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Let's Talk About Sex, Devushki

During a lecture this week at School No. 1748, the whispering died down when Olga Tryanina began describing different types of contraceptives, including those that are still unavailable in Russia. "There's nothing to be embarrassed about," she had told the 10th-grade girls, holding up a plastic model of the female reproductive organs. "It's your body, and you need to know about it to protect your health. Just as you clean your apartment, you need to take care of your body." It sounds like ordinary advice for a group of 16-year-old girls already practiced in the arts of cosmetics and attracting the attention of boys. But in the conservative context of the Russian education system, the lecture was something new. Sex education, in a variety of new programs, is finally being introduced into the curriculum of Moscow's schools. "Teenagers today know very little and unfortunately their mothers often don't know much more," said Tryanina, a neonatologist and instructor at the Center for Women and Family, a partnership between Saviour's Hospital in Moscow and Magee Women's Hospital in Pittsburgh, Pennsylvania. Although the one-year-old center's primary focus is childbirth, it now has four instructors lecturing on sex education in local schools and plans to become a training center for future instructors. The instructors tailor their lectures to the age of the students; those for eighth and ninth graders do not include information on contraception or sexually transmitted diseases. And as of now, the center does not have enough instructors to teach boys' classes. The realization that ignorance is not bliss in regard to adolescent health is also dawning in the Russian education system. Next fall, the Ministry of Education plans to offer secondary schools optional sex education courses for boys and girls, said Margarita Leonteva, the ministry's head of secondary school curriculum. She said that the program would probably be taught by chemistry and biology teachers, a fact that worries some health professionals. "Unfortunately we don't have specially trained professionals for this topic," said Leonteva. The lack of trained specialists is hardly surprising. It was not long ago that questions of sexuality and reproductive health were either taboo or considered unimportant in the worker's state. "Even the term 'family planning' was forbidden," said Inga Grebesheva, director of the Russian Association of Family Planning, whose specialists also lecture in local schools and have developed a complete sex education curricu`lum for grades 9 to 11. "What was plan? Children were needed to support the work force. One child was bad, three were good." The lack of information and contraception translates into a situation where abortion is the most common method of contraception for Russian women. Only one of every 100 women who visit gynecological clinics are seeking contraception; the remaining 99 are going for abortions, said Grebesheva. Ten percent of all abortions here are performed on women under 19, she said. Birth control methods common in the West, such as the diaphragm and sponge, are largely unavailable here, as are newer devices like the female condom. But that did not stop Tryanina from telling her students about them. "They might become available, so you should know about them," said Tryanina, who explained the basal temperature method of detecting ovulation. She urged the students to read instructions for birth control pills carefully, as misuse of the pills, which can be purchased without a prescription in commercial pharmacies here, is common. She also discussed personal hygiene, pre-menstrual syndrome, how conception occurs, abortion and adoption issues. Had Tryanina not run out of time, she would have discussed AIDS and sexually transmitted diseases. Students said the lecture was helpful. "These are all things we need to know, but parents get embarrassed talking about them," said Yuliya Satnova, 16. Tatyana Banchukova, the school's director, said she hopes to bring Tryanina back -- for the young female teachers. "When they heard we were doing this for our girls, they immediately asked 'What about us?'" she said. "Their knowledge on these issues is extremely limited." to plan? Children were needed to support the work force. One child was bad, three were good." The lack of both information and contraception today translates into a situation where abortion is the most common method of contraception for Russian women, who have an average of four to five abortions. Only one of every 100 women who visit gynecological clinics are seeking contraception; the remaining 99 are going for abortions, said Grebesheva. Ten percent of all abortions in Russia are performed on women under the age of 19, she said. Birth control methods common in the West, such as the diaphragm and the sponge, are largely unavailable here, as are newer devices like the female condom. But that did not stop Tryanina from telling her young students about them. "They might become available, so you should know about them," said the lecturer, who also spent considerable time explaining the basal temperature method of determining if ovulation is occurring. She urged the students to read instructions for birth control pills carefully, as misuse of the pills, which can be purchased without a prescription in many commercial pharmacies here, is common. She also discussed personal hygiene, pre-menstrual syndrome, how conception occurs, abortion and issues to consider before giving a child up for adoption. Had Tryanina not run out of time, the 90-minute lecture also would have included a discussion of AIDS and sexually transmitted diseases. Students said the lecture was helpful. "These are all things we need to know, but parents get embarrassed talking about them," said Yuliya Satnova, 16. Tatyana Banchukova, the school's director, said she hopes to bring Tryanina back for one more lecture -- for the school's young female teachers. "When they heard we were doing this for our girls, they immediately asked 'What about us?'" she said. "Their knowledge on these issues is extremely limited."

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