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Programs in Seed Grants

Quantification of doxycycline levels in neovaginal mucosa; implications for doxycycline bacterial STI prophylaxis in transgender women and transfeminine people

The seed grant research team at an LGBTQ+ event, preparing to recruit participants. From left: Dr. Benjamin Laniakea, Zachary Renfro, Dr. Fiona Yamamoto, and Dr. Benjamin Pinsky. Photo via Dr. Benjamin Laniakea.

When it comes to the treatment of bacterial sexually transmitted infections (STIs), could transgender women who have undergone vaginoplasties respond differently to common antibiotics as compared to other LGBTQ+ patients? This project seeks to find out and, in doing so, address a research gap for this under-represented population. Men who engage in sex with men who take antibiotics within 72 hours of unprotected sex have recently been found to contract chlamydia, gonorrhea, or syphilis significantly less often. However, transgender women are significantly underrepresented in such clinical trials, and transwomen who have undergone gender-affirming vaginoplasty are completely absent. Researchers hope to shed light on how doxycycline, a common antibiotic used to treat STIs, interacts with the body, particularly the neovaginal canal, for the duration of exposure. As transgender women experience a higher incidence and prevalence of STIs than their cisgender counterparts, this research could better inform STI prevention measures and enhance sexual health clinical care, especially for transgender women and other LGBTQ+ communities.

“This research concerns medications that have allowed patients previously deemed to be in ‘high-risk sexual behavior’ demographics to dramatically decrease their risk of bacterial STIs, notably in the LGBTQ+ communities,” said Principal Investigator Dr. Benjamin Laniakea, MD.

Principal Investigators:
Dr. Benjamin Laniakea, MD, Clinical Associate Professor, Stanford University School of Medicine, Department of Primary Care and Population Health, Chief, Stanford LGBTQ+ Health Program; Dr. Caitlin A. Contag, MD, Fellow, Stanford University School of Medicine, Division of Critical Care Medicine

Research Team:
Zachary T. Renfro, MD Student, MS Candidate in Epidemiology and Clinical Research, Stanford University School of Medicine; Dr. Vivian Levy, MD, Clinical Associate Professor, Stanford University School of Medicine, Division of Infectious Disease and Geographic Medicine, Chief of Infectious Disease, San Mateo Medical Center, STD Control Officer, San Mateo County; Kathy Yang, PharmD, MPH, Co-Vice Dean of Clinical Innovation and Entrepreneurship, Professor, University of California San Francisco, Department of Clinical Pharmacy; Dr. Adi Xiyal, PhD, MSTP Student, Stanford University School of Medicine; Meg Quint, MD Student, Stanford University School of Medicine; Muge Kalaycioglu, MD, Post-Doctoral Scholar, Stanford University School of Medicine, Institute for Immunity, Transplantation, and Infection; Shannon Amitin, QT Cruising Executive Producer, San Francisco

Stanford Center for Innovation in Global Health, Stanford Department of Medicine