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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 3. Detecting STI/RTI


HIV counselling and testing

Testing for HIV infection has several potential benefits, from promoting prevention to improving access to care and prevention of mother-to-child-transmission (see Chapter 7). HIV testing should always be voluntary, conducted by trained staff with respect for privacy and confidentiality, and include pre- and post-test counselling.


Indications for screening

In most communities, voluntary HIV counselling and testing services should be available:

  • as part of routine antenatal care or linked to those services;
  • for anyone who wants to know their HIV status (including partners of pregnant women).


Available screening tools

There are many kinds of HIV tests available. WHO recommends confirmatory testing with a second test of a different type before the client is notified of a positive result.


Implementing screening

Counselling and testing for HIV should be available to reproductive health clients on-site or through referral. Counselling and testing for HIV includes:

  • pre-test counselling;
  • HIV test with confirmatory test;
  • post-test counselling and referral if indicated.

Counselling and testing for HIV should be voluntary and the consent of the patient is always required. HIV testing should never be done on the request of another person, and results should only be given in person to the client.


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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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