Target Group for Testing

Routine testing at least annually: 

• Sexually active men and women under the age of 25
• Men who have sex with men
• Sex Industry workers

Testing is also recommended for people who have:

• A history of inconsistent condom use
• Recent partner change
• Unplanned pregnancy
• Symptoms suggestive of Chlamydia 
• Another STI 
• A sexual partner with Chlamydia 
• Chlamydia symptoms

Most men and women (up to 90%) will have no symptoms.  In women, infection may result in pain or urination, lower abdominal pain, or inter-menstrual or post coital bleeding. In men, infection may result in urethral discharge, pain on urination or urethral irritation. 

Test Options

The Chlamydia PCR test is highly sensitive (95%+) and specific (95%+). For men: initial stream urine taken at any time of the day (plus an anal swab if indicated) For woman: Initial stream urine or a cervical swab (plus anal swab if indicated), other options include a Thin Prep specimen, or a high vaginal swab.

Treatment Options

Azithromycin 1000mg stat; or Doxycycline 100mg bd for 7 days (not for use in pregnancy or breast feeding)

In pregnancy:

• Azithromycin 1000mg stat (Category B1) or
• Amoxicillin 500mg tds for 10 days (Category A) or
• ESS 800mg bd for 10 days (Category A)

Patient Follow-up

A repeat test should not be conducted less than 4 weeks after the initial positive test due to the likelihood of bacterial DNA still being present.  It is recommended that a pregnant woman testing positive be tested for cure at 4 weeks after treatment. All others with a positive test should be retested at 3-6months because of high risk re-infection. The frequency of further testing should then be based on an assessment of continuing risk factors. 

Contact Tracing

All sexual contacts for the past 6 months should be offered empirical treatment for Chlamydia and tested for Chlamydia and other STIs. A contact letter is available for use during this process. To download a contact tracing letter, see the Resources and Links page on the HNEPH website, www.chlamydiahelp.net 

Web Resources

Chlamydia resources for health professional and patients are available on the HNEPH website via: www.chlamydiahelp.net and www.gettested.com.au 

References

Chlamydia information resourced from the following:

1. www.chlamydiahelp.net

2. Hunter New England Health, NSW Health - issued October 2007 - Chlamydia Information brochure: STI HIV campaign

Further information

For further advice about chlamydia testing, speak to your doctor, make an appointment with a Sexual Health Service or a Family Planning Clinic call 1800 451 624 (in NSW Mon – Fri, 9am – 5pm).

In Hunter New England, Sexual Health Clinics are available at the following locations: