Inserted by the woman, but usually need to discuss with partner

1. FemaleCondom Female Condom • About the female condom: • A loose plastic sheath that is inserted into the vagina before sex. • No medical conditions limit use (NOT made of latex). No allergic reactions. • Helps protect against both pregnancy and STIs/HIV/AIDS • Client needs condom whenever: • Client is unsure whether he/she or his/her partner has an STI including HIV. • Client has other sex partners or is not sure if current partner has had other sex partners. • When condoms are used correctly every time, they are effective in preventing pregnancy. • May be less effective than the male condom in preventing pregnancy, HIV and other STIs. • Best if inserted before any sexual contact. • Effective when used EVERY TIME you have sex • Can be used alone or with other family planning methods • May be more effective against pregnancy when combined with another method, but cannot be used with the male condom. • Also used as back-up for another method of family planning (for example, missed pills, late for injection). • May be expensive • More expensive than the male condom and may not be as easily available. • Inserted by the woman, but usually need to discuss with partner • If partner does not want to use condoms,“We can discuss and practice what you might say.” • Practice with client how to talk with partner. Use Appendix 9. Next Move: “Do you want to know more about the female condom, or talk about a different method?” To discuss another method, go to a new method tab or to Choosing Method tab. If client wants to know more about the female condom, go to next page. FC1 Female Condoms

2.    Outer ring Inner ring Open end How to use a female condom Inner ring   • Gently insert the inner ring into the vagina • Place the index finger inside condom, and push the inner ring up as far as it will go • Make sure the outer ring is outside the vagina and the condom is not twisted • Be sure that the penis enters inside the condom and stays in it during intercourse • Open package carefully • Make sure the condom is well-lubricated inside • Choose a comfortable position – squat, raise one leg, sit or lie down • Squeeze the inner ring at the closed end Are you ready to choose this method? • To remove, twist the outer ring and pull gently • Throw away condom properly

3. FemaleCondom      Outer ring Inner ring Inner ring Open end How to use a female condom • Open package carefully • Make sure the condom is well-lubricated inside • Choose a comfortable position―squat, raise one leg, sit or lie down • Squeeze the inner ring at the closed end • Gently insert the inner ring into the vagina • Place the index finger inside condom, and push the inner ring up as far as it will go • Make sure the outer ring is outside the vagina and the condom is not twisted • Be sure that the penis enters inside the condom and stays in it during intercourse • To remove, twist the outer ring and gently pull • Throw away condom properly • Couples should use a new condom for each act of intercourse. • Condom should be inserted before penis touches vagina. • Condom can be inserted up to 8 hours ahead of time. • Condom is lubricated, but it may need extra lubricant inside so it is not moved out of place during sex. More lubricant can be added either inside condom or to the penis. • When finished, the woman must move away from partner and take care not to spill semen on vaginal opening. • The condom should be thrown away properly, in a bin or trash can as appropriate. Next Move: Does client understand how to use the female condom? Is she ready to choose method? If she has decided to use method, go to next page. If not, discuss further or consider other methods. FC2

4. What to remember • Use a condom EVERY TIME you have sex • Make sure you always have enough supplies of condoms • If a condom is not used correctly, consider emergency contraception as soon as possible • Can use more lubricant if needed Anything else I can repeat or explain? Any other questions?

5. FemaleCondom What to remember • “You need to use a condom EVERY TIME you have sex for full protection from pregnancy and STIs.” • If cannot use a condom every time,consider also using another method of family planning. • Use a condom EVERY TIME you have sex • Make sure you always have enough supplies of condoms • “Get more condoms before you run out.” • If female condom does not stay in place or if it gets pushed inside the vagina, emergency contraception may help prevent pregnancy. • Do not use if unopened package is torn or leaking, or the condom is dried out. • Clients that may have been exposed to HIV or STIs may also need post-exposure prophylaxis (PEP) for HIV and/or presumptive STI treatment. • If condom is not used correctly, consider emergency contraception as soon as possible • All female condoms are lubricated. This may make the female condom slippery at first. • Can use additional lubricant inside if needed. Can reduce noise during sex and makes sex smoother. • Any kind of lubricant can be used with the female condom. • Can also reduce itching. • Can use more lubricant if needed Last Moves: “Do you feel happy with this choice of method?Is there anything I can repeat or explain? Please come back any time!” Last, most important message: “Use a condom every time.” FC3

6. Vaginal Methods • Includes spermicides and diaphragm • Must be placed in the vagina each time before sex • Some users have side-effects • May be messy • Spermicides: • Less effective than other methods • No protection against STIs or HIV/AIDS • Diaphragm: • Can be effective when used correctly every time • Needs pelvic exam to check for size • Possible protection against some STIs Do you want to know more about these methods, or talk about a different method?