STI SPOTLIGHT: CHLAMYDIA
Welcome to Hot on Health’s first video/article in a series called ‘STI Spotlight.’ Sexual Health is an area of healthcare and day-to-day life that is still surrounded by a lot of stigma. In the community, people are wary of being too vocal about sexual health for fear of being labelled as promiscuous. Sexually Transmitted Infections are often classed as ‘dirty.’ As with so many areas of healthcare, these labels and this secrecy is counter-productive to self-care and good health outcomes! Sexual health is just a part of being sexually active, and STI Spotlight will provide overviews on common STIs and their treatment. In this way, hopefully people feel more empowered to talk to their friends about the importance of regular testing!
What is Chlamydia?
Chlamydia is a bacterial STI, caused by the bacteria chlamydia trachomatis. In this context we are talking about contracting chlamydia as a sexually transmitted infection, however it is possible to contract chlamydia in other ways and in other, non-sex-related areas (most commonly, as an eye infection).
Chlamydia is a site-specific STI, meaning that as opposed to a blood-borne virus which lives in your blood-stream (and therefore, throughout your body) it is located only in the mucous membranes of one area. This is either the genitals, rectum and/or throat.
Chlamydia has become the most frequently reported notifiable-infection in Australia. In 2012, there were over 80,000 cases reported. Chlamydia is commonly referred to as a young person’s STI, as over 80% of infections occur in people under 29 years old. Don’t let that make you placant though, as I see plenty of people of people over 30 with diagnoses of chlamydia at my workplace.
How do you get Chlamydia?
Chlamydia is most commonly contracted through sexual contact, i.e. when one person has one or multiple sites infected with chlamydia and these sites come into contact with another person’s uninfected sites. It’s important to note that ‘sexual contact’ doesn’t mean full penetrative sex, chlamydia can be contracted through brief contact. Some foreplay involves touching of the genitals, or contact between the genitals or rectum, and this is enough to become infected. Performing oral sex on a man also poses a risk, as the mucous membranes of the genitasl and throat will come into contact. Performing oral sex on a woman poses virtually no risk of contracting chlamydia.
Symptoms & Long-Term Risks
Perhaps the reason that chlamydia is so common is because it often presents with no symptoms. If you’re not having any obvious problem, why would you think anything is wrong with you? This unfortunately means that someone could have chlamydia for years before they’re tested and treated. Not only does this carry risk for that person, but it also means countless others have been exposed as well; this is why regular testing is so important.
If someone does have symptoms, the most common are a general discomfort or pain in the genitals, dysuria (discomfort or pain when urinating) or a clear discharge from either the genitals or rectum.
Despite often not having any symptoms, chlamydia does pose long-term health risks. In women, untreated chlamydia can migrate and lead to pelvic inflammatory disorder, which is incredibly painful and often causes infertility. The long-term risks are less common in men, however still present. Untreated chlamydia can lead to urethral scarring and very occasionally also cause sterility.
Testing for chlamydia is very easy and can be done at your local doctor or sexual-health centre. Since STI is site-specific, what kind of testing you receive will depend on your sexual history. For more details, check out the essay here.
To check for chlamydia in the genitals, a first-pass urine sample is most commonly used. This involves urinating into a sterile cup; first-pass means it must be the very first part of your urine that is collected and it’s important that at least 1-2 hours have passed since you last urinated. In some cases, a genital swab is used instead of a urine sample; this occurs mostly in women during a pap smear. For throat and rectal chlamydia, a sterile swab is taken. If you want more details about these tests, check out the essay here.
Treating chlamydia is incredibly simple and straight-forward. As opposed to other bacterial infections which require a full course of antibiotics, chlamydia can be treated with a stat dose of Azithromycin 1g taken orally. Generally speaking, this means just two tablets taken at the time of diagnosis. That’s it, two tablets just one time! For more complicated or non-straightforward presentations an alternative treatment might be required. If someone has an allergy or sensitivity to Azithromycin then a course of Doxycycline is often used as an alternative.
Treatment also includes a bit of aftercare. Once the medication has been taken, it is important to commit to no sex for seven days, to give the infection time to clear, and then it’s important to return for a Test of Cure, a repeat test to ensure the infection is gone before you continue to have sex.
In the realm of healthcare, the testing and treatment of sexually transmitted infections is actually relatively straight-forward. Of course, given their link to sex, the behaviours and attitudes around sexual health are much more complicated. Part of this is societal pressure and stigma, which Hot on Health is committed to changing.
For more details on sexual health please check out the resources below and do what you can to have open conversations. Taboos only remain when people stay silent, so remember that, “There is no healthcare without self-care.”
Resources/ Suggested Reading:
ASHA, 2014, ‘Australian STI Management Guidelines For Use in Primary Care’, Australasian Sexual Heath Alliance, viewed 01 December 2016, <http://sti.guidelines.org.au/>.
ASHA, 2014, ‘Chlamydia’, Australasian Sexual Heath Alliance, viewed 01 December 2016, < http://www.sti.guidelines.org.au/sexually-transmissible-infections/chlamydia#management >.
ASHM, 2014, ‘HIV, Viral Hepatitis, STIs: A Guide for Primary Care Providers (4th Edition)’, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, viewed 01 December 2016, <http://www.ashm.org.au/resources/Pages/1976963411.aspx>.
‘Third National Sexually Transmissible Infections Strategy 2014-2017’, Department of Health, Australian Government.