Katherine Gill

Several new sexual and reproductive health interventions are being evaluated or have been shown to be effective in clinical trials, including doxycycline post-exposure prophylaxis (PEP) and vaccines for gonorrhoea. This session explored these advances, identified evidence for implementation, and addressed integration into HIV prevention and treatment services.

Chase Cannon highlighted that there is ample evidence for Doxy PEP (for some populations) from four different trials however it is currently not understood why this intervention did not work for women in Kenya. Few MSM carry high STI burden and there is a need to better identify who might most benefit with the lowest antibiotic exposure risk. Much remains unknown about long-term effects on individual and population level. Public health guidance for doxy-PEP remains limited. Real-world implementation data may provide some answers. Jean-Michel Molina presented data from the Meningitis B Vaccine for Prevention of Gonorrhoea. He confirmed that progress against Gonorrhoea is far short of global targets. Evidence of 4CMenB vaccine efficacy to prevent Gonorrhoea in a clinical trial setting is still pending. He stressed the need to continue to advance basic science, translational research and clinical development of Gonorrhoea vaccines. Elizabeth Bukusi spoke about how to integrate STI prevention interventions into HIV services. She highlighted that traditional and novel strategies can reduce incidence while structural, institutional and individual factors can hinder implementation. She concluded that a multisectoral approach to address barriers and leverage successful implementation of other programs, needs to be considered

Novel ways to prevent STI infections are needed. Cautious implementation of doxycycline PEP has the potential to drastically reduce rates of syphilis and chlamydia in MSM most at risk of these infections and answer some of the questions about long-term effects. Gonorrhoea remains a major public health concern. Increasing concerns about anti-microbial resistance, limited access to diagnostic testing and serious morbidity in women and neonates makes the pursuit of a gonorrhoea vaccine of critical importance. The rising incidence of STIs especially in Africa necessitates novel and traditional approaches to preventing STIs.