Question re: Chlamydia Infection

[isoanswers]

Recently, both my new partner and I were diagnosed and treated for a Chlamydia infection. We are trying to figure out where it came from and are wondering if you might be able to help. Here are some details that I hope will help you provide an answer.

At my annual OBGYN exam, my doc always tests me for HPV and Chlamydia and my tests have always come back negative.

My previous partner (from whom I’ve recently split) and I had unprotected intercourse and I do not know if he was infected with Chlamydia, but given my prior negative test results, I assume he was not.

Approx. 37 days after our last unprotected encounter, I had my annual OBGYN exam and again tested negative for both HPV and Chlamydia.

Approx: 73 days after my last unprotected encounter with my previous partner, I engaged in some activity with another man (my current partner). Although we did not have intercourse, we did have oral sex and the very tip of his penis momentarily entered the opening of my vagina. He did not ejaculate inside of me, however, he did ejaculate, so his ejaculate was in the vicinity (on our bodies, fingers, etc)

And then, approx: 125 days after the last unprotected encounter with my previous partner, I had unprotected intercourse with my current partner over the course of a few days.

Shortly thereafter, we both got tested for every STD possible to be sure neither of us was infected with anything that we could have passed on to the other. (I was tested at 7 days post potential exposure and he was tested at 14 days.)

We both tested positive and were treated for Chlamydia. All the other tests were negative; however we understand that we may have tested too early for some infections.

That being the case, we have a few questions (please scroll down to the comments section for the questions)

Thank you for your help!

[H. Hunter Handsfield, M.D.]

There is a word limit to new questions, and the entire question is to be asked in the initial window.  The moderators don't necessarily see all windows at once and it is inconvenient to go back and forth, and I'm having trouble understanding the sequence of events and partnerships.  Apparently one of your exposures was by oral sex.  You can disregard that one; a woman cannot acquire genital chlamydia through cunnilingus.  Chlamydia is only transmitted through vaginal or anal intercourse; if there are exceptions there are rare.

As to whether you acquired the infection from your previous partner or your most recent one, and which of you brought the infection into the relationship, I cannot say with certainty.  Most likely you will never know for sure.  But I really don't see that it matters.  The important thing is that you both get treated.

In response to some of the questions below:  Re-testing for chlamydia is recommended 3-4 months after treatment, because of the slight chance of treatment failure, and because there is a high risk of reinfection.  The last is not possible, of course, if neither of you has other partners after treatment is complete.  Still, better safe than sorry.

False negative chlamydia tests are possible, but uncommon with the modern tests that are most commonly used.  Accurate testing can be done within a few day of exposure.

Regards--   HHH, MD

[isoanswers]

Here are our questions:

Since we both tested positive for Chlamydia, who infected whom, or more specifically was I infected by my former partner or my current one?

Since I am tested on an annual basis, and all of my tests up until this last one indicated that I was negative, I am assuming that my current partner was infected and passed the infection along to me (the last time he was tested for anything was in 2007), however, he is thinking that I might have been infected by my former partner and may have passed it along to him, even though I tested negative 37 days after my last unprotected encounter with my former partner. Your thoughts on this would be most appreciated.

Also, as neither of us are experiencing any symptoms and understand that one may still be infected even in the absence of symptoms, we have elected to do the responsible thing and abstain from unprotected intercourse until all of our tests are definitively negative.

So that said, when is the best time for us to test to ensure that we are “absolutely safe” to have unprotected intercourse as long as we remain monogamous, taking into account window/seroconversion/incubation periods?

Thanks again for your guidance!

[isoanswers]

While awaiting your reply (and reading some of the other forums) we came up with a few more questions:

Is it possible to test negative for Chlamydia, not have any symptoms and yet still be infected and pass it on? How likely is this?

Does Chlamydia ever clear on it's own, over time and without antibiotics, so that if you were once infected and didn't know it (no symptoms), and it cleared on it's own, your test results would be negative if it had, in fact, cleared up on it's own? How likely is this?

What is the most accurate window/timefram to test for Chlamydia after a potential exposure?

We think those are all our questions (for now, at least).

Thanks again for your time. We are eager for your reply and appreciate the good work you both do here!

[isoanswers]

Thanks for your reply. I apologize for the confusion, but to clarify, I have a few follow up questions:

The facts:

In the past, I always tested negative for Chlamydia at my annual OBGYN exam.

I was in a monogamous relationship with "Larry" for 10 years (recently ended).  Although I do not know if Larry was infected, I am assuming that he was not given my history of negative tests over the years.

In December, a new partner, "Paul", and I had unprotected intercourse one time and I do not know if he was infected with Chlamydia.

Approx. 37 days after my first and only unprotected encounter with Paul, I again tested negative for Chlamydia at my annual exam.

And then, approx: 85 days after I tested negative for Chlamydia, I had unprotected intercourse with my current partner, "Dan" over the course of a few days.

Shortly thereafter, we both tested positive and were treated for Chlamydia. I was tested seven days after we last had intercourse and Dan was tested at 14 days.

Since we both tested positive for Chlamydia, and Dan has not been tested for anything since 2007, I am assuming that Dan had Chlamydia and infected me.

He, however, seems to think that I was the one who infected him, but I say impossible because

a) Up until this last test, I was ALWAYS negative.
b) 37 days after my last exposure to Paul, I tested negative.
c) It was only after my exposure to Dan that I tested positive, therefore, I must have contracted the Chlamydia from Dan.

Of course, he's saying it must have come from me because the last two women he was with since 2007 weren't infected and if he had it, then they would have been infected as well.

As for me, based on my test results, I have every reason to believe that Larry was not infected, and if Paul were infected, then I would have tested positive on the test I took 37 days after having unprotected intercourse with him.

So my question is, in your professional opinion, did I get Chlamydia from Larry, Paul or Dan?

I really think it was Dan and that he’s not being honest with me, but I don’t want to jump to any conclusions, so your thoughts are most appreciated.

Thank you for your time and consideration.  

[H. Hunter Handsfield, M.D.]

I agree it is most likely you were infected by Dan.  This is not a definitive conclusion, however.  As I said above:  "As to whether you acquired the infection from your previous partner or your most recent one, and which of you brought the infection into the relationship, I cannot say with certainty.  Most likely you will never know for sure.  But I really don't see that it matters.  The important thing is that you both get treated."

[isoanswers]

Thanks so much for your quick reply. I appreciate your time and the valuable service you and Dr. Hook provide via this site.

The reason that this is so important to me is that I have been completely transparent with Dan, but get he feeling he is not being completely honest with me, especially given the way he is trying to intimate that perhaps it was I who brought the infection into this relationship, suggesting that Larry was not as faithful as I thought or that my past negative test results after my encounter with Paul were incorrect, etc, etc...

So I have quite a few concerns at this stage as Dan has instilled a good deal of doubt in my mind with regard to the source of the infection, even though the fact seem to indicate that he was the one who bought the infection into the relationship.

Perhaps we will never know for sure, but given that all of my tests were negative (up until the last positive one after having been with Dan) I have to agree that the infection must have come from Dan despite what he is saying and that he should reach out to the other two woman he was with immediately preceding me (one 14 months before me and the other 6 months before me) to advse that they should be tested as well.

He says he's spoken to both of them and they are both negative, which lead him to believe that the infection came from me, however, I do not believe he is being entirely honest with me, and that much doubt is not a good foundation for any relationship.

So, we'll see where Dan and I end up, but if you believe that the infection came from him, given the info above, that that is enough fo me to question the integity of what he is telling me and is making me reconsider this whole relationship.



The good news is that were were both treated. The bad news is I will always doubt Dan and think that perhaps he is not as honest as I thought.

[H. Hunter Handsfield, M.D.]

Certainly it is true that Dan's other partners should be treated.  But don't be critical of Dan.  He could be totally honest with you, to the best of his knowledge, and still have chlamydia.  If you otherwise trust and believe him, you should do so now as well.

That will be all for this thread.  Take care.