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Chlamydia

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Chlamydia (Contd)

Written by Dr Angela Robinson, consultant in sexual health

Men
Not so much is known about the risk of infection in men. Those at highest risk are men between the age of 16 and 30.

How is chlamydia diagnosed?

Smear tests A chlamydia test is not routinely carried out when you have a smear test.

Many women are under the illusion that it is, and are falsely reassured.

If you are unable to get the test at your local practice, get a check-up at your nearest GUM clinic.

This is really important if:

you are under 25

you changed sexual partner recently and developed symptoms a few months later

you have had more than two partners in the last year.

Women
Five years ago, the test for chlamydia was similar to a smear test: a doctor or nurse would take a swab from the cervix (neck of the womb).

Now tests can be done on urine samples or on swabs that a woman can insert into her vagina. The swab is then placed into the container provided and sent to the laboratory.

The new tests avoid the need for an intimate and uncomfortable examination and make testing much easier for women.

Men
For men, a urine sample is good enough and avoids the discomfort of a swab from inside the tip of the penis (urethra).

Some clinics continue to do the swab because it can give a more accurate result and is cheaper to process when there are many samples.

How is chlamydia treated?
Chlamydia is treated with antibiotics.

Make sure your sexual partner also gets treatment. Otherwise, the treated partner becomes re-infected. Repeated infection can cause far worse fertility problems in women.

Not all antibiotics are effective. There are two major groups of antibiotics that work, so make sure you get one of these.

Tetracyclines: the usual prescribed drug is doxycycline. One tablet should be taken twice a day for a week.

Macrolides: azithromycin is the most convenient treatment because you take four tablets at the same time.

If you have chlamydia, do what you can to encourage any ex-partners to get tested. This infection can stay unrecognised for months, if not years.

How can I make sure I don't get chlamydia?

Use condoms with new sexual partners.

Before you stop using condoms, make sure you and your partner get checked out for STIs by your local GUM clinic or GP.

How common is chlamydia?
In the UK chlamydia infections are rising. Between 2000 and 2005 the number of chlamydia infections increased by 14 per cent, with an estimated 1 per cent of women aged 16-19 having the infection.

Overall the rates of chlamydia in other Western European countries are lower than those in the UK.

The higher number of cases in the UK may partly be due to the national screening programme for chlamydia being rolled out in England. This should identify more people with the infection. Similar initiatives are underway in Scotland.

There have been high profile education campaigns targeted at the younger age group as part of the screening programme. STIs are now discussed in school-based sex education programmes.

Where can I get help?
Often the best place to get help is from the health advisers who work in sexual health (GUM) clinics.

To find your nearest clinic, check the phone book or NHS Direct (NHS 24 in Scotland).

Who offers chlamydia testing?

Home test kits Home testing kits are not the same as home sampling kits.

A home test kit will give you a result as soon as you take the test.

In home sampling, you take the sample and send it back to an accredited laboratory for testing.

Some kits that are sold online and in pharmacies are not very accurate and may give a false reading.

Take a conventional sampling test until a good home test kit becomes available.

How can we improve the current situation?
We could do with some patient power. The government has given money for chlamydia screening, but because of financial problems this money is not being spent on what was intended.

If you ask for a test and your GP is unable to provide it, demand may lead to a change in priorities in your local area.

As well as thinking about your own situation, don't forget the health and safety of your own children. Discussing sex isn't easy for everyone, but surveys suggest that kids like to hear about sex and relationships from a parent in preference to anyone else.

About half of under 16-year-olds are having sex. Some do not use any contraception at first, or they use condoms inconsistently. With a high teenage pregnancy rate, you expect a high chlamydia rate.

Celibacy may be the greatest protection against sexually transmitted diseases, but at that age the desire to have sex is considerable. It is unrealistic to expect adolescents to always make sensible, rational decisions, but many will if they are provided with information they can identify with.

Decent sex education in schools would help young people understand the consequences of their actions. Making an informed decision, and knowing where to go if you are concerned, is essential to get help promptly.

Other sources of information

To find your nearest GUM clinic visit the fpa site.

For more information on the national screening programme, visit the HPA website.

For more information on chlamydia, visit chlamydiae.com.

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