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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 4. STI/RTI education and counselling


General skills for STI/RTI education and counselling

Box 4.1 lists some general skills that health care providers should develop in order to educate and counsel patients. Many of them are also useful for history-taking and examination. Education and counselling often start early in the consultation, when the health care provider asks questions about risk, symptoms and signs of infection. Remember that adolescents in particular may not admit to being sexually active, and may not recognize, or be comfortable talking about, symptoms of infection or pregnancy. Prevention advice to individuals should be based on their personal needs and concerns, and related to practical steps they can take to reduce their risk of acquiring infection and developing complications.


Box 4.1. Skills for education and counselling

  • Welcome your patient warmly by name and introduce yourself.

  • Assure your patient that privacy and confidentiality will be respected.

  • Sit close enough to be able to talk comfortably and privately.

  • Make eye contact and look at the patient as she speaks.

  • Use language that the patient understands.

  • Listen to the patient and take note of body language (posture, facial expression, looking away, etc.). Try to understand feelings, experiences and points of view.

  • Be encouraging. Nod, or say "Tell me more about that."

  • Use open-ended questions.

  • Provide relevant information.

  • Try to identify the patient’s real concerns.

  • Suggest various options to the patient.

  • Respect the patient’s choices.

  • Always verify that the client has understood what has been discussed by having her repeat the most important information.

  • Do not:

– keep moving in and out of the room;

– encourage other providers to interrupt;

– write notes continuously as the patient is speaking;

– make judgemental comments or negative facial expressions.



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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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