2025/03/04 by Seitaro Abe, Daisuke Mizushima, Naokatsu Ando +8 · 1 voice · 1 citation
Immunology and Microbiology · Social Sciences · Medicine · #Reproductive tract infections research #Sex work and related issues #Syphilis Diagnosis and Treatment
paper · pdf · doi:10.1093/jacamr/dlaf054
openalex publication_date 2025/03/04 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Background: Bacterial sexually transmitted infections (STIs) like syphilis, chlamydia and gonorrhoea are often asymptomatic but can cause severe complications, including infertility and vertical transmission in cisgender women, particularly female sex workers (FSWs). Sex work is strongly associated with syphilis, with FSWs representing 38% of syphilis cases among Japanese women in 2021. Despite doxycycline's proven effectiveness in preventing bacterial STIs, its efficacy in high-risk cisgender women remains inconclusive, highlighting the need for targeted STI prevention strategies in this population. Objectives: We investigated the effectiveness of doxycycline pre-exposure prophylaxis (doxyPrEP) in preventing STIs and its impact on vaginal flora among FSWs. Participants and methods: This retrospective study included 40 FSWs aged ≥18 years who initiated doxyPrEP (100 mg/day) for STI prevention at a private clinic in Tokyo, Japan, between 1 October 2022 and 14 November 2023. Incidence rate ratios (IRR) for chlamydia, gonorrhoea, syphilis, bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC) were estimated using fixed-effects Poisson regression models. Adherence, side effects, and satisfaction were evaluated through follow-up clinical evaluations. Results: = 0.056), and syphilis cases dropped to zero. Gonorrhoea, BV, and VVC incidence showed no significant changes. Follow-up clinical evaluations indicated high adherence to doxyPrEP, no serious adverse events, and high satisfaction with doxyPrEP. Conclusions: DoxyPrEP significantly reduced the overall STI incidence among FSWs without increasing other vaginal infections.