Chlamydia test needed for her?

[Chris13]

Dr. HHH

I'm in a tight spot and looking for advice. I am a 27 year old straight male. Last tuesday, I went and got a urine test due to an itching sensation in my urethra.  The Dr. called back the same day saying my test was neg for UTI, chlamydia, and the clap.  He said my symptoms were likely due to a non-specific infection and put me on doxycycline as a precaution.  A few days later (not taking the so called "infection" serious enough) I had intimate contact with a girl I've been dating for a few weeks.  This was the first intimate contact we've had therefore, she is not the one I contacted anything from.  On 2 separate occasions we did rub bare genitals against each other, but did not have insertive sexual intercouse.  Today the dr. called me and told me and I had indeed tested positive for chlamydia and thus gave me a precription a diifferent antibiotic (4 pills taken all at once) just to make sure I'll clear it up.  I have an appointment this Friday to be retested to make sure it is gone.  Even though we didnt have insertive sex, was the bare gentials contact enough to warrant me telling her she needs to be tested for chlamydia?

Thanks

[H. Hunter Handsfield, M.D.]

The risk of transmission must have been very low during the exposure you describe.  But not zero.  You have to weigh the strong likelihood that she will not be infected and she (and you) could get away without testing, versus the slim chance that she'll develop a health problem that could be dangerous. On balance, I think you should tell her about your infection and she should be tested and treated.  If she has a positive test, it won't ncessarily be from you; assuming she has had other sex partners, there is at least some chance she already has chlamydia.  Anyway, since you clearly had an infection that you acquired before you and she got together, I see no reason why telling her about it should be a major problem in your relationship.

Retesting of people treated for chlamydia is recommended to be done 3 months later.  After both doxycycline and azithromycin (the 4 pills) you can be certain a short-term repeat test will be negative; when treatment fails, it more likely pops up later.  Also, the 3 month test picks up many people who have become reinfected in the interim.

Good luck--  HHH, MD

[Chris13]

Thanks Doc...Follow-up: I told her and she took it in stride. I think she likes me even more because of my honesty.  

1 follow up question: I took the anitbiotic (4 pills) Monday night.  On tuesday night I met up with friends for a few drinks.  Will the alcohol hurt the fighting affect the antibiotics have on the infection?

[Chris13]

Thanks Doc.  I told her and she took it in stride.  No big deal.

follow-up question:  I took the antibiotic (4 pills) Monday night.  Tuesday night I met up with friends for drinks.  Will alcohol hurt decrease the chance of the antibiotic killing the bacterial infection?  I get re-tested tommorrow...Friday.

[H. Hunter Handsfield, M.D.]

You did the right thing.  Good show.

Alcohol won't affect treatment effectiveness.

I hope you are insured and not paying for a repeat test out of pocket.  It is guaranteed to be negative, which is why CDC recommends against early re-testing ("test of cure") for chlamydia.  However, CDC strongly recommends (and I agree, since I helped write the guideline) that all persons with chlamydia have a delayed test-of-cure 3-4 months after treatment.  (Delayed test-of-cure is also called rescreening.  Those recommendations are new, and your doc might not be aware of them.  But s/he can look them up in CDC's 2006 STD treatment guidelines at www.cdc.gov/std.)

HHH, MD