiotic use contributes to resistance. I generally support sex workers using them, but all sexually active gay men going on DoxyPrep is a terrible idea for public health. As people who have lived through three plagues in our lifetimes - two of which disproportionately impacted us - we need to be community-minded in approaching our individual and collective health. 

"On an individual and population level, drug resistance will likely occur with the increased use of Doxy PEP, especially with the amount of doxycycline that will be indicated for many users. The extent to which this happens, and the impact, are still open questions, and must be carefully monitored." 

 

Drug resistance and Doxy PEP: Should we worry? - San Francisco AIDS Foundation

WWW.SFAF.ORG

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In late 2022, the San Francisco Department of Public Health and San Francisco AIDS Foundation began...

 

[+ BenjaminNicholas]

13 minutes ago, KensingtonHomo said:

I am incredibly pro-sex worker, but you do not understand antibiotic resistance. We have a massive overuse of antibiotics in this country (and globally), 20-60 percent of which are not medically necessary. Resistance does not happen in our bodies. It happens to the bacteria as they are exposed to drugs and evolve to survive them. All antibiotic use contributes to resistance. I generally support sex workers using them, but all sexually active gay men going on DoxyPrep is a terrible idea for public health. As people who have lived through three plagues in our lifetimes - two of which disproportionately impacted us - we need to be community-minded in approaching our individual and collective health. 

"On an individual and population level, drug resistance will likely occur with the increased use of Doxy PEP, especially with the amount of doxycycline that will be indicated for many users. The extent to which this happens, and the impact, are still open questions, and must be carefully monitored." 

 

Where did I say that resistance happened in our bodies?  I promise you I didn't.

I also never said or implied that 'all' sexually active gay men need to be on doxyprep.  I said it was simply one tool in an arsenal.

I do fully understand antibiotic resistance.  

I don't disagree that resistance is becoming more of an issue in society, but for a sex worker or someone who's putting themselves at a higher risk, you have to weigh your options and risk factors.  

I appreciate this discussion.  It's an important thing to keep on top of around here.

Edited May 15, 2023 by BenjaminNicholas

[Guest]

2 hours ago, BenjaminNicholas said:

...for a sex worker or someone who's putting themselves at a higher risk...

Or, how about PrEP and condoms... 🙄

[marylander1940]

6 hours ago, Unicorn said:

Or, how about PrEP and condoms... 🙄

Guys use PrEP in order NOT to use condoms, it's a fact Doctor!

[+ BenjaminNicholas]

33 minutes ago, marylander1940 said:

Guys use PrEP in order NOT to use condoms, it's a fact Doctor!

Many, yes, but not always. 

Condoms are still an important part of the equation. 

[Guest]

2 hours ago, marylander1940 said:

Guys use PrEP in order NOT to use condoms, it's a fact Doctor!

Maybe some guys use PrEP because 99.7% efficacy at preventing HIV is better than 80-90% (condoms). 99.9+% efficacy if you use both. And condoms help protect against a whole lot of other stuff. 

[KeepItReal]

When I see articles like this, it makes me wonder...

https://arstechnica.com/science/2024/03/super-gonorrhea-rate-quickly-triples-in-china-now-40x-higher-than-us/

[+ BenjaminNicholas]

2 hours ago, KeepItReal said:

When I see articles like this, it makes me wonder...

https://arstechnica.com/science/2024/03/super-gonorrhea-rate-quickly-triples-in-china-now-40x-higher-than-us/

I recommend never having sex again.

Find a comfortable plastic bubble and settle in.

[KeepItReal]

43 minutes ago, BenjaminNicholas said:

I recommend never having sex again.

Find a comfortable plastic bubble and settle in.

A for effort in slinging sarcasm. F for failure to show empathy to other sex workers. 

Edited March 31 by KeepItReal
Gif added

[+ BenjaminNicholas]

On 3/31/2024 at 10:26 AM, KeepItReal said:

A for effort in slinging sarcasm. F for failure to show empathy to other sex workers. 

Just one question professor...  Is this class grading on an average?

[marylander1940]

I know who take DoxyPep after seeing a guy taking loads at a hotel once or twice per year but would never abuse taking the pill every single week. 

 

[+ Tygerscent]

I have also been wondering about this… Intermittent, incorrect usage of Doxy, or being exposed to syphilis, chlamydia or gonorrhea when the levels of Doxy are low in your system, just seems like an opportunity for those bacteria to multiply and mutate into something monstrously resistant to anything we currently have~   Aren’t resistant variations of these diseases already on the rise despite our use of available medication’s treating them?  
 I also wonder about the effects of taking doxycycline on a daily basis for those who want to go that route. Perhaps taking only that medication on a daily basis, it’s not a problem, but, so many people actually take other medication’s, as well as artificial flavors, artificial colors, food, preservatives and live in areas with toxic water and toxic air and toxic land. Some honest part of me  Has great hesitance. Is this really somehow less expensive than just going in for a quarterly STI screening? Discovy makes sense to me… The Doxy has me uncertain~
 The past two years have already present themselves with the ugly picture of a penicillin shortage which affected how and who, with syphilis, was treated in various parts of the world. Losing the effectiveness of doxycycline, and maybe potentially running into a shortage at some point just seems like, silence of the lambs two waiting to happen~ whatever that means…  

[+ Tygerscent]

On 5/15/2023 at 10:51 PM, Guest said:

Maybe some guys use PrEP because 99.7% efficacy at preventing HIV is better than 80-90% (condoms). 99.9+% efficacy if you use both. And condoms help protect against a whole lot of other stuff. 

Unfortunately, condom break, condom, slip off during, and after orgasm, alms can leak, people can spill the contents of condoms on their partners on purpose, or by accident… People don’t use condoms for oral sex, which can likewise spread pretty much any disease that condoms are trying to prevent. Sex is a dirty, messy and beautiful thing. It’s the reason anyone of us is here at all~ There are risks to sex, even if it’s just you having it by yourself~ it’s amazing what in reality people put where by themselves in their own time. Hormones motivate creativity whether alone or with a partner or many partners.  There’s actually risk to not having sex: potentially an elevated risk for prostate cancer, changes in cortisol levels, sleep disturbances, psychological and/pr emotional distress~ 
 Despite not being perfect individuals, people do have the option, and in general potential for exercising good judgment, whether they are using condoms or not using condoms, using or not using prep… Personal responsibility and common sense can go a long way~    
 It seems somehow at least questionable if not an obvious caution to place the responsibility of safety, on either condoms or other prophylaxis when it comes to sex. Plenty of babies and STI are passed along any of it.