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Department of Reproductive Health and Research (RHR), World Health Organization

Sexually transmitted and other reproductive tract infections

A guide to essential practice



STI/RTI basics
Chapter 2. Preventing STIs/RTIs and their complications


How to prevent endogenous infections

Yeast infection and bacterial vaginosis are common endogenous infections that can be easily treated (Chapter 8) but often recur. Health care providers should be aware that:

  • pregnant women and women using oral contraceptives may get frequent yeast infections because of changes in vaginal acidity (pH);
  • certain medical conditions—e.g. diabetes—may increase the risk of yeast infections as may long-term use of steroids.

Less commonly, recurrent yeast infections may be a sign of a more serious illness that reduces immunity (such as long-term chronic illness or HIV infection). These should be considered only if there are other symptoms; yeast infection alone is common and usually easily prevented or treated.

Health care providers can offer advice about some simple ways to prevent endogenous infection.

  • Douching can disrupt the normal flora of the vagina and cause overgrowth of other microorganisms (bacterial vaginosis). Use of detergents, disinfectants, and vaginal cleaning or drying agents should be avoided. Cleaning the external genital area with soap and water is sufficient for hygiene.
  • Antibiotics can also disrupt the normal vaginal flora and permit overgrowth of yeast. Women taking antibiotics—especially long courses of broad-spectrum antibiotics—may also need treatment for yeast infection.

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Infections of the male and female reproductive tract and their consequences:

What are RTIs?

Why STI/RTIs are important?

What can be done about RTIs?

The role of clinical services in reducing the burden of STI/RTI

Preventing STIs/RTIs and their complications

How to prevent STI

How to prevent iatrogenic infections

How to prevent endogenous infections

Detecting STI/RTI

Detecting STI/RTI


Vaginal infections

Cervical infections

Pelvic inflammatory disease

HIV counselling and testing

STI/RTI education and counselling

Key points

Privacy and confidentiality

General skills for STI/RTI education and counselling

Health education


Promoting prevention of STI/RTI and use of services

Key points

Reducing barriers to use of services

Raising awareness and promoting services

Reaching groups that do not typically use reproductive health services

STI/RTI Assessment during Routine Family Planning Visits

Key points

Integrating STI/RTI assessment into routine FP services

Family planning methods and STIs/RTIs

STI/RTI Assessment in pregnancy, childbirth and the postpartum period

Key points

Management of symptomatic STIs/RTIs

Syndromic management of STI/RTI

Management of common syndromes

STI case management and prevention of new infections

STI/RTI complications related to pregnancy, miscarriage, induced abortion, and the postpartum period

Key points

Infection in early pregnancy

Infection in lated pregnancy

Infection following childbirth

Vaginal discharge in pregnancy and the postpartum period

Sexual violence

Key points

Medical and other care for survivors of sexual assault

Annex 1. Clinical skills needed for STI/RTI


Common STI/RTI symptoms

Examining patients

Annex 2. Disinfection and universal precautions

Preventing infection in clinical settings

High-level disinfection: three steps

Universal precautions

Annex 3. Laboratory tests for RTI

Interpreting syphilis test results

Clinical criteria for bacterial vaginosis (BV)

Wet mount microscopy

Gram stain microscopy of vaginal smears

Use of Gram stain for diagnosis of cervical infection

Annex 4. Medications

Medications in pregnancy

Antibiotic treatments for gonorrhoa

Annex 5.

STI/RTI reference table


Additionnal resources


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