Chlamydia: The Most Successful STD in America

Feeling a burn down there? It could be chlamydia, the most frequently reported sexually transmitted disease (STD) in the United States.

Now, on the one hand, being sexually active can be a lot of fun. We should stress that: a lot of fun. But being sexually active carries a lot of responsibility as well, and learning how to mitigate the risks of infection not only affects your own health and safety but also that of your partners.

The science of chlamydia

Chlamydia is a genus of bacterial parasites that can cause many different diseases and infections in humans. There are three species under the chlamydia genus: Chlamydia psittaci, Chlamydia trachomatis and Chlamydia pneumoniae.

However, the one we need to worry about here is Chlamydia trachomatis, the species of bacterial parasite that causes chlamydia, the STD that affects more than 1.6 million Americans.

Who gets chlamydia?

Chlamydia can affect anyone, but it's more common in women than in men, and most prevalent in young people.

Women with cervical ectropion—when cells inside the cervix are visible from outside the cervix—are particularly at risk for contracting chlamydia. Women taking oral contraceptives often have cervical ectropion, which is typically harmless and caused by normal hormonal changes. But cervical ectropion may increase the risk for chlamydia, according to the Centers for Disease Control and Prevention (CDC).

The CDC has suggested that barriers to STD prevention services may partially explain why more young people contract chlamydia. An inability to access transportation to a clinic or pay for the services can make it difficult to receive a diagnosis and treatment for an infection.

Chlamydia on the rise 

Chlamydia is one of the most common sexually transmitted infections in the world. In the United States, 1,628,397 cases were reported in 2021, according to the CDC.

While cases had been on the decline for years, incidences of chlamydia are rising again, a fact everyone should take note of, according to Kate Tulenko, M.D., M.P.H., former director of the U.S. government's global health workforce project and current CEO and founder of Corvus Health, a health systems and workforce services firm based in Alexandria, Virginia.

"Chlamydia is often forgotten about as an STD as most stories focus on HIV, AIDS, gonorrhea, syphilis, herpes, monkeypox," Tulenko explained. "Unfortunately, chlamydia is on the rise after the end of the [COVID-19] lockdowns."  

A lack of awareness may contribute to the heightened case rates, according to a September 2022 NPR interview with David Harvey, executive director of the National Coalition of STD Directors.

"There really is a lack of awareness in America about the scope of this problem," Harvey told NPR. "We're not testing enough. Patients aren't asking to be tested and doctors aren't doing enough testing and doing sexual health histories as part of primary care."

The COVID-19 pandemic is another factor contributing to the rise of chlamydia cases, with Harvey telling NPR the whole public workforce devoted to sexually transmitted infections (STIs) was redeployed to COVID. With the lack of healthcare workers devoted to STI prevention, people avoiding the doctor's office and the growing social inequities exhibited by the pandemic, it makes sense that STDs are on the rise.

How chlamydia spreads

Now that we know chlamydia cases are increasing, how do we remedy the situation?

The simple answer is to have safer sex. And safer sex starts with empowering ourselves through understanding how the infection spreads and how to mitigate the risks.

"Chlamydia spreads through infected body secretions, mainly through vaginal and anal intercourse," Tulenko said.

However, the risk is not erased if you engage only in oral sex.

"You can get chlamydia in your throat but it is less common," Tulenko confirmed.

Any time you come in close contact with infected tissue, you're at risk for contracting chlamydia. Plus, the STD can be passed from mother to baby during childbirth.

It's important to remember that infection can spread even if your partner doesn't ejaculate. Tissue exposure is all that's needed for infection to take place, meaning sharing sex toys with someone who has an active infection is risky, too, according to the United Kingdom's National Health Service (NHS).

In addition, you can be reinfected with chlamydia after completing treatment if you engage in sex with someone who has an active case. Treatment is necessary every time you contract the infection. Treatment is not "one and done."

Mitigating risk 

Risk factors for contracting chlamydia include unprotected sex, multiple sex partners, rough sex (which is more likely to break the skin), one or both partners having broken skin on their genitals, and having another STI, Tulenko said.

"People who engage in high-risk behaviors should discuss with their physician the possibility of getting tested regularly for STIs," she added. "Remember there is no such thing as 'safe sex,' only 'safer sex.'"

The No. 1 method to protect yourself and your partners from spreading sexually transmitted infections is to wear a condom every time you have sex. While pausing momentum to put on a rubber can feel decidedly unsexy, keeping yourself healthy is more important than any momentary awkwardness. If your partner is against wearing a condom, it may be time to rethink that encounter.

Debunking misconceptions about chlamydia

Due to a lack of sex education and the spread of misinformation, myths and misconceptions about chlamydia abound. Knowledge is power, so it's time to debunk some myths so you can be informed.

Myth No. 1: You cannot get chlamydia if you've had sex only once

STIs do not discriminate, and chlamydia doesn't care if you've had sex once or 100 times—either way, you can contract it. Even if you've had unprotected sex only once, get tested. It can't hurt and could save you major discomfort if you get diagnosed early.

Myth No. 2: You can't catch chlamydia twice

Unfortunately, your body does not provide immunity from chlamydia if you've had it before. Treatment clears up the current infection but leaves no ongoing protection. Repeat chlamydia cases are common. Women whose partners have not been treated are at high risk of reinfection and further serious complications, according to the CDC.

Myth No. 3: You need to get tested only if you have more than one partner

While it's true your risk factor increases with multiple sexual partners, even monogamous couples should get routinely screened for STIs. Getting tested doesn't mean you don't trust your partner; it only means you're both taking your sexual health seriously.

Myth No. 4: You can catch chlamydia from a toilet seat

OK, finally a positive note. You cannot catch chlamydia from a public toilet. You also can't get it from sharing towels or other clothing. Research suggests that the bacteria necessary for spreading the infection does not live long outside the body, perhaps surviving on surfaces for two to three hours under humid conditions.

Myth No. 5: Chlamydia isn't that big a deal

Chlamydia is extremely common, so it's easy to discount it as not being a serious infection. Chlamydia is very treatable, but there can be serious health consequences if it's ignored. Men with untreated chlamydia can suffer swollen, painful testicles. For women, untreated chlamydia can lead to pelvic inflammatory disease (PID), which can result in infertility and chronic pain.

Quick facts

Now you know all about how chlamydia spreads, how to manage your risk for the infection, and the truth about some common myths and misconceptions. If you really want to impress, though, here are some quick facts to know about this common STD:

• 1,628,397 U.S. cases of chlamydia were reported in 2021, according to the CDC.
• Chlamydia is more common in women.
• Chlamydia can cause long-term health issues, even in asymptomatic cases.
• The majority of cases are asymptomatic at the time of diagnosis, according to the European Centre for Disease Prevention and Control.
• Chlamydia is most common in people ages 14 to 24, according to Planned Parenthood.
• Incubation time from infection to first symptoms is one to three weeks.
• A vaccine for chlamydia has not yet been developed and approved for market.

In summary, chlamydia is a treatable sexually transmitted disease that can lead to serious health consequences if left untreated. If you think you may have chlamydia or you've recently had unprotected sex, you should get screened. And just to emphasize the point, screenings are an important part of commonsense sexual healthcare and should not be embarrassing.

If it's been a while since your last screening, talk to your healthcare provider or your local Planned Parenthood office to schedule a test today.

In-person follow-up might be required for conditions such as STIs/STDs, but the first step is the most important. Giddy telehealth is an easy-to-use online portal that provides access to hundreds of healthcare professionals whose expertise covers the full scope of medical care.