Reproductive health and STDs among clients of a women's health mobile clinic in rural Bali, Indonesia.

Recent studies in Indonesia have reported significant levels of STDs in low-risk urban groups. To gather data on rural women, a prevalence study was undertaken in Bali utilizing a women's health mobile clinic. Rural (n=312) women were tested for vaginal reproductive tract infections (RTIs) by on-site wet mount, for Neisseria gonorrhoeae and Chlamydia trachomatis by unamplified DNA (Gen-Probe) test, and for syphilis by rapid plasma reagin (RPR). Results were: candidiasis 5.8%; bacterial vaginosis (BV) 37.2%; trichomoniasis 15.1%; gonorrhoea 0.7%; chlamydial infection 5.6%; syphilis 0%. Overall 55.1% had at least one RTI and 19.2% had at least one STD. Reported non-monogamy, pain with urination and genital lesions, observed cervical friability and cervical motion tenderness were associated with cervical STD infection (P<0.05). We conclude that there is a need for improved services for STD prevention and RTI/STD management in rural Bali, and for condom promotion.