EXECUTIVE SUMMARY

The CDC has updated its guidance on prevention of the Zika virus, calling for women and men who are planning to become pregnant in the near future to consider avoiding nonessential travel to areas with active Zika virus transmission.

  • The CDC suggests that LARC methods represent the most effective type of reversible birth control for women.
  • The CDC guidance also increases the amount of time for men with possible Zika exposure but without symptoms to use a condom from at least eight weeks to at least six months after last possible exposure.

The CDC has updated its guidance on prevention of the Zika virus, calling for women and men who are planning to become pregnant in the near future to consider avoiding nonessential travel to areas with active Zika virus transmission.1

The guidance also extends the amount of time to wait to attempt conception for couples in which the man has had possible Zika exposure but no Zika symptoms from at least eight weeks to at least six months, as well as increases the amount of time to for men with possible Zika exposure but without symptoms to use a condom from at least eight weeks to at least six months after last possible exposure.1

Public health officials previously recommended that men with possible Zika virus exposure who were asymptomatic wait at least eight weeks from last possible exposure. The recommendation to wait at least six months for asymptomatic men is based on the range of time after symptom onset that Zika virus ribonucleic acid has been detected in semen of symptomatic men and the absence of definitive data that the risk for sexual transmission differs between symptomatic and asymptomatic men.1

Use Effective Contraception

Helping women who want to delay or avoid pregnancy during the Zika virus outbreak is a primary strategy to reduce Zika-related adverse pregnancy and birth outcomes, says the CDC. The best way to reduce the risk of unintended pregnancy is to counsel sexually active women and their partners to correctly and consistently use effective birth control.

LARC represents the most effective type of reversible birth control. To increase access to and availability of LARC, state- and jurisdictional-level-strategies can be implemented by state, local, and territorial agencies, health systems, and healthcare providers.

The seven strategies to increase access to LARC methods include:

  • train healthcare providers on current insertion and removal techniques for LARC;
  • remove logistical and administrative barriers for contraceptive services and supplies;
  • engage smaller or rural facilities including community healthcare centers;
  • reimburse healthcare providers for the full range of contraceptive services;
  • support youth-friendly reproductive health services;
  • facilitate partnerships among private and public insurers, device manufacturers, and state agencies; and
  • increase consumer awareness of contraception options and assess client satisfaction with service delivery.2

Continue the Course

According to the CDC, clinicians should continue offering the following guidance:

  • Women with possible Zika virus exposure who do not live in areas of active transmission but are thinking about becoming pregnant should wait at least eight weeks before trying to conceive.
  • Women and men who live in areas with active Zika transmission and considering pregnancy in the near future should talk with their healthcare providers about their pregnancy plans during a Zika virus outbreak, the potential risks of Zika, and how they can prevent Zika virus infection during pregnancy.
  • Women with possible Zika virus exposure who are not pregnant and do not plan to become pregnant and their male partners who want to minimize their risk of sexual transmission should use condoms in addition to their chosen birth control method, or not have sex for the same time periods listed for couples planning pregnancy. Couples should be advised that correct and consistent use of condoms reduces the risk for other sexually transmitted infections.
  • Women of reproductive age with possible Zika virus exposure who do not do want to become pregnant should use safe and effective contraception.1

“We are working as hard as we can to learn more about this virus, so that we can develop better strategies to protect mothers and ensure their babies are born healthy,” said Denise Jamieson, MD, chief of the Women’s Health and Fertility Branch, Division of Reproductive Health in the CDC’s National Center for Chronic Disease Prevention and Health Promotion.

In late September 2016, Congress approved a $1.1 billion Zika funding package to further vaccine development, research, and prevention. The package includes $394 million to help control Zika-carrying mosquitoes and another $397 million to help develop a vaccine against the virus and better tests to diagnose cases of Zika. The bill also includes $66 million allocated to healthcare for people affected by Zika in Puerto Rico and other U.S. territories.

“The fight against the spread of Zika cannot be won without the resources to support responsive and proactive solutions,” says Thomas Gellhaus, MD, president of the Washington, DC-based American Congress of Obstetricians and Gynecologists. “This comprehensive funding package is essential to our success and the health of women and babies.”

REFERENCES

  1. Petersen EE, Meaney-Delman D, Neblett-Fanfair R, et al. Update: interim guidance for preconception counseling and prevention of sexual transmission of Zika virus for persons with possible Zika virus exposure -United States, September 2016. MMWR Morb Mortal Wkly Rep 2016; 65:1077-1081.
  2. CDC. Increasing Access to Contraception in the Context of Zika Preparedness. Accessed at http://bit.ly/2e0lxWo.