Could meningitis vaccines be used to prevent gonorrhoea?
Cases of gonorrhoea have are on the increase among men who have sex with men.
Queer researchers are exploring how treatments for meningitis and malaria could be used “off-label” to prevent gonorrhoea, syphilis and chlamydia.
According to Canadian queer magazine Xtra, there are three ongoing trials, all helmed by queer scientists, looking at the antibiotic doxycycline and how it could be used to prevent sexually transmitted and blood borne infections (STBBIs) like syphilis and chlamydia.
Daily doxycycline pills are usually prescribed to prevent malaria, although it has other approved uses like treating severe acne and infections.
Darrell Tan, an infectious diseases specialist who leads one of the studies, said: “In addition to being a gay man, I wear my hat as a researcher. From that researcher’s perspective, most of us don’t feel like it’s quite ready for prime time yet.”
Tan said there are “still some important unanswered questions”, including the question of antibiotic resistance.
Although early results suggest doxycycline as a preventative measure for syphilis could be effective, Tan added: “What we need to better understand is exactly the magnitude of that increase in resistance, and the nature of it.”
But what the studies certainly show is that LGBT+ folk are still leading the way when it comes to queer sexual health.
Jody Jollimore, an LGBT+ health advocate and executive director of the Community-Based Research Centre (CBRC), told Xtra that he has started using himself as a test subject.
Jollimore uses established prevention methods like the HPV vaccine and PrEP, bit has also started treating himself with doxycycline, as well as taking the meningitis vaccine Bexsero to prevent gonorrhoea, which has seen promising results in preliminary studies.
While using medication off-label without comprehensive research is, of course, not recommended, Jollimore said that queer people “are once again exploring and leading the prevention efforts way before governments or public health”.
In the UK, recent data from Public Health England shows that STBBIs like syphilis, gonorrhoea and chlamydia are all on the rise, with queer men being one of the worst-affected groups.
In Canada, a 2019 survey of queer and trans men saw 15 per cent of respondents report having had chlamydia or gonorrhea within the past year, a level between 5,000 and 16,000 higher than the general population.
Jollimore said that when government funding is lacking, “local and community-based organisations who test, treat, educate about and help prevent these infections must do more with less”.
Gary Kinsman is an LGBT+ rights activist and sociology professor at Laurentian University who, during the AIDS crisis, smuggled HIV treatments across the US border into Canada.
He said: “Queer people have often had to use unauthorised, unapproved treatments — and that was especially the case in the context of AIDS and HIV… We responded to them leaving us to die.”
However, the science is clear: while Bexsero and doxycycline look like promising treatments to prevent STBBIs, far more research needs to be done before they are confirmed as safe and can become widely available.
Alex Smith, a doctor who works to get queer people more affordable access to medications like PrEP, said: “Be true to your values, do your homework and let the work speak for itself.
“Ultimately, it’s important we take care of each other in the best ways we know how. When conventional channels fail, we have to go beyond.”
