Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak — Puerto Rico, 2016

Published on Apr 1, 2016in Morbidity and Mortality Weekly Report13.606
· DOI :10.15585/MMWR.MM6512E1
Naomi K. Tepper25
Estimated H-index: 25
Howard I. Goldberg14
Estimated H-index: 14
+ 19 AuthorsDenise J. Jamieson97
Estimated H-index: 97
Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes including pregnancy loss intrauterine growth restriction eye defects congenital brain abnormalities and other fetal abnormalities (12). The virus has also been determined to be sexually transmitted.* Because of the potential risks associated with Zika virus infection during pregnancy CDC has recommended that health care providers discuss prevention of unintended pregnancy with women and couples who reside in areas of active Zika virus transmission and do not want to become pregnant.(dagger) However limitations in access to contraception in some of these areas might affect the ability to prevent an unintended pregnancy. As of March 16 2016 the highest number of Zika virus disease cases in the United States and U.S. territories were reported from Puerto Rico.( section sign) The number of cases will likely rise with increasing mosquito activity in affected areas resulting in increased risk for transmission to pregnant women. High rates of unintended and adolescent pregnancies in Puerto Rico suggest that in the context of this outbreak access to contraception might need to be improved (34). CDC estimates that 138000 women of reproductive age (aged 15-44 years) in Puerto Rico do not desire pregnancy and are not using one of the most effective or moderately effective contraceptive methods( paragraph sign)()** and therefore might experience an unintended pregnancy. CDC and other federal and local partners are seeking to expand access to contraception for these persons. Such efforts have the potential to increase contraceptive access and use reduce unintended pregnancies and lead to fewer adverse pregnancy and birth outcomes associated with Zika virus infection during pregnancy. The assessment of challenges and resources related to contraceptive access in Puerto Rico might be a useful model for other areas with active transmission of Zika virus.
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