Bacterial Sexually Transmitted Infection Prevention at Health Centers

Bacterial sexually transmitted infections (STIs) are common in the United States, with more than 1.5 million chlamydia, more than 500,000 gonorrhea, and more than 190,000 syphilis cases reported in 2024. STIs disproportionately affect people in certain sexual networks, including men who have sex with men (MSM), and where access to care or health- seeking behavior are compromised. Numerous strategies, including condom use, have been shown to reduce the likelihood of bacterial STI transmission or acquisition. More recently, the STI prevention toolkit has expanded with the addition of doxycycline post-exposure prophylaxis, an evidence-based intervention that can significantly reduce chlamydia, gonorrhea, and syphilis infections among MSM and some other populations. Doxycycline post-exposure prophylaxis consists of a single dose of doxycycline, 200 mg, taken by mouth within 72 hours after condomless sex. This publication will focus on the evidence for doxycycline post-exposure prophylaxis and its implementation at health centers.