The DoxyPEP trial aims to understand whether doxycycline might be useful to treat postpartum depression. Yet, it is under significant threat due to recent funding cuts. DoxyPEP is a promising new form of STI prevention. Staphylococci are responsible for infections like chlamydia, syphilis, and gonorrhea. Yet the U.S. Centers for Disease Control and Prevention (CDC) only recommends this life-saving medication to gay and bisexual men and other men who have sex with men. It is currently recommended for transgender women as well. Studies found that doxyPEP can reduce the chances of getting chlamydia and syphilis by over 80 percent. It can reduce the risk of gonorrhea by about 60 percent.
Dr. Jenell Stewart, an infectious diseases physician scientist, leads the nationwide clinical trial, which was set to enroll approximately 600 postpartum individuals over a span of more than five years. Participants in the trial would receive doxyPEP in varying doses: one-third on-demand following sexual encounters, another third weekly regardless of sexual activity, and the remaining participants would receive quarterly testing for infections along with counseling.
The Importance of DoxyPEP
DoxyPEP is already the standard of care for high-risk STI groups. This application has become an indispensable tool that empowers people to take charge of their sexual health. It further demonstrates effectiveness in investigating possible advantages to postpartum depression. The drug both prevents and treats problems, illustrating an important connection between sexual health and mental health. This is especially crucial for populations who are vulnerable to developing both diseases.
Dr. Stewart agrees that it’s critical to get through the trial—especially with such a negative funding environment expected.
“It doesn’t make economic sense. It doesn’t make ethical sense. There’s not a lot of rationale behind an abrupt end to a study network, or a study like [the doxyPEP trial], especially where the current administration has stated goals of improving longevity and quality of life.” – Jenell Stewart
Looking at the ongoing study, postpartum depression affects millions of new mothers every year. Lauren Osborne, Dr. Stewart’s current research colleague, sheds light on a major concern. Far too many women who experience postpartum depression aren’t getting the proper treatment they deserve, either.
“We do a shockingly bad job of treating postpartum depression in this country,” – Lauren Osborne
Challenges Amid Funding Cuts
These changes have led to serious concerns among other researchers working on the DoxyPEP trial and other similar studies. Chronic funding reductions threaten an irreplaceable array of important research initiatives. If successful, these initiatives would make transformative strides in our mental health and efforts to prevent and treat infectious disease worldwide.
Public health advocate Janet Handal noted the catastrophic effect these cuts have had on research initiatives.
“The cuts at NIH have just been devastating,” – Janet Handal
She argued that continuing projects today are now at risk of stopping altogether. This undermines decades of hard work focused on fostering more equitable health outcomes.
“All this work that’s been done — and remains to be done — it just comes to a standstill.” – Janet Handal
The abrupt cessation of funding not only affects current trials but disrupts the potential for future advancements in medical research.
Ethical Responsibilities to Participants
Researchers involved in the DoxyPEP trial express deep concern regarding their ethical obligations to participants who volunteered for the study. Thousands of enrolled patients rely on this research for direction and hopeful paths forward.
Lauren Osborne reminded us all of the moral obligation that researchers have to these participants.
“We made a promise to these people,” – Lauren Osborne
To abandon the trial now would pose serious ethical dilemmas. We can’t continue short-changing researchers as they try to meet these funding challenges and in turn balance their obligations. Dr. Stewart strongly believes in honoring their promise to participants even when the study’s findings will likely lead to unhelpful conclusions.
“It’s not going to give us any useful research material, but it completes that ethical obligation to our participants,” – Lauren Osborne
Despite these challenges, Dr. Stewart is hopeful that doxyPEP will show the same promise for postpartum depression.
“It should work; I think it’ll work for you,” – Jenell Stewart
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