[Question #5953] Chlamydia help

20 months ago

I’m seeking clarification on an issue surrounding chlamydia. I have scoured the thousands of questions in the forum and found them helpful, but am still feeling a bit confused.

The situation was my husband had unprotected oral sex as the receiver, with an escort. He insists the time frame was approximately 2-3 minutes. 7 days after the incident he tested positive for chlamydia. Most of the information I read here suggests contracting chlamydia through saliva during one incident is less than one in a thousand. Almost impossible. I’m staying off of google as it’s full of a million different suggestions and contradictory advice and information which confuses me even more. Can you give me any advice, information or statistics on the possibility of this. Clearly he tested positive for chlamydia, that’s not in question. I’m seeking to understand if this is potentially the only incident I’m dealing with here. Could he really contract chlamydia during only one incident of oral sex? Thanking you in advance for your time and help.

Edward W. Hook M.D.

20 months ago

Welcome to our Forum and thinks for your question. The short answer is that yes, it is possible that you husband acquired chlamydia from a single episode of receiving oral sex from a commercial sex work. We are learning more about oral chlamydial infections and while there is much to learn, we now know that the infection is present in about 1-2% of persons who have performed oral sex on someone in the past 60 days. As his partner was an escort, you might expect her likelihood of infection to be higher than average. Then, as for most exposures to infected sex partners, while most exposures do not lead to infection, transmission certainly does occur. There are no good estimates of how often transmission occurs, percentage wise, nor are there good data on how important duration of exposure is. Thus there are certainly people who acquired chlamydia from receipt of oral sex.

There is an old saying that, if your risk is one in a million but that if you are "the one" that's all that really matters. Thus I can assure you that a person can acquire virtually any STI from a single exposure and that while it is rare, it unfortunately occurs with some regularity.

I hope that this information is helpful to you. EWH

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19 months ago

Thank you for your reply. I’ve continued to follow the numerous threads posted here and I admit I feel confused. This is in no way meant to be offensive to the extremely qualified professionals here, just my own confusion and desire to understand the topic for the sake of my life situation.

Your reply made sense to me, however, I keep seeing over and over how here incredibly rare chlamydia of the mouth is (as it doesn’t prefer the oral cavity) and then also how it would be even more rare to be passed from the mouth, especially after only one instance....and then this statement made yesterday in a thread left me bewildered.

“Genital (penile) chlamydia has never once been documented to have been acquired by oral sex”

If this is in fact the case, I can make no sense of what has happened here in my life. Or, is it still the same old saying “if you’re that one in a million that’s all that really matters?”

My apologies again if this is slightly repetitive in the thread, but I felt confused and wondered if you could verify that statement, or add anything further. I appreciate your time and support. Thank you.

Edward W. Hook M.D.

19 months ago

Thanks for your follow-up. I'll do my best to clarify things. The thread that you saw on Chlamydia related to a client who believed that his penile infection was due to chlamydia, something that neither Dr. Handsfield or I think was what happened to him. It was in this context that the statement “Genital (penile) chlamydia has never once been documented to have been acquired by oral sex" was made in efforts to reassure the client. The statement is true- there are no cases in which oral-genital contact has been proven to lead to chlamydial transmission. On the other hand, as you correctly point out, we have very strong data that:

1. Chlamydia infections do rarely occur in the throat (in comparison to gonorrhea).

2. That while less biologically efficient than for genital--genital contact, that oral-genital contact can lead to transmission o gonorrhea.

3. Thus it is logical that on rare occasions, oral chlamydia can be transmitted to a man's penis through oral sex, even though this has not been scientifically proven.

Thus, I would again acknowledge that getting chlamydia from receipt of oral sex is a very, very rare event but is possible. I sense that your concern is whether your husband's acquisition of chlamydia was from a single brief misstep or was representative of something else. That I cannot answer.

I hope this comment is helpful and sorry if there was any confusions. EWH

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