This trial looks at men who have sex with men and transgender women who are at risk for sexually transmitted infections. It also examines the presence of methicillin-resistant Staphylococcus aureus (a type of bacteria that no longer responds to many common antibiotics) in the nose and changes in the gut microbiota (the community of bacteria that live in the intestines). Participants may be using pre-exposure prophylaxis (PrEP) (a daily pill taken to prevent HIV infection) or be living with HIV. The study medication is a daily oral tablet containing doxycycline, referred to in the protocol as doxyPEP, which is an antibiotic used to try to prevent infections after possible exposure. The trial also looks at the development of antibiotic resistance (when bacteria change so medicines no longer work).
The purpose is to see how taking this antibiotic affects the rate of resistant nasal bacteria, the frequency of sexually transmitted infections, and the composition of gut bacteria over one year. Participants will be asked to take the study tablet for about 12 months, attend a few clinic visits for simple nose swabs (samples taken from the inside of the nose) and stool samples, and answer short questionnaires about health and sexual activity. The study will compare the outcomes with those of participants who do not receive the antibiotic.



Spain