Janet D. Allan, Ph.D., R.N., C.S. is the Vice-Chair, U.S. Preventive Services Task Force. She has been Dean and Professor, School of Nursing, University of Texas Health Science Center at San Antonio since 1997. She previously worked in various executive positions within Family Nurse Practitioner Programs and has also been awarded a number of training grants in primary care.

What is Chlamydia?

Chlamydial Infection. If you are unfamiliar with this sexually transmitted disease (STD), you are not alone. Other STDs such as HIV/AIDS, herpes, and gonorrhea are familiar names, but many of us have never heard of chlamydia. And yet, chlamydia trachomatis is the most common bacterially transmitted STD in the United States (HIV, which causes AIDS, is transmitted as a virus). There are an estimated 3 million new cases of chlamydial infection each year. Rates vary in different communities, but 1 in 10 girls tested for chlamydia is infected.

Whom does chlamydia affect and why?
The U.S. Preventive Services Task Force (an independent group of experts charged with reviewing the clinical evidence on a variety of health conditions) recently stated in its new recommendations that if you are a woman age 25 and younger and are sexually active, you should be screened for chlamydia. The bacteria are transmitted through sexual intercourse. It is a concern for young women because the cells of your cervix are more susceptible to attack from the chlamydia bacteria than the cells of an older woman. However, whether you're under or over age 25, you are at risk if you practice unsafe sex such as not using condoms consistently or correctly, having a new sexual partner or changing partners frequently, and having a previous STD. While both men and women can get chlamydia, we see more reported cases among women because men are neither tested as regularly nor seek care as often as women do.

What are the symptoms of chlamydia and why is it a problem?
Chlamydia is often a silent disease -- most women show no symptoms for six months or longer. If it goes untreated, chlamydia can cause serious health problems such as pelvic inflammatory disease, infertility, and if you're pregnant, it may cause preterm delivery and other neonatal problems. Babies born to women with chlamydia can develop eye infections and pneumonia. Chlamydia can also cause tubal pregnancies, which can be fatal to the pregnant woman and can increase your chances of getting HIV infection because it breaks down the immune system, making you more susceptible to this virus. 

How is chlamydia treated, is treatment effective, and what does it cost?
Chlamydia is treated with antibiotics. Treatment is 100% effective and at present, it does not appear to resist antibiotics. You can either take a single dose of one antibiotic or a seven-day course of another kind. One dose of azithromycin (trade name "Zithromax") taken orally or doxycycline taken for seven days (this is cheaper but many people forget to finish the whole seven day treatment) are the most widely used drugs. Some tests are free and others can range in price from $30 to $100, depending on whether a pelvic examination is included. Insurance usually covers screening and treatment. Most states allow screening and treatment for STDs in young people after ages 14 or 15. Once you've had chlamydia, it is a good idea to be re-tested every six to twelve months since re-infection is possible.

What about treating men?
The U.S. Preventive Services Task Force found there was little evidence that it was effective to screen men for chlamydia infection. The reason is that, until recently, testing men was a very uncomfortable procedure and it was rarely done. More studies are underway to assess the effectiveness of screening men. Meanwhile, if you learn that you have chlamydia, your partners are also at risk and should consider being tested. New urine testing methods make it more feasible to screen men for chlamydial.

What should you do about chlamydia?
I want to encourage you to take control of your own health! In addition to developing healthy sexual habits, it is important to maintain good overall health so that you have a strong immune system. If you fall into any of the risk categories described above, ask your care provider (physician, nurse, practitioner, physician's assistant) to screen you for chlamydia. Some health care providers themselves may be unaware of chlamydia or they may not believe that you could have this problem. Therefore, it's important for you to be the one to bring it up and ask to be tested. Early detection of this disease is the most effective way to prevent serious health problems. Your health is your best resource in life!

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Created: 5/17/2001  -  Janet D. Allan, Ph.D., R.Rn, C.S.