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Anthea Rowan

Years ago, my mother and I were in my daughter’s university quarters when she returned from a lecture with dozens of boxes of condoms in her arms.
My daughter burst out laughing when she saw the shocked look on my mother’s face.
“Don’t worry, they’re not mine,” she said. “We give them out for free.”
As a female welfare officer at her college, she could give them out to students who asked for them.
Apart from preventing unwanted pregnancies, the condoms were meant to protect students from STIs, or sexually transmitted infections, such as chlamydia.
Chlamydia is a common STI caused by the bacterium Chlamydia trachomatis.
The STI is not at all unusual among university students. Studies show that the rate of infection in this group is just under 30 per cent, with higher rates seen in men than in women.

Rosa was one such student. On the website for the UK-based charity group Brook Young People, which provides sexual health and well-being services, she describes how she got out of the habit of using condoms when she was in a long-term relationship.
When it ended, however, she was “not in a good place emotionally”.
“I felt like I had to have a drink to be able to feel at ease having sex with someone new, so my inhibitions were lowered,” she admits, and she sometimes forgot to use a condom.
When she found herself in a steady relationship again, even though she had no symptoms, she thought it prudent to do an STI test.
She tested positive for chlamydia.
Reeves Wong, manager at Hong Kong social enterprise My Place – a health service run by local charity Aids Concern – has worked in sexual health for over a decade. He says that chlamydia is the most common STI in Hong Kong, according to figures from the health department’s Social Hygiene Service.
There were 2,135 cases reported in the city in 2024, with a male-to-female ratio of 2.1 to 1.

Sexually active individuals who do not use condoms are much more likely to get chlamydia, says Wong.
After sexual contact with an infected person, it usually takes one to three weeks to develop symptoms, if any arise.
Studies show that about 75 per cent of women and 50 per cent of men with chlamydia never develop any symptoms because the bacteria that cause it do not trigger a strong immune response.
Known as a “silent STI”, a chlamydia infection can persist undetected for months or years, allowing it to be spread unknowingly to others. If a mother-to-be has it, it can also spread to her baby during birth.
Symptoms are usually mild. In women, they may include an unusual vaginal discharge, bleeding after sex or between periods, a burning sensation when urinating, and sometimes lower abdominal pain.

Men can experience the same burning, but other symptoms for them include a discharge from the penis, itching around the testicles or penis, and sometimes painful or swollen testicles.
Due to the lack of symptoms – or the presence of only mild ones – sexually active people should get tested regularly to detect and treat chlamydia early and prevent complications.
It is possible to catch chlamydia while in a committed relationship, even if neither partner is cheating. A person can have it and not know about it, and the infection can remain dormant within the body for long periods of time without any symptoms.
If a person is infected with chlamydia or gonorrhoea – the two have similar symptoms – Wong says that his social enterprise always recommends their partner gets tested too, because of the “ping pong effect”.
That effect plays out like this:

One partner experiences STI symptoms and seeks treatment


The other partner is also infected but shows no symptoms and therefore does not seek treatment


When the treated partner heals, he or she may contract the STI again through unprotected sex with the untreated partner


In Hong Kong, Social Hygiene Clinics run by the Department of Health offer free and confidential examination, treatment and counselling for STIs, including chlamydia.
The first line of treatment, says Wong, is to take seven days of doxycycline, which is a broad-spectrum antibiotic. If that fails, the antibiotic azithromycin may be used.
Most patients, he says, respond well to the treatment, but it is recommended to retest 14 days after completing it.
Wong warns that having had chlamydia does not protect against having it again, “which means you can get infected again the next time you have unprotected sex”.
Left undetected and untreated, chlamydia can have a lasting and life-changing impact. It can cause infertility in both men and women.
In women, it can lead to pelvic inflammatory disease, which causes inflammation and scarring of the Fallopian tubes. This can block the tubes, preventing sperm from reaching the egg.

In men, chlamydia can cause inflammation of the reproductive tract, including the epididymis – a tiny coiled tube located on the back of each testicle where sperm mature and are stored – and testicles, which can lead to infertility by interfering with sperm production or function.
Both Rosa and her boyfriend, who also tested positive, were prescribed a course of antibiotics. She describes her experience as “traumatic”, but also as a valuable lesson. She learned to put her health first.
She had put off being tested because she felt ashamed of the thought of having an STI. Now, she writes, she knows how easily – and quickly – it can be stopped.
It is important to change the messaging around STIs to end the stigma, Wong says. Often, they are wrongly associated with infidelity and being unfaithful to a partner.
“People are afraid and anxious to have an STI check-up because they’re more afraid of the consequences: ‘How can I tell my partner if I am infected with an STI?’”


The key is to prioritise communication in your relationship, educate yourselves together and seek professional counselling to process emotions, he adds.
Do not perpetuate the stigma by feeling ashamed, staying silent and doing nothing. Frame it instead as an opportunity to address better health.
Rosa notes that by testing and treating her infection, she potentially avoided other serious health issues. She stresses that non-barrier forms of birth control, such as the pill, do not protect you from STIs.
“Always use a condom,” she writes, “and take the time to learn how to use one correctly.”
Wong agrees: avoid STI anxiety by not taking the risk of having unprotected sex.
Like what you read? Follow SCMP Lifestyle on Facebook, X and Instagram. You can also sign up for our eNewsletter here.


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Chlamydia is caused by the bacterium Chlamydia trachomatis. It is the most common STI in Hong Kong. Photo: Shutterstock

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Lifestyle

Health & Wellness

Health

Family & Relationships

Chlamydia, a sexually transmitted infection, is the most common STI in Hong Kong and can persist undetected for months or years


Chlamydia, a sexually transmitted infection, is the most common STI in Hong Kong and can persist undetected for months or years.


Disease

Medicine

Sex and relationships

Reproductive health

What is chlamydia? Cause, symptoms and treatment of ‘silent STI’ that can cause infertility

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Chlamydia, a sexually transmitted infection, is the most common STI in Hong Kong and can persist undetected for months or years

Chlamydia, a sexually transmitted infection, is the most common STI in Hong Kong and can persist undetected for months or years