The Blog

Sexclamation! - Part Six

Ok - here's the day. I'm on the blog first thing because yes - I woke up and the text was there on my phone. They must start early in that clinic - and working on a Saturday morning! Goodness me!

Sexclamation ! - Part Six

Ok - here's the day. I'm on the blog first thing because yes - I woke up and the text was there on my phone. They must start early in that clinic - and working on a Saturday morning! Goodness me!

I was nervous, and I looked at it for a few moments before I clicked on it. In fact, I took the phone into the bathroom so I could open the text in private.

This is what it says.

Your test results are back. The tests are negative, but, your chlamydia test is equivocal. Please contact the clinic.

Equivocal! Oh no! Relief the other test are negative of course, but have I or haven't I got chlamydia? At 55?

SO - here's the thing. I know these things because it's my job. When they do the chlamydia test, the result is not always black or white, there are shades of grey. All tests do not necessarily give you a yes or a no answer. This can be confusing but it is a fact.

The other thing is that these tests look for evidence of the DNA of the chlamydia organism. But in fact, to be sure absolutely sure an organism is present, you need to grow it from the specimen, not rely purely on a DNA test. With the DNA tests, they may test positive but sometimes even if they are positive, there is actually no infection. This means undoubtedly some of the positive chlamydia tests are false positives. BUT, in a working clinic environment, we can't do anything about this. Chlamydia is hard to grow in a laboratory setting, time consuming and expensive. So it just isn't done, except in research trials. So from the clinic perspective we have to treat a positive DNA test as a true positive test, and treat accordingly. If the patient is desperately upset as neither she or he say they have been unfaithful and there is no way they could have contracted the infection etc... we will explain this to try and stop this ending up in the divorce courts!

So, everybody - I've got to go back to the clinic and do the chlamydia test again! What can I do to ensure I get a better test result? The clinic does insist you have not passed urine for hours hours before you attend. Did I comply with this last time? I can't remember. If you have the swab done and you've just passed urine, you will have peed a lot of your chlamydial organisms down the toilet! There are real reasons for these instructions that the clinic gives out.

As a screening test in women with no symptoms, either a urine test or a vulvo-vaginal swab will suffice. The swab, is actually best taken by the patient themselves! - and is the test of choice. However, if a woman has urinary symptoms, a urine test for chlamydia may be needed. This is because women have two tracts, a urinary tract (kidney, bladder and urethra), and genital tract (ovaries, uterus vagina.) If she has symptoms such as vaginal discharge or pelvic pain, a vulvo-vaginal swab is required. For a man who is asymptomatic , they have one tract for everything, (urinary and genital) so a swab or a urine test are as good as each other, but most men strongly prefer to pass urine, than have anyone stick a swab down the urethra! So a urine test is the test of choice.

So - I'm getting my chlamydia test repeated first thing tomorrow.

I am relieved though that none of my other tests are positive. I can relax on that score. I now know how it feels for people waiting for test results, the anxiety of not knowing, and I have real sympathy, empathy almost, for anyone whose tests are positive.

For me it's going to be another five days.

A few other facts to tell you most people don't realise. There is an incubation period for STI's and usually we won't test - if you've been tested before anyway and this is just a routine screening test - unless there is a minimum of 10 days between your risk of exposure and the day of the test. If we test too early, you risk having a false negative result.

Also, we have the problem all the time, not unique to our clinic, that we can't contact some patients to give them their results. Every day we send hundreds of text messages to patients about their results. And every day a significant proportion are undelivered, often it's the wrong number that's been given. Or possibly even since the clinic visit the person has dropped their phone, lost it or had it stolen and not thought to tell us. We always ask for two means of contact, but some patients don't want to give us their email address or their home address. This can be very difficult, if we have a positive result and we have no way of letting you know! So do make sure if you need to visit a clinic, that your contact details are correct etc... it's vital!

The reassuring aspect of all of this is that chlamydia is treatable. Usually a seven day course of Doxycyline is the current recommended treatment of choice. A single dose of Azithromycin is an alternative, but recently there have been reports of Azithromycin resistance. If I do test positive next time, at least the infection can be eradicated and I'm not stuck with it forever. If I do test positive, thank goodness I did the test!

If do test positive I will have to tell my current partner. This won't be easy. He's quite a well-to-do kind of person who doesn't "do" illness at the best of times. My saving grace is that we will never know who gave it who. However, when I think about it I feel a goose walking over my grave. Fingers crossed we don't have to have that conversation.

I'll blog again shortly. But it will be another five days before my second chlamydia result is available!


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