STD Risks: Chlamydia and HIV Testing Explained

Q: STD Risks: Chlamydia and HIV Testing Explained

Xiao Chen： Hello! 1. <br>Testing has its limitations; although most results are accurate, it can sometimes be difficult to determine when results fall in the gray area between positive and negative. <br>2. <br>The theoretical risk of contracting HIV is low. <br>However, if you ar

Sexually transmitted infections (STIs) issues?

About seven weeks ago, on September 24, I had sexual intercourse with a sex worker.
I used a condom throughout the entire process, but my penis became soft during the encounter, causing the base to be outside the condom.
However, the glans was covered by the condom.
Five weeks later, I went to a clinic in Taichung City for a full sexually transmitted infection screening, including an HIV RT-PCR test, and all results came back negative.
Ten days later, I returned to the clinic for HIV, syphilis, and Chlamydia antibody testing.
Both HIV and syphilis tests were still negative, but the Chlamydia IgG showed 64X(+) positive.

My first question is, did I get infected with Chlamydia? In the first location (when I was tested five weeks later), both IgG and IgA were negative, so why did it turn positive at the second location?
My second question is, I tested negative for HIV with RT-PCR five weeks after the exposure, and I also tested negative for antibodies in the sixth week.
Is there still a possibility that I could have contracted HIV?

Xiao Chen, 10~19 year old female. Ask Date: 2015/11/14

Dr. Xu Weikai reply Urology

Xiao Chen: Hello! 1.
Testing has its limitations; although most results are accurate, it can sometimes be difficult to determine when results fall in the gray area between positive and negative.
2.
The theoretical risk of contracting HIV is low.
However, if you are still concerned, you can retest after a year for peace of mind.
3.
IgG generally indicates a past infection and may reflect an infection that occurred some time ago.
IgM, on the other hand, indicates a recent infection.
Of course, test results should be interpreted in conjunction with clinical symptoms and medical history.
If there are any unclear points, feel free to ask again so we can discuss and research further.
Online responses should only serve as a reference; if necessary, it is important to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/11/14

More Info

When it comes to understanding the risks associated with sexually transmitted diseases (STDs), particularly Chlamydia and HIV, it is essential to consider various factors, including the nature of the sexual encounter, the type of protection used, and the timing of testing.

In your case, you mentioned having sexual intercourse with a sex worker on September 24, during which you used a condom. However, you noted that the condom slipped off at the base of the penis, which raises some concerns. While the condom covered the glans (tip) of the penis, any exposure of the shaft can potentially lead to STD transmission if there is contact with infected bodily fluids.
You subsequently underwent testing for STDs, including an HIV RT-PCR test, five weeks after the encounter, which returned negative results. This is a good sign, as RT-PCR tests can detect the virus earlier than antibody tests. However, it is important to note that the window period for HIV testing can vary. While RT-PCR can detect HIV within 10-14 days post-exposure, antibody tests typically require a longer window period to provide accurate results.

Regarding your Chlamydia test, the IgG result showing a positive reading (64X) indicates a past infection. IgG antibodies develop after the body has fought off an infection, suggesting that you may have been exposed to Chlamydia at some point in the past. The negative IgG and IgA tests from the first location may indicate that you did not have a current infection at that time. However, the positive IgG result from the second test suggests that you may have had a previous Chlamydia infection that your body has since cleared.
To address your questions:
1. Do you have a Chlamydia infection? The positive IgG result indicates that you have been exposed to Chlamydia in the past, but it does not confirm a current infection. If you are asymptomatic and have not experienced any symptoms such as unusual discharge, pain during urination, or pelvic pain, it is possible that you do not have an active infection. However, it is advisable to consult with a healthcare provider for further evaluation and possibly a retest to confirm your current status.

2. Is there still a possibility of having HIV? Given that you tested negative for HIV using the RT-PCR method five weeks after the exposure and again tested negative for antibodies six weeks later, the likelihood of being HIV positive is low. However, it is essential to follow up with additional testing, as the standard recommendation is to test again at three months post-exposure for conclusive results.
In summary, while your initial tests are reassuring, it is crucial to maintain regular check-ups and follow the recommended testing timelines. Additionally, practicing safe sex, including consistent condom use, is vital in reducing the risk of STDs. If you have any ongoing concerns or symptoms, do not hesitate to reach out to a healthcare professional for personalized advice and treatment options.

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