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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


Privacy and confidentiality

Privacy and confidentiality are essential for all aspects of patient care—history-taking, examination, education and counselling. This is especially true for potentially stigmatizing conditions such as STI/RTI. All patients have a right to privacy and confidential services, but some—such as adolescents, sex workers, refugees and others who live or work in illegal or marginalized settings—may feel a particular need to know that services are confidential. Adolescents, especially those who are unmarried, often do not use services because they feel providers will be judgemental or disapproving and might reveal information to parents or elders. Patients will avoid a health care facility altogether—sometimes travelling to a distant clinic to preserve anonymity—if they feel that their privacy and confidentiality are not respected or that service providers are critical and judgemental.


Making space for privacy

Assuring visual and auditory privacy and confidentiality can be difficult in many health care settings, especially those that are busy or crowded—but it is essential. The space where interviews, examinations and counselling take place should be separated from waiting rooms, so that people waiting cannot see or hear what takes place between the provider and the patient. Forms and records should be stored securely and clinic staff should avoid talking about patients both inside and outside the clinic. Patients should be treated with the same respect whether or not an STI is detected or suspected, and regardless of age or marital status. Where health care providers are likely to know patients’ extended families or neighbours, they must take extra care to reassure patients (and their partners who may be asked to come in for treatment) that confidentiality will be respected.


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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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