Fig. 2: Impact of doxy-PEP on incident gonorrhoea infections across different antibiotic susceptibility statuses among GBMSM.

Show mean annual gonorrhoea incidence rates (per 100 person-years) under various scenarios, by antibiotic susceptibility status: A “Neither” (exhibiting neither Ceftriaxone DS nor HL TetR); B “Ceftriaxone DS only”; C “HL TetR only”; and D “Both” (concurrent Ceftriaxone DS and HL TetR). E Projects 10-year (2025–2034) mean cumulative change (with 95% UI error bars) in gonorrhoea infections (thousands) compared to the base case for each intervention scenario. Bars within each scenario are stratified by the four susceptibility statuses (defined in A–D) and two aggregate categories: “All HL TetR” (sum of “HL TetR only” and “Both”) and “All Ceftriaxone DS” (sum of “Ceftriaxone DS only” and “Both”). All results shown are means (with 95% UI error bars) derived from n = 900 independent simulations (30 stochastic simulations for each of the 30 best-fitting parameter sets). GBMSM gay, bisexual, and other men who have sex with men, STIs sexually transmitted infections, Doxy-PEP doxycycline post-exposure prophylaxis, PrEP pre-exposure prophylaxis, DS decreased susceptibility, HL TetR high-level tetracycline resistance (used as a proxy for doxycycline resistance).