This chapter focuses on advances in reproductive health research that permit sample and data collection within population-based studies in a wide range of nonclinical settings, including the home. Areas of interest are assessment of classical sexually transmitted infections (STIs) and other reproductive tract infections, including oncogenic human papillomavirus (HPV), the principal causal agent of cervical cancer. Assessment of pregnancy loss is also addressed. The importance of linking behavioural data with biological sampling, in order to provide interpretable information for the development and evaluation of disease prevention and control programmes, is discussed. Finally, a number of strategies are proposed for the incorporation of biological sampling into survey research.

The study of reproductive morbidity in population-based studies was hindered for many years by the difficulty of diagnosis and the selectivity of the populations studied. Biological samples to assess many reproductive tract infections and STIs could only be obtained through genital and/or pelvic examination. In addition, available tests for many conditions required specialized handling of samples (in the case of gonorrhoea culture, for example) or immediate testing (such as wet mounts for trichomonas). Thus, studies were largely restricted to selected clinic-based populations, including users of antenatal or STD (sexually transmitted diseases) clinics, and results could not be generalized to the population as a whole. These limitations were particularly acute in rural settings with poor access to clinical services and laboratories, to say nothing of basics such as water and electricity