@article{fdi:010072423,
  title = {{P}ost-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men : an open-label randomised substudy of the {ANRS} {IPERGAY} trial},
  author = {{M}olina, {J}. {M}. and {C}harreau, {I}. and {C}hidiac, {C}. and {P}ialoux, {G}. and {C}ua, {E}. and {D}elaugerre, {C}. and {C}apitant, {C}. and {R}ojas-{C}astro, {D}. and {F}onsart, {J}. and {B}ercot, {B}. and {B}ebear, {C}. and {C}otte, {L}. and {R}obineau, {O}. and {R}affi, {F}. and {C}harbonneau, {P}. and {A}slan, {A}. and {C}has, {J}. and {N}iedbalski, {L}. and {S}pire, {B}. and {S}agaon {T}eyssier, {L}uis and {C}arette, {D}. and {L}e {M}estre, {S}. and {D}ore, {V}. and {M}eyer, {L}. and {ANRS} {I}pergay {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {I}ncreased rates of sexually transmitted infections ({STI}s) have been reported among men who have sex with men. {W}e aimed to assess whether post-exposure prophylaxis ({PEP}) with doxycycline could reduce the incidence of {STI}s. {M}ethods {A}ll participants attending their scheduled visit in the open-label extension of the {ANRS} {IPERGAY} trial in {F}rance (men aged 18 years or older having condomless sex with men and using pre-exposure prophylaxis for {HIV} with tenofovir disoproxil fumarate plus emtricitabine) were eligible for inclusion in this open-label randomised study. {P}articipants were randomly assigned (1:1) at a central site to take a single oral dose of 200 mg doxycycline {PEP} within 24 h after sex or no prophylaxis. {T}he primary endpoint was the occurrence of a first {STI} (gonorrhoea, chlamydia, or syphilis) during the 10-month follow-up. {T}he cumulative probability of occurrence of the primary endpoint was estimated in each group with the {K}aplan-{M}eier method and compared with the log-rank test. {T}he primary efficacy analysis was done on the intention-to-treat population, comprising all randomised participants. {A}ll participants received risk-reduction counselling and condoms, and were tested regularly for {HIV}. {T}his trial is registered with {C}linical{T}rials.gov number, {NCT}01473472. {F}indings {B}etween {J}uly 20, 2015, and {J}an 21, 2016, we randomly assigned 232 participants (n=116 in the doxycycline {PEP} group and n=116 in the no-{PEP} group) who were followed up for a median of 8.7 months ({IQR} 7.8-9.7). {P}articipants in the {PEP} group used a median of 680 mg doxycycline per month ({IQR} 280-1450). 73 participants presented with a new {STI} during follow-up, 28 in the {PEP} group (9-month probability 22%, 95% {CI} 15-32) and 45 in the no-{PEP} group (42%, 33-53; log-rank test p=0.007). {T}he occurrence of a first {STI} in participants taking {PEP} was lower than in those not taking {PEP} (hazard ratio [{HR}] 0.53; 95% {CI} 0.33-0.85; p=0.008). {S}imilar results were observed for the occurrence of a first episode of chlamydia ({HR} 0.30; 95% {CI} 0.13-0.70; p=0.006) and of syphilis (0.27; 0.07-0.98; p=0.047); for a first episode of gonorrhoea the results did not differ significantly ({HR} 0.83; 0.47-1.47; p=0.52). {N}o {HIV} seroconversion was observed, and 72 (71%) of all 102 {STI}s were asymptomatic. {R}ates of serious adverse events were similar in the two study groups. {G}astrointestinal adverse events were reported in 62 (53%) participants in the {PEP} group and 47 (41%) in the no-{PEP} group (p=0.05). {I}nterpretation {D}oxycycline {PEP} reduced the occurrence of a first episode of bacterial {STI} in high-risk men who have sex with men.},
  keywords = {{FRANCE}},
  booktitle = {},
  journal = {{L}ancet {I}nfectious {D}iseases},
  volume = {18},
  numero = {3},
  pages = {308--317},
  ISSN = {1473-3099},
  year = {2018},
  DOI = {10.1016/s1473-3099(17)30725-9},
  URL = {https://www.documentation.ird.fr/hor/fdi:010072423},
}