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One of the trickiest STIs is chlamydia—it’s widespread, primarily because it usually produces no symptoms. People who are unaware they have the infection often pass it to their sexual partners, who then transmit it to others. But recent studies have shown that at-home testing for chlamydia could help more people get screened regularly. Researchers believe that, ultimately, at-home testing could make a big difference in transmission rates (Wilson, 2017; Wilson 2019).
How common is chlamydia?
According to the Centers for Disease Control and Prevention (CDC), chlamydia is the most commonly reported sexually transmitted bacterial infection in the United States. In 2018, the CDC estimated that four million people had chlamydia—it’s likely that many people had this STI and didn’t realize it (CDC, 2021). Having unprotected sex is a risk factor for getting many STIs, including chlamydia.
Symptoms of chlamydia
Only about 10 percent of men and 5–30 percent of women who test positive for the Chlamydia trachomatis bacteria will have any signs that they’re infected. The symptoms of chlamydia infection can include vaginal discharge, penile discharge, or pain while urinating. Because so few people have symptoms, you are more likely to spread it to your sex partners—especially if you don’t get chlamydia testing.
Can chlamydia cause complications?
If you have chlamydia, you want it diagnosed because untreated chlamydia can lead to health problems in men and women.
In some men, untreated chlamydia can lead to urethritis (inflammation of the urethra), epididymitis (swelling in the tube at the back of the testicles), and prostatitis (infection of the prostate).
Untreated chlamydia in women can lead to serious complications like pelvic inflammatory disease (PID) and infertility. In pelvic inflammatory disease, the female reproductive organs (the cervix, uterus, ovaries, and fallopian tubes) become inflamed. The fallopian tubes can become scarred or blocked, which can lead to infertility. PID also increases the risk of developing an ectopic pregnancy, which can be fatal in some cases.
Chlamydia can also be passed from infected pregnant women to their infants during childbirth, leading to conjunctivitis (pink eye) or pneumonia in newborns.
Lastly, untreated chlamydial infection is a risk factor for contracting the human immunodeficiency virus (HIV) (Pillay, 2021).
How is chlamydia diagnosed?
Of the multiple tests available for diagnosing chlamydia, the nucleic acid amplification test (NAAT) is the most sensitive. First, you’ll need a sample—those with a penis can give a urine sample, while people with a vagina need a vaginal swab.
Depending on the types of sexual contact you participate in (oral sex, anal sex, or vaginal sex), you may also want to get those other sites tested. If you engage in oral sex and worry you may have pharyngeal chlamydia, you can have a throat swab tested. Similarly, your healthcare provider should obtain a rectal swab if you participate in receptive anal intercourse (Hsu, 2019).
What is an at-home chlamydia test?
There are currently no FDA-approved at-home tests for chlamydia or gonorrhea. However, there may be a role for this kind of testing, especially if it helps someone who otherwise would not get tested.
Some people find sexual health clinics inconvenient or stigmatizing, preventing them from getting the care they need. Unfortunately, this leads to many STIs going undiagnosed, easing their spread through the population. Home testing can help remove this barrier.
In a recent study, researchers found that people who were invited to use a take-home STI test were nearly twice as likely to get tested than the group of people who had to get STI testing by reporting to a clinic or doctor’s office (Wilson, 2017).
Online only at-home testing means that you are the one who orders the test, collects the sample, and sends it back to the lab. You do not need to go to a clinic or laboratory to have the samples taken and processed, which some people find appealing. Check to make certain that the laboratory your at-home test will go to is CLIA certified—this means that it follows the regulations set down by the FDA, CMS, and CDC regarding testing human samples.
Chlamydia: symptoms, diagnosis, risk factors, and treatment
How to get an at-home chlamydia test
In the U.S., STI testing is available online, via companies such as Let’s Get Checked, which sells take-home STI tests in different tiers; the basic test allows you to check for two STIs (chlamydia and gonorrhea), while other options screen for more STIs, including syphilis, HIV, trichomoniasis, herpes, and ureaplasma (PrivaPath, n.d.). Take-home STI tests may also be available over-the-counter in your pharmacy.
How do you use the at-home chlamydia test kit?
Depending on which test you order, there are likely specific instructions regarding how to activate and submit your testing kit. Everything you need to collect your sample will be included in the kit. Those with a penis will need to collect their initial stream of urine (first-catch), while people with a vagina may use a vagina or cervical swab to collect their sample.
Read the instructions carefully to ensure the most accurate results. Don’t hesitate to contact the company if you have any questions or concerns regarding the testing process.
How do you submit your sample for testing?
Carefully follow the instructions on the at-home chlamydia test kit regarding how to submit your sample for testing. The kit will include shipping instructions and information, with most companies providing prepaid shipping labels.
How do you get test results?
Most testing kits have an online notification system that tells you your results within a few days. In some cases, a provider may be available for phone consultations if you get a positive result or should you have any questions.
How accurate are at-home tests?
The accuracy of STI testing depends on the quality of the sample that you send for testing. Some people are concerned that at-home chlamydia screening may not be as accurate as those done in a healthcare facility because healthcare providers do not take the samples. One study that looked at people who collected their own samples for STI testing had test results of equal or better accuracy than clinical providers (Sexton, 2013).
However, another trial showed that the samples collected by the providers were slightly more accurate. Still, the researchers felt that at-home testing is a reasonable option for those with a barrier to getting sexual health care (Lunny, 2015).
Another problem is that many at-home testing chlamydia testing kits only provide the option to send a urine sample. For women, a vaginal/cervical swab is better at diagnosing chlamydia than urine tests. Data suggests that self-collected vaginal swabs may be as accurate as those collected by the providers (Lunny, 2015).
At-home vs. in-office chlamydia testing
Testing for chlamydia at home vs. in your provider’s office is not very different. In both cases, you will need a sample to send for testing. When you go to a healthcare facility, a trained provider will get the sample and send it off to the laboratory for testing. Both kinds of testing typically take a few days before the results come back.
If you are testing in a facility and the test comes back positive, your healthcare provider can start you right away on the appropriate antibiotic treatment rather than waiting to get an appointment after an in-home test.
Is there a chlamydia vaccine?
Lastly, depending on your insurance and the testing price, there may be a difference in your out-of-pocket costs.
Benefits of at-home chlamydia testing
As mentioned, one of the benefits of at-home chlamydia testing is that you can obtain and perform the test discreetly in the comfort and convenience of your own home. Whether you have transportation issues, trouble getting access to sexual health care, or simply feel awkward talking about chlamydia with your provider, at-home testing can help you get peace of mind that you are taking care of your sexual health.
Disadvantages of at-home chlamydia testing
The major downside of at-home chlamydia testing is the lack of direct contact with a healthcare provider. Not only is a provider more likely to obtain an accurate test result, but they are also there as a source of information to answer your questions and alleviate your concerns. You may need STI testing for more than just chlamydia, and your provider can help guide you through that process.
Some people may have trouble interpreting their test results. Also, if you test positive with an at-home test, you will still likely need to see your healthcare provider to get the necessary antibiotic treatment. Your provider can also assist you in contacting your sexual partners to make sure they get tested and treated.
Who should get chlamydia testing?
Anyone who has symptoms of a sexually transmitted disease (STD)—including vaginal discharge, urethral discharge, burning during urination, etc.—should see a health care provider about STI testing and avoid having sex in the meantime.
The CDC’s current recommendations are that sexually active women younger than 25 and sexually active women 25 and over with new or multiple sexual partners should be screened for chlamydia and gonorrhea once a year. Men who have sex with men should also be tested at 3-month, 6-month, or 1-year intervals (CDC, 2021).
Getting regular STI panels could be a good idea for everybody—talk to your doctor about what’s right for you.
- Centers for Disease Control and Prevention. (2021, Jan). Chlamydia – CDC fact sheet (detailed). Retrieved May 10, 2021 from https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm.
Hsu, K. (2019). Clinical manifestations and diagnosis of Chlamydia trachomatis infections. In UptoDate. Marrazzo, J. and Bloom, A. (Eds.). Retrieved from https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-chlamydia-trachomatis-infections
Lunny, C., Taylor, D., Hoang, L., Wong, T., Gilbert, M., Lester, R. et al. (2015). Self-collected versus clinician-collected sampling for chlamydia and gonorrhea screening: a systemic review and meta-analysis. PLoS One, Jul 13;10(7):e0132776. doi: 10.1371/journal.pone.0132776. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26168051/.
Pillay, J., Wingert, A., MacGregor, T., Gates, M., Vandermeer, B., & Hartling, L. (2021). Screening for chlamydia and/or gonorrhea in primary health care: systematic reviews on effectiveness and patient preferences. Systematic Reviews, 10(1), 118. doi:10.1186/s13643-021-01658-w. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33879251/.
PrivaPath Diagnostics. (n.d.). Home STI Testing. Retrieved from https://www.letsgetchecked.com/us/en/home-sti-test/fb=sexualhealth&gclid=Cj0KCQjwwb3rBRDrARIsALR3Xebkze97oAi0v0TWj7NV5PWfiKWIKvmqrpLAkK9pcvL9KZ2L5hxS3e8aAjamEALw_wcB.
Sexton, M. E., Baker, J. J., Nakagawa, K., Li, Y., Perkins, R., Slack, R. S., et al. (2013). How reliable is self-testing for gonorrhea and chlamydia among men who have sex with men?. The Journal of Family Practice, 62(2), 70–78. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23405376/.
Wilson, E., Free, C., Morris, T. P., Syred, J., Ahamed, I., Menon-Johansson, A. S., et al. (2017). Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial. PLOS Medicine, 14(12), e1002479. doi: 10.1371/journal.pmed.1002479. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29281628/.
Wilson, E., Leyrat, C., Baraitser, P., & Free, C. (2019). Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sexually Transmitted Infections, 1–6. doi:10.1136/sextrans-2019-053992. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31175210/.