[Question #12521] Retest after (Protected) Sex 3.5 weeks After Azithromycin for Chlamydia
7 months ago
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Hi, I took 1g of AZ 6Dec24 and was told by my doctor to wait 14 days to have sex. I had protected sex with a new partner 25 days after—on 1Jan25 to 4 Jan25z I get retested on 17Jan25 and I am very nervous as this is my first (surprise) STI ever and after reading that AZ is not as effective as doxy, that retesting at 3 months is ideal because there could be false positives if testing is too early.
My biggest question is on the effectiveness of AZ, and whether if it’s out of me or not, if 25 days later is pretty safe, and what the likelihood is that I passed it even with condom use—FYI there was rubbing with parts before condom use/insertion.
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H. Hunter Handsfield, MD
7 months ago
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Welcome to the forum. I'm happy to help.
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The bottom line is that your chlamydial infection was was cured and your new partner not at risk.
Azithromycin is now (in the past several years) understood to be less effective than earlier research suggested, and therefore doxycycline is preferred. However, azithromycin is still pretty good, with 90-95% cure rates in women. In addition, retesting at 3 months is not advised in order to detect treatment failures; retesting at 3 weeks is good for that purpose. Later testing is recommended to detect possible re-infection due to sex with either the same or new partner(s) at risk.
You should still plan on follow-up testing to be sure you were cured, but the chance you still were infected 25 days after treatment is around 5-10%. Yes, it would have been best to delay sex with a new partner a bit longer and to have been retested before that. But most likely you were cured and did not risk infecting your new partner. And of course you were wise to use a condom for that new exposure: condoms are highly effective in preventing chlamydia transmission, if in fact you were not cured. So your new partner is at very low risk of infection. (Genital contact without penetration -- "rubbing" before the condom -- is little or no risk.)
You don't need to wait until Jan 17 for retesting. Have a chlamydia test now: plenty of time has passed for a reliable test. You can expect it to be negative.
I hope these comments are reassuring. Let me know if anything isn't clear.
HHH, MD
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