**4. Socio-psychological and partner problems of chlamydia infection therapy**

The most difficult and intractable are the socio-psychological and partnership problems of chlamydia infection therapy. Therapy of chlamydial infection is carried out on the principle of voluntariness. Patients may not follow the recommendations. Sexual partners often shy away from examination and treatment, especially if they have no clinically expressed complaints, they are not interested in therapy and have other sexual contacts.

Many patients have their own understanding of the disease and its impact on health, their own past individual experiences of sexuality and treatment, and their own vision of therapy. It is purely subjective and often determined by motives other than maintaining health. Chlamydia infection is widely discussed on the Internet and everyone can find confirmation of their views. The notion that today's evolving pharmacotherapy can easily and quickly solve any problem is strong. There is a lot of information about the negative impact of antibacterial therapy on the immune system, liver function. As a result, many patients are focused on a short course of antibacterial therapy and expect a guaranteed cure. The need for a deeper examination and long-term treatment for fibrotic processes is not understood by either patients or health care organizers. In the current situation, doctors have to find a satisfactory balance in each case among the expediency of a full-fledged examination, the duration of antibacterial therapy for chlamydia persistence, and the widely discussed negative consequences of antibiotic therapy, between their professional views and perceptions and fears of the patient to achieve compliance.

It may be difficult to cooperate with a specialist who is treating a sexual partner due to individual differences in views on the clinical situation. Unified approaches to the diagnosis and therapy of chlamydia infection, on the one hand, help when working with a partner couple (e.g., they position the mandatory treatment of a partner when a chlamydia infection is detected) and, on the other hand, limit the possibilities of an individual approach. For example, complex treatment of a patient with chronic long-term chlamydia infection may be useless if the partner is not examined, receives only a short course of antibiotics, does not take medications, or does not use protection against STIs.

Etiotropic therapy of chlamydia infection is not very effective in polygamous relationships. Promiscuity behavior is quite widespread among young people. The search for a variety of sexual experiences, the constant change of partners, and the predominance of relaxation motives often precede the establishment of a partner sexual relationship. During this period, the correct and consistent use of protective equipment (condoms) is important. Unfortunately, condoms are often used from time to time or incorrectly [10]. The main focus of the partners is on HIV prevention, everything else is considered irrelevant. If a man or woman is subjectively convinced that his or her partner is not HIV-positive, condoms can stop being used.

Men are often not interested in the examination and treatment of STIs, which are asymptomatic. There is an opinion that chlamydia infection is widespread, there is a high probability of infection when changing partners, so it is inexpedient to be examined and treated only after establishing monogamous partnerships and planning a pregnancy. This pattern is supported by the common notion that a chlamydial infection can be easily cured by taking 1 g of azithromycin.

Therapy of chronic chlamydia infection is difficult in couples in which at least one partner has other sexual contacts and plans to keep them. A full-fledged examination and therapy of all patients from the chain of contacts, as a rule, is unrealistic.

It is necessary to take into account some features of public consciousness regarding chlamydia infection. Among them are two opposing views "chlamydia cannot be completely cured, chlamydia remains" and "a short course of antibiotics is enough to guarantee a cure." Both of these views prevent the responsible implementation of the doctor's recommendations.

Chlamydia is a common cause of reproductive dysfunction. Traditionally, concern for reproductive health is more characteristic of women. They visit a gynecologist more often than men visit an urologist, conduct examinations more often, and are more focused on conducting therapy. Less interest of men and their resistance can nullify the therapeutic efforts of a couple.
