Presentation on theme: "The Power of the Provider to Promote Female Condoms"— Presentation transcript:
1 The Power of the Provider to Promote Female Condoms
2 What we are going to cover The field of female condomsWhy female condoms matterHow to use female condomsEffective promotion strategiesThe provider’s roleHands-on practice and role playsAbout the Chicago Female Condom CampaignNext stepsResources
3 But first, let’s talk ground rules We’re all here to learnListen actively and respect others when talkingParticipate to the fullest of our abilitiesSpeak from own experiences with “I” statementsSit by someone you don’t know!Promise that what is said here, stays hereAsk questionsAnything else?
4 A word about languagePeople who are not female-identified may be turned off by the name “female condom”Other names for FCs include…Internal condomReceptive partner condomBottom condomInsertive condomManhole coverCatcher’s mittWhat other terms have you heard?
5 A word about language and gender Best practice to affirm & respect clients’ gender expression & identityDon’t make assumptions about a person’s genderAsk their preferred pronoun such as: she/her, he/him, ze/hir, they/them, etcDon’t be afraid to ask! Just be respectfulTell them yours too!
6 Pre-testHelp us assess what you know and think about FCs before the trainingTake post-test after completing trainingShow you AND us what you learned today
7 Let’s get to know each other! Your name, agency, role, & preferred gender pronoun1=Never heard of FCs2=Heard of FCs, but haven’t talked at length about them3=Feel pretty confident talking about FCs, but have more to learn4=Very knowledgeable & comfortable w/ FCs5=Know tons about FCs; talk about them with everyone I meet!
8 Your thoughts on FCs What do YOU think about FCs? What do you think when you see them?Do you think FCs are effective prevention tools?What do you say when they are mentioned?Do you think they enhance pleasure?
9 Renewed energy & interest in condoms CDC prioritization of condom distributionGates recent RFP for “Next Generation Condom”Several female condom products on the market today, and additional products in developmentPromotion of FC2 for receptive partners of all gendersFolding silicone male condom in clinical trialsFirst RAI condom in acceptability trials
10 The field of female condoms Female Health Company’s FC2Nitrile (synthetic latex)Pre-lubricated with silicone-based lubricantDoes not contain spermicideMost widely distributed FC around the worldOnly FC available in U.S.
11 About the FC2 FDA approved FC2 early 2009 What’s different between FC1 and FC2?Non-allergenic for people with latex allergiesSofterSeamlessQuieterMore affordableWarms to body temperature
12 Anatomy of the FC2 6.5 inches long Has 2 flexible rings—inner and outerInner ring stays inside of FC when used for vaginal sexInner ring enables insertion into vagina and up to cervix where it locks into placeOuter ring at FC opening lays outside of vagina against the vulva or outside of the anusOuter ring helps acts as guide for penetration, which prevents bunching
13 The field of female condoms The Woman’s CondomPolyurethane with capsule applicatorCapsule dissolves upon insertionFoam shapes hold it in placeCommercially available in China
14 The field of female condoms CupidLatexSponge assists with insertionOuter ring helps keep it in place during sexAvailable EU, Brazil, Portugal, and South AfricaPre-qualified by WHO
15 The field of female condoms Panty CondomPolyethylene sheath pre-lubricated w/ VaselineLimited distribution in Colombia, under review for WHO pre-qualificationPhoenursePolyurethane, silicone lubricatedInsertion toolLimited availability in China & Brazil, under review for WHO pre-qualification
16 Pop quiz! What FC is available in the U.S.? Are all FCs made out of the same material?Of what material is the FC2 made?What is the function and purpose of the inner ring?What is the outer ring’s function & purpose?Can you take inner ring out for vaginal sex?
17 Why promote female condoms Women and men need optionsPrevention and protectionEmpowermentPleasure
18 Female condoms are for: WomenMenYouthTransgender peopleQueer peopleStraight peoplePregnant womenPre or post-menopausalPeople living with HIVPeople who are HIV—People who have had a hysterectomy
19 Why promote FCs—more options People need variety of tools for different times and situationsNon-hormonal contraception is limitedNo side effectsOffer post-menopausal women solution to vaginal drynessNo biomedical combination contraceptive and HIV prevention tool yet exists
20 Why promote FCs—prevention & protection Only tool that offers women dual protection against pregnancy, STIs, & HIVComparable to male condoms in reducing risk of STIs, pregnancy, HIVExternal genitalia coverage reduces skin-to-skin STIsHopkins economic analysis showed DC’s FC program prevented 22 HIV infections in first year, saving $8m in future medical costs
21 Why promote FCs—empowerment Receptive partners of all genders need array of tools to take active role in their own healthWomen need tools to help control if/when they have childrenProvides additional option when male condom negotiation is not possible or safe
22 Why promote FCs—pleasure FC feels more “natural”, allows for increased sensation and heatReceptive partners can take charge of own healthFC2’s rings double partners’ pleasureEnables spontaneity because FC isn’t reliant on erect penisDon’t have to pull out right awayFCs can be used in sexual play
23 Most importantlyProtected sex acts INCREASE when FCs are offered alongside male condomsConsistent condom users often switch between methods when both male and female condoms are available
24 Pop quiz! Why should providers talk with their clients about pleasure? How can FCs enhance intimacy?Are FCs comparable in protection to male condoms?
25 Giving people the right tools Essential to provide education along with FCs to ensure client comfort and confidenceStudy showed intensive training increased FC use and decreased unprotected sex overall by 10-25% among U.S. womenNYS study found that intent to use FCs among clients was significantly associated with provide FC knowledge, FC attitudes, and self-efficacy for FC promotion
26 The power of the provider Health care providers are trusted info sourcesPeople who learn about FCs from providers or clinics are more likely to use themProvider perspective translates to clientCritical provider feels comfortable & confident with FCNegative provider bias=reduced client intent to use
27 Critical components of FC education Use positive and affirming language to introduce FCsHighlight pleasurable aspectsHelp clients/patients become familiar with FCsTake the FC out of the packageExplain FC construction and purposeInform them that practice makes perfect
28 Critical components of FC education Talk through vaginal & rectal anatomy, using model or picturesDemonstrate insertionHave client demonstrate back to:Make sure comfort with insertionCorrect mistakesCreate space for questionsCompare to learning something new--tampons, contacts, etc.
29 External female anatomy Mons pubisPubic boneClitorisUrethraVaginal openingLabias (Lips)Anus
33 Use FCs to… Alternate who wears the condom Enhance intimacy by having partner stay inside after climaxHave safe sex even when a partner refuses to wear a condomKeep the spontaneity goingTake care of self and partner
34 When not to use female condoms When using a NuvaRingWhen using a diaphragmWhen using male condomWith a pessary – a device to hold a pro-lapsed uterus’s in placeIf it feels uncomfortable or hurts
35 Female condoms for vaginal sex MUST keep inner ring inside for vaginal sexEnables FC to stay in place by locking behind pubic boneDO NOT remove inner ring when using FC for vaginal sexCan be inserted prior to sex
36 A note about FCs and anal sex Anal sex, it’s not just for gay men!Women have anal sex, it’s usually unprotectedFCs can open important dialogue on anal sexFC2 is NOT FDA approved for anal sex (neither are MCs)Inconclusive safety and NO efficacy data on FCs for anal sexCampaign promotes FCs for anal sex as risk reduction strategy
37 How to insert FCs for vaginal sex Squeeze inner ring between thumb and middle finger.Insert inner ring into vagina and use index finger to guide inside.Put finger inside FC and gently push into vaginal canal. Inner ring will fit behind the pubic bone, over the cervix.
38 How to insert FCs for anal sex FCs for anal sex is a risk reduction strategyInsert at time of sex actOptions for use:Insert FC into anus like similar to vaginal useRemove inner ring, place FC on penis or dildoUse lots of lube and enter the anus slowly123
39 After FC insertion Make sure FC is not twisted FC should be smooth against walls of vagina or anusOuter ring must be outside vagina or anus, covering external genitalia/anusAdd lube for increased pleasure and easy movementHold FC in place; guide penis into FC so as not to push FC to the sideIf FC gets twisted, comes out, or bunches, use a new one!
40 A note about lube FC2s pre-lubricated w/ silicone-based lubricant Nitrile, like polyurethane, tolerates oil-based lubricantImportant to be careful about messaging to ensure client doesn’t think oil-based lube can be used with all condomsOil-based lube DESTROYS latex condomsIf clients prefer oil-based lube, FC2s may be a good option for them
41 When finished To remove FC, twist outer ring to keep the semen inside Gently pull FC out, and throw awayUse a new FC with every sex actNEVER use a male condom and a FC at the same time
42 Troubleshooting with the FC What should you do if the FC is pushed inside the vagina?What should you do if the FC sticks to the penis?What should you do if the penis slips between the FC and the vaginal wall?
43 Down and dirty of FCsFCs reduce risk of HIV, STIs, and unintended pregnancy.Just one gets it done. Never use FC & MC at same time.Inner ring must remain inside for vaginal use.FC must be inserted for anal sex at point of the sex act.Outer ring lies over lips of the vagina or anal opening.Put lube inside FC to increase pleasure and make sure FC doesn’t stick to penis.FCs can increase pleasure for both partners.Practice makes perfect.
44 Make your FC pitch!Take 5 to 7 minutes to draft your own pitch about female condomsThink about the main points that MUST be made and what information to include to increase a person’s intent to use the female condomsWe will regroup to share pitches
45 Pop quiz! What are the essential components of FC education? How are female condoms used for vaginal sex?Can female condoms be used with male condoms?Can female condoms be used for anal sex?When must a person start with a new female condom?What about lube is important to talk about with clients?
46 How to use model correctly Must be right side upCover cut out with handNO adjusting through cutoutUse vaginal opening to insert FC
47 Full demonstration: vaginal and anal Let’s put it all together!Full Demonstration: Talk your partner/group through a FC demonstration for vaginal and anal use from expiration date to removal as if they have never seen one before.
48 Demonstration feedback How’d it go?How was it for you to practice inserting the FC?What challenges did you encounter?What additional information do you need to coach a client to correctly insert the FC?What additional resources might you need?
49 Role playsRole plays: We’ll read through sample scenarios provide suggestions for what a provider should/could say to the clients.
50 Where to get FCs FHC FC2 finder Text“findFC2” toIndividuals can buy FCs at select WalgreensVisit stores near that stock themOrder them onlineAgencies, clinics, Chicago businesses, & others who participate in the Chicago Community Condom Projects/svcs/get_free_condomsatoneofourstispecialtyclinics.html
51 Insurance coverage of FCs Private health insurance and Illinois Medicaid cover female condomsHOWEVER, commercial availability is woefully limitedSelect Walgreens stores stock FC2sDoes your organization have a clinic or pharmacy?If so, does it stock FC2s?
52 Getting FCs for your community IDPH-go through lead agentChicago Community Condom ProjectRun by CDPHAccess MCs and FCs for free!Contact Marguerite Harrold at to learn how your organization can participate!
53 Chicago Female Condom Campaign Mission: Increase awareness, access, and use of FCsBroad-based coalition including HIV, reproductive health and justice, harm reduction, domestic violence, LGBT, women’s health, youth, and others!Achieve mission through provider trainings, resources, media, & advocacyTrained 400 providers on effective FC promotionPart of a national movement
54 The FC movement is growing Chicago is one of 7 cities with an FC program and is leading advocacy and education effortsAtlantaHoustonLos AngelesNew YorkSan FranciscoWashington, DC
55 Chicago Female Condom Campaign Available resources:TrainersBrochuresPalmcardsTips for providersPowerPointRingOnIt.orgFacebook & Twitter
56 When you return to your agency Assess how your agency makes FCs availableSee how visible FCs areAsk your colleagues how they talk about FCsDetermine if staff near the FC bin know FC basicsPair information gathered with what you learned today to create a pro-FC culture at your agency
57 Create pro-FC culture at your agency/clinic Make FCs visibleInclude FCs in prevention conversationsMake FC materials availableShare what you learned with colleagues;Encourage participation in FC trainingsGlobal Female Condom Day!What will you do with what you learned today?
58 Next stepsWhat next step do you commit to taking when YOU return to your agency?How will you share what you learned today?Complete training evaluationPick up materialsEndorse the campaign!Be a part of Global Female Condom Day!
59 Post-test Let’s see what you learned today! Write your same number at the top of the test.
60 Post-testThe female condom is a barrier method that reduces a person’s risk of unplanned pregnancy and sexually transmitted infections (STIs), including HIV.TRUEThe FC2 female condom is latex-free and pre-lubricated with a silicone-based lubricant.The female condom can be used together with the male condom.FALSE
61 Post-testThe FC2 female condom can be used safely for vaginal sex without the inner ring.FALSE5. The female condom is Food and Drug Administration (FDA) for both vaginal and anal sex.The U.S. Food and Drug Administration (FDA) approved using the FC2 female condom more than once.
62 Post-test7. Understanding the female reproductive system and the location of the cervix helps women properly insert a female condom.TRUE8. The FC2 female condom is inserted properly into the vaginal opening by squeezing the inner ring with your thumb and middle finger or twisting he outer ring into a figure 8.9. The FC2 is currently the only female condom available in the U.S.