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Volume 25, Number 11—November 2019
Dispatch

Preventing Sexual Transmission of Zika Virus Infection during Pregnancy, Puerto Rico, USA, 20161

Beatriz Salvesen von EssenComments to Author , Katie Kortsmit, Lee Warner, Denise V. D’Angelo, Holly B. Shulman, Wanda Hernández Virella, Aspy Taraporewalla, Leslie Harrison, Sascha Ellington, Carrie Shapiro-Mendoza, Wanda Barfield, Ruben A. Smith, Denise J. Jamieson, Shanna Cox, Karen Pazol, Patricia García Díaz, Beatriz Ríos Herrera, Manuel Vargas Bernal, on behalf of the Puerto Rico Department of Health, and the Women’s Health and Fertility Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B. Salvesen von Essen, K. Kortsmit, L. Warner, D.V. D’Angelo, H.B. Shulman, A. Taraporewalla, L. Harrison, S. Ellington, C. Shapiro-Mendoza, W. Barfield, R.A. Smith, S. Cox, K. Pazol); Puerto Rico Department of Health, San Juan, Puerto Rico, USA (B. Salvesen von Essen, W. Hernández Virella, P. García Díaz, B. Ríos Herrera, M. Vargas Bernal); Emory University School of Medicine, Atlanta (D.J. Jamieson)

Main Article

Table 2

Adjusted prevalence estimates and ratios of self-reported condom use during pregnancy by maternal characteristics and receipt of provider counseling on condom use during pregnancy, Pregnancy Risk Assessment Monitoring System–Zika Postpartum Emergency Response Study, Puerto Rico, USA, 2016*

Characteristic Total, n = 1,794†
Any condom use
Consistent condom use
% Respondents (95% CI)‡ Crude PR (95% CI) Adjusted PR (95% CI)§ % Respondents (95% CI)‡ Crude PR (95% CI) Adjusted PR (95% CI)§
Age, y
<19 51.5
(43.9–59.0) 1.62
(1.29–2.04) 1.22
(0.96–1.54) 24.5
(18.3–31.9) 1.68
(1.12–2.53) 1.13
(0.73–1.75)
20–34 41.8
(39.3–44.3) 1.16
(0.95–1.40) 0.99
(0.82–1.18) 20.4
(18.4–22.5) 1.12
(0.80–1.57) 0.94
(0.67–1.31)
>35
42.4
(35.3–49.8)
Referent¶
Referent

21.7
(15.8–29.1)
Referent#
Referent
Education level
High school or less 46.8
(42.4–51.4) 1.24
(1.12–1.38) 1.14
(1.02–1.27) 25.2
(21.5–29.2) 1.40
(1.17–1.69) 1.31
(1.07–1.60)
More than high school
41.1
(38.6–43.7)
Referent
Referent

19.2
(17.1–21.5)
Referent
Referent
Marital status during pregnancy
Unmarried 41.4
(38.8–44.1) 1.03
(0.92–1.15) 0.91
(0.82–1.02) 20.4
(18.4–22.7) 1.05
(0.88–1.26) 0.93
(0.78–1.10)
Married
45.3
(41.4–49.3)
Referent
Referent

22.0
(18.9–25.3)
Referent
Referent
Prenatal WIC program participation
Yes, did not receive a Zika 
prevention kit 41.6
(34.9–48.6) 1.32
(1.02–1.71) 1.29
(0.99–1.68) 18.7
(14.1–24.3) 1.08
(0.72–1.61) 0.96
(0.64–1.43)
Yes, received a Zika prevention kit 44.5
(41.9–47.1) 1.52
(1.23–1.87) 1.38
(1.12–1.70) 21.4
(19.3–23.7) 1.36
(1.00–1.86) 1.10
(0.80–1.51)
No
32.3
(26.2–39.0)
Referent
Referent

19.5
(14.4–26.0)
Referent
Referent
Prepregnancy condom use
Yes 64.7
(57.5–71.2) 1.64
(1.45–1.85) 1.60
(1.42–1.80) 34.7
(28.2–41.9) 1.84
(1.48–2.28) 1.78
(1.44–2.21)
No**
40.5
(38.2–42.8)
Referent
Referent

19.5
(17.7–21.4)
Referent
Referent
Received counseling on condom use to prevent Zika
Yes 45.9
(43.4–48.4) 2.57
(1.99–3.32) 2.25
(1.73–2.91) 22.8
(20.9–25.0) 3.28
(2.12–5.09) 3.07
(1.97–4.79)
No 20.4
(15.7–26.0) Referent Referent 7.4
(4.8–11.4) Referent Referent

*PR, prevalence ratio; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.
†Unweighted sample size.
‡Adjusted weighted percentage.
§All prevalence and prevalence ratio estimates were adjusted for maternal age, education, marital status, prenatal WIC participation, receipt of provider counseling, infant birth month, and region.
¶Adjusted p value (<0.01) for linear trend based on maternal age.
#Adjusted p value (<0.05) for linear trend based on maternal age.
**Included women who reported they were not doing anything to prevent pregnancy and women who were using a contraceptive method other than condoms to prevent pregnancy.

Main Article

1Preliminary results from this study were presented at the 2018 American Public Health Association Annual Meeting in San Diego, California, USA, November 10–14, 2018.

Page created: October 15, 2019
Page updated: October 15, 2019
Page reviewed: October 15, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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