Background Tver region belongs to the Central part of Russia, its territory is 84,200 km² with a population of 1,342,200 inhabitants, including the city of Tver populated by 406,918 inhabitants. The aim of this paper is for the first time to internationally present the epidemiological trends of STIs in the region.

Methods Site visits and yearly epidemiological reports of the Center.

Results The peripheral laboratories are poorly equipped and therefore the diagnosis of STIs is mainly concentrated to the Center of the Specialized Medical Aid in Tver. However, the long distances for specimen transportation and lack of appropriate transport system are large obstacles for providing effective diagnosis of STIs. In 2009, vaccination against human papilloma virus (HPV) was introduced into the prevention programme against cervical cancer in Tver. The epidemiological trends of the main STIs in the Tver region are changing. A decrease in the incidence (cases per 100,000 inhabitants) of almost all STIs has been observed, namely during the years 2008 and 2012 the incidence of syphilis was 62.1 and 21.0, gonorrhoea - 42.5 and 19.2, genital chlamydial infection - 58.7 and 34.4 cases, T vaginalis - 120.5 and 73.6, genital herpes - 8.1 and 6.5, and anogenital warts 21.1 and 16.6, respectively. Since introduction in 2009, 373 girls, aged 12–13 years, have been vaccinated for HPV.

Conclusion . In Tver, Russia, the difficulties to reach the population in most need for testing is of major concern. The reported epidemiologic data is also suboptimal due to many reasons such as lack of appropriate diagnostic methods, frequent use of self-treatment (antibiotics available over the counter), and private laboratories and outpatient clinics do commonly not report STI cases to the authorities. Accordingly, it is imperative to optimise the laboratory diagnosis and epidemiological surveillance of STIs, and introduce evidence-based STI guidelines.