AboutMark Behar Expertise Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP); Board of Directors, National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)
Publications Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology;
Distinguished Fellow, American Academy of Physician Assistants;
Fellow, Wisconsin Academy of Physician Assistants
Past/Present Clients Brady East STD Clinic, Milwaukee, WI
Question QUESTION: Dear Mark,
I have a boyfriend and usually we have unprotected sex.
So far I do not have any abnormal symptoms.
Is it true that a female can contract chlamydia without feeling any symptoms ?
How am I certain I have not contracted chlamydia ?
Do I have to take urine tests periodically to make sure I have no chlamydia ?
Thanks for your time.
ANSWER: Hello Helen,
Chlamydia can infect the throat, the cervix, the anus, the urethra (usually the penis in men), the eyes. Symptoms and signs are your body's reaction to an irritant such as an infection. Sometimes, if nerve endings are not there, or if they don't have the ability to activate the nerve pathways that you recognize as "itch," "burn" etc., then a person may not detect these signs or symtoms (S/Sx). Or, you may not be able to determine that the S/Sx are from an upper viral infection from say the cold virus, and chlamydia, if the throat is infected.
So either men or women may not detect these S/Sx, or be able to differentiate them from more innocent (innocuous) infections caused by say, the cold. Now you can't "catch a cold in the cervix" as upper respiratory germs don't infect the tissues of the lower genital tract. But chlamydia, as I mentioned, can infect multiple places. You can have a cervical chlamydial or anal chlamydial infection, and not recognize the usually subtle S/Sx of such an infection, until they get worse and affect other bodily structures.
The only way to know that you haven't been so infected, is by not exposing yourself through sexual activity, and by being tested and examined periodically to make sure everything is okay. Urine tests for chlamydia, but cervical tests are more accurate. In men, urine tests are more accurate than urethral/penile swabs.
Good luck!
--mark
---------- FOLLOW-UP ----------
QUESTION: Dear mark,
Many thanks for your reply.
1. You mentioned cervical tests are more accurate than
urine tests (in women), does it mean if I do a urine
test for chlamydia, the chance of a 'false negative'
result is high ?
2. What does a cervical test entail ? Is it PAP smear ?
Is it painful ?
What is the %chance of a 'false negative' still ?
3. Or if I get my boyfriend to do a urine test for
chlamydia, if he tests negative, does it imply I am
100% free from chlamydia ? (I do not have other sex
partners)
Thanks for your kind advice.
Answer Hi Again, Helen,
1) Cervical tests are more accurate than urine tests in women. If you do a urine test, it could come back as falsely negative, meaning you have an infection but the test is negative. I am not aware of comparison tests to determine how much better the cervical test is over the urine test. I'm sure they have been done, but I just don't know them.
2) The test involves a standard pelvic exam, with a swab inserted into the cervix. This is not painful, like the corresponding test for men (swabs in the penis are much more painful). It is not a Pap smear, which involves scraping the front or face of the cervix with a little plastic/wooden spatula or stick, or a little brush. This too is not usually painful. It is highly unlikely to have a false negative if this test is done correctly.
3) If boyfriend has a negative test, that means he may have been treated already, or he switched his urine with someone else's to deceive the doctor, he is lying and told you he was negative but didn't show the lab report paperwork, or he is truly negative. If one of your was previously positive for chlamydia, than it had to come from somewhere-- another sex partner with the infection. If he is truly negative, and you never had sex with someone else, than it is not possible for you to be positive for chlamydia yourself!
