Chlamydia (NGU or Urethritis)

Chlamydia infections have been on the rise in King County over the past couple of years, especially among gay and bisexual men. Since there are often no symptoms, it isn't something that most people would know that they have, meaning they don't get treated and are more likely to pass it on to other partners.

Chlamydia is a bacteria that causes non-gonococcal urethritis. Like gonorrhea, a chlamydia infection is usually limited to the site of infection and has similar symptoms. Up to 40% of chlamydia infections are asymptomatic, making it difficult to diagnose.

Although not as common as gonorrhea, 75% of the time where there is one you will find the other, which is why you should always get tested for both at the same time. Also, infection with either gonorrhea or chlamydia could mean that you've been infected with other STDs as well.

How do you get it?
Like gonorrhea, chlamydia is spread through anal sex. It may also be spread through oral sex, although this is probably less common than with gonorrhea. Chlamydia can be found in your anus, and occasionally in your throat, though throat tests are not usually performed.

In men who are tops, NGU can also be caused by bacteria other than gonorrhea or chlamydia that live in other men's butts. In most cases, it is not possible to identify what bacterium is causing NGU. However, these cases are still probably bacterial infections, and most get better with antibiotics.

If untreated, the infection can spread from your urethra to your epididymis and prostate. You can even spread it to other parts of your own body. Occasionally, chlamydia can infect the eye, either when cum gets in the eye or from touching your eye when your hand has chlamydia on it.

How do you avoid it?
Much like gonorrhea, using condoms for anal and oral sex with an infected person is the best way to keep from getting chlamydia and/or NGU. Urinating after sex may help flush out bacteria from the urethra, although there is not much hard evidence to support this idea.

Symptoms?
You may not have any symptoms with chlamydia. Symptoms often show up 7-21 days after being exposed, and include:

Testing and treatment
The most accurate test is a scrub from your urethra that is sent to the lab for DNA testing. Some health care providers swab a small amount of fluid from your penis, throat or ass and look at it under a microscope. Even if you have no symptoms, bottoms should be tested for rectal chlamydia infection at least annually. Asymptomatic men can easily spread the infection through both anal and oral sex without condoms.

The infection is treated with antibiotics. It is very important to a) remember to finish all the meds even if symptoms go away, and b) inform your most recent sex partners. If you have a partner who has not been treated and you have sex again, you can get it again and can pass it back and forth. By informing your recent sexual partners so that they can be treated can make a dramatic difference in the number of STDs that are transmitted due to lack of knowledge. This is because some STDs are asymptomatic, meaning that there could be no noticeable symptoms.

If you are diagnosed with gonorrhea, it is common that your treatment will include antibiotics active against chlamydia as well since co-infection is so common.

What else should you know?
NGU is very common in men. Symptoms may be mild and many men do not realize they have the infection. They can unwittingly spread it to partners. Chlamydia can also infect your mouth and anus. If you pass foreign objects into your urethra you can cause an infection. Men with penile piercings that pass through the urethra are also more likely to develop urethritis, which may not be sexually transmitted. Chlamydia may develop into a serious infection if not treated.

Testing
You can get tested at the Harborview STD clinic. Call (206) 731-3590 for more info.

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