Chlamydia - Treatment and Testing Window

[Clare90210]

Hi there,

I think this may come across as a bit of a paranoid post!  About a three weeks ago I had unprotected sex with a guy I had only just met.  I immediately became a bit paranoid about having contracted an STD, especially Chlamydia or Gonorrhea.  I had testing done for Chlamydia, Gonorrhea and Trich 5-6 days after this encounter.  The tests were PCR using cervical swab.  Due to my anxiety, the doctor prescribed me 1g zithromax for Chlamydia and gave me a shot to treat any possible Gonorrhea.  To date, I haven't had any symptoms of venereal disease - though perhaps some itching/thrush sensation as a result of heavy antibiotics lately.  All three test results came back negative.

My concern is that during this time I have recently gotten back together with a former boyfriend.  We had unprotected sex about 7 (almost 8) days after me taking this treatment.  I have become absolutely paranoid that: (a).  The test results were false positives - i.e. that 5-6 days post exposure was too early to obtain a positive result; (b)  Even though I have been treated for Chlamydia and Gonorrhea, the treatment may have failed (I have read elsewhere of this happening); and finally that I had unprotected sex with my former boyfriend too soon after treatment - i.e. that not all of the bacteria will have been killed and he may now have caught something off me.

I can kind of see that perhaps I am feeling a little guilty about this sexual encounter and how it might impact my new relationship - but what is the likelihood of needing to worry about any of my concerns above?

I know the lesson here is to use protection, always!!


Thanks in advance for your advice.

[H. Hunter Handsfield, M.D.]

Thanks for your kind comments.  Take care.

[Clare90210]

Dear HHH,

Thank you so much for your response - I feel a great deal better.  I agree that it is definitely guilt over my behaviour that is getting to me at this stage.  I will work on that one!


Thanks again - this forum is so important and so greatly appreciated.

[H. Hunter Handsfield, M.D.]

The gonorrhea and chlamydia probably were nucleic acid amplification tests (NAAT, i.e. PCR or related technology).  My guess is that the trich test was a culture.  I saw these comments before I replied above.  They don't change my opinion or advice.  

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Bottom line:  you can be 100% you have neither chlamydia, gonorrhea, nor trichomonas and could not have transmitted either of them to your boyfriend.

First, although it is certainly possible you were exposed to one of these infections, it isn't very likely. Even the most common STDs are present in only a few percent of sexually active persons at any one time.  Second, even if he had an infection, the chance of transmission for any single unproteced exposure is not certain -- probably around 50%.  Third, the tests are very accurate; your negative tests were reliable; 5-6 days after exposure is plenty of time for accurate results.  Finally, the treatments you received are highly reliable against gonorrhea and chlamydia.  If despite all odds you nevertheless had been infected, within 1-2 days of taking the drugs you were no longer infectious for your partner.

Could any one of those factors gone the wrong way?  Sure.  But the odds of all four going the wrong way (partner infected, you caught it, tests missed it, AND the treatment didn't work) are infinitessimal -- zero for all practical purposes.  You don't need further testing and need not worry about infecting your partner.

I agree with your own self-assessment -- that the main problem here is your guilt over your behavior.  But don't beat yourself over the head with it -- and you can put aside the STD aspects.  However, I have a single word for you in the event you find yourself similarly tempted in the future:  Condom!

Best wishes--  HHH, MD

[Clare90210]

Sorry - another note:  I'm not certain the tests were PCR they may have been a culture?

[Clare90210]

Apologies - in my post above I wrote that I was concerned (under (a)) that the test results were false positives as it was too early to test - i mean I am concerned that they are false NEGATIVES as it was too early to test.

Thanks