STD: Overview of Chlamydia
Guest: Dr. David Soper – Obstetrics-Gynecology
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I am Dr. Linda Austin. I am interviewing Dr. David Soper who is Professor of OB/GYN at the Medical University of South Carolina. Dr. Soper, Chlamydia is a disease that women and men often do not think about as a sexually transmitted disease. Just what is Chlamydia?
Dr. David Soper: Chlamydia is a microorganism that can be transmitted between a man and a woman during the act of sexual intercourse. It can be prevented by the obligate use of condoms. The real problem with Chlamydia is two issues. One is we have not talked about it in awhile so people have kind of forgotten that Chlamydia is still out there. The second is that Chlamydia causes little to no symptoms. So, women, and men, that are infected with this microorganism do not know they are infected.
Dr. Linda Austin: Well, if they do not know they are infected, why is it a problem?
Dr. David Soper: The big problem with Chlamydia in women is that it can cause an inflammation of the lower genital tract, or cervicitis, but then can ascend up into the uterus out into the fallopian tubes and cause pelvic inflammatory disease. Pelvic inflammatory disease leads to infertility, ectopic pregnancy and chronic pelvic pain. It is the prevention of PID and of further transmission that really has warranted the CDC to recommend screening. Screening can be done actually with a urine test with a vaginal-cervical examination, and with a urethral examination in men, or a urine test in men.
Screening for Chlamydia should be performed in all sexually active adolescent women every time, essentially, they see a healthcare provider. The reason for that is this population is particularly at high risk for the infection and even at high risk for re-infection.
Dr. Linda Austin: What is the time course of that, from the time a young woman becomes infected to when she develops PID, or pelvic inflammatory disease? How long does that process take?
Dr. David Soper: It actually can be quite rapid. We are talking within a couple of weeks.
Dr. Linda Austin: So, screening does, what, then?
Dr. David Soper: Screening identifies patients with the infection. Contact tracing, then, her sexual partners, or partner, can then lead to additional identification and treatment and the prevention of further spread of the disease. It can also prevent the morbidity, or the adverse effects, of the ascending infection of the Chlamydia microorganism.
Dr. Linda Austin: You know, young women, I think, think in terms of asking their partners to be screened for HIV which, of course, is a blood test. But, what you are saying is that they should also ask their male partners to be screened for Chlamydia?
Dr. David Soper: That is true. Again, the test used to be a urethral swap, which can be uncomfortable and which many males will want to avoid. But, now it can just be an early morning urine void. So, it does not hurt to get the test and the screening can be very valuable.
A report was just published about how we are doing with screening for Chlamydia.
Unfortunately, healthcare providers are not really stepping up to the plate on this. Less than half of women, sexually active adolescents, at risk are being screened. Less than half of sexually active adolescents are being screened for this very significant sexually transmitted infection. We need to do better. We really need to get those numbers up over the 90 percentile.
So, my message to your listeners is that if you are a sexually active adolescent, or if you are under the age of 25 and you have a risk factor for sexually transmitted infection, which means, essentially, you have a new sex partner, next time you see your healthcare provider, ask for Chlamydia screening.
Dr. Linda Austin: Because it is simple and it certainly can save you a lot of suffering later.
Dr. David Soper: Absolutely.
Dr. Linda Austin: Thank you so much, Dr. Soper.
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