HIV / AIDS Infectious Diseases Sexual Health Skin Health

BC Centre for Excellence, Ministry of Health partner to reduce spread of bacterial STIs

BC Health Minister Adrian Dix (at podium) announces support for new program to reduce bacterial STIs. BC Centre for Excellence on HIV/AIDS Executive Director Julio Montaner (at left) and Providence Health Care CEO Fiona Dalton (Right) look on.

The BC Centre for Excellence in HIV/AIDS in Vancouver is launching an initiative to make it easier and cheaper to get treatment for bacterial sexually transmitted infections.

The targeted program, supported by the British Columbia Ministry of Health, will start for BC-CfE patients who meet certain criteria on December 1, 2023.

Anti-bacterial to be free for eligible patients December 1

“We are making it easier and more affordable for people in B.C. to get the treatment they need to protect themselves against bacterial sexually transmitted infections (b-STIs) specifically syphilis, gonorrhea and chlamydia,” says Adrian Dix, Minister of Health. “That is why starting December 1, we are making post-exposure prophylaxis (PEP) doxycycline available at no cost to eligible patients, which is a crucial step in reducing the spread of b-STI in B.C.”

He adds this is an expansion of the Treatment as Prevention strategy (known as TasP) “that we know works and has had tremendous success with the fight against HIV/AIDS.”

Syphilis cases on the rise in BC

This announcement comes in the context of an evolving outbreak of syphilis. According to BC Centre for Disease Control data, the number of Infectious Syphilis cases in British Columbia has nearly doubled from 911 in 2020 to 1973 cases in 2022. Between January and June 2023, 988 cases were reported in BC.

A recent New England Journal of Medicine report, focused on men who have sex with men and transgender women, found a 200-milligram dose of Doxycycline taken within 72 hours of a high-risk sexual encounter can decrease sexually transmitted infection incidence by two-thirds. Similar results were also reported from a recent pilot Canadian multicenter study, including BC-CfE and BCCDC investigators, the Dual Daily HIV and Syphilis (DuDHS) trial.

Dr. Julio Montaner, Executive Director and Physician-in-Chief of the BC-CfE, which is housed at St. Paul’s Hospital, says: “The new Doxycycline initiative is based on the successful model that has made the BC-CfE a world leader in the treatment and prevention of HIV/AIDS. It builds on the made-in-BC (TasP) strategy which includes the facilitated and supported access to testing, treatment in the form of ART and prevention, including HIV PrEP. TasP has been very successful in reducing new HIV infections in BC. It is a fundamental part of BC-CfE’s mandate to improve the health of British Columbians through the development, facilitation, monitoring and evaluation of new research and treatment programs for individuals living with or at risk of communicable diseases.”

Doxycycline is a second-generation, generally well tolerated, tetracycline with a limited antibacterial spectrum. It was first available commercially in the 1960s, and since then, has been used by millions for treatment of acne vulgaris with favorable safety and efficacy. While doxycycline is already a PharmaCare benefit for acne vulgaris, including it in the BC-CfE’s Drug Treatment Program because it is a safe, effective and inexpensive strategy to reduce the incidence of bacterial sexually transmitted infections, including gonorrhea, chlamydia, or syphilis will help more people access and benefit from doxycycline at no cost.

BC-CfE to monitor, report on doxycycline safety, efficacy

Prescriptions will be available to health care providers using the same mechanisms currently in place to prescribe HIV PrEP or Anti-Retroviral Therapy (ART) through the BC-CfE.  At this time, the criteria for eligibility are limited to those who have seen the benefit of this treatment in published, peer reviewed research. As part of its rigorous ongoing monitoring for safety and efficacy of HIV treatment and prevention, the BC-CfE will monitor, evaluate and report on the safety and efficacy of the doxycycline initiative with the reports publicly accessible on the BC-CfE website.