Welcome to the forum. Thanks for your questions. I’ll be glad to answer although it will not be possible to provide you with a definitive answer to your questions. Before I address your question regarding your recent positive test, please let me congratulate you and your partner on your decision to test early in your relationship and get treated. I wish that happened more often.---

Thank you for your professional reply. This conversation should not be embarrassing but informative. I asked my nurse if I could speak to my doctor regarding my results. I specifically asked if I should consider another antibiotic and I was met with “well you can get it again” I’m not naive to that fact and I understand that there are risks but I also understand that bacteria can become resistant to certain antibiotics. 

You were asking good, but very difficult to answer questions. Infection with any bacteria, including chlamydia is not an all or nothing thing. For chlamydia with each exposure the likelihood of being infected goes up. Following a single exposure it is estimated that infection is transmitted from men to women about 20-30% of the time so, speaking probabilistically, it is more likely than not that you would’ve been infected prior to January however one can never be sure. I wish I had a better, more definitive answer for you. EWH---

Addendum: I apologize if it seems like I am dancing around your question but with STI’s in particular one can never say never and I wanted to be as informative as possible for you. EWH---

Thank you your help. I understand that there is no way to actually narrow the source of my transmission with 100% certainty and I understand that partners are not always honest. I just like to be educated on all aspects of the situation.  For my final follow up…I know you can’t truly answer with certainty. It seems as though not everyone is educated on the latest treatment recommendation. I know that dormant gut infections have been studied in animals. Is there any current research that suggest that  could have happened with our  case with the azithromycin treatment failure rates verses doxycycline? Thank you for all your replies. I am so grateful that I stumbled upon this resource. 

Once again you are asking important, sophisticated questions for which answers are not complete. In animal models chlamydial infection of the gut are demonstrable and important side of infection. Humans however are not laboratory animals and these results have not been duplicated in humans. On the other hand, emerging evidence strongly suggests that chlamydial infection is occurring in the rectum are much more difficult to treat than genital infections. Rectal infections can occur through receptive rectal intercourse, or in women, through local contamination of the rectum by genital secretions. In both instances however, high-quality randomized clinical trials, show conclusively that the failure rates with azithromycin are higher at the rectum than with tetracycline.. This has led to concerns that rectal treatment failures in women can then lead to reinfection of the uterus and cervix following azithromycin therapy.  This has also led to the relatively recent change in treatment recommendations to favor treatment of all chlamydia infection with doxycycline rather than azithromycin---