Chlamydia

[tiopreocupado]

Dear Dr.

On the 22nd of June 2005 I had sex with a sex worker from Brasil in a spanish nightclub. The sex was protected (both oral and vaginal) during the entire relation. Due to anxiety and guilt I got tested at 4, 12 and 24 weeks on Hep A (only at 4 weeks mark), Hep B, Hep C and Hiv (antibodies 1&2 and antigen P24). All the results were negative. Besides this afair I only had sex with my wife (over the last 15 years).

My wife and I do not have sexual relations very often and always protected by condom (she gave birth on the 30th of March 2005). In September 2005 she complaint a little about an itching feeling in her vagina, starting just several days after our last sexual encounter. Guilt and Axiety made me avoid having sex with her again until 2 weeks ago. During 2 or 3 days after this sexual encounter she lost a little blood (she noticed it cleaning herself after urinating). Two days ago we had sex again and when we finished I saw blood on the condom and she was bleeding a little when she cleaned herself. Beside the blood she lost some bloody tissue/membrane like material (her period should come within the next 4 days.

Question 1: The sex worker washed with her hands first her vagina with water and after that my penis, also with water. Is any STD transmision, like Chlamydia, possible through this behaviour?

Question 2: Could the symptoms of my wife be related with any STD?

Question 3: Today, the 22nd of February, I went again to the laboratory and gave some blood, in order to examine it on antibodies of a possible Chlamydia infection. Will the result of this examination be definitive or could there be a possibility of getting a negative result while there is no bacteria any more in the blood, as it has been 8 months since the encounter with the sex worker?

Question 4: Could you please reassure me that neither Hepatitis nor HIV has been contracted by this one time encounter with the sex worker? (there is no way some hiv virus is in my body, not enough to get a positive result by a test but enough to be triggered by some other infection in the future?)    

Thanks for your patience!

[H. Hunter Handsfield, M.D.]

You seem to have greatly overreacted.  The chance you acquired any STD from condom-protected sex (both vaginal and oral) is extremely low; all the hepatitis testing was unnecessary.

1) No STD can be acquired in the way you descibe.

2) I cannot say what is causing your wife's symtpoms. There are many posible causes, including chlamydia and other STDs--but many non-STD causes as well.  If your wife considers her symptoms abnormal, she should see her health care provider.  But if she has an STD, it did not originate with your exposure in Brasil.

3) There is no blood test that can accurately diagnose chlamydial infection.  If the result is positive, it will mean you were exposed sometime in your life, and nothing more.  And many people who have had chlamydia have negative blood test results.

4) There is no such thing as being exposed, having a negative blood test, and still being infected.  Your test results prove you were not infected during your Brasil exposure.

Good luck--  HHH, MD

[cbonner]

Chlamydia is a infection of the uretha. You had your covered for vaginal and oral sex. You can't get any safer than that! Relax you do not have chlamydia and your past test proves you dont have HIV or hepatitas. If you had gonnoreah you would have symptoms ( most males do ) Wait for the doc to reply but if his words do not stop your anxiety then get tested, not for medical reasons as you WONT be infected but for psychological reasons to rid you of any anxiety.

[tiopreocupado]

Thanks for your answer.

One last question. Are there more STD's without symptoms in myself, such as Syphilis, that could cause my wife's symptoms?

Or should I just forget about this one time encounter with the sexworker and stop further testing?

Thanking you in advance.......

[H. Hunter Handsfield, M.D.]

I cannot say more about the cause of your wife's symptoms than I already have.  I already said you overreacted and did not need all the tests you have. So yes, of course you should stop further testing; it would be senseless.

HHH, MD

[Kata100]

I am very anxious about a recent positive test result for chlamydia.  My boyfriend and I have been dating for a year and a half and have been sexually active for that amount of time (though we began having unprotected sex just a year ago).  We are completely monogomous.  Recently I experienced much cramping in my lower abdominal, pelvic area.  I was surprised to be positive for this STD, since my boyfriend had been tested a month before and his results were negative.  Could he have had a false negative, even though he has had no symptoms of the disease?  Also, I had unprotected sex in a previous relationship, but was tested for chlamydia and had negative results--is is possible that those were false?  And, if so, could I have had the disease for a year and a half with almost no symptoms?  My doctor did not detect any other irregularites in my pelvic exam, but I'm worried about the damage I've done to my reproductive organs.  Also, I had wanted my boyfriend to get tested at the beginning of our relationship (something I was immensely and regretably foolish to not persist about)...could he have had the disease for over a year and a half and had no symptoms?  And, if he had the disease, why did it resolve itself on its own with him and show up in me?  We have both been treated as of four days ago, though I am still having pelvic cramping after a dose of Zithromax.  Is this normal? Or could I have something else?  Is it possible that I had a false positive test? I am freaking out!!!!

[Kata100]

Also, I wanted to add that I did have what I now see as symptoms several months ago--some vaginal discharge that I thought was due to a yeast infection.  I made my boyfriend get tested then, and since his test was negative, I figured I didn't have anything to worry about.  So the symptoms really began eight months after we began having unprotected sex. Is that normal?  We have been completely faithful to one another and I trust him completely (though I'm mad at him for not getting tested sooner before the disease resolved itself in him, if that's what happened).  Sorry to be so anxious and long-winded about this--I'm just worried about the long term damage to our bodies.