Few women in states at risk for the Zika virus are using the most effective forms of contraception and states should do more to facilitate contraceptive access, according to a CDC report published Tuesday, STAT News reports (Branswell, STAT News, 8/2).
Background on Zika virus
The Zika virus is not easily diagnosed, and it does not have a cure or vaccine. It is linked to the birth defect microcephaly, a condition in which an infant is born with an abnormally small head and brain. The condition is fatal for some infants, while others experience permanent disabilities.
The virus is most commonly transmitted by a bite from an infected mosquito, but it can also spread through sexual activity.
As of July 27, CDC reports that there have been 1,658 cases of Zika in the continental United States and 4,750 cases in U.S. territories. U.S. health officials do not anticipate an outbreak in this country similar to outbreaks seen in Latin America and the Caribbean.
In Florida, officials have identified several cases of Zika virus that was likely transmitted by local mosquitos. CDC has issued an advisory directing pregnant women to avoid the Miami neighborhood where officials believe the mosquitos are present (Women's Health Policy Report, 8/2).
Key findings
CDC's report is based on data from four surveillance systems monitoring contraceptive use in the United States.
In terms of overall contraceptive use, the researchers found that between 12.3 percent and 34.3 percent of women at risk for unintended pregnancy did not use any form of birth control (STAT News, 8/2). For example, the researchers found that the rate of women ages 18 to 44 who did not use contraception at last instance of sexual intercourse was 18.7 percent in Mississippi, 26.1 percent in Texas and 27.5 percent in Florida.
The researchers also examined contraceptive use among young women in high school and found that the rate of sexually active high school-age women who did not use contraception at last instance of sexual intercourse ranged from 7.3 percent to 22.8 percent. The researchers determined that the rate of sexually active high school-age women who used no contraception at last instance of sexual intercourse was 14 percent in Mississippi, 16.5 percent in Florida and 18.5 percent in Alabama (Leonard, U.S. News & World Report, 8/2).
Among young women in high school, the researchers found that the rate of LARC use at last sexual intercourse ranged from 1.7 percent to 8.4 percent (STAT News, 8/2). According to the study, the rate of high school-age women who used LARC was 2 percent in Florida, 2.9 percent in Alabama and 4.8 percent in Mississippi (U.S. News & World Report, 8/2).
CDC urges states to facilitate contraceptive access
In the report, CDC advised states to remove barriers to and promote use of LARC. According to the agency, states could help women access LARC by revising limited provider reimbursement policies, bolstering provider training and boosting access to services aimed at teenagers.
Denise Jamieson -- co-leader of the CDC's Zika pregnancy and birth defects team and co-author of the report -- said, "Zika provides a context where preventing unintended pregnancy and planning pregnancies becomes even more critical."
Jamieson continued, "I think Zika really highlights the importance of providing the full range of contraceptive methods and making access to those methods for women and their partners who want them … readily available." She added, "Contraception to prevent unintended pregnancies should actually be considered a medical countermeasure for Zika" (STAT News, 8/2).
Federal officials cite need for Zika funding
In related news, federal health officials on Tuesday said they had distributed more stopgap funding to Zika response efforts across the United States while waiting on additional federal allocations, Reuters reports.
According to Reuters, CDC's announcement came amid calls from several lawmakers for Congress to temporarily reconvene during the recess period to pass a Zika-response funding measure.
Background
The White House in February called for $1.9 billion to combat the virus (Grover et al., Reuters, 8/2). However, Congress failed to send a funding measure to the president before leaving last month for a seven-week recess. Existing funding for Zika response efforts is expected to run out in late July or early August, according to HHS Secretary Sylvia Mathews Burwell (Women's Health Policy Report, 8/2).
The Obama administration said $201 million of the $374 million reallocated in April for Zika has been spent. According to The Hill, CDC has used about half of the $222 million it had available (Ferris, The Hill, 8/2).
CDC allocates additional stopgap funding
CDC on Tuesday announced that it has awarded more than $16 million in funding to 35 states and five territories to monitor Zika-related fetal anomalies, such as microcephaly (Reuters, 8/2). According to The Hill, the funding will be distributed to states and territories experiencing or at risk of local Zika transmission.
CDC Director Thomas Frieden in a statement said, "It is critical to identify infants with birth defects related to Zika virus so we can support them and their families" (The Hill, 8/2). However, agency officials noted that the funding allocations are only "a stopgap diverted from other public health resources until Zika funds are provided by Congress" (Reuters, 8/2).
According to The Hill, CDC officials have emphasized the need for strong systems for tracking Zika transmissions, reiterating that there is a lack of medical understanding of the disease (The Hill, 8/2).
NIH begins Zika vaccine trial
In other related news, NIH on Wednesday announced that researchers have launched a clinical trial for an experimental Zika vaccine, USA Today reports. According to USA Today, the trial follows Inovio Pharmaceuticals' study of a Zika vaccine that was launched last month.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the researchers started the NIH Zika trial on Tuesday, one month earlier than scheduled. The early launch followed news of the cases of likely local transmission of Zika in Florida.
According to Fauci, researchers will test the vaccine on 80 healthy volunteers between the ages of 18 and 35 at three locations throughout the United States. Volunteers will receive varying doses of the active vaccines, and none will receive a placebo.
Pending positive results from the current study, Fauci added that the agency would follow up with a larger study in a territory or country affected by the virus as soon as January. However, Fauci expressed concerns about the funding impasse on Zika response efforts, noting that NIH might run out of funds before the larger study could begin.
Fauci noted that if the vaccine shows success, it would be offered to reproductive-age women and girls, as well as their sexual partners. He explained that vaccinating women would shield a fetus from the virus if a woman became pregnant, while vaccinating men would protect future sexual partners from possible infection.
Fauci said, "A safe and effective vaccine to prevent Zika virus infection and the devastating birth defects it causes is a public health imperative." He added, "Results in animal testing have been very encouraging. We are pleased that we are now able to proceed with this initial study in people" (Szabo, USA Today, 8/3).
Fla. gov. calls for no-cost Zika testing for pregnant women
Florida Gov. Rick Scott (R) on Wednesday issued an order mandating that county health departments provide Zika testing kits at no cost for pregnant women in the state, the AP/Sacramento Bee reports.
Scott said the state would bolster lab services to help meet the projected increase in demand and ensure timely processing of test results. According to the AP/Bee, the order does not apply to private providers. Scott added that the state will bolster mosquito control efforts as well, including spraying.
The announcement follows reports from physicians that increased demand for Zika testing has strained capacity, forcing them to decline testing requests from some pregnant women. Overall, according to Scott, more than 2,400 state residents have been tested for the virus, including more than 140 individuals from the Wynwood area of the state, where local transmission was first reported.
Separately, electronic health records vendor Athenahealth said it is collaborating with local health centers to contact patients who may be at risk for Zika and urge them to come in for testing. The vendor said it has identified about 1,800 at-risk patients in the area (Kennedy, AP/Sacramento Bee, 8/3).
