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The times they are a-changin’. Only a few years ago, it was someone else’s job to book our flights, ring up our groceries or stand in front of a map and tell us what the weather was going to be like. In what seems like the blink of an eye, advancements in technology have enabled us to do all that stuff ourselves and plenty more besides. The latest task we may all soon be handling? Checking ourselves for sexually transmitted infections (STIs).
- In 2017, more than 1.7 million cases of chlamydia were reported, though the CDC estimates that this is far fewer than the total number of chlamydia infections in the United States.
- Just 10% of men and 5 to 30% of women who test positive for the Chlamydia trachomatis bacterium will have signs that they’re infected.
- A 2017 study found that people who had at-home testing kits were nearly twice as likely to engage in testing than a group of people who had to go somewhere to get STI testing.
- While home-testing removes a barrier, treatment still needs to be given by a healthcare provider to decrease transmission rates.
One of the trickiest of all STIs is chlamydia. It’s extremely common, largely because it usually produces no symptoms. People who are unaware they have the infection pass it to their sexual partners, who in turn pass it on. But a 2017 study has shown that at-home testing for chlamydia could help more people get screened regularly (Wilson, 2017). The authors of that research posit that, ultimately, at-home testing could make a big difference in transmission rates.
How common is chlamydia?
According to the Centers for Disease Control and Prevention, chlamydia is the most commonly reported sexually transmitted bacterial infection in the United States (CDC, 2016). In 2017, 1.7 million cases were diagnosed. But the agency believes that a total of 2.9 million people were actually infected, meaning that over a million of them didn’t know they had it.
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What are the symptoms of chlamydia?
Chlamydia will have symptoms in a minority of cases: About 10 percent of men and 5 to 30 percent of women who test positive for the Chlamydia trachomatis bacterium will have signs that they’re infected.
The symptoms of chlamydia infection can include vaginal discharge, penile discharge, or pain while urinating. In some cases, untreated chlamydia can lead to epididymitis — a swelling in the tube at the back of the testicles that can be painful.
Can chlamydia cause complications?
It’s especially important that chlamydia is diagnosed because untreated chlamydia can also lead to pelvic inflammatory diseases (PID), which can affect a woman’s fertility. In pelvic inflammatory disease, the female reproductive organs (the cervix, uterus, ovaries, and fallopian tubes) become inflamed. The fallopian tubes can become scarred or blocked, which can lead to infertility or ectopic pregnancy, which can be fatal in some cases.
Chlamydia can also be passed from an infected mother to an infant during childbirth, which can lead to pneumonia in the baby.
Chlamydia can cause complications in men, too, including epididymitis, in which the tubes behind the testicles become inflamed and swollen.
Untreated chlamydia can also increase a person’s chances of contracting HIV, the CDC says.
How is chlamydia diagnosed?
There are several forms of diagnostic tests for chlamydia. A vaginal swab is the preferred test for women, and a urine sample is the method of choice in men, the CDC says.
What is the chlamydia at-home test?
In a late 2017 study conducted by the London School of Hygiene & Tropical Medicine, researchers found that people who were invited to use a take-home STI test — which involved mailing the test kit back and going online for their results — were nearly twice as likely to engage in testing than a group of people who had to get STI by reporting to a clinic or doctor’s office (Wilson, 2017).
“Sexual health clinics play an important role in community health, but some people may find them inconvenient or stigmatizing, which can stop them attending,” said Caroline Free, one of the researchers. “More long-term monitoring and evaluation of e-STI testing services is needed, but our study showed that when e-STI testing was made available alongside face-to-face services, the number of people getting tested for STDs nearly doubled.”
Among young adults aged 16-30 who had never taken an STI test before, the take-home group’s participation was also double that of the conventional test-takers (45 compared to 24), according to a 2019 secondary analysis of the data (Wilson, 2019). This suggests that take-home testing could be especially helpful in cutting chlamydia rates — most cases are reported in adolescents and young adults, the CDC says (CDC, 2018). (It’s estimated that 1 in 20 sexually active young women between the ages of 14 and 24 have chlamydia.)
The digital testing service (a.k.a. e-STI testing) used in the study is London-based SH:24. In the US, STI testing is available online, via companies such as Let’s Get Checked, which sells take-home STI tests in different tiers; the basic test allows you to check for two STIs (chlamydia and gonorrhea), and the deluxe set will screen for 10, including trichomoniasis, herpes, and ureaplasma (PrivaPath, n.d.). Take-home STI tests are also available in many pharmacies, such as CVS and Walgreens. Companies like EverlyWell and MyLab offer take-home tests through Amazon, although they can’t be shipped to certain states.
“At home testing for STIs is an important advance that will likely increase the diagnosis of many STIs,” says Amesh A. Adalja, MD, a urologist and senior scholar at the Johns Hopkins Center for Health Security. “STIs are often stigmatized, and patients (and physicians) may not feel comfortable discussing risks and testing. Unfortunately, this leads to many STIs being undiagnosed and facilitates their spread. Home testing removes a barrier.”
A flaw with current at-home testing, says Adaja, is that people who test positive aren’t in a conversation with a healthcare provider and get the treatment they need.
“With positive or negative tests, it is still important to discuss the results with a physician to discuss treatment options, prognosis, contagiousness and other tests that might be indicated,” he says.
How accurate are at-home tests?
Although take-at-home tests aren’t regulated, the CDC supports the concept of take-home testing. “There’s no FDA indication for at-home collection and sending it into a laboratory,” John Papp, a microbiologist in the CDC’s Division of STD Prevention and author of CDC’s lab testing recommendations for gonorrhea and chlamydia, told NPR. “Having said that, if the specimen is collected properly, regardless of the setting, the test is probably being performed adequately.” According to a study published in the Journal of Family Practice, patients who collected their own samples for STI had test results that were of equal or better accuracy than those of clinical providers (Sexton, 2013).
Who should be tested for chlamydia?
Anyone who has symptoms of a sexually transmitted disease (STD) — including genital discharge, burning during urination, sores, or irritation — should see a health care provider about STI testing and avoid having sex in the meantime.
The CDC’s current recommendations are that sexually active women younger than 25 and sexually active women 25 and over with new or multiple sexual partners be screened for chlamydia and gonorrhea once a year. Men who have sex with men should also be tested at 3-month, 6-month, or 1-year intervals. Getting regular STI panels could be a good idea for everybody — talk to your doctor about what’s right for you.