Sexually transmitted infections (STIs) have been on the rise for several years, especially cases of gonorrhea, syphilis, and chlamydia. Chlamydia, in particular, is the most common bacterial STI among 16-24 year olds, especially in women. Its contamination often goes unnoticed because there are few symptoms, if any at all. The teleconsultation platform ZAVA wanted to assess the knowledge of the French regarding this infection… and it seems that their level of information leaves something to be desired on several points. In May last year, the United Nations (UN) warned of a significant increase in STIs in several regions of the world, with four curable STIs – syphilis, gonorrhea, chlamydia, and trichomoniasis – alone responsible for over a million infections per day. France is not spared by this phenomenon, especially when it comes to Chlamydia infection.
The French Social Security system has reported that the rate of people tested at least once a year for Chlamydia trachomatis infection has nearly doubled (+86%) between 2014 and 2021, with a larger increase in men than in women. Moreover, the number of people aged 15 and over diagnosed with Chlamydia infection at least once a year in the private sector (test reimbursed by Social Security) was estimated at around 96,900 in 2021, an increase of 15% compared to 2020 and 9% compared to 2019. This number more than doubled between 2014 (about 40,700) and 2021.
Faced with this resurgence, the online medical consultation service ZAVA wanted to find out if the French are sufficiently informed about the risks associated with this infection and if they know how to protect themselves. The organization conducted a survey of 1030 people in France and analyzed the overall responses, as well as by gender and age groups.
Their general knowledge in this area was scrutinized through 5 distinct questions: «do you know how the infection most often manifests itself?», «do you know the means to prevent it?», «do you know how the screening is done?», and «do you know if there is an effective treatment, what are the consequences of an untreated infection?». Results? Only 2.5% of the surveyed individuals have general knowledge about all these points. «Chlamydia remains an infection that few people know the most common symptoms, diagnostic methods, prevention, treatment, and consequences of. » warn the authors of the study. «In order to reduce the number of new infections, it is essential to promote the dissemination of information. Better information will provide the necessary knowledge to improve infection prevention, effective screening, treatment, and thus avoid sometimes serious complications. » adds Dr. Laura Joigneau Prieto, a physician at ZAVA who initiated this study.
Most people infected with Chlamydia do not show any symptoms; therefore, this infection is often underdiagnosed. «Whether in men or women, nearly half of those infected with the bacterium Chlamydia trachomatis have no symptoms. It is then called a silent infection. The proportion of asymptomatic individuals was 46% in 2015. The acute form of Chlamydia infection is rare. It includes fever, pelvic pain (lower abdomen), and metrorrhagia (bleeding between periods).» specifies the Social Security. However, if symptoms appear, they usually manifest two to six weeks after exposure. Chlamydia can cause a burning sensation when urinating. Other symptoms include abdominal or lower back pain, painful sexual intercourse, abnormal vaginal discharge, bleeding between periods or during or after sexual intercourse, abnormal urethral discharge, itching around the urethral opening, swollen or painful testicles, and pain, bleeding, or discharge in the rectum.
Regarding diagnosis, the Institut Pasteur states that the diagnosis of Chlamydia infection is done in a medical analysis laboratory by PCR, from a urine sample or a sample taken from the affected organs (urethra, vagina, rectum, throat), the latter method being more effective. A clinical examination can also help with the diagnosis. In addition, according to Public Health France, «screening can be done following a consultation with your treating physician, gynecologist, or dermatologist-venereologist who will refer you to a laboratory, or for free in the Free Information, Screening, and Diagnostic Centers (CeGIDD) and family planning or education centers. » A new infection after recovery, however, is still possible, especially if the partner(s) is (are) not screened and treated if necessary.
Chlamydia infection is a disease that can be treated and cured: an uncomplicated Chlamydia infection is treated with antibiotic tablets, particularly azithromycin or doxycycline. «Chlamydia infections, whether symptomatic or not, are treated as a first-line treatment with azithromycin in a single dose of 1 gram or with doxycycline 100 mg, twice a day for 7 days. Chlamydia infection in pregnant women is treated with a single dose of 1 gram of azithromycin or with 500 mg of erythromycin, twice a day for 14 days. Another antibiotic (an intramuscular injection of 500 mg of ceftriaxone) is added in case of simultaneous gonococcal infection. «, confirms the Social Security. The infection can recur if sexual partners are not treated and if people have unprotected sex with an infected person.
Prevention of Chlamydia infection, like all STIs, relies on the systematic use of condoms during sexual intercourse (even for fellatio). Only two contraceptive methods known as «barriers» protect against Chlamydia infections: the male condom and the female condom. It is important to note according to the Social Security that the following contraceptive methods do not protect against STIs in general, and therefore, against Chlamydia infection: the contraceptive pill, the implant, the patch, the contraceptive ring, the intrauterine device, spermicides. «Even if you use one of these contraceptive methods, you must use a condom, whether male or female.» recommends the Social Security.
There is no vaccine against the infection, which is why, to break the transmission chain, anyone diagnosed as infected must notify their recent sexual partners (1 month) so that they can be tested. However, even though 69.7% of people know that Chlamydia infection can be avoided by using condoms during sexual intercourse, a high percentage do not know that certain measures are completely ineffective: avoiding sitting on public toilets, taking the contraceptive pill, or having good hygiene do not prevent Chlamydia infection.
The consequences of untreated Chlamydia infection can be severe, leading to complications such as infertility, chronic pelvic pain, ectopic pregnancy, and adverse effects on other organs. The majority of those surveyed understand that untreated infection can have significant medium and long-term consequences, such as infertility and other organ conditions, but there are still some misconceptions among a portion of the respondents. It is crucial to educate the public about the risks associated with Chlamydia infection, the importance of early detection, and the need for timely treatment to prevent severe complications and reduce the spread of the infection. The study findings highlight the gaps in knowledge and awareness among the French population and underscore the importance of ongoing education and outreach efforts to address these issues.
