**7. Prevention and patient education**

The high prevalence of asymptomatic chlamydial urethritis is gradually increasing the rate of undiagnosed or untreated infections. Therefore, screening is protective. At least annual follow-up of all sexually active women under 25 years of age and women over 25 years of age who are at risk for sexually transmitted infections is also recommended to reduce the rate of male infection. These screening programs have been shown to decrease the prevalence of infection and rates of complications. There is insufficient evidence for the efficacy and cost-effectiveness of routine *Chlamydia* screening in sexually active young men. However, in risky and high-prevalence areas, performing this screening to the extent allowed by clinical conditions is beneficial [29].

Risk groups include:


Patients with chlamydial infection should also be evaluated for other sexually transmitted diseases such as gonorrhea, syphilis, and HIV. The diagnosis and treatment of sexual partners are also important [29].

#### *Chlamydia Infection from Androgical Perspective DOI: http://dx.doi.org/10.5772/intechopen.110045*

In many countries, notification of *C. trachomatis* infection is mandatory. The sexual partner must be informed, examined, and treated. Partner antibiotic therapy can also be performed in some cases without face-to-face contact with the patient to expedite treatment.

Patients should be informed about the serious risks of chlamydial infection and the importance of screening. Those who feel uneasy about urethral swap sampling for diagnosis should be tested using a first-void urine sample and prevented from leaving without being screened.

In the USA and other developed nations, the prevention of sexually transmitted genital infections and their complications is based on annual screening and treatment of nonpregnant women under the age of 25. In the presence of a risk factor, other women should also be screened. High-risk young men should also be screened if resources allow [29].

Health workers and nurses should educate patients about the importance of using condoms during sex and provide information about safe sex. Candid communication with the patient and helping them feel comfortable are essential in diagnosis, treatment, and follow-up [9].

Early treatment and full-dose antibiotics provide a near-perfect cure rate. Urethral infection with *C. trachomatis* produces a low-level immunological response [20]. The rise of chlamydial infections, for which there is not yet a vaccine, can be prevented by completed treatment, patient education, and screening.

The American Centers for Disease Control and Prevention (CDC) recommend that a sexual history should be obtained from patients and risk reduction strategies recommended when deemed necessary. In addition, the U.S. Preventive Services Task Force recommends that all sexually active adolescents and adults at risk of sexually transmitted infections be provided intensive counseling [3].

Patients should not engage in sexual intercourse for at least 7 days after the completion of treatment and sex should only be allowed after their partner has also completed treatment and symptoms have fully resolved [3].

Patients with urethritis should be vaccinated for other infectious diseases for which vaccines are available (hepatitis A/B, HPV).

The use of condoms reduces the risk. Selective sexual intercourse should be practiced and uncontrolled intercourse avoided. Circumcision was found to be beneficial in terms of genital ulcers and HPV, but ineffective in terms of transmission of *C. trachomatis* and gonorrhea [3].

When a sexually transmitted infection is detected, the patient should be educated by a team including physicians and trained healthcare professionals. Adequate sensitivity should be shown to patients regarding partner treatment and recurrence. An environment where patients feel safe and comfortable should be provided to enable the patient to ask questions and ensure accurate history-taking. If the patient does not feel safe, it will be difficult to obtain a detailed sexual history. This causes delays in diagnosis and treatment. Providing diagnosis and treatment with a professional approach will help curb the rapid rise of this disease [9].
