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多西环素暴露后预防细菌性性传播感染:临床医疗服务提供者是否支持?

Doxycycline post-exposure prophylaxis for preventing bacterial sexually transmitted infections (STIs): Are clinical providers supportive?

作者信息

Imerlishvili Esma, Lake John, Todorovic Sara, Gonzalez Charles, Boos Elizabeth M, Hart-Malloy Rachel

机构信息

New York State Department of Health AIDS Institute, Albany, NY, USA.

Partnership for Research and Action for Health, Tbilisi, Republic of Georgia.

出版信息

Int J STD AIDS. 2025 Mar;36(4):297-303. doi: 10.1177/09564624241309433. Epub 2024 Dec 24.

Abstract

BACKGROUND

Bacterial sexually transmitted infections (STIs) continue to increase in the United States. Despite evidence of the effectiveness of doxycycline post-exposure prophylaxis (Doxy-PEP) to prevent STIs, little is known about providers' attitudes and willingness to implement Doxy-PEP.

METHODS

An online questionnaire was sent to 575 clinical providers in New York State in September 2022.

RESULTS

Ninety-one eligible individuals responded. Most providers served men who have sex with men (MSM) (84%); reported willingness to recommend Doxy-PEP (98%, 77%, and 67% for chlamydia, syphilis, and gonorrhea, respectively); preferred Doxy-PEP administration for MSM and transgender populations; believed recurring bacterial STIs (88%) and reported condomless sex (85%) were the most important characteristics to consider for recommending Doxy-PEP; and were concerned about antibiotic resistance (90%) (primarily for ). Insurance costs were the most perceived community-associated barriers (35%). There were no significant differences in providers' recommendations towards Doxy-PEP use when comparing clinicians' years of experience, regions, or professional titles.

CONCLUSIONS

Study results suggest high willingness and support for implementing Doxy-PEP. As this survey was administered prior to national guidelines on the use of Doxy-PEP, these data can be used as a baseline to compare to studies conducted after their release to formulate appropriate messages for providers to improve implementation.

摘要

背景

在美国,细菌性性传播感染(STIs)持续增加。尽管有证据表明多西环素暴露后预防(Doxy-PEP)对预防性传播感染有效,但对于医疗服务提供者对实施Doxy-PEP的态度和意愿知之甚少。

方法

2022年9月,向纽约州的575名临床医疗服务提供者发送了一份在线问卷。

结果

91名符合条件的个体做出了回应。大多数医疗服务提供者服务于男男性行为者(MSM)(84%);报告愿意推荐Doxy-PEP(衣原体、梅毒和淋病的推荐率分别为98%、77%和67%);倾向于对男男性行为者和跨性别群体进行Doxy-PEP给药;认为复发性细菌性性传播感染(88%)和报告的无保护性行为(85%)是推荐Doxy-PEP时要考虑的最重要特征;并且担心抗生素耐药性(90%)(主要针对)。保险费用是最常被提及的与社区相关的障碍(35%)。在比较临床医生的工作年限、地区或职称时,医疗服务提供者对使用Doxy-PEP的推荐没有显著差异。

结论

研究结果表明对实施Doxy-PEP有很高的意愿和支持。由于这项调查是在关于使用Doxy-PEP的国家指南发布之前进行的,这些数据可以用作基线,与指南发布后进行的研究进行比较,以便为医疗服务提供者制定适当的信息,以改善实施情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/643d/11993814/ecc75960d719/10.1177_09564624241309433-fig1.jpg

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