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Chlamydia damage, treatment and prevention for my girlfriend
Hi Doc,
I have posted a message on HIV prevention forum several weeks ago. I am a 24 yrs old straight male. My exposure is french kissing, protected vaginal sex and semi-protected oral sex with a CSW in macau at 29th DEC 08. I had a comprehensive std panel test (HIV, syphilis, Chlamydia, gonorrhea, Hepatitis B & C, HSV 1 and HSV 2) on 5 weeks (35 days post exposure) which is done at university health center. Everything comes back negative except herpes 1. I also have a 7.5 weeks HIV 1 DNA PCR, HIV 1/O/2 antibody test done at lapcorp, 9 weeks hiv1/2 antibody test done at health center and 12 weeks (83 days) comprehensive std tests (same as the 5 weeks) done at health center. However, Chlamydia show positive for the 12 weeks comprehensive std test. The following are my stupid questions,
1) Since both chlamydia tests are the same (Urine PCR), how could it be negative on 5 weeks then positive on 12 weeks? (I have no sex after that exposure)
2) Since my exposure is protected vaginal sex, semi protected oral and french kissing, so it means chlamydia can pass through the condom? or I experienced condom breakage?
3) If you think that I experience condom breakage and given my hiv test results, do I still at risk of HIV (conclusive and definitive?) or Chlamydia can delay or alter the accuracy/reliability of HIV DNA PCR and antibody testing results?
4) Will this infection cause me infertility even I will start treatment tomorrow?
5) The last and the most important, I am living with my girlfriend. We don't have any sex (anal, vaginal and oral) after my high risk exposure in Macau. Do any of these daily events, like kissing, sharing the same food, drinks or utensils etc, feasible to pass Chlamydia on her? I am afraid she got infected since she experience flu-like symptoms like sore throat, fever etc?
I know my questions are a bit long and stupid and your answers will solve my anxiety. Thank you very much.
I have posted a message on HIV prevention forum several weeks ago. I am a 24 yrs old straight male. My exposure is french kissing, protected vaginal sex and semi-protected oral sex with a CSW in macau at 29th DEC 08. I had a comprehensive std panel test (HIV, syphilis, Chlamydia, gonorrhea, Hepatitis B & C, HSV 1 and HSV 2) on 5 weeks (35 days post exposure) which is done at university health center. Everything comes back negative except herpes 1. I also have a 7.5 weeks HIV 1 DNA PCR, HIV 1/O/2 antibody test done at lapcorp, 9 weeks hiv1/2 antibody test done at health center and 12 weeks (83 days) comprehensive std tests (same as the 5 weeks) done at health center. However, Chlamydia show positive for the 12 weeks comprehensive std test. The following are my stupid questions,
1) Since both chlamydia tests are the same (Urine PCR), how could it be negative on 5 weeks then positive on 12 weeks? (I have no sex after that exposure)
2) Since my exposure is protected vaginal sex, semi protected oral and french kissing, so it means chlamydia can pass through the condom? or I experienced condom breakage?
3) If you think that I experience condom breakage and given my hiv test results, do I still at risk of HIV (conclusive and definitive?) or Chlamydia can delay or alter the accuracy/reliability of HIV DNA PCR and antibody testing results?
4) Will this infection cause me infertility even I will start treatment tomorrow?
5) The last and the most important, I am living with my girlfriend. We don't have any sex (anal, vaginal and oral) after my high risk exposure in Macau. Do any of these daily events, like kissing, sharing the same food, drinks or utensils etc, feasible to pass Chlamydia on her? I am afraid she got infected since she experience flu-like symptoms like sore throat, fever etc?
I know my questions are a bit long and stupid and your answers will solve my anxiety. Thank you very much.
MEDICAL PROFESSIONAL
No, it is not possible to be "completely sure". That is the most likely explanation, but it isn't definite. To maximize safety for your partner, she should be treated on the assumption that you might have been infected.
I also did a urine test before taking the antibiotics since I believe in your professional opinion. I got a the result on Friday and it's NEGATIVE. Can completely sure that I didnt catch chlamydia and the results of the 2nd time urine test is false positive? Thanks doc.
MEDICAL PROFESSIONAL
1) You were given the recommended treatment.
2) Your girlfriend must be treated as well. You can have sex within a day or two of after both of you have finished treatment.
3) Retesting is recommended at 3 months. It's not primarily to detect treatment failure, which is rare, but is recommended because 10-20% of people get reinfected within the next few months. Even if you think your risk for reinfection is zero, you should be retested then. Until then, you can assume you were cured, since you might not have been infected anyway. But if you insist on early testing, don't do it until at least 3 weeks have passed; before that, false positive results are positive. (Dead chlamydia can show up on PCR testing for that long.)
4,5) Chlamydia has no effect on HIV test results. MedHelp experts are asked to not disagree overtly with questioners' own health care providers, but either your NP is wrong about the timing of HIV tests or you misunderstood what she said. It was a waste of money to have an RNA test. Your panoply of mostly unnecessary tests proves you absolutely, positively, 100% do not have HIV. Do not ask about it again.
HHH, MD
2) Your girlfriend must be treated as well. You can have sex within a day or two of after both of you have finished treatment.
3) Retesting is recommended at 3 months. It's not primarily to detect treatment failure, which is rare, but is recommended because 10-20% of people get reinfected within the next few months. Even if you think your risk for reinfection is zero, you should be retested then. Until then, you can assume you were cured, since you might not have been infected anyway. But if you insist on early testing, don't do it until at least 3 weeks have passed; before that, false positive results are positive. (Dead chlamydia can show up on PCR testing for that long.)
4,5) Chlamydia has no effect on HIV test results. MedHelp experts are asked to not disagree overtly with questioners' own health care providers, but either your NP is wrong about the timing of HIV tests or you misunderstood what she said. It was a waste of money to have an RNA test. Your panoply of mostly unnecessary tests proves you absolutely, positively, 100% do not have HIV. Do not ask about it again.
HHH, MD
I have acquired treatment of chlamydia today as well as my girlfriend. The following are my last questions,
1) I was given a single dose treatment which are 2 Azithromycin 500 mg tablets (The total is 1 gram). Is this enough for curing chlamydia infection?
2) What is the best timing to have sex with my girlfriend after the treatment (1 week or 2 weeks)?
3) How many days the chlamydia urine pcr test will turn negative after the treament and the timing for re-testing so as to confirm the infection is gone?
4) Since the nurse practitioner insists that the hiv antibody test is only 50% accurate at 12 weeks and my exposure is regarded as high risk, she ask me to have HIV 1&2 elisa antibody testing and HIV 1 RNA testing at 12 weeks. And all of these tests came back negative. Will this chlamydia infection delay or affect the results of my HIV 1&2 elisa antibody testing at 12 weeks or 84 days or the HIV 1 RNA testing at 12 weeks?
5) Are these tests (HIV 1&2 elisa testing at 5, 7.5 and 12 weeks, HIV 1 DNA PCR at 7.5 weeks and HIV 1 RNA testing at 12 weeks) solid proof for not catching hiv and don't need to retest at 6 months?
Thank for your help these days and these will be my last post in this year.
1) I was given a single dose treatment which are 2 Azithromycin 500 mg tablets (The total is 1 gram). Is this enough for curing chlamydia infection?
2) What is the best timing to have sex with my girlfriend after the treatment (1 week or 2 weeks)?
3) How many days the chlamydia urine pcr test will turn negative after the treament and the timing for re-testing so as to confirm the infection is gone?
4) Since the nurse practitioner insists that the hiv antibody test is only 50% accurate at 12 weeks and my exposure is regarded as high risk, she ask me to have HIV 1&2 elisa antibody testing and HIV 1 RNA testing at 12 weeks. And all of these tests came back negative. Will this chlamydia infection delay or affect the results of my HIV 1&2 elisa antibody testing at 12 weeks or 84 days or the HIV 1 RNA testing at 12 weeks?
5) Are these tests (HIV 1&2 elisa testing at 5, 7.5 and 12 weeks, HIV 1 DNA PCR at 7.5 weeks and HIV 1 RNA testing at 12 weeks) solid proof for not catching hiv and don't need to retest at 6 months?
Thank for your help these days and these will be my last post in this year.
MEDICAL PROFESSIONAL
Your questions are not stupid at all.
You describe an atypical situation. There are only 3 possibilities to explain the negative first chlamydia test and positive second test: 1) You were infected and the first test was falsely negative. (If you were infected with chlamydia, it probably was there before you had sex in Macau.) 2) You were not infected at all, and the second test is falsely positive. 3) You were infected after you returned from Macau, i.e. both tests gave true results. But this is impossible if your sexual history is accurate, so I'm going to disregard it.
DNA testing by PCR or other methods, false negative tests (especially on urine) are more common than false positives. That suggests that you had chlamydia and that the first test missed it. If this is the explanation, it is probable you had the infection before you went to Macau, because it is extremely unlikely you could have caught chlamydia through an intact condom. And to answer one of your questions now, it is very unlikely the condom broke without you knowing it. However, false positive results can happen, and they are slightly more common with PCR than the other chlamydia DNA tests on the market.
The bottom line is that I cannot solve the mystery. Putting it all together, my best guess is that the second test was false positive and you never had chlamydia. However, there is no way to be certain and probably you will never know for sure. To be completely safe, your regular partner should be tested, even if you and she have not had sex since your Macau trip. As I said, it is possible you were infected before then, in which case your partner might be infected.
I believe those comments answer questions 1-3. As for question 4, chlamydia doesn't cause infertility in men (unless it causes epididymitis, which is a severely painful infection, which you didn't have). There is no risk to your fertility. And I already answered question 5: Your girlfriend needs to be tested, but not becaue you infected her by kissing, sharing food, etc. Chlamydia cannot be transmitted that way. And chlamydia doesn't cause sore throat or flu-like sympoms.
Bottom line: Most likely you weren't infected, but to be safe you and your girlfriend both need treatment for possible chlamydial infection. Ideally, she should be tested as well.
Best wishes-- HHH, MD
You describe an atypical situation. There are only 3 possibilities to explain the negative first chlamydia test and positive second test: 1) You were infected and the first test was falsely negative. (If you were infected with chlamydia, it probably was there before you had sex in Macau.) 2) You were not infected at all, and the second test is falsely positive. 3) You were infected after you returned from Macau, i.e. both tests gave true results. But this is impossible if your sexual history is accurate, so I'm going to disregard it.
DNA testing by PCR or other methods, false negative tests (especially on urine) are more common than false positives. That suggests that you had chlamydia and that the first test missed it. If this is the explanation, it is probable you had the infection before you went to Macau, because it is extremely unlikely you could have caught chlamydia through an intact condom. And to answer one of your questions now, it is very unlikely the condom broke without you knowing it. However, false positive results can happen, and they are slightly more common with PCR than the other chlamydia DNA tests on the market.
The bottom line is that I cannot solve the mystery. Putting it all together, my best guess is that the second test was false positive and you never had chlamydia. However, there is no way to be certain and probably you will never know for sure. To be completely safe, your regular partner should be tested, even if you and she have not had sex since your Macau trip. As I said, it is possible you were infected before then, in which case your partner might be infected.
I believe those comments answer questions 1-3. As for question 4, chlamydia doesn't cause infertility in men (unless it causes epididymitis, which is a severely painful infection, which you didn't have). There is no risk to your fertility. And I already answered question 5: Your girlfriend needs to be tested, but not becaue you infected her by kissing, sharing food, etc. Chlamydia cannot be transmitted that way. And chlamydia doesn't cause sore throat or flu-like sympoms.
Bottom line: Most likely you weren't infected, but to be safe you and your girlfriend both need treatment for possible chlamydial infection. Ideally, she should be tested as well.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
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STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
