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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



Improving services for prevention and treatment of STI/RTI
Chapter 5. Promoting prevention of STI/RTI and use of services


Raising awareness and promoting services

Even when accessibility and acceptability barriers to clinic attendance have been removed, some people may not use the facilities because they are not aware that anything is wrong. Prevention efforts, as well as promotion of clinic services for STI/RTI detection and treatment, must therefore be directed to people in the community.

Health care workers should promote early use of services for people with symptoms or concerns about STIs/RTIs. This includes:

  • raising awareness of STIs/RTIs and their complications;
  • educating people about STI/RTI symptoms and the importance of early use of health care services;
  • promoting screening services such as syphilis testing early in pregnancy;
  • promoting services and reaching out to young people or other vulnerable groups who may not feel comfortable using clinic services.

Messages should emphasize the benefits of prevention, and of early treatment over later treatment (Box 5.1). Health care providers can contribute to a public health approach to STI/RTI control and help reduce the burden of disease in the community by reaching all kinds of people and convincing them of the value and importance of early use of STI/RTI services.


Box 5.1. Messages to promote use of services for prevention and treatment of STIs/RTIs

People in the community should be aware of STIs/RTIs and know how to prevent and treat them

Prevention is better than cure —The most effective strategy is to prevent infection in the first place by reducing exposure (delaying initiation of sex, reducing number of partners and/or using condoms consistently).

Early treatment is better than late treatment—When STIs/RTIs do occur, early identification and treatment can eliminate infection before it causes complications or spreads to other people.

Better late than never—Diagnosis and treatment of complications are possible even if the first two levels of prevention fail. However, interventions at this level are often less effective and more expensive than those applied earlier.

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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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