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This is a Cohort Study study (also classified as: Quasi-Experimental).

January 14, 2026Open Forum Infectious Diseases0 citationsOpen Access

P-722. Impact of Doxy-PEP on Chlamydia and Gonorrhea Percent Positivity at a Large Sexual Health Clinic in the Bronx, New York

GSGrace SchulerAlbert Einstein College of Medicine CMCaroline E. MullisAlbert Einstein College of Medicine EMEric A. MeyerowitzAlbert Einstein College of Medicine

Key Points

To evaluate the impact of doxycycline post-exposure prophylaxis (doxy-PEP) on Chlamydia percentages.
Retrospective cohort study
Clinical data extraction from patients at a sexual health clinic
Comparison of pre- and post-doxy-PEP implementation periods using chi-squared tests and interrupted time series analysis.
Grouping patients based on CDC doxy-PEP guidelines criteria.
Chlamydia positivity decreased from 5.1% to 3.4% in total cohort post-doxy-PEP (p<0.001).
Significant reductions in Chlamydia positivity for MSM and TGW included in doxy-PEP guidelines.
NG positivity also showed a decrease but was less consistent across groups.

Abstract

Abstract Background The 2024 CDC Guidelines recommend doxycycline post-exposure prophylaxis (doxy-PEP) to prevent chlamydia (CT), syphilis and gonorrhea (NG) infections gay, bisexual, and other men who have sex with men (MSM) and transgender women (TGW) with a history of a bacterial STI in the past 12 months. Real-world data for doxy-PEP are needed. Methods In this retrospective cohort study, we extracted clinical data for all patients with CT and NG testing at The Oval Center at Montefiore (TOCM), a large sexual health clinic in the Bronx, NY. Patients were grouped as either included in or excluded from the doxy-PEP guidelines based on a sex and gender assignments, MSM designation, and history of rectal swab test in the electronic medical record. Pre- and post-doxy-PEP implementation periods were designated based on timing of TOCM staff training. Pre-post percent positivity was compared using chi-squared tests, and rate of change of percent positivity was calculated using interrupted time series analysis. Results The cohort included 4,322 and 3,180 unique patients in the pre- and post- periods (Table 1). CT positivity declined from 5.1% (563/10,943) to 3.4% (208/6,078) (p 0.001), 7.2% (416/5,764) to 5.4% (170/3,169) (p 0.01), and 2.8% (147/5,179) to 1.3% (38/2,909) (p 0.001), and NG positivity declined from 5.3% (577/10,941) to 4.3% (261/6078, p 0.01), 8.7% (502/5763) to 7.6% (242/3173, p=0.08), and 1.4% (75/5178) to 0.6% (19/2905, p 0.01) in the pre- and post- periods for the total cohort, those included, and those excluded from the CDC guidelines. In the post-period, CT positivity decreased by -0.17% per month (95% CI, -0.348%, 0.002%, p 0.05) and by -0.36 % per month (95% CI -0.54%, -0.18%, p 0.001) in participants not included and included in the doxy-PEP guidelines, respectively. In the post-period, NG positivity decreased by -0.05% per month (95% CI -0.11%, -0.004, p =0.03) in those not included in doxy-PEP guidelines and was not statistically significant in those eligible for doxy-PEP (-0.30%, 95% CI -0.70, 0.10, p=0.14). Conclusion In this real-world analysis of individuals at a sexual health clinic in the Bronx, we found CT positivity declined after doxy-PEP implementation in all groups, and more for those included in the CDC guidelines. Disclosures Eric Meyerowitz, MD, Mannkind Corporation: Grant/Research Support|Paratek: Grant/Research Support|UpToDate: Honoraria

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