[Question #12008] worried about chlamydia

11 months ago

First off, I just want to thank you for all the work you do on here. I am a 22 year old female, and 3 years ago I caught chlamydia from an unprotected one night stand with a guy (He took condom off without my knowledge). I didn’t have symptoms until I had my yearly check up 2 months later, where I was positive for chlamydia. I obviously was treated and negative after that. It wasn’t until recently that I have become extremely anxious about contracting STIs, specifically chlamydia. I have had a partner that I have been seeing for almost 7 years and had been having unprotected with him most of this time. He has never given me anything, but I have started using condoms with him to be sure. I started seeing another guy at the beginning of this year, we have been having unprotected sex and I got tested after I first saw him to make sure. It was negative. I am worried about getting something from the first guy, and passing it to the new person I have been seeing (since I still see both of them). I use a condom with the first guy, he reassures me that he is clean and doesn’t see others. I have unprotected sex with the second guy. So, do i have to be worried about contracting chlamydia from the first guy, if I use a condom with him every time and it doesn’t break? I probably sound redundant, sorry about that, but I wanted to get a professional opinion.

H. Hunter Handsfield, MD

10 months ago

Welcome to the forum. Thank you for your confidence in our services.

I'm sorry your first unpleasant STD experience is still echoing all these years later. I'll try to help.

First, I'll point out what you probably know intellectually, that most people do not lie about STDs (both past and potentially current) when asked directly in a frank but caring manner. Second, that you have had a handful of sex partners since the one who infected you, without being infected again. Third, another approach that should improve your confidence -- and a very smart move in terms of sexual safety -- is for both persons embarking on a new relationship to be tested for common STDs-- gonorrhea, chlamydia, syphilis, HIV. If both test negative, you would know you are not at risk. (As concerning as chlamydia has been for you, the other three are far more dangerous! Nobody wants chlamydia, but the large majority of infections are not very harmful, especially when promptly diagnosed and treated.)

As to whether you should be concerned about getting chlamydia from any particular partner, you know him (or them) and I do not. Your judgement -- based on their backgrounds, sexual history, past STDs, and apparent honesty -- is far more reliable than my guess would be. You know them -- I don't!

On top of all this, of course you should plan on being tested from time to time (for all 4 infections mentioned) if you have any doubt at all about your partners' histories, sexual fidelity, and so on. But if you follow these guidelines, you can expect to remain free of these STDs.

Finally a word about HPV, the most common STD of all: I hope you are a) vaccinated (it prevents infection with the 9 HPV types that cause 90% of serious HPV problems, i.e. warts and cancers); and that you are following standard Pap smear recommendations.

I hope you find these comments helpful. Let me know if anything isn't clear.

HHH, MD

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10 months ago

Hello, thank you for your reply! I forgot to mention that I have been tested for all of these (gonnoreah, trich, HIV HPV etc) and were all negative. I worry about the others as well but I think chlamydia the most because I have dealt with it.

I am more just hyper focused on if the condoms, when worn properly , will prevent me from getting chlamydia if I was exposed to it. If I am wearing them every time, should I be worried about it/getting tested following each time of protected exposures? Or is condom use considered safe sex in this regard and I can carry on without worrying? I just don’t want to be irresponsible.

10 months ago

I realized I also said “protected exposures” I meant to say just protected encounters, as in having protected sex with someone. If i am using condoms and being careful, should I be getting tested for this after each time I have sex ? or is that unnecessary? Especially if I have no known exposures which i don’t think i have had so far, but the “what if” really freaks me out. i just want to know if using condoms indicates safe sex and that i can carry on (with condoms) and not be potentially exposing anyone. I read condoms are pretty effective in preventing STIs like chlamydia but I wanted to talk with a doctor to be sure, you never know with the internet!

10 months ago

Just wanted to check back in and see if anyone has seen my response:) I noticed others getting answered so i didn’t know if mine maybe skipped over

H. Hunter Handsfield, MD

10 months ago

Apologies for the delayed response! Somehow I missed the email notification of it.

Condom efficacy: Two concepts to keep in mind. Biological efficacy: is infection possible for any particular exposure? With a properly used condom that doesn't break, nearly 100% effective against STDs transmitted by fluids (chlamydia, gonorrhea, HIV) and ~90% for those transmitted skin to skin (HPV, syphilis, herpes). With careful use, this should apply every time. "Use effectiveness" takes into account mis-use, human error, breakage etc and applies to condom use over time. It depends on proper and careful use by both partners. Because people are human and condoms sometimes break, use effectiveness is lower than biological; for pregnancy prevention, use effectiveness is ~90% in most settings (which is why couples serious about contraception shouldn't rely on condoms exclusively); probably it's about the same for HIV, chlamydia, etc. In terms of your chlamydia concern, if condom use occurs correctly and as planned, I see no need to test after every exposure. Periodic testing after several sexual events makes more sense.

I think those comments cover all these questions -- but let me know if not. Sorry again for the delayed reply.

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10 months ago

No problem!! yes, that answers my question. So just to reiterate if the condom doesn’t break and stays on the whole time, it has done its job against any possible bodily fluid stds almost 100%? Also, if I am ever worried about a particular exposure, say if the condom breaks or something, how long after sex would be a good time to test? I read 14 days about chlamydia/gonnoreah but sometimes I feel like i see sooner than that. Thank you for your reply:)

H. Hunter Handsfield, MD

10 months ago

You've got it exactly right about condoms. But wrong about testing time for chlamydia. Any time more than 4-5 days after exposure is fine.

That concludes this thread. Thanks for the thanks!

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