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Chlamydia Positive; HIV risk?
Hey Doctor:
I am a 22 year old male. I had unprotected sex with a female friend multiple times (probably 8-10 times) in four nights. We only had vaginal intercourse. We both had been tested in the past 6 months, and we both were clean on the standard STD swab test; neither of us had new partners.
Nonetheless, two weeks later I had a painful feeling when I urinated. I went to the doctor, and I was tested and diagnosed with chlamydia. My partner was tested for HSV, syphilis, gonorrhea, and chlamydia. She came back positive for chlamydia as well. She was not tested for HIV.
I waited three more weeks, and I was tested again for everything HIV, syphilis, gonorrhea, chlamydia, and HSV. All tests came back negative. I realize now that I did not wait to hit the 6 week benchmark; I waited only 5. I had the blood test done on me. I have had no symptoms, but I worry now because I read on how chlamydia is a large risk factor for HIV.
Do you think I am fine even if did not wait for the 6 week benchmark? Is one week going to make that big of a difference in the testing for HIV especially when a blood test is being used? I mean I do not want to go to doctor again seeming overly anxious, and I would prefer not to get 3 STD tests in one summer.
Thanks.
I am a 22 year old male. I had unprotected sex with a female friend multiple times (probably 8-10 times) in four nights. We only had vaginal intercourse. We both had been tested in the past 6 months, and we both were clean on the standard STD swab test; neither of us had new partners.
Nonetheless, two weeks later I had a painful feeling when I urinated. I went to the doctor, and I was tested and diagnosed with chlamydia. My partner was tested for HSV, syphilis, gonorrhea, and chlamydia. She came back positive for chlamydia as well. She was not tested for HIV.
I waited three more weeks, and I was tested again for everything HIV, syphilis, gonorrhea, chlamydia, and HSV. All tests came back negative. I realize now that I did not wait to hit the 6 week benchmark; I waited only 5. I had the blood test done on me. I have had no symptoms, but I worry now because I read on how chlamydia is a large risk factor for HIV.
Do you think I am fine even if did not wait for the 6 week benchmark? Is one week going to make that big of a difference in the testing for HIV especially when a blood test is being used? I mean I do not want to go to doctor again seeming overly anxious, and I would prefer not to get 3 STD tests in one summer.
Thanks.
MEDICAL PROFESSIONAL
Welcome to the HIV forum.
It would be interesting to know for sure you had a positive lab test for chlamydia. Sometimes "diagnosed with chlamydia" means the doctor found something like nonconococcal urethritis (NGU) and assumed chlamydia without testing for it.
But regardless of all this, the chance you also caught HIV is virtually zero. Chlamydia and HIV have totally different epidemiologies. The first is the most common bacterial STD in the US and other industrialized countries, where HIV one of the rarest STDs. The chance your partner had HIV is very low -- statistically speaking, well under one chance in 1,000. And if she had it, the transmission risk is rougly 1 in 2,000 for each episode of unprotected sex. That means a 1 in 2 million chance each time you had sex.
Still, I'm interested that she wasn't tested for it, however. Anybody tested for any STD should also be tested for HIV. Not that your partner is likely to have it, but it just makes sense to test for the worst possible STD as long as any testing is being done at all.
As for chlamydia as a "large risk factor" for HIV, it depends on context and what is meant by "large". Some one with chlamydia who is exposed to HIV has roughly double the chance of becoming infected. But first you have to be exposed. And given the transmission risk figures cited above, doubling the risk means 1 chance for ever million exposures instead of 2 million. No big deal.
With the HIV tests in standard use, nearly all newly infected people have positive results by 5 weeks -- so your negative HIV test is very powerful evidence you don't have it. If you remain nervous, you could have another one at say 8-12 weeks. But if I were in your situation, I wouldn't think it necessary. You're home free.
Final word, going back to your chlamydia: Have a follow-up chlamydia test 3-4 months after treatment. It's called "rescreening", and is important: 10-15% of people with chlamydia have the infection back when retested, either because of (rare) delayed treatment failure or because of reexposure and reinfection.
I hope this helps. Best wishes-- HHH, MD
It would be interesting to know for sure you had a positive lab test for chlamydia. Sometimes "diagnosed with chlamydia" means the doctor found something like nonconococcal urethritis (NGU) and assumed chlamydia without testing for it.
But regardless of all this, the chance you also caught HIV is virtually zero. Chlamydia and HIV have totally different epidemiologies. The first is the most common bacterial STD in the US and other industrialized countries, where HIV one of the rarest STDs. The chance your partner had HIV is very low -- statistically speaking, well under one chance in 1,000. And if she had it, the transmission risk is rougly 1 in 2,000 for each episode of unprotected sex. That means a 1 in 2 million chance each time you had sex.
Still, I'm interested that she wasn't tested for it, however. Anybody tested for any STD should also be tested for HIV. Not that your partner is likely to have it, but it just makes sense to test for the worst possible STD as long as any testing is being done at all.
As for chlamydia as a "large risk factor" for HIV, it depends on context and what is meant by "large". Some one with chlamydia who is exposed to HIV has roughly double the chance of becoming infected. But first you have to be exposed. And given the transmission risk figures cited above, doubling the risk means 1 chance for ever million exposures instead of 2 million. No big deal.
With the HIV tests in standard use, nearly all newly infected people have positive results by 5 weeks -- so your negative HIV test is very powerful evidence you don't have it. If you remain nervous, you could have another one at say 8-12 weeks. But if I were in your situation, I wouldn't think it necessary. You're home free.
Final word, going back to your chlamydia: Have a follow-up chlamydia test 3-4 months after treatment. It's called "rescreening", and is important: 10-15% of people with chlamydia have the infection back when retested, either because of (rare) delayed treatment failure or because of reexposure and reinfection.
I hope this helps. Best wishes-- HHH, MD
Thanks for the clarification. That makes sense.
MEDICAL PROFESSIONAL
Well, I'm glad you ultimately got the right treatment. Cipro is not recommended and not particularly effective for NGU; it was the wrong drug even if you hadn't had chlamydia. Azithromycin is good for both.
The Padian article wasn't wrong. It's the difference between population level risk and the chance of infection for any particular person. In a country with uncontrolled chlamydia, a doubling of HIV risk in infected people might mean thousands more people catching HIV each year than if chlamydia didn't exist. But the enhanced risk for any individual remains small.
The Padian article wasn't wrong. It's the difference between population level risk and the chance of infection for any particular person. In a country with uncontrolled chlamydia, a doubling of HIV risk in infected people might mean thousands more people catching HIV each year than if chlamydia didn't exist. But the enhanced risk for any individual remains small.
Thanks Doc!
Weight off my shoulder.
The original diagnosis was NGU; my doctor called me after the lab work came back 3 days later. I was originally treated with cipro for 5 days. Then, he gave me the 1 gram of Azithromycin just to make sure it was "dead".
I got the large risk factor from the 1997 Padian article.
Thanks again Dr. Handsfield. It means a lot. I feel a lot better.
Weight off my shoulder.
The original diagnosis was NGU; my doctor called me after the lab work came back 3 days later. I was originally treated with cipro for 5 days. Then, he gave me the 1 gram of Azithromycin just to make sure it was "dead".
I got the large risk factor from the 1997 Padian article.
Thanks again Dr. Handsfield. It means a lot. I feel a lot better.
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