NEW YORK — U.S. health officials released data Tuesday showing how chlamydia, gonorrhea and syphilis cases have been accelerating, but doctors are hoping an old drug will help fight the sexually transmitted infections.
Experts believe STDs have been rising because of declining condom use, inadequate sex education and reduced testing during the COVID-19 pandemic.
Millions of Americans are infected each year. Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans.
"Sexually transmitted infections are an enormous, low-priority public health problem. And they've been a low-priority problem for decades, in spite of the fact that they are the most commonly reported kind of infectious disease," said Dr. John M. Douglas Jr., a retired health official who lectures at the Colorado School of Public Health.
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To try to turn the tide, many doctors see promise in doxycycline, a cheap antibiotic that has been sold for more than 50 years.
FILE - A pharmacist holds a bottle of the antibiotic doxycycline hyclate in Sacramento, Calif., July 8, 2016. On Tuesday, April 11, 2023, the Centers for Disease Control and Prevention released data about some of the most common infectious diseases in the U.S. The numbers show how chlamydia, gonorrhea and syphilis infections have been accelerating across the country. Meanwhile, the CDC is considering recommending the antibiotic doxycycline to be used after sex to prevent those infections. (AP Photo/Rich Pedroncelli, File)
The Centers for Disease Control and Prevention is drafting recommendations for using it as a kind of morning-after pill for preventing STDs, said Dr. Leandro Mena, director of the agency's STD prevention division.
The drug is already used to treat a range of infections. A study published last week in the New England Journal of Medicine showed its potential to prevent sexually transmitted infections.
In the study, about 500 gay men, bisexual men and transgender women in Seattle and San Francisco with previous STD infections took one doxycycline pill within 72 hours of unprotected sex. Those who took the pills were about 90% less likely to get chlamydia, about 80% less likely to get syphilis, and more than 50% less likely to get gonorrhea compared with people who did not take the pills after sex, the researchers found.
The study was led by researchers at the University of California, San Francisco and built on a similar French study that saw promise in the idea.
"We do need new approaches, new innovations" to help bring sexually transmitted infections under control, said Dr. Philip Andrew Chan, who is consulting with the CDC on the doxycycline recommendations.
Mena, of the CDC, said there is no sign the STD trend is slowing.
Mississippi had the highest rate of gonorrhea cases, according to 2021 CDC data released Tuesday. Alaska saw a sharp increase in its chlamydia case rate that allowed it to overtake Mississippi at the top of that list. South Dakota had the highest rate of early-stage syphilis.
FILE - This 1975 microscope image made available by the the Centers for Disease Control and Prevention shows Chlamydia trachomatis bacteria. U.S. health officials released data Tuesday, April 11, 2023, showing how chlamydia, gonorrhea and syphilis cases have been accelerating, but doctors are hoping an old drug will help fight the sexually transmitted infections. Experts believe STDs have been rising because of declining condom use, inadequate sex education and reduced testing during the COVID-19 pandemic.(Dr. E. Arum, Dr. N. Jacobs/CDC via AP)
And Arizona had the tragic distinction of having the highest rate of cases in which infected moms pass syphilis on to their babies, potentially leading to death of the child or health problems like deafness and blindness.
Using an antibiotic to prevent these kinds of infections won't "be a magic bullet. but it will be another tool," said Chan, who teaches at Brown University and is chief medical officer of Open Door Health, a health center for gay, lesbian and transgender patients in Providence, Rhode Island.
Experts noted the CDC will have many factors to weigh as it develops the recommendations.
Among them: The drug can cause side effects like stomach problems and rashes after sun exposure. Some research has found it ineffective in heterosexual women. And widespread use of doxycycline as a preventive measure could contribute to mutations that make bacteria impervious to the drug, as has happened with antibiotics before.
Nevertheless, the San Francisco Department of Public Health in October became the first U.S. health department to issue guidance about doxycycline as an infection-prevention measure. And some other clinics have been been recommending the antibiotic to patients who may be at higher risk.
Derrick Woods-Morrow, a 33-year-old artist and an assistant professor at the Rhode Island School of Design, is an early adopter. Woods-Morrow, said he isn't a fan of condoms — they can break and sometimes people slip them off during sex. But he wants to stay healthy.
About a decade ago, he started taking an anti-viral medication before sex to protect himself from HIV infection. Five years ago, a doctor told him about research into whether doxycycline might protect people from other diseases.
"I thought it was probably in my best interest to protect myself, and my partners as well," he said. He said it's been a positive experience and that he hasn't tested positive for chlamydia, gonorrhea or syphilis while using it.
"I feel like it's a tool to sort of take back the sexual freedoms that someone may have lost and to really enjoy sex and interactions with people with a piece of mind," he said.
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10 small, healthy things you should do for yourself every day
1. Find one small way to add more steps to your day.
Martha Gulati, M.D., a cardiologist and editor-in-chief of the American College of Cardiology’s CardioSmart, confirms that we sit too much. Get closer to your 10,000 daily steps by parking at the end of the office parking lot; getting off the bus or subway one stop earlier; doing 10 jumping jacks between video calls; or taking the stairs instead of the elevator or escalator.
2. Just be — even for five minutes a day.
Pure Yoga instructor Alison O’Connor believes in spending time alone every day. “Taking a few minutes for yourself — away from social media, work, entertainment and anyone who demands something from you — can go a long way toward mental health.”
3. Make sleep a top priority.
The average adult needs seven to nine hours of sleep each night in order to stave off depression and keep stress hormones at bay, preventing overeating, crabby moods, succumbing to sugar cravings, and inflammation.
4. Refill your water bottle.
Water is, quite simply, essential. It helps your skin look fresh, flushes toxins from your body, helps maintain healthy bowel functions and keeps muscles from fatigue.
5. Take a few deep breaths.
According to Gulati, remembering to pause periodically and spend one full minute focused on deep breathing and positive energy can help you cope better with anxiety and stress and ground you in the present.
6. Wear something you love.
Feeling confident and happy can come from knowing you look good, says Forever Freckled stylist Carrie Greenberg. “Dust off classic pieces and consider investing in some great new accessories,” she says. Make it a point to wear something that makes you feel fantastic every single day.
7. Make something in the kitchen.
New York-based personal chef and fitness instructor Alyssa Gagarin says cooking your own food “gives you full control over what’s going into your body.” Load up on fruits, veggies, whole grains, eggs, meats, seafood, nuts, seeds and legumes—and stop eating once you’re full.
8. Deliberately choose a healthy ingredient.
Even if you aren’t able to prepare your own meals, Gulati suggests mindfully choosing at least one healthy meal or snack a day. Reach for the banana in the office fruit bowl, or add one more veggie to your chicken Caesar salad.
9. Pay attention to your needs.
Ellen Friedrichs, a Brooklyn, New York-based health and sexuality educator, says we need to assess our needs, moment to moment. Do you really need those potato chips, or are you just thirsty for a big glass of water? You’re exhausted—RSVP “no” to that cocktail party. Feeling distant from your partner lately? Suggest a date night.
10. Tell the truth as often as you can.
“Acting with integrity — where all of your words and actions align with your core beliefs — brings peace of mind and a sense of freedom,” O’Connor says. This may seem challenging, but she believes that lying or ignoring your principles could make you sick, both mentally and physically.
(Real Simple magazine provides smart, realistic solutions to everyday challenges. Online at www.realsimple.com.)
