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

Boulet, Sheree L.; D’Angelo, Denise V.; Morrow, Brian; Zapata, Lauren B.; Berry-Bibee, Erin; Rivera, María I.; Ellington, Sascha; Romero, Lisa; Lathrop, Eva; Frey, Meghan; Williams, Tanya L.; Goldberg, Howard I.; Warner, Lee; Harrison, Leslie; Cox, Shanna; Pazol, Karen; Barfield, Wanda D.; Jamieson, Denise J.; Honein, Margaret A.; Kroelinger, Charlan D.

doi:10.15585/mmwr.mm6530e2

Cited by 45 publications

(34 citation statements)

References 9 publications

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“…Puerto Rico (4), and on 1 August 2016, local transmission was confirmed in Miami, Florida (5). The ongoing ZIKV epidemic has been accompanied by several severe clinical manifestations, including Guillain-Barré syndrome (6) and congenital malformations in the fetuses of women infected with ZIKV during pregnancy (7).…”

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confidence: 99%

Development and Characterization of Recombinant Virus Generated from a New World Zika Virus Infectious Clone

Weger-Lucarelli

Duggal

Bullard-Feibelman

et al. 2017

J Virol

112

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Zika virus (ZIKV; family Flaviviridae, genus Flavivirus) is a rapidly expanding global pathogen that has been associated with severe clinical manifestations, including devastating neurological disease in infants. There are currently no molecular clones of a New World ZIKV available that lack significant attenuation, hindering progress toward understanding determinants of transmission and pathogenesis. Here we report the development and characterization of a novel ZIKV reverse genetics system based on a 2015 isolate from Puerto Rico (PRVABC59). We generated a two-plasmid infectious clone system from which infectious virus was rescued that replicates in human and mosquito cells with growth kinetics representative of wildtype ZIKV. Infectious clone-derived virus initiated infection and transmission rates in Aedes aegypti mosquitoes comparable to those of the primary isolate and displayed similar pathogenesis in AG129 mice. This infectious clone system provides a valuable resource to the research community to explore ZIKV molecular biology, vaccine development, antiviral development, diagnostics, vector competence, and disease pathogenesis.IMPORTANCE ZIKV is a rapidly spreading mosquito-borne pathogen that has been linked to Guillain-Barré syndrome in adults and congenital microcephaly in developing fetuses and infants. ZIKV can also be sexually transmitted. The viral molecular determinants of any of these phenotypes are not well understood. There is no reverse genetics system available for the current epidemic virus that will allow researchers to study ZIKV immunity, develop novel vaccines, or develop antiviral drugs. Here we provide a novel infectious clone system generated from a recent ZIKV isolated from a patient infected in Puerto Rico. This infectious clone produces virus with in vitro and in vivo characteristics similar to those of the primary isolate, providing a critical tool to study ZIKV infection and disease.

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confidence: 99%

Development and Characterization of Recombinant Virus Generated from a New World Zika Virus Infectious Clone

Weger-Lucarelli

Duggal

Bullard-Feibelman

et al. 2017

J Virol

112

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“…8,9 Although only an estimated 11% of parous US women, 15–44 years old, use LARC, 10 use among postpartum women is higher (7–31%). 11 Therefore, providing LARC immediately after birth can further improve effectiveness. However, reasons for low immediate postpartum LARC uptake are complex.…”

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confidence: 99%

Policy change is not enough: engaging provider champions on immediate postpartum contraception

Okoroh

Kane

Gee

et al. 2018

American Journal of Obstetrics and Gynecology

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Rates of short-interval pregnancies that result in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception methods have annual failure rates of <1%, compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to long-acting reversible contraception in the immediate postpartum period, several State Medicaid programs, which include those in Iowa and Louisiana, recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum long-acting reversible contraception insertion. We used a mixed-methods approach to analyze 2013–2015 linked Medicaid and vital records data from both Iowa and Louisiana and to describe trends in immediate postpartum long-acting reversible contraception provision 1 year before and after the Medicaid reimbursement policy change. We also used data from key informant interviews with state program staff to understand how provider champions affected policy uptake. We found that the monthly average for the number of insertions in Iowa increased from 4.6 per month before the policy to 6.6 per month after the policy; in Louisiana, the average number of insertions increased from 2.6 per month before the policy to 45.2 per month. In both states, the majority of insertions occurred at 1 academic/teaching hospital. In Louisiana, the additional increase may be due to the engagement of a provider champion who worked at both the state and facility level. Recruiting, training, engaging, and supporting provider champions, as facilitators, with influence at state and facility levels, is an important component of a multipart strategy for increasing successful implementation of state-level Medicaid payment reform policies that allow reimbursement for immediate postpartum long-acting reversible contraception insertions.

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“…Because of this eligibility criterion, our results are not generalizable to sexual-minority women who may 1) be in same-sex relationships and perceive no need for contraception services; 2) avoid clinical settings because of previous negative interactions; or 3) are currently or would like to become pregnant in the next year. Our sample is also drawn from women in Salt Lake County, which has some unique characteristics, including some of the highest rates of IUD and implant use in the nation [21]. Finally, while we assessed gender identity in the study, only 16 participants identified as transgender or gender-nonconforming, thus we did not analyze differences by gender identity.…”

Section: Discussionmentioning

confidence: 99%

One in three: challenging heteronormative assumptions in family planning health centers

et al. 2018

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Objectives: To estimate the prevalence of sexual-minority women among clients in family planning centers and explore differences in LARC uptake by both sexual identity (i.e., exclusively heterosexual, mostly heterosexual, bisexual, lesbian) and sexual behavior in the past 12 months (i.e., only male partners, both male and female partners, only female partners, no partners) among those enrolled in the survey arm of the HER Salt Lake Contraceptive Initiative. Methods: This survey categorized participants into groups based on reports of sexual identity and sexual behavior. We report contraceptive uptake by these factors, and we used logistic and multinomial logistic models to assess differences in contraceptive method selection by sexual identity and behavior. Results: Among 3901 survey respondents, 32% (n=1230) identified with a sexual-minority identity and 6% had had a female partner in the past 12 months. By identity, bisexual and mostly heterosexual women selected an IUD or implant more frequently than exclusively heterosexual women and demonstrated a preference for the copper T380 IUD. Exclusively heterosexual and lesbian women did not differ in their contraceptive method selection, however, by behavior, women with only female partners selected IUDs or implants less frequently than those with only male partners. Conclusion: One in three women attending family planning centers for contraception identified as a sexual minority. Sexual-minority women selected IUDs or implants more frequently than exclusively heterosexual women. Implications: Providers should avoid care assumptions based upon sexual identity. Sexual-minority women should be offered all methods of contraception and be provided with inclusive contraceptive counseling conversations.

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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

Cited by 45 publications

References 9 publications

Development and Characterization of Recombinant Virus Generated from a New World Zika Virus Infectious Clone

Development and Characterization of Recombinant Virus Generated from a New World Zika Virus Infectious Clone

Policy change is not enough: engaging provider champions on immediate postpartum contraception

One in three: challenging heteronormative assumptions in family planning health centers

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