In clinical trials, antibiotics for STI prophylaxis have been shown to be effective in condomless sex between men who have been assigned male at birth ( AMAB ) and trans* men who have sex with men ( AMAB ).
Based on these findings, the following people may benefit from antibiotic bacterial STI prophylaxis:
Men who have sex with men (AMAB) and who
- have condomless anal sex with multiple partners and/or
- had a bacterial sexually transmitted infection (STI) within 12 months and/or
- engage in sex with multiple partners within a short time frame (more than two partners) and/or
- Engaged in chemsex (refers to the use of drugs such as methamphetamine, GHB/GBL, and mephedrone before or during sex to enhance or prolong the experience)
Taking into account modes of transmission within communities, the following may also benefit from antibiotics for STI prophylaxis on a shared decision basis
- Persons assigned male at birth who engage in condomless sex with multiple partners and have had a bacterial STI diagnosed within the past year, and have ongoing elevated risk for bacterial STIs.
- Persons assigned female at birth who do not engage in vaginal/front hole sex, had a bacterial STI within 12 months and have ongoing elevated risk for bacterial STIs.
Early research in heterosexual cisgender women was inconclusive because of medication intake irregularities. What's more, antibiotic STI prevention has not been evaluated in people under 18.
As antibiotic STI prophylaxis is relatively new, ongoing research may expand the eligibility criteria.