| 1. |
Have you had unprotected sex at least once? |
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| 2. |
Do you have unprotected sex at least once monthly? |
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| 3. |
Do you use a condom every time you have sex? |
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| 4. |
Do you use any form of contraceptive? |
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| 5. |
Have you used this contraceptive consistently in the last month? |
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| 6. |
Have you had more than one sexual partner? |
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| 7. |
Has your partner had other partners? |
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| 8. |
Are you uncertain as to when during her cycle a woman can get pregnant? |
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