STDs and reproductive tract infections (RTIs) are a serious threat to the health of men and especially women. This is especially true in developing countries, where the prevalence of these diseases is high, women's position regarding decision-making on sexual matters is often low, and RTI/STD diagnostic and treatment facilities are extremely limited. In addition to pain and discomfort, women frequently experience long-term impairment of their reproductive health as a consequence of RTIs and STDs.

The emergence of HIV as a sexually-transmitted disease, and its association with other STDs, has renewed interest in the prevention and control of STDs and RTIs. Despite this, many primary health care facilities, including maternal-child health and family-planning clinics, fail to address STDs/RTIs in women. When genital tract infections are suspected, the only alternative for many clinics is to refer the patient to a special "STD clinic", which is usually overcrowded, under-funded and stigmatizing. Recognition of these issues argues for incorporating STD/RTI services into a comprehensive programme of reproductive health that is accessible and acceptable to women as well as men.

In the low-risk populations of apparently healthy women seeking family planning services, the prevalence of STDs is often high but underestimated because of the scarcity of signs and symptoms. Early recognition and prompt treatment are nevertheless important to prevent complications such as pelvic inflammatory disease and its consequences. Perhaps of even greater concern is the high prevalence of pre-cancerous lesions of the cervix, one of the most common malignancies among women in many countries.

The approach to reproductive health care services should be comprehensive. To particularly increase women's access, attention can be given to designing a "supermarket for women's reproductive health" concept, whereby several aspects of reproductive health are integrated into primary health care facilities or women's clinics. This approach can be strengthened by promoting community involvement through outreach activities and health education. This may encourage the participation of women who would normally not access the health care system such as adolescents and other vulnerable groups. Although there are costs involved in providing these services, the emphasis on prevention and early detection is clearly less resource intensive than dealing with the severe consequences of STDs and RTIs that escape detection.