ZIKV-Related Ideations and Modern Contraceptive Use: Cross-Sectional Evidence from the Dominican Republic, El Salvador, Honduras, and Guatemala

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  • 1 Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana;
  • | 2 Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana;
  • | 3 College of Public Health, Temple University, Philadelphia, Pennsylvania;
  • | 4 Louisiana Department of Health, Office of Public Health, Baton Rouge, Louisiana;
  • | 5 The Population Council, New York, New York

Zika virus (ZIKV) can be sexually transmitted and can lead to severe neonatal and child health issues. The current study examines whether ZIKV-related ideational factors, including awareness of ZIKV and associated birth defects, are related to modern contraceptive use among women and men with sexual partners in four Latin American and Caribbean (LAC) countries. Data used are from cross-sectional household surveys conducted in 2018 in the Dominican Republic, El Salvador, Guatemala, and Honduras with representative samples of men and women aged 18–49 (N = 1,100). The association between self-reported use of modern contraception and measures of Zika knowledge, risk perceptions and social norms, and contraceptive self-efficacy was examined via sex disaggregated multivariate logistic regression models. Both men (OR 3.70, 95% CI 1.36–10.06, P < 0.05) and women (OR 3.71, 95% CI 2.30–5.99, P < 0.0001), who reported discussing family planning with their partner in the last year were more likely to use modern contraception compared with those who did not. Contrary to our hypothesis, knowledge that ZIKV can affect a fetus was negatively associated with modern contraceptive use for women (OR 0.49, 95% CI 0.29–0.85, P < 0.05). Given the cross-sectional nature of the survey, women not using contraception may be more likely to remember that ZIKV can affect a fetus. In the event of a related outbreak, future health promotion and communication efforts in LAC should focus on known determinants of modern contraceptive use, such as knowledge and partner communication, and knowledge of the health effects of ZIKV if pregnant, to influence family planning decision-making behavior.

Author Notes

Address correspondence to Julia M. Fleckman, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Suite 2210, New Orleans, LA. E-mail: jfleckma@tulane.edu

Financial support: Funding for the current study was provided by the United States Agency for International Development (USAID) as part of the ongoing social and behavior change research and evaluation project, Breakthrough RESEARCH. Breakthrough RESEARCH is made possible by the generous support of the American people through USAID under the terms of cooperative agreement no. AID-OAA-A-17-0018. The contents of this manuscript are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the United States Government.

Authors’ addresses: Julia M. Fleckman, Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mail: jfleckma@tulane.edu. Martha Silva and Paul Hutchinson, Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mail: msilva3@tulane.edu and phutchin@tulane.edu. Jeni Stolow, College of Public Health, Temple University, Philadelphia, PA, E-mail: jeni.stolow@temple.edu. Kendra LeSar, Lousiana Department of Health, Office of Public Health, Baton Rouge, LA, E-mail: kendra.lesar@la.gov. Kathryn Spielman, The Population Council, New York, NY, E-mail: kspielman@popcouncil.org.

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