Prevention was in the spotlight during the 30e edition of the conference on retroviruses and opportunistic infections, which was held from February 19 to 22 in Seattle (United States). Particularly prevention against sexually transmitted infections (STIs). Two effective strategies were presented. A French study has thus confirmed the interest, against bacterial STIs, of a preventive dose of a well-known antibiotic, doxycycline, taken one to three days after sexual intercourse without a condom. This antibiotic is classically recommended in the treatment of infections of the urethra, cervix, fallopian tubes or anus. It is also indicated in the treatment of syphilis, Lyme disease, certain skin diseases (rosacea, acne, etc.), dental infections and diarrhea of bacterial origin, but also in the prevention of malaria.
The concept of post-exposure prevention by doxycycline emerged at the end of 2017, during the Ipergay trial, conducted by the National Agency for Research on AIDS and Viral Hepatitis (ANRS). Used within twenty-four to seventy-two hours after intercourse, this antibiotic reduced the risk of chlamydia infection and syphilis by about 70%.
At the same time, various epidemiological studies have reported in recent years that people vaccinated against meningococcal B (with GSK’s Bexsero vaccine) could see the risk of gonococcal infection reduced by around 30%. “There are common antigens between meningococcus B and gonococcus”explains Jean-Michel Molina, head of the infectious and tropical diseases department at Saint-Louis Hospital and Lariboisière Hospital (Paris-Cité University), hence the possible cross-protection conferred by the meningococcal vaccine against this STI. .
No severe adverse effects
The DoxyVAC study, coordinated by Jean-Michel Molina, was promoted and funded by the ANRS. Between January 2021 and July 2022, the researchers recruited 502 male volunteers (with a median age of 39) who had sex with men (with a median of ten sexual partners in the last three months) and who lived in the region. Parisian. All were on PrEP (an HIV preventive treatment) and had a history of STIs within the previous year. They were divided by lot into four groups, according to the rules of the trials « randomized”. The first benefited from post-exposure prevention with doxycycline (within twenty-four to seventy-two hours after unprotected sexual intercourse), the second from vaccination against meningococcal B, the third from the combination of these two interventions and the last had no interventions.
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