[Question #9854] CHLAMYDIA QUESTION

28 months ago

Hello Doctors!

I am gay/on PREP. Here is my situation:

Feb 4-I have protected intercourse and unprotected oral/analingus with GUY#1

Feb 17-I have 5 to 10 minutes of open-mouth kissing with GUY#2

March 20-GUY#1 informs me he has anal chlamydia. I go to urgent care, am started on Doxycycline and take urine test/anal swab/oral swab. A few days later all tests/swabs come back negative.

I recently read that oral chlamydia can clear on its own and now I am worried that I WAS positive for oral chlamydia when I open-mouth kissed GUY#2 but that my infection cleared on its own before I got swabbed which is why my swab was negative.

Incidentally, I ran into GUY#2, told him about my exposure to chlamydia but also told him that he had nothing to worry about from our kissing session because my oral swab was negative. Should I leave things alone, or do I need to warn GUY#2 that I might have been positive at the time we kissed after all even though I technically have no evidence this was the case?

28 months ago

Also-the specifics of my question aside-I can't get a clear sense if open-mouth kissing is a route for chlamydia transmission in the first place. From reading posts on this site, I have learned that there is a big debate around oral gonorrhea and kissing but I can't get a sense of where the current thinking on oral chlamydia and open mouth kissing is.

Edward W. Hook M.D.

28 months ago

Welcome to our Forum and thanks for your questions. Congratulations on taking PrEp and your forthright approach to your sexual health. I’ll be glad to comment.

The short answer is I would not be worried in the least and encourage you to move forward without concern. Your partner did the right thing by telling you of his infection as did you. The topic of clearance of untreated chlamydia is complex. It certainly occurs although relatively rarely over the course of a week or two. Further, rather than risk infection, it is appropriate and recommended to treat persons with exposure to known infection.

Your situation is slightly different. The site of infection does affect the likelihood of infection. For reasons that are unknown chlamydia does not “like” the throat and very rarely causes infection there, even when exposed. Further, kissing is an inefficient mechanism for transmission of throat infections. While treatment was appropriate, it is unlikely that you were infected and virtually certain that you did not transmit infection to your subsequent partner.

Hope this information is helpful. EWH

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28 months ago

Hello Dr Hook!

Thank you so much for this response. One more quick question:

Another thing I have been worried about is whether or not I inadvertently cured myself by Amoxicillin in between the kissing encounter and my negative swab. I'm pretty sure I didn't, but I have a stash of Amoxicillin from a prior sickness and I occasionally pop a few if I'm feeling under the weather.

But if I'm reading your response correctly, you are saying that even if I truly HAD oral chlamydia when I open-mouth kissed GUY#2 (unlikely as that is), there's basically no way I passed the infection from my mouth to his mouth. And that when I ran into him later and told him that there was basically no way he got oral chlamydia from our kissing session, I was telling him correct information.

Does that about sum it up?

28 months ago

I meant to type:

Another thing I have been worried about is whether or not I inadvertently cured myself by TAKING Amoxicillin in between the kissing encounter and my negative swab.

Edward W. Hook M.D.

28 months ago

Amoxicillin is sometimes effective for chlamydia treatment although it is not the preferred therapy as it is somewhat less effective than doxycycline. That said, as I pointed out earlier, even if you had been infected (there would be close to no risk of transmitting you infection through subsequent open mouth kissing. I urge you not to worry further - either bout yourself or partners. EWH---

28 months ago

Thanks Dr. Hook! I feel much better!!