Antimicrobial-resistant Gonorrhea

We are facing the very real possibility that gonorrhoea infections are going to become untreatable in the not so distant future. Antimicrobial resistance (AMR) is making gonorrhoea infections more and more difficult to treat. Previous research has shown that an important consideration for modelling gonorrhoea is the role of a “core group” (a group of individuals who have much higher contact rates than the rest of the population) (see: here). At the same time, some new research suggests that doxycycline PEP (post-exposure prophylaxis with doxycycline (within 3 days) after unprotected sex in men who have sex with men (MSM) and transgender women is very effective. However, it seems like increased use of doxy-PEP could further contribute to increasing antimicrobial resistance. Develop a model to answer the following question: Under what conditions do you think that introducing doxy-PREP into the public health toolbox for this population will or will not contribute to AMR?