Land & Health Inequity Acknowledgement
The Principal Investigators, Community Advisory Board, and study team and staff respectfully acknowledge that this work takes place on the traditional and unceded and treaty lands and territories of diverse Indigenous communities across the country now commonly called Canada. We also respectfully acknowledge the devastating legacies and harms of colonialism in creating ongoing, systemic health inequities for marginalised individuals and communities across Canada. We especially recognise these ongoing impacts in healthcare, sexual health, and associated research on Black, Indigenous, and people of colour (BIPOC) as well as Trans and genderqueer folks, and other members of 2SLGBTQIA+ communities. The DISCO Team is committed to ensuring that our work acknowledges and actively works to address these current and past harms, that we actively work to prevent replicating these harms, and to further ensuring that we work in solidarity and allyship with our BIPOC and queer communities across this land. We believe that our research in bacterial STI prevention can improve sexual health for all people, including especially those individuals and communities currently and historically impacted by the legacies of colonialism, racism, heterosexism, cissexism, patriarchal privilege(s), homophobia, and transphobia.
The DISCO study is a prospective multicentre, open-label randomized controlled trial (RCT) examining the use of the antibiotic doxycycline in preventing sexually transmitted infections (STI).
There are two study arms: (1) STI pre-exposure prophylaxis (PrEP; daily 100mg doxycycline); STI post-exposure prophylaxis (PEP; 200mg doxycycline after exposure event). The study will recruit 560 Canadian gay, bisexual, and other men who have sex with men (gbMSM) and transgender women, who will be followed for 15 months.
The primary objective of the study is to establish the non-inferiority of STI PrEP vs. PEP, by examining the efficacy of each intervention in preventing incident bacterial STI (syphilis, gonorrhea, and/or chlamydia, including LGV) cases in gbMSM. The study will also be examining tolerability and safety, changes in sexual behaviour, adherence measures, antimicrobial (i.e. antibiotic) resistance development, as well as some mathematical modeling and economic evaluation work examining the impact of PrEP and PEP on STIs.
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