[Question #4393] Wife tested positive for Chlamydia

28 months ago
My wife and I have been married for 6 years and have just found out we our having a 2nd child.  After the initial OBGYN appointment, my wife received a call that she tested positive for chlamydia.  I DO NOT believe she has ever stepped outside of our marriage and I know for a FACT that I never have.  I am wondering how this could have happened. I just took a test and am waiting on results. Our marriage is on the line and I have no way to prove to her that I HAVE NEVER had an affair other than my word... Neither of us have ever tested positive for any STI before.  Her last screening was in January for her yearly appointment and it came up clean, mine was last year when signing up for life insurance and also came up clean. Our son is 3 and nothing ever came up during that pregnancy.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Welcome to the forum. Thanks for your confidence in our services.

First and foremost, this definitely should not put "[your] marriage on the line". If you are as confident as you say about absence of risk for either you or your wife to have acquired chlamydia recently, I'm sure you are correct. There are other possible explanations for your wife's positive test, discussed below.

This situation -- newly diagnosed chlamydia in one member of a monogamous couple -- is not all that rare. Life insurance exams almost never include STIs other than HIV, and maybe sometimes syphilis, but certainly not chlamydia. Your and your wife's normal insurance exams are irrelevant. However, STI testing during pregnancy usually includes chlamydia, so you can be confident your wife had a negative test at that time.

So what's going on?

1) The test result is wrong. Chlamydia tests are perfect. Although false positive results are uncommon, they happen. More frequently with some tests than others. Can you find out exactly what test your wife had? (If it was a blood test, then for sure the results can be ignored. Such tests cannot ever pick up an active infection.) As another example, the modern nucleic acid amplification tests (NAATs) usually are accurate, but the older DNA probe tests are less reliable.

2) It is conceivable that your wife has harbored chlamydia for many years. Recent research suggests that chlamydia may survive many years in the gastrointestinal tract. Some newly positive genital test results may result from contamination of the genital tract from cross contamination from the rectum. This is a theory, not proved, but many experts believe it may explain some situations like this.

3) It is also theoretically possible you have been infected for many years. This is the least likely explanation, and it is extremely rare for males to carry chlamydia for years without symptoms, but I cannot say it never happens.

There are three important bottom lines. First, you'll probably never know which of these explains your situation. Second, you both need treatment:  it's far safer to treat both members of a couple like you than to assume that only she is infected or that the test was false. Third and probably most important, as I said above, this situation does not require that either your wife or you recently has had other sex partners. That's why this definitely should not be a threat to your marriage.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
28 months ago
Forgive the typo in my reply to question 1. I hope you understood I meant to write that the chlamydia tests are NOT perfect.---