04 Aug CDC Urges Wider Availability of Contraceptives In Regions Affected by Zika
MedicalResearch.com Interview with:
Charlan D. Kroelinger, PhD
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Zika virus infection during pregnancy can cause microcephaly and other severe fetal brain defects. Doctors have also found other problems in pregnancies and among infants infected with Zika virus before birth, such as absent or poorly developed brain structures, defects of the eye, hearing deficits, and impaired growth. Nearly half of all pregnancies in the United States are unintended. Increased access to birth control may lead to reductions in unintended pregnancies, which may result in fewer adverse pregnancy and birth outcomes in the context of a Zika virus outbreak.
A new report from CDC estimates that use of highly effective, reversible forms of birth control, called long-acting reversible contraception (LARC), which includes intrauterine devices (IUDs) and implants, remains lower than use of moderate or less effective methods such as oral contraceptive pills and condoms, although contraception use varied across states and by age group and race/ethnicity.
CDC scientists used data from four state-based surveillance systems to estimate contraception use for non-pregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students who live in states with the potential for local Zika virus transmission. Less than one in four sexually active women of reproductive age and fewer than one in 10 sexually active female high school students reported using LARC. A higher percentage of postpartum women reported LARC use. Moderately effective and less effective contraceptive methods, including pills, patches, rings, injections, condoms and other barrier methods, were used more frequently than highly effective methods. These estimates are of concern because the most commonly used methods of contraception are not as effective at preventing unintended pregnancy.
MedicalResearch.com: What should readers take away from your report?
Response: Efforts to increase availability of and access to the full range of FDA-approved contraceptive methods, especially highly effective methods, can reduce unintended pregnancies among women who wish to delay or avoid pregnancy and may lead to fewer adverse pregnancy and birth outcomes during a Zika virus outbreak. In areas with potential Zika virus transmission, the full range of FDA-approved contraceptive methods, including LARC, should be available and accessible for women and couples who want to delay or avoid pregnancy. States and local jurisdictions can implement strategies to increase access to contraceptive services to reduce unintended pregnancies among women who may be exposed to Zika virus.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: CDC collects surveillance data from states to better understand behaviors and experiences of adults and youth in the U.S. and territories. All of these surveillance systems regularly publish reports on health behaviors. In this report, only 39 of the 41 states with the potential for local Zika virus transmission had data from at least one surveillance system, suggesting a continued need for ongoing collection of state-level data on contraceptive use.
MedicalResearch.com: Is there anything else you would like to add?
Response: Effective contraception use is a primary strategy to prevent poor pregnancy and birth outcomes linked to Zika infection during pregnancy. Barriers to the access and availability of contraception may include high device costs, limited provider reimbursement, lack of training for providers serving women and female adolescents on insertion and removal of LARC, provider lack of knowledge and misperceptions about LARC, limited availability of youth friendly services that address adolescent confidentiality concerns, limited client-centered counseling, and low consumer awareness of the range of contraceptive methods available. State and local jurisdictions can implement strategies to remove barriers to the access and availability of highly effective long acting reversible contraception (LARC).
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Boulet SL, D’Angelo DV, Morrow B, et al. Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness — United States, 2011–2013 and 2015. MMWR Morb Mortal Wkly Rep. ePub: 2 August 2016.
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