Drop in Syphilis Cases as Gay Men Turn to doxyPEP
report from the Centers for Disease Control and Prevention (CDC) finds that the sharp and drastic increases in the number STI diagnoses seen following the end of COVID-era lockdowns appear to have slowed.In 2023, over 2.4 million cases of syphilis, gonorrhea, and chlamydia were diagnosed and reported, with 1.6 million chlamydia cases, 209,000 cases of syphilis, and over 600,000 cases of gonorrhea.But the number of STIs decreased nearly 2% from 2022 to 2023.
The report reveals that there was a 7.2% decrease in gonorrhea diagnoses in 2023, and a less than a 1% change in chlamydia, indicating that the infection rate has stabilized.Syphilis was more mixed — overall, there was a 1% increase in all stages of syphilis, but much of that increase was driven by a 12% increase in the rate of cases of unknown or later-stage syphilis (meaning people were infected years ago), as well as 3,882 cases of congenital syphilis (transmitted from pregnant mother to infant), including 279 stillbirths or infant deaths.At the same time — in what many health experts are hailing as good news, there was a 10% decrease in diagnoses of primary- and secondary-stage syphilis, with only 53,000 cases reported.The report found that the decrease in primary- and secondary-stage syphilis was chiefly driven by a 13% decrease in diagnoses among gay and bisexual men, who have historically accounted for nearly half of all infections.As reported by the Detroit News, the decrease in syphilis among sexual-minority men marks the first drop since the CDC began reporting data for that subgroup in the mid-2000s.Infectious disease experts said they believed that the reversal in syphilis diagnoses among gay and bisexual men was due to doxyPEP, a prevention protocol in which a person takes one 200-milligram tablet of doxycycline within 72 hours of condomless sex.In recent years, three randomized controlled trials showed a 70% reduction in chlamydia and syphilis infections and a 50% reduction in gonorrhea infections.
