Describe how a diaphragm functions as a barrier method of contraception and name one practical step needed when using it.
(Total for Question 1 is 2 marks)
2
State two reasons why a young person might be encouraged to use condoms even if they or their partner are using a hormonal method such as the pill or implant.
(Total for Question 2 is 2 marks)
3
Describe briefly how male condoms act as a barrier method of contraception and give one additional health benefit of correct condom use.
(Total for Question 3 is 2 marks)
4
Compare the condom and the diaphragm as barrier methods of contraception, stating one similarity and one difference in how they are used or how they protect against pregnancy or infection.
(Total for Question 4 is 3 marks)
5
Describe two routes by which HIV can be transmitted between people, and state one common way HIV is not transmitted.
(Total for Question 5 is 2 marks)
6
Describe three ways in which health education in a community can reduce the spread of sexually transmitted infections such as HIV.
(Total for Question 6 is 3 marks)
7
Describe how the use of barrier contraception during sexual intercourse can reduce transmission of blood-borne STIs in situations where there are genital sores or bleeding.
(Total for Question 7 is 2 marks)
8
Describe the basic way the combined contraceptive pill prevents pregnancy, naming the type of substance the pill contains and its main effect on ovulation.
(Total for Question 8 is 2 marks)
9
State briefly what is meant by sterilisation as a surgical method of contraception and name one advantage and one disadvantage of sterilisation.
(Total for Question 9 is 2 marks)
10
Describe how a contraceptive implant works and give one reason why it is considered more effective than the rhythm method.
(Total for Question 10 is 2 marks)
11
Evaluate, with reference to effectiveness, user-dependence and protection against STIs, the use of hormonal methods (for example the pill or implant) compared with barrier methods (for example condoms).
Extended response: evaluate hormonal versus barrier contraception.
(Total for Question 11 is 6 marks)
12
A public health team must decide between investing in free condom distribution or in subsidised long-acting hormonal implants for reducing unintended pregnancies and STIs in a town. Using evidence-based reasoning, suggest a combined strategy the team could recommend and justify it with two reasons.
(Total for Question 12 is 5 marks)
Mark scheme · 1.6 Methods of Birth Control and Sexually Transmitted Infections
Question 1
B1 function: the diaphragm is placed over the cervix to block sperm entering the uterus
B1 practical step: must be inserted before intercourse and often used with spermicide, left in place for a specified time afterwards
Answer: Diaphragm covers the cervix to block sperm; it must be inserted before intercourse and left in place for the recommended time
Question 2
B1 reason 1: condoms provide protection against STIs which hormonal methods do not
B1 reason 2: condoms provide backup protection if the hormonal method fails or is not used correctly
Answer: Because condoms protect against STIs while hormonal methods do not, and as backup protection if the hormonal method fails or is used incorrectly
Question 3
B1 barrier action: a condom covers the penis and collects semen, preventing sperm entering the vagina
B1 additional benefit: reduces transmission of sexually transmitted infections such as HIV
Answer: Condoms cover the penis and trap semen so sperm cannot enter the vagina; they also reduce STI transmission including HIV
Question 4
B1 similarity: both act as a physical barrier to stop sperm reaching the egg
B1 difference: condom covers the penis and also reduces STI transmission, diaphragm covers the cervix and does not protect against STIs
B1 difference in use: condom is used at the time of intercourse and removed afterwards, diaphragm must be inserted before intercourse and left in place for a specified time
Answer: Both block sperm physically; condoms cover the penis and also reduce STI transmission while diaphragms cover the cervix and do not protect against STIs; condoms are used and removed at intercourse, diaphragms are inserted beforehand and left in place afterwards
Question 5
B1 route 1: unprotected sexual intercourse involving exchange of bodily fluids
B1 route 2: sharing contaminated needles or blood transfusion with infected blood
Answer: HIV can be transmitted by unprotected sex with exchange of bodily fluids and by sharing contaminated needles or infected blood; it is not spread by casual contact such as hugging or sharing food
Question 6
B1 education can encourage correct and consistent condom use among sexually active people
B1 education can promote testing and early treatment so infected people are identified and counseled to reduce further spread
B1 education can raise awareness about transmission routes and safer behaviours, reducing risky practices
Answer: Health education can encourage condom use, promote testing and treatment, and raise awareness of transmission routes to reduce risky behaviour
Question 7
B1 barrier contraception prevents contact between the partners body fluids and skin with sores, reducing blood to blood or fluid transfer
B1 this lowers the chance that viruses in blood or sores are passed from one person to another
Answer: Barrier contraception prevents contact between body fluids and skin with sores, so blood to blood or fluid transfer is reduced and the chance of transmitting blood-borne STIs falls
Question 8
B1 contains hormones (oestrogen and progesterone or progestogen)
B1 main effect: prevents ovulation so no egg is released
Answer: Contains hormones (oestrogen and progesterone or progestogen) and prevents ovulation, so no egg is released
Question 9
B1 definition: a surgical operation that permanently prevents gametes meeting, for example cutting or blocking the fallopian tubes or sperm ducts
B1 one advantage and one disadvantage: advantage could be permanent and highly effective; disadvantage could be that it is usually irreversible and does not protect against STIs
Answer: Sterilisation is a surgical operation that permanently prevents gametes meeting, for example cutting or blocking the fallopian tubes or sperm ducts; advantage: permanent and highly effective, disadvantage: usually irreversible and gives no STI protection
Question 10
B1 implant: a small device inserted under the skin releases hormones over a long period to prevent ovulation or thicken cervical mucus
B1 reason: effectiveness is higher because the implant provides continuous hormone release and does not rely on user timing or daily action
Answer: Implant is inserted under the skin and releases hormones to stop ovulation or thicken cervical mucus; it is more effective because it gives continuous protection and does not depend on timing
Question 11
Level 1 (1-2): Simple statements about one or two features of hormonal and barrier methods, with little comparison or justification.
Level 2 (3-4): Comparative points made about effectiveness and user-dependence with some explanation, and a brief mention of STI protection differences.
Level 3 (5-6): Clear evaluation comparing effectiveness, user-dependence and STI protection. Reaches a balanced judgement supported by reasons and examples.
Indicative content:
Hormonal methods typically have high effectiveness when used correctly because they prevent ovulation or change mucus, and implants are long acting so reduce user error
Pills can be less effective if doses are missed, so they are more user-dependent than implants
Barrier methods like condoms are less effective than perfect-use hormonal implants but are effective in typical use if used correctly every time
Condoms provide protection against STIs including HIV, whereas hormonal methods do not protect against STIs
Consideration of side effects and acceptability may influence effectiveness in practice because users stop or misuse methods
A judgement might conclude that implants are best for preventing pregnancy while condoms are necessary when STI protection is required, so the best option depends on priorities
Question 12
B1 suggests combined strategy eg provide free condoms widely and subsidise implants for those who want long-acting pregnancy prevention
B1 justification 1: condoms reduce STI transmission immediately and are accessible, tackling infections
B1 justification 2: implants reduce unintended pregnancy effectively because they reduce user error, lowering pregnancy rates long term
B1 justification 3: combined approach allows individuals to choose according to priorities, and pairing both reduces both pregnancy and STI rates
B1 explicit consideration of cost or implementation logistics or equity, for example targeting implants to those who want long-term contraception while keeping condoms free for general population
Answer: Provide free condoms for everyone to reduce STI spread and offer subsidised implants to those who want reliable long-term pregnancy prevention; this tackles both infections and unintended pregnancy, allows choice and can be targeted to those most in need