[Question #7491] Chlamydia and fidelity

4 months ago
I have tested positive for Chlamydia.

I have been in a monogamous relationship for 8 and a half years. My partners also claims that he has not had any other sexual partners. 

He is getting tested but we have not gotten the result yet. 

My questions are :

1. Is there any possibility that I have had this for 8+ years and have just been asymptomatic? The same query for him? I read it is more likely for women to have it and yet be asymptomatic and for men, it is not possible for this long. 

2. I read while one's immune system can clear the infection but it is not likey to take 8+ years. It would be more like a year? How soon - any indication? I understand research is limited on this. 

3. Is this remedy of bacteria without antibiotic only applicable to men? While for women the bacteria doesn't go away unless treated? 

4. In case he tests positive is there any likely scenario that he may not be cheating on me? 
The way I understood, that for him, staying asymptomatic and yet testing +Ve is unlikey for 8+ years. 
Or I had the infection all along, and I only gave it to him in the past year and so without treatment he is testing +ve now. Does it matter on frequncy of sex - if so how, can you quantify?
Or I had the infection, he had it too or one of us had it before our relationship. The immune system wiped it off for him. But in the recent past, got it again from me. 
Or any other possibility I might be missing if he ends up +ve. 

5. Of course, even if he tests negative, there is scenario - that he knew about it, got tested, got treated but passed it to me. 
Basically is there any point in getting tested or do I take his word? 

6. Is it possible that even if I had tested negative in the past for STDs, the tests might have missed the infection in rectum, gast. tract and now the bacteria has moved to vagina? 

7. Can typical antibiotics treat for other illnesses treat this? That is can one treat it without intending to? 

Kindly answer point by point. Appreciate your help, lots on the line here. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
Welcome. Thanks your your confidence in our services.

First, I'll state the obvious, which your question makes clear you understand:  by far the most frequent explanation for situations like yours -- appearance of new chlamydia in a monogamous couple after anything more than a few months -- is that one partner or the other has acquired it sexually from another partner. However, there are many exceptions. While it is reasonable to have a sensitive and hopefully caring discussion witn your partner. but if you have no other reason to question his fidelity or truthfulness, don't assume the worst until you have more direct evidence.

There is one possible clue that you don't mention. Why were you tested for chlamydia? Was there already some suspicion in your mind that led you to request it? Or was this purely a routine screening test? Obviously it would be signficant if you already suspected your partner of having other partners, for example.

Women can carry chlamydia without symptoms for long periods:  a year is common, and up to 4 years has been documented, and it probably can be longer, even 8 years. Question 6 shows you are aware of recent research about the possibility of chlamydia persistence in the GI tract, undetected with genital testing, then migrating to the rectum and from there reach the genital tract. This probably explains some apparently new infections in situations like yours. (This possibility is based primarily on animal research. Many animals have their own chlanydia species,, which most commonly inhabit the GI tract. How frequently this occurs in the most evolutionarily advanced mammal -- humans -- isn't clear.) 

Another theoretical possibility is that your test result is false. This is rare -- the standard chlamydia tests are very good and rarely give false positive results. But this probably explains occasional situations like yours.

Those commetns partly cover some of your questions, but to be explicit:

1. Carriage by you for 8 years probably is possible, for the reasons described above. Such prolonged carriage ihas never been documented in the male genital tract. The potential for GI tract carriage in men hasn't been studied, but if it happens, there is no obvious easy path for it to migrate to the genital tract and then be transmitted to a female  partner,

2. These are correct statements, addressed above.

3. I don't understand what this question means. Please re-state it if my other comments don't cover it.

4. Assuming his test is positive, there are two broad possibilities:  he caught it redently; or you have had it chronically, and he only recently caught it from you. Such prolonged carriage has not been documented in men and undoubtedly is very rare, if it occurs at all. However, it is indeed possible one or both of you were infected when your relationship began, and that you (but not he) have carried it ever since then.

5. You correctly understand the implications if he tests negative. But I suggest waiting for his test result then discussing again.

6. See my comments above. This is a possibility, at least theoretically.

7. Some antibiotics are active against chlamyida, others not. Antibiotic treatment for other infections therefore can sometimes cure undiagnosed infection. We can discuss this further if you have received antibiotics in the past 8 years (e.g. for a strep throat,, bronchitis, or a skin or urinary tract infection), and can recall what antibiotics were used.

Fill in some of the blanks and otherwise let me know if anything isn't clear, and we'll take it from there. However, you need to be prepared for a strong possibility that you'll never have the answers for certain. Much will depend on clarifying things with your partner and your judgment of his honesty and truthfulness. I can't judge these:  you know him and I don't. But I hope my comments so far are partly helpful.

HHH, MD
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4 months ago
To answer your initial question, why I got tested- I started having symptoms of dryness and odd discharge, and random cramping after we had sex at the end of September. The symptoms were sporadic and mild. We had sex again the second week of November, and I had pain (as I have been having for years that my doctor said was likely endometriosis, which is why we don't have sex very frequently) but decided that I wanted to get checked out.

When I  got examined me and said it looked like I had a yeast infection, but that didn't explain the pain, so she would test for STIs to rule out all possibilities if I wanted to, and she wanted me to also schedule an ultrasound. I wasn't suspicious other than these symptoms seeming to coincide with us having sex, but agreed to rule out all possibilities.

I know it sounds naive, but I truly do trust my partner, and previously didn't have suspicions (and I'm naturally not a very trusting person); he is insistent that he has had no sexual contact with anyone during our relationship and he was adamant about getting tested right away. We are expecting his results Monday. 

When she called with the results she said I tested positive for Yeast infection and Chlamydia and that because I was also tested in 2015 for STIs (because of the same pain issues), but those results were all negative, that this must be a new infection? Correct? 

My main follow up question would be, although I'm sure this seems unlikely, is it possible that I contracted this 9 years ago, and my body cleared the genitial infection/ or it just migrated to my GI tract, thus not showing up on my test in 2015, but then re-emerged recently in the genital infection thus showing up on the swab test that I just had? I'm sure that seems far-fetched, it just seems like the only possible conclusion if my partner has truly not had any outside sexual contact. Is it clutching to remove possibility?

Also, would the existence of the yeast infection have anything to do with this re-emerging or showing up now when it didn't in 2015? Is it possible that this has been living in my system and has caused PID and the pain I experience during sex is a result of PID, but because I tested negative in 2015 my doctor has not suspected PID? 

Thank you again for your time and expertise.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
4 months ago
Thanks for the clarifications.

"I know it sounds naive...":  It seems you should continue to trust him, but only you can make that judgment.

"When she called...":  This isn't necessarily a new infection, because of the possibilty stated next....

"My main follow up question..." GI tract infection would not be detected by your genital test in 2015. This possibiliy is not "far fetched".

"Also, would the existance of the yeat infection....?" Probably not. All women carry yeasts in the genital tract from time to time. Its detection, or that it caused symptoms, probably is entirely unrelated to the chlamydia issue.


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