National technical guidelines on sexually transmitted infections and reproductive tract infections (2024): Summary of updated recommendations from the National AIDS and STD Control Program in India

Artificial intelligence and sexual health in the USA

To meet the needs of female adolescents from low-income urban areas for sexual and reproductive health (SRH) care, vouchers providing free-of-charge access to SRH care at 19 primary care clinics were distributed in Managua, Nicaragua. These vouchers substantially increased the use of services, demonstrating that many adolescents are willing to use such services, if readily accessible. The voucher redemption made it possible to identify the nature of existing, but largely unmet, needs for SRH care. The medical files from 3301 consultations with female adolescents were analysed using descriptive statistical methods and multiple logistic regression. Female adolescents presented SRH problems that merited medical attention. The mean number of problems presented was 1.5 per consultation: 34% of the vouchers were used for contraceptives, 31% for complaints related to sexually transmitted infection (STI) or reproductive tract infection (RTI), 28% for advice/counselling, 28% for antenatal check-up and 18% for pregnancy testing. A new category of health care users emerged: sexually active girls who were neither pregnant nor mothers and who sought contraceptives or STI/RTI treatment. Contraceptive use doubled among the sexually active non-pregnant voucher redeemers. Consultation with a female doctor younger than 36 years was associated with a higher chance of having contraceptives prescribed. Accessible and appropriate SRH care has the potential to make an important contribution to the increased contraceptive use, decreased risk of unwanted teenage pregnancies and decreased prevalence of STIs/RTIs among underserved adolescents. Once adolescents access the services, providers have a crucial role in ensuring current and continuing needs are met.

Sexually transmitted infections (STIs) remain a major public health problem in most parts of the world. Failure to diagnose and treat STIs at an early stage may result in serious complications, including infertility and other pregnancy comorbidities. The Centers for Disease Control and Prevention released their latest guidelines for the management of various STIs in July 2021 that replaced the 2015 guidelines. The National AIDS Control Organization under Ministry of Health and Family Welfare, Government of India released the latest guidelines for management of various STIs in late 2024. The management protocols have been changed for certain STIs, and there are also notable changes made to the syndromic management kits compared to the previous guidelines. These guidelines have not yet been updated in the current editions of standard venereology or dermatology textbooks. We have brought together the recent treatment guidelines under a single roof in this article. In addition, we have also briefed about the newer treatment options currently available for various STIs. We hope our article will serve as a useful ready reckoner for postgraduates preparing for their examinations and for practicing dermato-venereologists.

BackgroundThe burden of sexually transmitted infections (STIs) has been increasing in Kenya, as is the case elsewhere in sub-Saharan Africa, while measures for control and prevention are weak. The objectives of this study were to (1) describe healthcare provider (HCP) knowledge and practices, (2) explore HCP attitudes and beliefs, (3) identify structural and environmental factors affecting STI management, and (4) seek recommendations to improve the STI program in Kenya.Methods and findingsUsing individual in-depth interviews (IDIs), data were obtained from 87 HCPs working in 21 high-volume comprehensive HIV care centers (CCCs) in 7 of Kenya’s 8 regions. Transcript coding was performed through an inductive and iterative process, and the data were analyzed using NVivo 10.0. Overall, HCPs were knowledgeable about STIs, saw STIs as a priority, reported high STI co-infection amongst people living with HIV (PLHIV), and believed STIs in PLHIV facilitate HIV transmission. Most used the syndromic approach for STI management. Condoms and counseling were available in most of the clinics. HCPs believed that having an STI increased stigma in the community, that there was STI antimicrobial drug resistance, and that STIs were not prioritized by the authorities. HCPs had positive attitudes toward managing STIs, but were uncomfortable discussing sexual issues with patients in general, and profoundly for anal sex. The main barriers to the management of STIs reported were low commitment by higher levels of management, few recent STI-focused trainings, high stigma and low community participation, and STI drug stock-outs. Solutions recommended by HCPs included formulation of new STI policies that would increase access, availability, and quality of STI services; integrated STI/HIV management; improved STI training; increased supervision; standardized reporting; and community involvement in STI prevention. The key limitations of our study were that (1) participant experience and how much of their workload was devoted to managing STIs was not considered, (2) some responses may have been subject to recall and social desirability bias, and (3) patients or clients of STI services were not interviewed, and therefore their inputs were not obtained. While considering these limitations, the number and variety of facilities sampled, the mix of staff cadres interviewed, the use of a standardized instrument, and the consistency of responses add strength to our findings.ConclusionsThis study showed that HCPs understood the challenges of, and solutions for, improving the management of STIs in Kenya. Commitment by higher management, training in the management of STIs, measures for reducing stigma, and introducing new policies of STI management should be considered by health authorities in Kenya.

Gandhiji prophesized that education and effective healthcare services to all at local levels is the key for the upliftment of a country to a progressive nation. India is a nation of over 1.3 billion people and the majority of its population is young. Therefore, reproductive health is of prime importance for the country. Gandhiji's devotion to women began with his devotion to his mother and Kasturba, most particularly to women as mother. Motherhood became increasingly his model for liberation of India. "Whether a healthy mother is responsible for a healthy child or whether a healthy child makes a healthy mother? To say one is more important than the other is an understatement." "A happy working of the human machine depends upon the harmonious activity of the various component parts." – M.K. Gandhi In keeping with the quotes of our revered leader, the National Institute for Research in Reproductive Health (NIRRH) has been working towards a holistic approach in Maternal and Child Health. Towards this, a women-centric lifestyle approach is being employed by addressing reproductive health challenges of adolescents, reproductive tract infections by improving menstrual hygiene, preventing unsafe abortions, preventing maternal mortality and morbidity, improving nutrition status of mothers and children, providing genetic testing services and counselling to the affected couples, etc. It is the only institute in the country dedicated to addressing the various issues of reproductive health in accordance with the nation's needs and priorities. It is one of the premier institutes of the Indian Council of Medical Research (ICMR), established as a family planning unit in 1954. During its inception the focus was on population stabilization towards building a healthy nation. Several emerging contraceptives like NET-EN, vaginal rings, oral pills, injectables were evaluated for their safety, efficacy and acceptability for induction into the National Family Welfare Programme. The Experimental Animal Facility at the Institute was used for the preclinical testing of contraceptives. Over the years, there was a felt need to address the issues of infertility in women, as women had to bear the burden of family bearing and rearing. Harsha, India's first scientifically documented test tube baby, was a fruit of efforts in this direction.Mahatma Gandhi opening a Free Maternity Home and Dispensary, organized by the Welfare Centre by the members of Rotary Club Poona, at Khadakvasala village, Poona, November 15, 1945.The Institute for Research in Reproduction (IRR) was inaugurated on February 21, 1970 by Hon'ble Union Health Minister, Dr. K.K. Shah (top-left), in presence of Dr. P.N. Wahi, DG ICMR and Dr. Shanta S. Rao, Officer-in-Charge (top-right). The Institute in 1970 as IRR (below-left) and in 2018 as NIRRH (below-right).Through the years, the Institute has seen enormous expansion, both in terms of infrastructure and research. NIRRH has an impressive mandate, be it Research, Collaboration, Training, Products, Policies and Programs, or as a research nucleus. The World Health Organization has recognized the Institute as a Collaborative Centre for Research in Reproductive Health, as well as a Centre of Excellence for imparting training in diagnosis and management of infertility. A dedicated team of around 40 scientists is the pillar of strength of this institution. These scientists with their diverse academic background and training form the backbone of the basic, clinical, operational and socio-behavioral research conducted in this Institute and continue to strengthen the activities of the Institute. HEALTHY MOTHER – HEALTHY BABY "Our parents who bring us into this world do not, as a rule, cultivate self-control. Their habits and their way of living influence the children to a certain extent. The mother's food during pregnancy is bound to affect the child." – M.K. GandhiInstitute's success stories: Baby Harsha, conceived through IVF (left); and Technology Day Award to Dr. M.I. Khatkhatey (extreme right) by Ministry of Science and Technology on May 8, 2001 by Hon. Vice President of India, Shri Krishan Kant for transfer of urine-based fertility kits developed at the Institute to industry.The well-being of mothers, infants, and children is an important public health goal, which determines the health of the next generation. NIRRH is involved in improving the health and nutritional status of vulnerable segments of the population by implementing a multicomponent health and nutrition education intervention. Providing iron supplementation to under-five children, demonstration of preparing nutritious delicacies using locally available food, and health education are the main activities undertaken. ICMR has initiated a major programme in three states in partnership with Indian Council of Agricultural Research (ICAR), M.S. Swaminathan Research Foundation (MSSRF), and Biotechnology Industry Research Assistance Council (BIRAC, DBT) to develop a district-level model to address undernutrition and hidden hunger. Palghar, a tribal district in Maharashtra, is one of the study sites and the work here is being coordinated by NIRRH. Gandhiji's vision for people to adopt a healthier lifestyle and his teachings on healthy eating and exercise for a better standard of living are propagated through our community outreach programmes via family welfare clinics set up in semi-urban areas. Community awareness and motivation is a key for disease prevention and for a swasth (healthy) India. Through the clinics, lectures and talks on the importance of eating healthy, regular exercise, cleanliness and routine health examinations for a healthy life are also disseminated. Regular yoga camps are organized in the community to inculcate yoga in the day-to-day routine. PREVENTING UNSAFE ABORTIONS Thirteen per cent of maternal deaths in developing countries are attributed to unsafe abortions. Women who survive unsafe abortions are likely to suffer long-term reproductive morbidity. The Institute embarked upon research programmes to identify reasons for seeking abortions and unsafe abortions and has also played an important role in developing non-invasive, medical methods of pregnancy termination. These research endeavours at the Institute have contributed to the Drug Controller's approval to use RU 486 and misoprostol combination for first trimester abortion in the country. "To call women the weaker sex is a libel; it is man's injustice to woman." – M.K. Gandhi Gandhiji's message almost eight decades ago at the All India Women's Conference on December 23, 1936 was: "When woman, whom we call abala, becomes sabala, all those who are helpless will become powerful." In keeping with his ideologies on female power, NIRRH also worked towards empowering women tolerating domestic violence, with choices in family planning. DIAGNOSIS OF GENETIC DISEASES The Genetic Research Laboratory at the Institute has been involved in detecting chromosomal abnormalities and inborn errors of metabolism. It also offers counselling and prenatal diagnosis to couples harbouring defective genes.Intervention activity to improve nutritional status and health held at a village in Dahanu. Lectures were given to women and lactating mothers on diet, supplementary nutrition, and rest (Top-Left). Demonstration of low-cost nutrition recipes from locally available foods to pregnant women and mothers of under-fives by nutrition experts (Top-Right). Yoga camps organized by the institute (Below-Left) and clinical examination of under-5 children at Kokner village in Palghar district (Right). Ectodermal dysplasia Progeria CutisChildren with genetic disorders examined at the Genetic Clinic of the Institute.PREVENTION OF REPRODUCTIVE TRACT INFECTIONS AND PROMOTING MENSTRUAL HYGIENE Reproductive Tract Infections (RTIs) including Sexually Transmitted Infections (STIs) are also causes of morbidity and mortality in affected individuals. The Institute is actively pursuing several research programmes addressing basic, clinical and operational aspects of RTIs/STIs including HIV. NIRRH was involved in the development of the National Guidelines on prevention, management and control of RTIs/STIs and preparation of the training material. The training modules are being used for training in the NACP-3 and RCH-2 programmes under the National Health Mission (NHM). In addition, the Institute has also contributed in the development of Operational Guidelines for programme managers on prevention and control of RTIs/STIs. Vigorous efforts are also being made to create awareness about RTIs and STIs and their impact on reproductive and general health among rural and tribal women. Linkages have been strengthened between HIV (ICTC/PPTCT) and family planning services for the prevention of unwanted pregnancies among women living with HIV/AIDS. The risk of infection (including sexually transmitted infection) is higher than normal during menstruation. Menstrual health hygiene is therefore an area that cannot be ignored. The Institute has been advocating use of washable menstrual pads which, apart from being hygienic and reusable, are economical and environment-friendly, unlike the commercially available disposable sanitary napkins, wherein disposal is an environmental hazard. In the interest of safeguarding our environment and preventing its hazardous effects on health, the National Centre for Preclinical Reproductive and Genetic Toxicology at NIRRH has been studying the impact of endocrine disruptors on reproductive health and evaluating several promising drugs for their safety.Inauguration of Adolescent Friendly Health Clinics 'Maitri'Doctoral students of the Institute with his Excellency President of India, Dr. APJ Abdul Kalam, September 12, 2005 on the eve of inauguration of the Global Forum for Health Research.ADOLESCENT HEALTH Adolescents constitute about one-fifth of India's population and represent a huge opportunity that can transform the social and economic fortunes of the country. However they are also the most vulnerable population to physical and sexual abuse as is obvious from the daily news reported. This vulnerability stems from their naivety and lack of proper information on reproductive and sexual health. Keeping this unmet need in mind, Adolescent Friendly Health Clinics (AFHCs) named 'Maitri' were established which covered adolescent and youth population falling in the age group of 10–24 years. IEC material in the form of posters were developed at NIRRH and submitted to Government of Maharashtra. These were adapted and made available on a large scale in the state.Mahatma Gandhi playing with Nandini, niece of Pyarelal Nayyar (not in picture) at Sevagram Ashram, Wardha, August 1944.Following Gandhiji's ideals for a Shreshtha Bharat, NIRRH takes pride as one of the leading institutes for building the next generation of researchers through its PhD programme, and shaping students and faculty all over the country for scientific excellence by way of workshops, training courses and conferences. Research done at the Institute has translated into 'Swadeshi' or 'Make in India' products. Kits for urine-based fertility assessment, kits for detection of Chlamydia trachomatis, sperm quality and Fertility Assessment Tests were developed and are some of the indigenous achievements of the institute. We aspire to continue our walk into the future on the Gandhian ideology towards a 'Swachh, Swasth and Shreshtha Bharat' where the reproductive needs of all its citizens can be met.Mahatma Gandhi and Kasturba Gandhi talking to girls of Mahila Ashram (Wardha), on the occasion of Rantia Jayanti (Spinning Wheel Anniversary) in front of Mahatma Gandhi's hut at Sevagram Ashram, Wardha, 1940.FINANCIAL SUPPORT & SPONSORSHIP: None CONFLICTS OF INTEREST: None

The goal of the STAR Sexually Transmitted Infection Clinical Trial Group (STI CTG) Programmatic meeting on Sexually Transmitted Infections (STIs) in Pregnancy and Reproductive Health in April 2018 was to review the latest research and develop recommendations to improve prevention and management of STIs during pregnancy. Experts from academia, government, nonprofit, and industry discussed the burden of STIs during pregnancy; the impact of STIs on adverse pregnancy and birth outcomes; interventions that work to reduce STIs in pregnancy, and the evidence, policy, and technology needed to improve STI care during pregnancy. Key points of the meeting are as follows: (i) alternative treatments and therapies for use during pregnancy are needed; (ii) further research into the relationship between the vaginal microbiome and STIs during pregnancy should be supported; (iii) more research to determine whether STI tests function equally well in pregnant as nonpregnant women is needed; (iv) development of new lower cost, rapid point-of-care testing assays could allow for expanded STI screening globally; (v) policies should be implemented that create standard screening and treatment practices globally; (vi) federal funding should be increased for STI testing and treatment initiatives supported by the Centers for Disease Control and Prevention (CDC), the Centers of Excellence in STI Treatment, public STD clinics, and the President’s Emergency Plan for AIDS Relief (PEPFAR).

Novel gonorrhea strain in the United States of America leading to increase of sexually transmitted diseases load: is it an outcome of inexorable process of developing antibiotic resistance?

Prevention control and syndromic management of reproductive tract infections (RTIs) and sexually transmitted infections (STIs) in women - IJOGR- Print ISSN No: - 2394-2746 Online ISSN No:- 2394-2754 Article DOI No:- 10.18231/j.ijogr.2019.057, Indian Journal of Obstetrics and Gynecology Research-Indian J Obstet Gynecol

Chapter 6 - Sexually transmitted viral infections

Introduction: Transgender, non-binary, gender non-conforming, and other gender diverse individuals (TGN) may be at higher risk of sexually transmitted infections (STIs). Transgender women specifically bear a disproportionate burden of HIV and other STIs worldwide. This study describes STI knowledge, risks, and prevention practices among TGN to better characterize barriers to sexual health care and identify potential platforms for sexual health education focusing on STI prevention. Materials and Methods: Qualitative interviews were conducted with N = 14 TGN individuals until thematic saturation was reached. Transcripts were coded and analyzed using thematic analysis. Results: Four major themes emerged: (1) Sexual risk behaviors and STI prevention practices varied across participants; (2) individuals who demonstrated more knowledge about STIs either had a significant identifiable sexual educational experience or had a past personal experience with an STI; (3) individuals were interested in receiving information about STIs and sexual health from health care providers, school sexual education programs, and online resources based on a desire for accessible, private, factual, and inclusive content; and (4) public messaging around sexual health and STIs was seen both as potentially stigmatizing, but also important for increasing awareness of available services. Discussion: We found that while important, considering gender alone may not adequately characterize risk of STI infection for TGN populations, and more research is needed to better characterize risk profiles. Individuals were interested in learning about sexual health and STI prevention from school curricula, health care settings, online resources, and public messaging advertisements, and had recommendations to ensure that these forms of information sharing were relevant, inclusive, and non-stigmatizing.

Background: Prevention and treatment of sexually transmitted infections (STIs) are important to reduce associated morbidity and mortality. Awareness and knowledge about STIs promote healthy reproductive health behaviours. Objective: This study assessed the knowledge about STIs and their prevention among sexual and reproductive health clinic attendants. Methods: A survey was administered to attendants at two sexual and reproductive health clinics in Ghana. Questions included demographics, utilization of reproductive services, knowledge about STIs, and personal behaviours regarding STI prevention. AnSTI Knowledge Score was created by summing correct responses to thirty-three factual questions on STI transmission, prevention, and symptoms. Results: Of 155 participants, 85.8% reported any knowledge about STIs, and 56.8% had been educated about STIs by healthcare providers at the sexual and reproductive health clinic. Initial education about STIs was most encountered at school (56.3%). Most participants correctly identified gonorrhoea (87.1%), syphilis (65.8%), and human immunodeficiency virus(94.8%) as STIs, however, less than half correctly identified chlamydia (46.5%) and hepatitis B (45.2%). Regarding knowledge of transmission, 93.5% knew that STIs are transmitted through unprotected intercourse, however,36.1% incorrectly believed that STIs could be spread by sharing cups and spoons. The majority (90.2%) correctly identified condoms as a method of STI prevention. On a 33-point STI Knowledge Score, participants had a mean[±standard deviation (SD)]of 21(±-1.2). overall, 21.2%of participants had “poor” knowledge, 50.4% had “satisfactory” knowledge and 28.4% had “excellent” knowledge. Overall, 79% of participants felt that they were prepared to share information about STIs with others. A higher level of knowledge was associated with a greater preparedness to share. Conclusion: Attendants of sexual and reproductive health clinics have a high awareness about STIs, however important knowledge gaps exist. We highlight the importance of sexual and reproductive health clinics providing comprehensive STI counselling

INTRODUCTION: Sexually transmitted infections (STIs) are a public health problem and hospital workers may serve as a repository of knowledge for the lay public and for themselves in the management and treatment of STIs. METHODOLOGY: A cross sectional survey was carried out to evaluate the knowledge, attitude and practice of prevention of sexually transmitted infections (STIs) among female hospital workers in Ogun State. A 28-item questionnaire consisting of open and close ended questions was issued to the respondents. The questionnaire contained information on demographics, knowledge, attitude and practice of management and prevention of STIs. RESULTS: A total of 100 questionnaires were analysed. The average age+SD were 28.76+7.52. Sixty five percent had post- secondary education while 99% had heard of STIs. Radio (62%) and books (59%) were their major source of information. A 100% of them knew that HIV/AIDS as a sexually transmitted infection and 90% knew the causes of STIs. Only 47% and 22% of the respondents knew that adults and infants respectively could contact STIs. Only 12% felt they could contact STIs and 79% felt that being faithful would prevent one from contacting STIs, 87% knew that STIs could be treated. The differences in their level of education and their years of working in the hospital on their knowledge, attitude and practice were not statistically significant respectively. CONCLUSION: The study showed that the respondents had knowledge of STIs however this knowledge is inadequate as some misconceptions still exist among them and hence the need for awareness and health education programmes. Keywords : Sexually Transmitted Infections (STIs), KAP (Knowledge, Attitude and Practice), Female Hospital Workers. NQJHM Vol. 16 (4) 2006: pp. 132-137

Sexually transmitted infection (STI) incidence is on the rise in the United States. The increase is especially pronounced in adolescents (15-24 years of age). Despite making up only a quarter of the population, adolescents account for approximately half of new STIs in the United States every year. This review summarizes recent developments in the field of STIs, excluding HIV, in adolescents. In this review, we examine the epidemiology, screening, management, and prevention of STIs in adolescents. STI rates in adolescents have been rising since 2014, with young women and MSM at particularly high risk. Barriers to STI screening for adolescents include confidentiality concerns and lack of access to health services. Prevention through STI vaccines represents a promising way to combat the epidemic. STIs are a growing concern for adolescents. Routine screening and management are of critical importance. Furthermore, prevention efforts such as human papillomavirus vaccination should be prioritized. Much of the current literature on STIs does not address the unique nature of STIs in adolescents, and additional research into effective prevention and treatment strategies of STIs in adolescents is urgently needed.

The burden of sexually transmitted infections (STIs) on the health and well-being of the population in the developing world is considerable. The World Health Organization (WHO) estimates that there are 340 million new cases of curable STIs in the world each year; 174 million new cases of trichomoniasis, 92 million new cases of Chlamydia infection, 62 million cases of gonorrhea, and 12 million new cases of syphilis (Table 1). Approximately three quarters of these infections are in countries encompassing tropical regions of the world in Latin America, sub-Saharan Africa, and South and Southeast Asia. The prevalence of viral STIs is even higher; infection with Herpes simplex virus-2 (HSV-2) is the most common STI worldwide and as many as 50% of sexually active individuals will be infected with human papillomavirus (HPV) during their life. The prevalence of STIs is considerably greater than many classical tropical diseases and it is unfortunate that they do not receive more attention and resources from international programs and donor groups. The public health impact of these diseases extends well beyond the immediate effects and morbidities of infection. STIs have been implicated in facilitating acquisition and transmission of HIV, in pregnancy complications such as pre-term births, low birth weight infants, stillbirth, neonatal death and blindness, in the inducement of cervical and prostate cancers, and in increased risk of pelvic inflammatory disease and infertility. Failure to diagnose and treat STIs at an early stage thus increases the already substantial burden these conditions impose on the populations of developing countries. Although effective diagnostic tests and treatments are available for these STIs, they are often unavailable or inaccessible in resource-limited tropical settings. As a consequence, syndromic management of STIs remains the option of choice for individual case management. The inadequate public health response coupled to ongoing socioeconomic and demographic trends have led to an epidemic of STIs in many countries in the developing world. The development of antimicrobial resistance is an ongoing problem and new agents are often much more expensive, increasing the burden of control. The economic costs of these diseases and their infection sequelae place a considerable burden on national health budgets and household income. In developing countries, STIs are among the top five reasons for which adults seek medical care. Due to the prevalence and public health implications of STIs in the tropics a discussion of STIs should be included in any compilation of tropical medicine. This chapter will cover sexually transmitted infections caused by Trichomonas vaginalis (trichomoniasis), Chlamydia trachomatis (chlamydia and lymphogranuloma venereum), Neisseria gonorrhoeae (gonorrhea), Treponema pallidum (syphilis), Haemophilus ducreyi

Introduction: Reproductive Tract infections among women of reproductive age group {including both sexually Transmitted Infection (STI) & Non STI} are responsible for major ill health and have important concern as these are associated with risk of HIV Transmission & complications like Pelvic inflammatory Disease (PID), Infertility etc. This study was conducted to determine prevalence of microorganism & their antibiogram & their association with socio demographic profile & menstrual hygiene. Methods: This was a cross sectional study included 200 women with discharge of 15-44 year age. Detail history was taken about their socio demographic data, Symptoms & menstrual hygiene; vaginal or endo cervical swab & blood sample (for serological diagnosis of syphilis) were collected. Results: Among STI most common infection is Candidiasis (45.6%) & Bacterial Vaginosis (27.8%) whereas among Non STI Esch. coli (27.3%) & Staph. aureus (26.4%). Among STI most common symptom was lower abdominal Pain & Lower backache whereas in Non-STI Vulvular itching & fever. Both STI & Non STI shows statically significant positive association with Labourer population & who uses cloth during their menstrual period whereas STI also shows statically significant positive association with younger, lower education & lower socio economic status population. Staph. aureus highly sensitive to linezolid, vancomycin whereas Esch.coli was most common gram negative bacteria & highly sensitive to imipenem & piperacillin-tazobactum. Conclusions: To conclude, by proper assessment of Prevalence & risk factor of STI and Non STI & by health education, we can reduce these infection & antibiotic resistance by prudent use of antibiotics. Key Words: Reproductive tract infection, STI, Non-STI