dormancy period for chlamydia

Hello,
Can you still have chlamydia after consistently testing negative for years? I recently tested positive, after testing negative only a few months ago. Also, I have been getting tested for years with my annual exam and have had 1 monogamous partner for the past several months.  Before that I was abstinent for 4 years aside from one encounter, where condoms were used.  I tested negative between that partner and my current one. I'm confused where I contracted it because I my partner says he was tested a year ago and tested negative aswell, and because we use condoms.  He says I couldn't have contracted it from him. Is it possible I contracted this years ago, have been testing negative until now? And, is it possible I could've contracted it from my current partner with condom use? Thanks for your help.

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I'll try to help.

The quick answer to the opening question is no.  Probably it is not possible to have chlamydia for years with negative tests.  Chlamydia can be carried for long periods, but the longest ever documented in women is 4 years and that's rare.  And the modern chlamydia tests are very sensitive -- that is, they are very good at detecting infection.  The odds you have both such a longstanding infection AND that all your tests over the years were negative are too low to calculate.

That means that there are 2 possible explanations for your positive test.  First, the test could be wrong.  False positive tests are rare, but they can occur.  The likelihood depends a bit on the specific test that was done; several tests are on the market and used by various labs, and some are more likely to give false positive results than others.

Second, you have been infected sometime since your previous negative test.  This seems the most likely explanation, but only if your partner has had sex with other partners.  Of course I cannot judge whether your partner is being truthful about that.  Condoms are highly protective, but not perfect.

It would be a good idea for you to be re-tested, and tell your provider you want either the  Aptima test (marketed by Gen-Probe) or Probe-Tec (from BD diagnostics).  Avoid the Pace II test (also by Gen-Probe) or Amplicor (by Roche Molecular diagnostics); those are the ones more likely to give false positive results.  Also, your partner should be tested.  Finally, to be safe, you and your partner both should be treated (before your new test specimens have been collected).

I hope this helps.  Best wishes-- HHH, MD