Adolescent reproductive health being in the state of its development may be subjected to the influence of the factors bearing consequences for a young developing organism and may cause not only lengthy disorders of reproductive health but the entire capability of a reproductive function as well. And the influence of sexually transmitted diseases on the reproductive system may reflect on the offspring thus causing incurable diseases of the following generation.

Alongside with such well – known diseases as gonorrhea, syphilis, trichomoniasis there are noted nowadays more than 20 diseases, which can be sexually transmitted and are associated with the peculiarities of sexual behavior – chlamidosis, ureplasmozis, mycoplasmosis, virus and anaerobic infections etc.

At present a global threatening situation with such diseases as syphilis, gonorrhea, chlamidos, urinoplasmosis and micoplasmosis infections AIDS/HIV is turning out. So, teenagers and their parents must get information about these diseases. HIV leads to damage of the organism by AIDS – or Acquired Immune – deficiency Syndrome that belongs to chiefly sexually transmitted diseases resulting in death. There may be different duration of this disease and on average it lasts for 5 – 6 years. In addition there may occur pneumonia, caused by pneumocystis and cytomegaloviruses; damage of central nervous system cells, meningitis, encephalitis, abscess, indigestion, diarrhea, Kaposi’s sarcoma, virus, supportive fangous skin diseases. AIDS virus is transmitted from mother to child if she is infected during pregnancy and childbirth. Statistics proves that 50 – 70% of children born to infected mothers catch the diseases. There haven’t yet been created any effective medical means to cure AIDS so far.

Together with AIDS a casual intercourse may result in such a disease as syphilis presenting a great threat to an individual’s reproductive health as well as his/her offspring.

By present syphilis remains a classic venereal disease with lingering chronic disease course (with the absence of a specific therapy) and irreversible consequences. Beginning with painless little ulcers on genitals or other areas in 20 – 30 days after catching the disease syphilis pathogen penetrates into all cells of the organism. Syphilis damages central nervous system - causing meningitis, neuritis, and meningomielitis; internal organs - causing hepatitis, myocarditis, and agertitis pleurisy, gastritis; supporting – motor apparatus - causing pereostitis, osteomyelitis and may also result in threatening skin damage in the form of tumors and gumms. The circumstance, that syphilis is taking its course for a long time and without symptoms with organic damages reminding of other diseases but resulting in death, is very dangerous. A total course of syphilis lasts from 2 – 3 years up to 10 years and more.

There occur considerable changes in the reproductive function of women who have no idea that they suffer from this illness resulting in frequent miscarriages and stillborn.

Syphilis is extremely dangerous for the offspring since one of the ways of its transmission is from a contagious mother to a fetus in mother’s womb through the placenta. Inborn syphilis leads to appearing of physically and mentally retarded children those who often perish in the result of the damage of internal organs and a nervous system.

Syphilis possessed by parents or grandparents may result in the so called “parasyphilitical” illnesses when the offspring suffer from different defects of a physical, neurological, psychological and intellectual character. At the same time the presence of this disease in a child may not be revealed even through specific serological reactions for its discovery. These damages are revealed in children whose parents or grandparents have suffered from the late forms of syphilis.

The above – mentioned leads to a high social danger of syphilis occurrence among adults, all the more among teenagers and not only for their health but that of their offspring.

Another well – spread bacterial infection of genitals of gonorrhea. Every year according to the WHO data 150 – 200 million people fall ill. In a number of countries incidences of gonorrhea according to its frequency among infectious diseases are inferior only to the flu. Gonorrhea has a local character as rule in urine – genital organs. Gonorrhea very seldom becomes a generalized disease, however a possibility of its dissemination on other organs of the organism is not excluded. There have been observed some cases of Gonocock septicemia disseminating gonorrhea infection.

Gonorrhea of men as well as that of women in case of absence of any treatment may cause complications with a subsequent disorder of sexual and reproductive functions. Thus chronic gonorrhea, prostatitis, epidemitis, veseculitis lead to weakening of sexual function of men as a result of which there may develop impotence, spermatogenesis disorder with a subsequent infertility. With women gonorrhea infection leads to endocervitis, endometretis, ooforis and uterine tube inflammation right up to pelvioperetonitis. Gonorrhea is extremely dangerous during a pregnancy period for it threatens not only mother’s organism but that of a developing baby as well. Very often this illness causes spontaneous miscarriages, premature labor and a prematurely born child.

Low informativeness on STDs and absence of alertness towards these diseases result in gonorrhea infection of newborns for they catch it in the course of labor. Very often newborns’ gonorrhea may be caused by untidiness of mothers and fathers since gonorrhea has an everyday way of catching infection. For example, there is a possibility of transmission of the disease through sponges, swaddling dotes, chamber pots usually occurring with little girls being in close contacts with sick parents.

In association with gonorrhea urine – genital trichomoniasis is often met. Trichomanadous damage is a widely spread parasitical sexually transmitted disease. There may also occur an indirect contagion through dirty from discharge linen of sick people and occurs in the same as in the case with gonorrhea conditions. Such contagion is observed among teenagers. There exists a danger of trichomoniasis contagion in the course of labor from a sick mother to a newborn baby. In addition newborn girls have transit vaginitis and urine track infection. Such way of contagion is observed in 5% of cases.

While among woman trichomonias in 95 – 99% of cases develops into vaginitis and more seldom cervicitis, among men it develops into utetritis.

Recently in the world and in Turkmenistan as well chlamydia infection of urine – genital organs has been spread. Chlamydia trichomonas may cause complications very often resulting in infertility. Every fifth man who has suffered from chlamydia epidemitis experiences secondary infertility. Chlamydia infection is very dangerous for men. It does not only cause serious pathology of the lower part of the urine tract but often is accompanied by the development of rising and disseminating infections, pelvic inflammatory diseases, infertility, contagion of newborns and partners. Clinic spectrum urine – genital chlamydosis include utetritis, epidemitis, prostatitis, cepvicitis and small pelvic inflammatory diseases. However, clinic symptoms of urine – genital chlamydia are not clearly expressed and give only light (nonspecific) manifestation. About 2/3 of infected sick people do not feel the symptoms of this disease in connection with this it creates problems for population health care programs. Clinical symptoms develop very slowly and some sick people display them in many years after being infected. Sick people may not complain, considering themselves healthy refusing any treatment. This circumstance persistently demands better information service to prevent chlamydia infections.

As well as other sexually transmitted diseases, chlamydia causes a great threat to women reproductive health and has a clearly expressed influence on heredity. According to WHO experts’ data 40 – 50% of children born to mothers with chlamydia cervicitis have a clearly expressed chlamydia infection. Usually the infection is transmitted to the child in the course of labor and chlamydia trichomonas is sowed from eyes, nasopharygnx, larynx, tongue vagina and fecal discharges of newborns. Among complications a newborn has due to chlamydia infection most often met are (10 – 50%) conjunctivitis and bronchopneumonia and less often gastroenteritis. Sometimes conjunctivitis is accompanied by other eye area damage and results in scars and even blindness. Infecting by chlamydia increases a risk of stillborn and causes a death of a newborn.

Preventive activity against chlamydia infection and information service among teenagers is of special topically. In view of the fact that in future many of them will become mothers and fathers but chlamydia infection has a weak display of symptoms and besides there is a danger of transmission of the disease in an everyday way, chlamydia threatens to turn one person’s disease into a disease of the whole family, acquired in addition by children. Approximately 30 – 35% of children in the families with sick parents are affected by urine – genital chlamydia. A danger of catching this disease by children consists in the fact that there is a possibility of girls’ primary infertility development caused by scar changes of uterine tubes or orchoepidimitis suffered by boys.

The most dangerous from the point of view of its complications and treatment is genital herpes. The disease is transmitted chiefly through sexual intercourse and presents a serious medico – social problem. Above 90% of the people of the Earth are infected by the virus of a plain herpes and about 21% of them have these or those clinical symptoms of the infection. Possessing neurodermotropism it damages skin mucous membrane, central nervous system (meningitis, encephalitis), eyes (conjunctivitis, ceratilis). Plain herpes virus unfavorably effects reproduction: it causes the pathology of pregnancy and labor, very often it leads to “spontaneous” abortions and fetus death or results in a general infection of newborns. There is also marked some connection between genital herpes and cervical cancer and prostaticis cancer. A danger of this infection consists in the fact that the genital herpes is transmitted from those having no any symptoms of the disease at the moment of the contact or even having no idea about their infection. A risk of neonatal infection of a newborn depends on the form of his mother’s genital herpes form and makes up to 75%. Genital herpes problem presents difficulty since it is a reoccurring disease often very difficult for treatment turning into lethal condition.

In the last decade doctors’ attention has been also attracted by urine – genital ureplasmosis and mycoplasmosis, sexually transmitted and playing a great role in the reproductive function, especially in pregnancy pathology. Besides, such diseases as papillomavirous infection, virus hepatitis B, lyambliosis, scabies, tropical treponematosis may be sexually transmitted.

It needs to be marked that the spectrum of these diseases is rather wide, so STD problems concern both any individual risking of catching them and any country striving for the reduction of their level and protection of the rising generation from them.

Among one of the most dangerous factors threatening teenage reproductive health abortions in adolescence may be noted. In the puberty period girls’ reproductive system begins to form and function. And if in this very complicated and responsible period of their life girls disturb the harmony of an emerging organism by such a traumatic and rather tough operation as an abortion it may result in serious complications of a medical, psychological and social character.

Medical consequences are more often connected with a high level of post – abortion complications among which the most spread ones are inflammatory genital diseases, infertility, spontaneous miscarriages, premature labor, menstrual cycle disorders etc.

Together with medical consequences abortions bear a deep psychological trauma for teenagers and young women since in most cases infertility or premature fetus is a consequence of the first pregnancy termination by an abortion.

An abortion also reflects on a sexual life of a woman resulting in weakening a sexual sense of some of them or frigidness development (lack of sexual appeal) that are directly connected with central nervous system disorders.

An abortion or miscarriage is pregnancy termination during the period from its beginning up to 28 weeks. By their character abortions may be divided into two groups: induced and spontaneous. Spontaneous abortions occur without any attempts of a pregnant woman or other people to terminate her pregnancy. An induced abortion is a voluntary pregnancy termination or the one for medical or social reasons.

An abortion performed even in hospital environment is dangerous for a woman’s health. Extremely dangerous and harmful is an abortion performed outside medical institutions. Such abortion is called criminal. Morbidity after these abortions is very high. The most dangerous complications of a criminal abortion are the following: uterus perforation, hemorrhage, infections and septicemia. The consequences of these complications may result in stable invalidation and sometimes even a woman’s death.

An abortion is allowed in 98% of the countries of the world. A treat to mother’s life and woman’s physical health safety is accepted as a legal basis for pregnancy termination. In 62% of the countries where 75% of the whole population of the world live this circumstance is a basis for a legal abortion. According to WHO experts assessment 25 million abortions are performed annually where they are legalized.

In Turkmenistan an abortion is a legal medical procedure performed in medical institutions in all velayats. Its performance is regulated by medical regulations and the legislation of the country.

Frequency of abortions is approximately 1 abortion per three labors; i.e. every fourth pregnant woman applies for abortion performance. Totally in Turkmenistan there is observed a stable tendency towards decrease of abortion frequency almost by 15%. It is perfectly obvious that this is connected with the improvement of the reproductive health care service.

However, it needs to be noted that the legacy of abortion performance doesn’t mean an absolute permission. Teenagers are ready to set outside marriage sexual relations neither physically or physiological. But if this has occurred and there is an occurrence an unwanted pregnancy it is necessary to know that young women and teenagers may be offered a safer and technically simple method of pregnancy termination –a mini-abortion. A mini-abortion is performed within the pregnancy term under 5 weeks and has minimal post – abortion complications.

However, a negative influence of abortions on reproductive organ functioning is obvious, so teenagers should be informed of it as of a risk factor threatening to reproductive organs.

Diseases and inflammatory processes occurring in childhood or teenage period of life present another factor influencing girls’ reproductive system formation and development. The problem is that in a traditional people’s viewpoint there is an opinion that a young organism of a teenager is not subjected to any threatening influences on a woman generative function and so teenagers’ complains about their health are understood as some age changes which cease in time. However, existing for a long time studies in child and teenage gynecology in the world practice prove that functional disorders of one or several links of a reproductive system even in a teenage period lead to a pathological course not only during a period of puberty but may be a direct reason for generative function disorder in the following years of a woman’s life.

According to the data of foreign scientist’ studies gynecological diseases are revealed on average to 30% among girls of a preschool period and 42% among girls at the age of 14 – 15. In the structure of incidences inflammatory genital diseases make about 60%, menstrual function disorders – 15 – 30%, traumas – 5 – 10%, development disorders about 5%, tumors – 1 – 5%***.

Child and teenage gynecology development experience has shown that in connection with anatomy – physiological peculiarities of girls’ reproductive system their diseases are different both in spreading and development.

Little girls more often suffer from such widely spread diseases as vulvitis and vulvovaginitis while a menstrual function disorder is a main pathology of a puberty period.

In child and teenage gynecological morbidity the leading place is occupied by inflammatory diseases of external genital organs and considerably less are presented by diseases of internal genitals. The specific part of vulvitis and vulvovaginitis among children before puberty makes from 40% to 65%, but inflammatory processes of internal genitals among girls to 3.1%****. Despite the fact that frequency of inflammation processes of internal genital organs before puberty is comparatively small they must attract more gynecologists’ attention since these sick people make a high – risk group of due to infertility during a reproductive period. Chronic inflammatory diseases of uterus appendage of a nonspecific etymology are very dangerous for teenage reproductive system. As is known they occur as a result of diplocock peritonitis a disease of a large intestine or appendicitis suffered by people in their childhood.

Diplocock peritonitis is a disease occurring only in childhood and in 92% of incidence girls suffer from it. Since the source of peritonitis as a rule is absent, many authors consider that its emergence is not connected with diseases of abdominal organs. It seems that the most important role in pathogenesis of this disease is performed by a gematogene way of contagion and less often – vaginal *****.

Numerous studies have been devoted to the issue of transmission of the infection from the appendix on uterus appendage. A possibility of inflammatory diseases of uterus appendage in the right may be conditioned by anatomic links between them.

According to M.H. Kuzhetsova’s data even in 1980 there were observed girls with tumor formation in the tract of appendages. Some of them were not timely operated on acute appendix, they were treated conservatively and observed until there appeared tumor swelling inflammatory formations in the tract of the right uterus appendage. In the course of operation there were revealed purulent tubooveral formations in the side of which there was found a changed appendix or its remnants. A quick involvement of uterus appendage into the inflammatory process should be noted.

It may be supposed that the above mentioned diseases carried at any age create in the organism sources of lengthy latent infections outbreaks of which may occur in different spaces of time under the influence of provoking moments. Endocrine and immune reconstruction of the organism, physical and mental loading, supercooling, insufficient and regular feeding connected with a desire to loose one’s weight, stress situations and many other factors resulting in weakening of organism resistance to infections – all of them belong to the latter ones.

The peculiarities of the development of inflammatory process of internal genitals among the girls of a puberty age is a lack of an acute beginning of the disease, predomination of a lack of symptoms. Perhaps, this is an indirect evidence of immunological immaturity of a teenage organism. It goes without saying that a great role in the pathogens of chronic salpingophoritis the previous and chromic extra – genital diseases as well as operation interference connected with pelvic organs’ diseases play a great role.

Timely revealing and rational therapy of inflammatory processes of internal genitals of girls and maids is an effective prophylactic of women generative function disorders during their reproductive period.

Children and teenage reproductive system pathology revealing plays an important role in connection with the fact that genital function disorders occur in childhood and in the course of puberty preserve and progressively develop in a reproductive period.

In Turkmenistan the problem of child and teenage gynecology acquires a particular importance due to a low population reproductive health index in Turkmenistan.

Thus, according to the data of the department of children gynecology of SCC MCHP during 1994 from the consulted children and teenagers there were revealed 90.5% of gynecological pathology. Infectious – inflammatory genital diseases of different etymology including vulvoginitis – 49.4% made 72.2% a considerable part of this pathology.

Analogous data were obtained in the course of gynecological pathology performed in Dashhovuz velayat and the city of Ashgabat by the research workers of SCC MCHP. In the course of examination of girls from 10 to 18 there were revealed menstruation cycle disorders observed among 89.6% in Dashhovuz velayat but among their peers in Ashgabat only in 50.3% of cases. The second place was occupied by pathological ovary changes observed in 22% of cases among patients from Ashgabat and in 14.6% of cases among girls from Dashhovuz velayat.

That is why there increases topicality of information service and preventive activities among teenagers and their parents to timely reveal teenage reproductive organ pathology.

One of important problems connected with reproductive health is the problem of infertility rooted in childhood and adolescence. And sometimes infertility may be caused by fetal development disorders. In this case there should be raised a problem of early diagnostics of the pathology leading to infertility.

Speaking about teenage development it is possible to mark girls with an absolute form of fertility and three risk-groups due to its development.

An absolute form of fertility occurs in the condition when the generative function of a woman is impossible. For example, in case of congenital absence of genital glands (disgenesis and agenesis gonad), uterus or cervix of the uterus, castration in childhood or a puberty period.

Patients of a high risk are those having refractive ovaries, an obliterated form of gonad disgenesis, subtotal resection (almost full removal) of genital glands, tumors of hypotalamo – hypophysis area of the brain (i.e. the area in charge for sexual hormone development), bilateral piosalphynx (purulent saccus formation in uterus tubes). This pathology must be timely diagnosed and a necessary treatment should be proscribed by an experienced specialist. Contemporary diagnostics depends to a great deal on informativeness of parents and persons working with children and teenagers about the fact that the above – mentioned pathology may cause a serious threat to girls’ reproductive function later resulting in infertility. That’s why they must express their interest and a responsible attitude toward prophylactic examinations of girls in a teenage development time.

Patients having reproductive system pathology conditions which can be adequately restored in case of a timely consultation with a doctor make a group of a moderate risk. However, such patients need a very serious and careful attitude and their treatment must be lengthy and comprehensive under observation of an experienced gynecologist. Besides, parents and teachers need to remember about some reasons promoting girls’ reproductive system disorders and their appearance in the group of a moderate risk. To those belong the following: acute and chronic emotional stress especially the one connected an abrupt loss or putting on one’s weight, hard physical or mental work.

Patients having dysfunctional uterus hemorrhage and those after removal of a large area of ovaries as well as patients with belated (development of secondary genital symptoms and the beginning of menstruation after 15) or premature (before 8) sexual development. If such changes are revealed parents, teachers and family doctors should not view them as problems of an age character but must consult a specialist since this pathology to the most degree may be restored in case of a timely consultation. Otherwise there may occur serious reproductive system disorders and fertility development.

Together with the problems girls have in the issues of reproductive health boys’ reproductive system disorders should be noted. Rather often in Turkmenistan there occurs the pathology of cryptorchism being an important factor of male fertility. Clinic experience shows that very often parents reveal the absence of testicles and consult a doctor very late or even don’t pay any attention to this fact.

It’s known that patients with cryptorchism as a rule have a changed temperature regime of the testicles that results in dystrophy changes and a subsequent lack of spermatogenesis.

The results of morphological studies of nondropped testicles conducted during the last years by SCC MCHP testify that the initial symptoms of degenerative changes are revealed at the age of 1 year and irreversible changes in testicles by 10 – 11 years of age. At this period there is marked some slowing down of Certolicells growth and the number of spermatogony becomes extremely insignificant. In connection with this treatment of cryptorchism is recommended to be started in the earliest terms – at the age of 1 year.

A surgical method of treatment is a leading one in andrology and oncology. Surgical interference during a teenage period that as a rule is performed after creptorchism is revealed at the military commission examination doesn’t prevent infertility in the mature age. In connection with this it is very important with the purpose of prophylactics to timely diagnose male reproductive function disorders and treat boys having creptorchism. All children treated for creptorchism need a dispensary andrologist or urologist observation till those age limits when their full spermalogenesis and fertility restoration is finished. Parents as well as teenagers need to be taught to all symptoms of this disease to make them pay much attention to changes in their children’s organisms and ask for medical aid in time. This will allow solving one of the most important reproductive health problems – male infertility and the whole family in general.

Together with the above – mentioned factors threatening to reproductive health there should be pointed out one, that is closely connected with the above – listed ones and sometimes even they are consequences of this factor – socio – behavioral.

As has already been mentioned at this age teenagers’ interest to sexual issues and interrelations of genders increases. They often find answers to their questions not in their disputes with teachers, doctors or parents but in the company of their peers. A company of peers in this situation may influence unfavorable development of teenagers and form corrupted stereotypes of their behavior. The consequences of this “education” are unpredictable. Since in psychological comprehension of a teenager his romantic ideas may be changed by a rough vulgar comprehension of gender interrelations there may occur a breakdown in an individual’s emotional development. It may result in a careless attitude towards one’s reproductive and sexual health and a negative attitude to education to these issues. As the data of the conducted studies of schoolchildren and their parents in Ashgabat, Akhal velayat, Mary and Mary velayat (where 2525 schoolchildren and 2211 parents have been questioned) show the most part of teenagers spend their free time at home or at relatives’ – 44% of the respondents. It means that a considerable part of teenagers is under the influence of their parents and they display their attachment to their homes and family feelings. I.e. emotional formation of individuals takes place under their parents’ care and they perceive or are ready to perceive the basics of reproductive knowledge, behavioral stereotypes from the traditions of their families. Here the potential of their parents may be used to inform them of reproductive health care issues.

Further we observe that 13% of teenagers spend their free time in the company of their peers and 10% in the street or yard. All in all it makes 23% of the questioned schoolchildren. Just here to our mind a danger of getting vulgar information by this part of adolescents lies. Since past time gives birth to attraction towards discussions and especially discussions of the issues of gender interrelations. But discussions of gender interrelations in the circle of peers who themselves are not enough educated and do not possess qualified information threaten to provide them with vulgar ideas of sex and reproductive health.

It should be noted that only 7% of teenagers spend their free time in sport sections and circles according to their interests. Unfortunately this testifies about weakening of the influence of extracurricular training institutions on young people and one of the reasons for a possible strengthening of an unfavorable influence of a social microenvironment.

A danger of strengthening of the unfavorable microenvironment influence on adolescents is supported by the data showing that the main source of information to discuss issues of unfavorable behavior, drug addiction and prostitution in particular is a circle of peers. As the data show the main circle of discussion is a company of peers for 36.2% of the questioned teenagers. I.e. in social environment the main place of discussions of the mentioned problems is a circle of peers. An alarming is the fact that discussions in an unqualified environment will result in negative consequences. And these problems are discussed with parents only in 25.7% of cases, while with teachers only in 4% of cases. I.e. a considerable part of schoolchildren get answers to topical questions of formation a person in a social communication microenvironment through peer circles.

As a consequence of this socio – behavioral factor there emerge other factors of a reproductive behavior threat – sexually transmitted diseases, unwanted pregnancies and abortions.

The data obtained testify that a peer circle is their main channel of involvement of girls into prostitution. Among teenagers 16.4% have marked it as the major one. The rest have marked the way through procuress peers or independently established relations accordingly 1%, 4% and 7.5%. Parents’ assessment comes to the fact that the main channel is a circle of friends – 29.3% of the questioned have marked this item. The rest items haven’t got many answers from the questioned parents: through procuresses – 13%, through peers – 5.5%, independently established relations - 9%. It needs to be marked that a considerable number of adolescents do not know about the channels of involvement – 68.1% and 38% of the questioned parents also have no idea of the ways of involvement of girls into sex dissoluteness. So, it is necessary to intensify the activity of educational institutions to more occupy young people with socio – useful work or promote the development of their capabilities through involvement of them into circles according to their interests or sport sections. Sexual dissoluteness besides a threat to a reproductive health bears in itself a threat to traditional ideas of family – marital relations. That’s why reproductive health care can’t be separated from moral – ethical activity with adolescents. Forms and methods of this activity may be quite different but the goal is one – medical and social training of girls for motherhood and young men for fatherhood.

Reproductive health care depends first and foremost on an individual himself, a degree of his informativeness and knowledge of what this notion means and what its full condition is connected with. But the problem of acquiring knowledge of reproductive health care issues is not a problem of only one person, but presents a concern of the whole society. Knowledge of notions in this field begins from an early childhood and doesn’t stop with teenagers’ coming of age. It is perfectly obvious that the leading role in this process belongs to parents in the course of formation of a personality and it is a measure of their responsibility for a proper reproductive health of their children. Teachers and doctors must perform upbringing of a sense of responsibility of our children and teenagers for their reproductive health. I.e. a process of getting knowledge of reproductive health care by children and teenagers must be performed step by step depending on the age and taking into account national traditions with the participation of not only a family, but also educational and cultural institutions. There is no doubt, that in this process a great role belongs to mass media. In connection with this the task of the community consists in satisfying informative needs of the population, including the rising generation, in the reproductive health care issues.

Knowledge is one of the elements of learning reality especially in a teenage period of maturity, when the rising generation acquires knowledge about environment with a special perception. Knowledge at this period finishing formation of teenage evaluative structure of consciousness makes up a basis of behavior. That is why knowledge of reproductive health care issues acquired in youth comes out as an important means of reproductive system protection not only in the course of growing up but during the whole life. Topicality of information service activity on the issues of reproductive health care among teenagers consists just in this.

Issues of reproductive health care include knowledge not only of anatomy, physiology and hygiene of sexual sphere, but that of a danger of early sexual contacts, preventive measures and fertility regulation, their consequences in the form of unwanted pregnancies, sexually transmitted disease (STDs). Orientation of teenagers must be focused on their training for future motherhood and fatherhood, based on feelings of love and respect to each other, understanding of gender relation, responsibility for the future generation health.

One of important preventive measures and fertility regulation is usage of contraceptives. Contraceptives are unwanted pregnancy protection means; some of them being preventive measures against sexually transmitted diseases (STDs). The topicality of the problem is conditioned by the absence of informativeness of teenagers in contraceptive issues connected with a lack of information for the public in general and mass media to conduct sanitary – educational activities in the field of reproductive health care. In some countries there are several delusions regarding contraceptive use propaganda. The first delusion is connected with the fact that contraceptives are viewed as birth restriction means. However, the main goal of their use consists in birth space lengthening (inter – genetic interval) that is necessary for a woman’s health restoration and reproduction of a healthy offspring, prevention of unwanted pregnancies and STDs. The second delusion lies in the fact that many people mistakenly consider that the expansion of knowledge about contraception stimulates sexual activity and dissolution among teenagers. However, according to the World Health Organization (WHO) data teenagers knowing about reproductive health problems including contraceptives postpone sexual life beginning for a later date and are more discerning in their relations with a partner. Besides teenagers’ informativeness in the contraceptive issues is a factor of reduction of a number of unwanted pregnancies and abortions and their consequences as well. So, its study is very important in education program development.

As the conducted analysis data show most of the questioned (56%) don’t know about contraception at all, the less part (39%) know at least one method of contraception. And 5% of the questioned have avoided their answer that means they too do not know about protective measures against pregnancy.

At the same time alarming is the fact that teenagers having no idea about contraception owing to their physiological development may enter sexual relations and cause a risk to their reproductive health. According to our survey data in this group of ignorant there has been revealed a category of teenagers who have had sexual contacts – 18.9% of them. Besides some of them have had several partners and this fact causes great concern since improper sexual life and ignorance of preventive and protective measures may result in increasing a number of unwanted pregnancies and as a consequence of this - abortions, sexually transmitted diseases with all negative consequences.

The diagram presented demonstrates that with the age there grows a number of teenagers competent in contraception and by 18 already 82.5% know at least one type of contraceptives. Interest to contraception increases very sharply beginning from 16. The diagram shows that from the questioned respondents at the age of 16 – 43.8% know about contraception and in 17. So, the restrictions in presenting information through mass media are not quite justified. This or that way teenagers learn about protective means but the quality of this information is troublesome. It is necessary to pay attention to the sources where teenagers first learn about methods of contraception from. As the study shows a source of information for most respondents (21.5%) is TV and video. It’s more likely that the advertisements and insertions that unfortunately advertise only one type of contraceptives giving no information about others. For our country a more available and acceptable is a lactation method (breast-feeding) and an IUD for women of a fertile age, but for teenagers – hormonal tablets and condoms that the population is not sufficiently informed about. It should be mentioned that the quality of information teenagers get leaves much to be desired. In connection with this we’d like to express a hope that mass media will help to inform simply, in detail and correctly the population of the country including teenagers. One of the most popular sources of information for teenagers is that from their peers – 17.4% of the respondents. But a lack of knowledge or misrepresented comprehension about contraception of peers themselves is troublesome as for the quality of the information presented to each other. Thus, it is necessary to introduce health programs into schools, secondary schools, colleges, and high educational institutions to provide peers themselves with correct and qualitative information about methods of contraception and reproductive health care issues. Then circle of friends also will become a reliable source of information.

It is satisfying to note that such a qualified source of information as a conversation with a doctor has been used by 9.3% of teenagers that testifies about a high degree of trust to doctors and doesn’t raise a doubt in the quality of the knowledge received by teenagers. In connection with this qualified doctors should take a very active part in development and implementation of educational reproductive health care programs.

The less important information sources teenagers make use of are books (6.4% of the respondents have used them) and their parents – 5.6%. Very alarming is the fact that just insignificant number of teenagers learn about contraception from their parents, though just parents must display their concern towards their children’s health and fate and they should play the most important role in explaining reproductive health care issues. All the necessary information about gender a child must get in the course of displaying his interest towards it. Parents mustn’t suppress a child’s inquisitiveness whatever the sides of the life it concerns. Parents’ negative reaction towards gender pushes a child away, deprives him of a chance to address his parents with these questions in future and throws him just into the arms of “street educators” thus promoting just what opponents of gender discussions are afraid of, namely comprehension of cynical and vulgar objectives in gender and sexuality issues. A lie in the answers to children’s questions about gender is not so innocent as it seems to be. The main condition is creating mutual understanding and trust, normalization of relations between children and parents. It needs to be properly learnt that gender education begins from babyhood. Gender education of preschool children gets under way at the age of children’s maximum comprehension, formation of their attitude to the world and gender in general, including that to his own gender in the period of gender identity development and sex – role behavior. It is naturally that some parents experience embarrassment while discussing these delicate issues with their children or simply avoid them considering that they will learn everything in the course of time. To overcome this obstacle for children is much more difficult. However, an arousing interest to these issues makes them turn to these or those sources of information if they don’t receive a proper and understandable answer from their parents. But very often a part of parents limit themselves only by providing literature that teenagers can’t always form an understanding of. It is very important that parents at this moment shouldn’t lose a psychological contact with their children. An international experience shows that education in the issues of a family life promotes formation of responsible relations between teenagers including refraining from first sexual intercourse thus postponing the beginning of sexual life for a later period, broad usage of contraceptives and more scrupulous choice of a partner. The best results are achieved in cases when children and parents frankly discuss the issues touching upon reproductive health and childbirth.

Unfortunately, among the respondents only 2.4% have got information from their teachers, though just this source of information may be of a substantial importance due to a great authority a teacher enjoys among the population. This figure gives some idea. Firstly, insufficient psychological contact of teachers with schoolchildren and parents needs to be marked. Secondly, a lack of informative literature and absence of teaching experience in these issues at schools have resulted in a low level of teachers’ readiness to teach sexual behavior issues. The activity of the organization concerned should be directed at teaching teachers through training and work – shops as well as publishing relative literature. It is necessary to develop a handout on reproductive health for schools with participation of medical workers, psychologists, lawyers, sociologists and teachers. Thirdly, as a rule they experience a feeling of embarrassment and apprehension during talks with teenagers about reproductive health care a relations between genders, since some teachers being in the same social environment with parents of their schoolchildren are afraid of a negative attitude to them on the side of an unprepared part of parents in case of explaining this information. So, reproductive health issues taught by rural teachers must be concentrated on general questions of gender relations such as medico – physiological processes, contraception, safe sex, abortions, STD prevention, observance of birth spaces, and other questions must be taught by invited medical workers. This may become a broad sphere of activity for International organizations concerning reproductive health care and school programs aiming at joining teachers’ and doctors’ attempts for achieving a final result, that is nation health improvement and a successful implementation of the President of Turkmenistan Saparmurat Turkmenbashi’s Program “Health”.

As is seen from the given diagram, a rather large proportion is made of teenagers having no source of information that creates a danger for their reproductive health. In the course of analysis of the diagram concerning teenagers’ knowledge of contraception it’s marked that 56% of them have no idea about it and in the following diagram it’s cleared out that 34.5% of teenagers have no sources of information. This confirms our thought that despite of the presence of these or those information sources (TV, video, a circle of peers), many teenagers still don’t know about methods of preventing pregnancy, that once more emphasizes a lack and low quality of information got by teenagers.

Within the framework of the given question in the group of those having no idea of contraception gender distribution of schoolchildren looks like this: there are 846 (60%) of girls and 561 (39.8%) of boys. In general these are schoolchildren from national schools (78.6%) and from schools with Russian language teaching – 21.4%. This sets tasks to intensify activities in national schools including publishing information literature in Turkmen.

Among those who know about contraception there are 588 (59.8%) girls and 380 (40.5%) boys. A specific number of those who know and those who don’t know among boys and girls in their subgroups are the same.

This circumstance is explained on the one hand by the peculiarities of psychological and physical development of girls and on the other hand by a rooted attitude towards a woman as a keeper of a home hearth and a successor of a family in connection with which preparation for a family life has been targeted in general at girls. The peculiarities of girls’ physical development are the following: earlier puberty of girls, their growing up and brightly expressed instinct of self – preservation. Girls’ inquisitiveness, mobility, heightened interest to their own organism and relations of sexes are referred to their psychological development peculiarities. This leads to a rather wide circle of girls’ sources of information.

Unlike girls boys’ training as future fathers hasn’t been paid a due attention that is why they are happy with more accessible source of information: TV and video. However, the quality of information received by them leaves much to be desired since there is no systematic and consistent coverage of reproductive health issues. It’s high time for adults to understand that the responsibility of boys for wellbeing and health of the family as well as healthy offspring reproduction is the same as that of girls. In connection with this in the course of development of educational programs it needs to pay more attention to teaching boys to reproductive health care issues.

Judging from the given diagram it is pleasant to know that 75% of boys and 35% of girls among competent respondents know about condoms. This is quite positive since a condom is not only a means of protection from a pregnancy, but a unique method of STD prevention, and it also prevents cell pathology of cervix and reduce a risk of cervix cancer. However, it is alarming that even in the group of competent teenage boys they are very little informed of other contraceptive methods. Turkmenistan is once of the countries with a chiefly traditional lifestyle, where a leading role in the family belongs to a man and very often while making a choice of a contraceptive by wife this is husband who has a casting vote. In connection with this it’s very important to cover men by information on all types of contraception, their advantages and disadvantages, since they are the heads of the families and thus they should know about family health reproduction care issues, the importance of birth space (intergenetic interval). Education must be conducted among boys and men to teach them to carefully treat sexual life problems and fulfil parenthood responsibilities since today’s boys are tomorrow’s fathers of the families. And so they must be aware of the degree of a risk women are subject to during a pregnancy period and giving birth to a child, as well as reproductive health threat connected with sexual life performed with many partners – “a harmful traditional practice”, and early beginning of a sexual life. Women reproductive and sexual health problems need mutual understanding and participation of both partners. Educational work among boys on family life issues is very important for the health of the family and the whole society. Besides, boys disseminate the received information in their peers’ circles and may act as sources of information among less educated part of them. So, education needs to be conducted in such questions as hygiene of sexual life, birth space, contraception, abortion and its consequences, girls’ and boys’ genital pathology prophylactics, sexual health, safe sex, sexually transmitted disease including AIDS etc.

It’s interesting to note that the range of girls’ interests in contraception is considerably wider than that of boys. Their range of knowledge of types of contraceptives is wider. This is quite clear since just girls express greater concern for their reproductive health and show their interest towards ways of its protection and safety rather early and very often they have to pay very dearly for committed errors. However, an alarming is the fact that 49% of girls know about IUDs and only 16% know about hormone tablets. Unfortunately, the questioned teenagers almost don’t know about physiological methods of protection against pregnancy. The matter is that girl – teenagers are not recommended to use an IUD for its complications (infections resulting in fertility, menstrual function disorders and others). It would be better if girls knew more about condoms, hormonal tablets and physiological methods of contraception that are more acceptable at their age. In connection with this explanation of advantages and disadvantages of every type of contraception for different age groups is very important for teenagers within educational programs. The investigation conducted allows us to emphasize long – term tasks among which one of the most important is learning how to use different types of contraceptives by teenagers and adolescents and their influence on reproductive organs of an organism as well.

As the data of the conducted survey show the knowledge level of the issues connected with precipitate sexual contacts very often resulting in sexually transmitted diseases is rather low among teenagers.

To reveal socio – individual characteristics and factors creating favorable conditions for spreading of venereal diseases among teenagers they have been asked a number of questions touching upon STD symptoms and preventive measures. All in all 2522 schoolchildren have been questioned among which there are 971 or 40% of boys and 1451 or 60% of girls. The most of the questioned are schoolchildren at the age of 14 – 18 (96.3%) living chiefly in the rural area – 70% of the respondents, that reflects a real structure of youth distribution among regions of residence thus giving an objective assessment of their responses.

As is seen from the diagram no single venereal disease has been given by 53.3% of the respondents, i.e. more than a half of the respondents haven’t possessed minimum information about this issue their answer being “No”. This data causes great alarm in connection with the fact that a lack of information about this issue is one of the factors promoting STD spreading among teenagers. However, it needs to be noted that 46.7% of the respondents have got an idea from one to 3 diseases. This confirms the fact that in teenage environment there is a considerable number of young men and girls interested in sexual problems and dangerous consequences of sexual relations.

Taking into account the above mentioned, it has made sense to study reasons for socio – demographic factors resulting in such situation. A more sufficient factor causing the level of informativeness about STDs among schoolchildren of the questioned amount appears to be a region of residence.

This fact is rather predictable: young men and girls living in town have more opportunities to make use of different means of information including reproductive health care issues. Besides traditional TV they have a wide access to literature, libraries, video – production. Urban teenagers have wider opportunities in getting different information during communication and exchange of information among them, with representatives of other age group adolescents (students of colleges, secondary schools, high educational institutions) and adults of different professions. Together with this urban conditions of life create a much wider range of temptations and an idle way of spending one’s time for teenagers: bars, night clubs, discotegues and casino that may act as conditions of a risk of casual sex contacts with subsequent STD contagion. This circumstance also increases teenagers’ interest in venereal disease symptoms.

Teenagers and adolescents living in rural area as a rule to get this information may use in general TV and radio, where STD symptoms and its prophylactic issues are not sufficiently discussed. Besides rural teenagers have less opportunities for a much wider circle of communication due to being occupied with housekeeping. A traditional lifestyle creates favorable conditions for upbringing of teenagers – their involvement into socio useful activities. However, in connection with an intensive course of market reforms there is an intensifying connection between town and village, processes of international integration are expanding and all this creates the necessity for rural teenagers to learn reproductive health care issues including the basic issues of STD prevention.

Further analysis has been performed on comparative data of the groups of those who have no idea of STD (I group) and the group respondents knowing about symptoms of 1 – 3 diseases (II group).

A comparative analysis of two groups has shown that a significant factor influencing teenagers’ knowledge of STD symptoms is a social position of their parents. Since Turkmenistan refers to the region with a chiefly traditional lifestyle where a social position of the family is defined by father’s profession, the analysis has been performed according to professions of teenagers’ fathers. So, in the first group 45.5% of the questioned teenagers’ fathers were workers, 32.1% - businessmen, 11.2% - specialists with high education, 9% - peasants and 2.2% - unemployed.

Teenagers of the second group who have named from one to three sexually transmitted diseases, make 1178 persons. These teenagers’ fathers in 36.2% of cases are workers, in 31.8% - specialists with high education, in 24.4% - entrepreneurs and businessmen, in 5.2% of cases – pleasant, and in 2.4% - unemployed.

The data obtained testify that teenagers’ knowledge of STD issues is connected with the family social position and parents’ education. Parents of teenagers of the second group (knowing about STDs) almost 3 times more often that those of the first group (not knowing about STD) are specialists with high education. This means that in the families with a high educational status some attention is paid to the issues of sexual education and teenagers learn about dangerous consequences of uncontrolled sexual behavior under direct influence of their parents.

A low informativeness level of teenagers in the families of workers, peasants and businessmen in all probability is connected with the fact that they participate in economic and entrepreneur activity and are occupied with earning family income.

If a social position of the family is defined by a father’ profession ethical and moral upbringing as a rule is conducted by a mother. It’s confirmed by the circumstance that in the course of information – research work parents in great majority have been presented by mothers of the questioned teenagers. It has been revealed that mothers of teenagers knowing STD symptoms in 50.1% of cases are doctors, teachers, engineers and other specialists with a high educational status. I.e. mothers with education are aware of the importance of this information and this or that way create conditions for acquiring this knowledge by their children. At the same time mothers of teenagers having no information on STDs in 50% of cases are housewives. However, it can’t be viewed as the circumstance impeding to getting information about this issue. The analysis of housewives’ responses from the survey of teenagers’ parents testifies that the overwhelming majority of them (83.7%) consider their children’s knowledge of venereal diseases very important. Obviously housewives themselves can’t conduct an explanation activity with their children due to a lack of information and bad knowledge of STD symptoms and consequences or there exists a psychological barrier between parents and children to speak about intercourse but an intuitive maternal feeling of concern about her children’s future prompts her the necessity of this knowledge for young people and girls.

The fact that knowledge of AIDS as one of STDs is a predominant one may be explained by a broad information propaganda about HIV/AIDS, their consequences for life, ways of transmission and contagion in mass media through advertisement and publicity. This is explained by the fact that AIDS spreading in the world acquires a threatening size and has reached according to the WHO data 30 million infected people. The situation becomes complicated due to the fact that there are no effective drugs for curing this disease that results in an unavoidable death of the patients. This circumstance seems to have conditioned a great interest and a high level of knowledge about AIDS among questioned teenagers in velayats. Topicality of information – educational work devoted to HIV/AIDS in Turkmenistan is obvious and is connected with the epidemic AIDS situation in CIS countries (the Ukraine, Russia, and Kazakhstan) which are connected with our country by close economic relations.

An alarming fact in receiving data is a low level of knowledge teenagers have about such a serious disease as syphilis and actual absence of information about gonorrhea and trichomonisis. Probably the absence of elementary ideas and knowledge about these diseases, their consequences for their own life future offspring is one of the reasons for the growth of venereal diseases among teenagers. In connection with this it is necessary to enliven informational – educational activity among the rising generation making use of all means of information possible.

Taking into account that at present the most effective STD preventive means is a condom, its teenagers’ knowledge analysis seems to be topical and timely. As the data show more than a half of the questioned 50.9% quite correctly point out the role of condoms as an STD protector. It needs to be noted that 32.7% of teenagers are disorientated in this question and probably they think that venereal disease contagion may be avoided in case of the use of an IUD, menstrual cycle calendar, and hormonal tablets. From the total number of the questioned 16.4% have absolutely avoided any answer to the question.

This circumstance is explained by physiological peculiarities of puberty of boys and intensive development of sexual appeal. Besides, a condom as a rule is intended for usage by men, so information about it is spread more quickly among young people.

Knowledge of condoms increases according to the age as the diagram show.

Such dynamics is quite natural since it reflects a process of maturity of teenagers and accordingly growth of interest towards gender relation issues.

Thus, the higher teenagers’ informativeness about sexually transmitted diseases the higher their interest towards the issues of their prevention.

The next step of the received data analysis is investigation of sources of information that could be used by the rising generation for meeting their needs in knowledge of STD issues.

More often the respondents would prefer to address their parents (30.3%) as the most reliable and a close source of information they trust very much. The fact that 25.3% of the respondents would consult a doctor to get necessary information is very satisfying. It testifies that they are aware of seriousness and importance of STD problems and would prefer a competent source of information. In connection with this there should be created opportunities for free and unimpeded consulting of teenagers through trusting telephones within the framework of reproductive health centers and dermato – venereological hospitals. Taking into account that ¼ of the questioned have spoken out their desire to have a reliable information of professionals it would make sense to enliven school doctors’ activity and attract obstetrical – gynecologists and dermato – venereologists to take part in classes devoted to health issues.

Lately reproductive health care issues have acquired special importance in socio – demographic development of the society. In connection with this there is taking place an intensive process of accumulation and receiving information about factors influencing reproductive system condition of both adults and teenagers. But unfortunately numerous new data are the matter of discussion of a narrow circle of specialists, scientific workers, remaining inaccessible for the public in large. It is promoted by a lack of attention on the part of mass media, workers of educational and medical systems towards information – educational activity among adults and teenagers. As a consequence very often knowledge of teenagers and adults is of a non-systematized and a superficial character but gaining proper information by population is one of the main means of reproductive health care.

To educate teenagers to these or those issues it is very important to have among educators also their parents to make them give teenagers full and proper information. This explains our interest in the level of knowledge of parents themselves of one of the most widely – spread reproductive health issues – contraception.

It has been revealed that 92% from 2200 of the responded parents know about contraception and the greater part of them know 2 types of contraception – 42%. 38% of the responded parents know one method of contraception while only 12% of them know all 4 effected methods of contraception. It is turned out that 8% of parents have no idea about contraception. Of course, in the whole amount this is not a significant figure, but in the course of analysis of absolute figures they present 180 parents having no idea of contraception.

I.e. still a rather big number of parents don’t know about contraception. So, effectiveness of information, consulting and educational activity depends on teaching parents to all methods of contraception for them to become a trusting source of information for their children being able to save their children from early and unwanted pregnancies.

Assessing parents’ knowledge of types of contraception – the question answered by 2172, it’s been revealed that a greater part of parents know about IUDs – 53.3%. And this is clear, since for the last decade this has been the most spread and used method of contraception in Turkmenistan. Recently there has taken shape a rather wide choice of contraceptives, however parents seem to be not informed of the advantages of the rest. This circumstance once more emphasizes a need to expand information activity among parents. Even condoms are informed about only in 18.7% of cases. It would be very nice if this percentage were higher and parents knew and could talk with their children about all advantages of a condom including its ability to prevent cervix cancer and STDs. Unfortunately only 9.7% know about hormonal tablets and a menstrual cycle method is familiar only to 9%. And only 9.3% of the responded parents know about all listed methods of contraception.

Data analysis has shown that education is a very important factor for the level of knowledge about contraceptives. Among the respondents with high education the percent of those who know two methods (47.7%) and four methods (28.6%) is high as compared to the respondents with secondary (accordingly 40.7% and 10.1%) and incomplete secondary education (accordingly 27.2% and 5.1%). And the index of those who don’t know about contraception is lower (5%) than that of the respondents with secondary and incomplete secondary education – accordingly 8.3% and 11.1%.

The data testify that information activity among parents should be performed differentially aiming at independent objectives and tasks in the course of work with each group of parents.

To assess the level of informativeness of the adult population about an STD danger and early symptoms of sexually transmitted diseases as well as preventive measures against them 2211 people have been questioned. Among them there have been 1624 (73.5%) of women and 559 (25.3% of men), the average age of the questioned being 38.5.

In the course of analysis of the responses to the question about STD symptoms there have been got the following results: 67.1% (1399 persons) have named 1 – 2 venereal diseases, and 32.1% (685 persons) haven’t known any symptoms of a single venereal disease.

The data obtained testify that there prevail adult respondents knowing about STDs. But it should be noted that 1/3 of the questioned parents have no idea of sexually transmitted diseases. This is rather alarming since they being parents of teenagers of 14 – 18 themselves are still at a sexually active age when there exists a possibility of catching an STD. Unfortunately the percentage of STD patients at the age of 30 – 40 is rather high. Absence of information and ideas of sexually transmitted diseases among adults is a predisposition factor for venereal disease contagion. Alarming is the fact that parents having no idea about STDs can’t help their children to orientate in the present situation with these diseases and give them elementary ideas about them. Teenagers are devoid of the most trusting source of information they prefer to address more often in necessary cases. Among the questioned 1/3 of those who don’t know this information is a rather considerable part of parents being at a fertile age are unable to help their children with STD prevention issues.

In connection with this the analysis has been focused on comparative characteristics of socio – demographic indices of adults informed of STDs and ignorant in this problem. Most important seemed to be the investigation of the influence of educational level of the questioned parents on their knowledge in this field. In the amount of the data used in the following analysis there have occurred 716 parents with high education and a scientific degree, 1019 respondents - with secondary and secondary special education and 318 adults - with incomplete secondary education. The results have revealed the fact that the highest level of knowledge is characteristic of people with high education – 77.5% of them have named one or two sexually transmitted diseases. Somewhat lower are the indices of informativeness of adults with secondary and secondary special education – 64.1%. Parents with incomplete secondary education have the index of 51.9%. The given data testify that the higher the level of adult’s education the higher the index of those who know STD symptoms in their subgroups. As the results of the investigation of teenagers show, students from families with a high educational status better orientate in STD symptom issues as compared to other teenagers. I.e. there is observed some influence of the educational level on the interest in STD knowledge of both parents and their children. Adults with high education have wider ideas of contagion ways, consequences and dangers these diseases may threat a human health. As a result of the analysis there has been revealed a direct dependence of informativeness in this issue on the educational level: with the growth of educational level there increases a number of those who know about venereal diseases and with falling of the educational level there increases a number of those who are not informed of STDs.

Therefore, a low level of education may be a favorable factor for spreading venereal diseases. A lack of knowledge about symptoms, ways of STD spreading may result in the situation when a sick person misses early clinical symptoms of these diseases going on to lead a sexual life being a source of contagion for one’s relatives.

Assessment of the level of informativeness of parents in sexually transmitted diseases was defined by a number of diseases the symptoms of which they could give. The analysis showed that more than a half of parents with high education were well orientated in STD issues and could name symptoms of two diseases. Parents with secondary and incomplete secondary education demonstrated low knowledge since only 37% and 21% of the respondents of these groups named symptoms of two STDs.

The data obtained are alarming since most of parents of teenagers in the regions of the survey are persons with secondary and incomplete secondary education and low level of STD knowledge. Consequently, there is created a situation when in most families there occurs a lack of information about reproductive health care issues and parents are unable to explain their children elementary notions concerning this problem. Such situation can’t be left without attention of workers of education, health care system and international organizations dealing with reproductive health of the population. First of all it is necessary to focus all efforts on providing the adults with secondary and incomplete secondary education with all available and various sources of information. This will allow cutting misbalance between the levels of education. Besides, it should be noted that in this delicate question it is necessary to possess also skills to communicate with teenagers. However, a low level of knowledge causes a lack of tactics of conducting such conversations provoking some parents’ sense of awkwardness and embarrassment even with their own children. So, one of the most important moments of enjoying reproductive rights is acquiring skills to establish psychological contacts with teenagers that should be properly explained to parents and in special literature.

Knowledge of such important problems as STDs is defined not only by the level of education, but by the influence of social environment as well. Investigation of dependence of the level of adult informativeness in venereal diseases on social factors has revealed that the adult respondents who have got high education in the capital have not any knowledge about STDs in 20.8% of cases from 495. At the same time teenagers’ parents, who have got an analogous education in a velayat center do not orientate in this issue more often and the number of ignorant in these issues is 30.5% from 131 of the respondents. This is explained by the fact that in the capital there are more opportunities go get the necessary information, using various sources and different communication means. The same situation is preserved at present. In velayat centers there are less official information opportunities. So, accordingly the level of informativeness is lower as compared to that in the capital. This means that for effective implementation of reproductive health care program institutions of high education in velayat centers must become objects of information provision.

It’s necessary to point out that informativeness in this issue among adults with secondary education obviously differs depending on the place it’s been received: respondents after finishing urban schools have the level of informativeness about STD of 67%. Parents with secondary education got in rural schools have the level of informativeness 1.5 times lower as compared to urban ones. This proves the fact that the process of getting information about reproductive health basics, including sexually transmitted diseases in rural area is somewhat labored. So, adults who have finished rural schools in 50% of cases can’t name a single venereal disease. The previous analysis of teenagers’ knowledge showed that the situation is analogous: both young people and girls from rural area were worse orientated in reproductive health care as compared to urban teenagers.

The situation becomes complicated due to a lack of special literature in the national language about these issues both for adults and teenagers. Taking into account the fact that the major part of the population of Turkmenistan are rural inhabitants and their birth rate is considerably high than that in urban area, the problem of informativeness of the rural population is becoming especially topical and dictates the necessity of development of activity complexes and reproductive health care programs, including those for STD prevention. One of the main ways of this work is information provision of rural schools by literature of these topics and development of school programs on reproductive health.

The level of venereal disease knowledge of men is somewhat higher than that of women. It may be connected with the fact that men are more sexually emancipated and spend more time outside home. While women are more inclined to monogamy relations and they try to pay the main part of their time to their families.

The next stage of the investigation is study of informativeness of teenagers’ fathers and mothers in the types of STDs. As the data obtained show, men have a higher level of informativeness in gonorrhea and syphilis than women have. It most likely connected with an earlier beginning of sexual life and frequency of before and out of marriage sexual contacts men have. Besides symptoms of these diseases appear in some period of time after contagion, causing anxiety of a sick man and his suspicions of a possible STD. Since at present gonorrhea and syphilis are more spread men’s and women’s fears of a possibility of catching it as well as transmission of them to their children are quite understandable. Women as compared to men orientate in symptoms of trichomonisis and AIDS much better. This is explained by the fact that trichomonisis very often and for a long time is running without any symptoms causing no troubles to a sick person. As a rule this disease is diagnosed quite by chance when a woman consults a gynecologist for some other reason. So, infection of trichomonasis very often is revealed when women don’t suspect it. This information testifies the necessity of highlighting the ways of contagion, clinical symptoms and consequences of trichomonasis through information – educational activity among population, since the consequences of this disease are not less dangerous for reproductive health than syphilis or gonorrhea.

The level of women knowing about AIDS is 24% while that of men is considerably low – only 14.9%. These indices both for men and women are extremely low and testify about underestimation of HIV/AIDS danger by parents.

Informativeness of adults about STD is defined according to their profession. Parents are presented in groups according to their specialties allowing to compare a part of those who know and don’t know about it: teachers, doctors, economists and other white collar workers – 720 respondents, entrepreneurs members of a private enterprises, individuals working by themselves – 145, heads of enterprises – 112, engineers, servicemen, workers of internal affairs department – 160, workers – 423 persons, housewives – 272, pensioners, religious men – 49, unemployed – 63, peasants – 114 persons.

According to the specialty there has been revealed the following dynamics of informativeness of the questioned parents about this issue: the highest level of STD knowledge was that of teachers, doctors, economists and other white collar workers. This fact is rather predictable since they have a wider range of interests and knowledge of these problems for most of them are conditioned by the field of their activity. Besides them responses of entrepreneurs members of a private enterprises and individuals working by themselves. This social group has been formed recently with transfer to market economic relations in general from specialists with high educational status. So, the level of their STD issue knowledge is also rather high. Besides numerous business contacts with business partners and frequent business trips, abroad broadens their scope of knowledge including also the issues of sexually transmitted diseases.

A rather high level of informativeness in this problem is demonstrated by heads of enterprises (72.3% of respondents). In overwhelming majority this is a category of specialists with high education, often possessing a scientific degree, with great life experience and practice of communication with different layers of population. A specific nature of their activity needs informativeness in different fields of knowledge including reproductive health care and STD problems.

The next group according to informativeness about STDs is the one including engineers, servicemen, workers of internal affairs department etc. Though the number of knowing is 67.5% this index is insufficient since the representatives of this group take an active part in socio – economic sphere of the society development and participate in upbringing of the rising generation and youth as due to their activity they contact with high risk groups so they must orientate in STD problems.

The level of housewives’ STD informativeness is especially interesting since this social group is rather numerous in Turkmenistan and plays an important role in upbringing of the rising generation. Most of them have shown good knowledge of this problem but the fact that 40.8% of the respondents have no idea of STD symptoms is very troublesome. Housewives fulfil an important social function consisting in continuity of traditions from the older generation to the rising one. Spending most of the time in housework and housekeeping restricts their opportunities of expanding their knowledge of reproductive health care issues.

At the same time housewives preserve a family influence, perform upbringing of children, pass national traditions and moral behavioral norms to them, take care of their physical development. As the above mentioned studies of teenagers have shown the most reliable source of information about STDs for them are their parents, mothers more often, 17.8% of them being housewives. Answers to the question about sources of information have shown that 27.5% of housewives point out the absence of such. So, it is necessary to create conditions for housewives allowing them to get information about STDs, taking into account their role in formation of a child’s philosophy of life. In connection with this it makes sense to expand the opportunities of educational system in organizing their activity with parents, to use women movement and NGO potential and to establish publication of special literature, magazines for housewives.

Informativeness about sexually transmitted diseases is rather important for such a significant for economic sphere of the society social layer as workers. The level of knowledge of STDs reaches 59.3% from the total number of the respondents. This group includes builders, drivers, maintenance men etc. Special attention in this group should be paid to long distance drivers since during long trips they may run a risk of casual sexual contacts resulting in STDs contagion. So, it is important to pay attention to this group to teach them STD issues and provoke clarifying discussions distributing special brochures, booklets, and inserts highlighting STD symptoms and prevention.

The lowest indices of STD knowledge revealed among unemployed, peasants are in direct connection with a low educational level of representatives of this group and with their activity that is not connected with an intellectual load. In the group of pensioners it is connected with age peculiarities when this problem loses its importance and a risk of STD morbidity is lowered. Besides, the level of pensioners’ informativeness in venereal diseases perhaps is influenced by existing earlier stereotypes of “shamefulness” and hushing up this very important problem by the society. Taking into consideration an important role of pensioners in the family, their participation in moral bringing up of the rising generation, and existing national traditions of honor and respect towards elders’ opinion, they should be attracted to information – educational activity devoted to reproductive health care issues. To achieve this it is necessary to use mass media and publication of a special magazine for those who spend time at home.

In the group with low indices of STD knowledge there are peasants who name STD symptoms in 49.3% of cases. Such level of knowledge peasants have is rather explicable and predictable in connection with their employment in agricultural labor and restricted opportunities of using sources of information about reproductive health care issues.

Taking into account a great number of sexually transmitted diseases it was expedient to study adults’ knowledge level according to types of these diseases.

While answering the question about STD symptoms in the group knowing 1 – 2 diseases there have been received the following data: 37.1% know about syphilis, 33.1% - about gonorrhea, 21% - about AIDS, 8.6% - about trichomonias, 0.2% - other diseases. Comparing these data with teenagers’ responses it should be noted that adults are much better – informed about syphilis, gonorrhea, trichomonias. But teenagers know about AIDS 2.5 times better than adults. This may be explained by the fact that adults know better “old” or classical venereal diseases, the representatives of which are syphilis and gonorrhea. They seem to know about these diseases from their youth when such venereal diseases as syphilis and gonorrhea were described in science – popular literature. Only 1/5 of the respondent parents knows about AIDS calling it a sexually transmitted disease. This fact proves a low level of sanitary – educational activity dealing with HIV/AIDS in mass media, underestimation on the part of adults the threat from this disease to their lives and a lack of desire to have any information about it. So, at present informativeness of the population about the ways of transmission, clinical symptoms, preventive measure against this disease are very important since AIDS presents a problem for everybody and his/her offspring.

Besides AIDS at present there exist “new” venereal diseases also presenting a great threat to reproductive health. This group of diseases nowadays is rather spread in all countries of the world and causes great medical – social problems connected with their expansion. So, broad informativeness of the population including teenagers about existence of these diseases and their danger for health is very important. Unfortunately, only 3 adults from 2211 of the respondents are informed about these diseases.

This is explained by the absence of any mass media publications about such diseases as chlamidosis, ureplasmosis, mycoplasmosis infections, genital herpes and others, very often causing irreversible damage to reproductive health. More often knowledge of these infections is observed only among doctors, who directly deal with these problems. Nowadays these diseases acquire great social significance in connection with economic, physical losses caused by spreading of these diseases and their consequences leading to reproductive function disorders.

The next step of the work was study of STD information sources used by adults. As it follows from the presented diagram the most spread adults’ information source is special literature – 38% of parents has made use of it. No less important source of information for parents are conversations and consultations of doctors – 28.7%. Thus more than a half of the questioned adult respondents use literature and consultations of doctors for getting knowledge about STD. Unfortunately at present there is experienced a lack for special literature, highlighting sexually transmitted diseases and very often there is an absolute absence of it especially in the national language. Another source of information about STD, named by adults is communication with friends from which they can get new information dealing with this problem. A minimum number of teenagers’ parents get information from relatives and other sources. From the total number of adults who’s answered the question 17.5% point out absence of any information about STD.

Data analysis according to sources of information has shown the following dependence: men are more informed in STD issues, since they more often than women read special for getting necessary information as well as do it through communication with their friends. In fact equal number of men and women prefer to get information about STD from a more reliable source – a doctor.

An analogous tendency is observed among their children for whom such source of information as talks with a doctor are also very important and according to their significance occupy the place after TV, video and radio. Among adults and their children there is some difference in evaluation of a primary source of information. For adults reading special STD literature from which they can get the most detailed information about these diseases and the ways of their treatment is more important. Besides this way of getting information presupposes keeping confidentiality for such a delicate problem.

Information source usage depends on parents’ educational level. Adult respondents with high education prefer to have special literature as a source of information in 53.3% of cases. Respondents with secondary education address this information source in 32.3% of cases with incomplete secondary education only in 20.2% of cases. The given data allow making a conclusion that high education forms a desire for self – education and self – knowledge as a result of this adults with high education prefer to get necessary information independently. This tendency should be taken into consideration in the course of performing information – educational activity and publishing literature devoted to reproductive health care problems. Those who have secondary (31.4%) or incomplete secondary education (28.5%) more often use talks with a doctor as a source of information about STD. Respondents with high education consult a doctor for STD information in 24.9% of cases.

As a matter of fact in all subgroups questioned parents two times less address friends than doctors. The rest sources have turned less important for parents.

8.3% of parents with high education, 19.1% - secondary education and 33.7% with incomplete secondary education haven’t had any sources of information about this issue. Thus, educational level influences parents’ informativeness in STD issues as well as their choice of information sources. This dynamics should be taken in consideration for conducting a system of reproductive health care activities, using family doctors’ potential for individual talks among parents with secondary and incomplete secondary education.

Analysis of information sources depending on the region of residence has brought to light the following peculiarities: city dwellers in most part get information about STD from special literature. Only 1/6 of urban respondents consult doctors for this purpose and this testifies about their striving for self – education in STD issues. This may be conditioned by the opportunity of usage of various literary sources in town. But in rural area respondents use literature to get knowledge about STD only in 34.2% that is considerably lower than that of parents from cities. At the same time in rural area frequency of getting information about STDs through doctors is twice as much as that in town. This is explained by a high degree of trust of countrymen in doctors and a traditional authority they enjoy on the part of the population, which is expedient to be used for conducting reproductive health care information – educational activity. Information provided by a village doctor or medical worker is perceived with great attention and interest leading to awareness of the importance of this problem and necessity of getting knowledge about STDs. However, a great obstacle on the way of knowledge of STD issues in rural area is absence of special literature in the national language. This is confirmed by a large number of respondents having no information about STD in rural area as compared to that of town.

Such information source as communication with friends is practically used in an equal degree. On the basis of the given data this source is not the major one and is evaluated by most respondents as a secondary source. So, only 12.1% of urban and 11.8% of rural residents make use of it.

The rest information sources including information from relatives are insignificant for the respondents and reveal no statistic regularity.

In the course of analysis adult respondents’ knowledge of sexually transmitted diseases, it needs to discover also a level of their informativeness in methods of STD prevention.

An important component of STD problem knowledge is awareness of the importance and ways of usage of condoms to prevent contagion by AIDS, syphilis, gonorrhea and other venereal diseases. A general level of informativeness of an individual about STDs is characterized not only by knowledge of its symptoms, STD types, but also knowledge of effective means of protection against them. Only in this case it is possible to speak about proper knowledge of this problem. A person having such level of informativeness may not only himself resist STD spreading but also be a source of information for relatives, friends, colleagues etc. Fragmented ideas about this problem result in underestimation of importance and danger for health from these diseases. And as a result a risk of STD contagion increases. So, in the course of reproductive health information program development a complex and systematic provision of knowledge about sexually transmitted diseases should be performed.

In the course of the survey for parents to reveal a level of their knowledge about methods of STD prevention there has been offered a question: “What methods of sexually transmitted disease prevention do you know?” in which there have been foreseen several possible answers including wrong ones.

As the adults’ responses have shown 44% from 2003 of the respondents call a condom as a preventive means. Avoiding casual sexual contacts as a means of STD prevention has been called by 29% from the total pointed number. 27% of the respondents are disorientated in proper methods of STD prevention; they call contraceptives (IUDs, hormonal tablets) means of protection against these diseases.

The given data according to knowledge of the role of a condom in STD prevention are obviously insufficient for adults since more than a half of them don’t mention it in their responses, though lately there is going on its intensive advertising in the whole world as well. This information is a peculiar signal to enliven information – educational work to spread propaganda of a condom as an effective STD preventive method. It needs to be mentioned that almost 1/3 of the respondents are orientated at hormones sexual contacts with one constant sexual partner when a risk of catching a sexually transmitted disease becomes minimal. Such position is justified and corresponds to oriental ideas of moral purity.

An alarming is the fact that among parents of teenagers there exists a group of those being unable to tell contraceptives from STD prevention means. This fact is an unfavorable index in the respect of STD contagion risk by adults themselves and it also testifies that such parents are unable to help their children to orientate in the issues of preventing venereal diseases. Disorientation in STD prevention issues is interconnected with a low level of knowledge of their symptoms. In the group giving wrong answers about preventive measures only 46.7% have been able to call 1 – 2 venereal diseases. While in the group of competent in condoms as means of STD prevention 61.4% call symptoms of 1 – 2 diseases. These data allow coming to the conclusion that people knowing early symptoms of STD better orientate in the issues of their prevention.

Analysis of dependence of knowledge of a condom as a preventive means on the region of residence has shown that there are certain differences in assessment of measures of STD prevention between urban and rural residence. Among town dwellers from 420 respondents 50.7% know a condom as a preventive method against venereal diseases. This village dwellers’ index is considerably lower and makes 40.7% from 1552 persons. These data once more confirm a lower level of knowledge of villagers in STD issues and preventive measures in connection with limited opportunities to such information access.

Assessment of avoiding casual sexual contacts as a method of prevention against venereal diseases is somewhat higher with rural residents than town dwellers. It is explained by stronger traditional ideas of family values and marital fidelity in rural area. It should be noted that among this category there are more disorientated persons in STD prevention methods as compared to town dwellers and it corresponds with limited opportunities of getting information in village conditions.

Depending on gender there have been revealed differences in knowledge of STD preventive measures: among women (1503 respondents) 39.1% know condoms while among men (538 respondents) a condom as a preventive method is called by 51.5%. Besides, men show a higher level of informativeness in other methods of prophylactics against venereal diseases – avoiding casual sexual contacts. That’s why among men a number of those who can’t tell contraceptives from STD preventive measures is three times less as compared to women. This is connected with an active social role of a man in the society, a broad circle of communication, resulting in their better informativeness in this problem. Among women – respondents a significant part of them was from rural area taking part in house – keeping spending most of their time in housework. So, it is rather difficult for them to get information about this problem.

In the course of analysis there has been marked a clear dependence of informativeness level of teenagers’ parents on their education. Level of knowledge of this issue was considerably better among respondents with high education. Responses of 2058 parents have been subjected to analysis of dependence of informativeness on education. Among them there have been 742 persons with high education, secondary – 1008, incomplete secondary – 308. At the same time 53.9% of parents with high education have called a condom as a preventive means. Parents with secondary or incomplete secondary education have shown a considerably low knowledge of condoms: accordingly 38.3% and 27.9% have called it a preventive means.

Besides, awareness of avoiding casual sexual contacts as an effective method of STD prevention is more expressed among parents with high education (31.4% of respondents).

Unfortunately, awareness of importance of this venereal diseases preventive method by parents with secondary and incomplete secondary education is somewhat lower: 29.2% and 26% of the respondents from this group. An alarming is the fact that parents with a low educational status have the index of those who are disorientated in STD preventive methods three times higher than that of parents with high education. The data obtained once more confirms that the higher education the more striving for self – reproach and self – education in different fields of knowledge. Thus, more attention should be paid to families with low education of parents using different means and ways of information provision.

While conducting analysis of STD preventive methods depending on marital status there have been distinguished two groups: those, married (1849 persons) and unmarried or divorced (110 persons). In the first group a condom as an STD preventive means is called by 41.4% and in the second group – 57.3% of the respondents. Avoiding casual contacts as a method of STD prevention is called by 29.9% of married persons, while among unmarried parents this index is somewhat lower – 26.4%. A considerable difference in these two groups according to disorientation in methods of STD prevention is marked. Unmarried parents disorientated in proper STD preventive methods make 16.4% and among married respondents 28.7% give wrong answers. It is followed from this fact that unmarried parents know a condom better and more seldom mix up STD preventive measures with contraception methods. I.e. marriage creates conditions of psychological compose connected with stability of their sexual life and presence of a permanent partner that reduces their interest in STD problems and their preventive methods.