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Volume 26, Number 11—November 2020
Dispatch

Preventing Vector-Borne Transmission of Zika Virus Infection During Pregnancy, Puerto Rico, USA, 2016–20171

Katherine KortsmitComments to Author , Beatriz Salvesen von Essen, Lee Warner, Denise V. D’Angelo, Ruben A. Smith, Carrie K. Shapiro-Mendoza, Holly B. Shulman, Wanda Hernández Virella, Aspy Taraporewalla, Leslie Harrison, Sascha Ellington, Wanda D. Barfield, Denise J. Jamieson, Shanna Cox, Karen Pazol, Patricia Garcia Díaz, Beatriz Rios Herrera, and Manuel Vargas Bernal
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Kortsmit, B. Salvesen von Essen, L. Warner, D.V. D’Angelo, R.A. Smith, C.K. Shapiro-Mendoza, H.B. Shulman, A. Taraporewalla, L. Harrison, S. Ellington, W.D. Barfield, S. Cox, K. Pazol); Puerto Rico Department of Health, San Juan, Puerto Rico, USA (W. Hernández Virella, P. Garcia Díaz, B. Rios Herrera, M. Vargas Bernal); Emory University School of Medicine, Atlanta (D.J. Jamieson)

Main Article

Table 1

Adjusted weighted prevalence estimates and prevalence ratios of receiving provider counseling on personal protective measures during pregnancy to prevent vector-borne transmission of Zika virus by maternal characteristics, PRAMS-ZPER, Puerto Rico, USA, 2016–2017*

Maternal characteristics Received provider counseling on types of clothes to 
wear to prevent mosquito bites
Received provider counseling about using 
mosquito repellent
2016, n = 2,241†
2017, n = 1,375†
2016, n = 2,244†
2017, n = 1,382†
%‡ aPR (95% CI)‡ %‡ aPR (95% CI)‡ %‡ aPR (95% CI)‡ %‡ aPR (95% CI)‡
Total§
87.1
NA

79.8
NA

92.0
NA

90.2
NA
Age, y
≤19 90.0 1.09 (1.02–1.17)¶ 82.2 0.97 (0.89–1.06) 91.5 1.00 (0.96–1.05) 95.9 1.03 (0.99–1.08)
20–34 87.3 1.06 (1.00–1.13) 78.7 0.93 (0.88–0.98)¶ 92.1 1.01 (0.97–1.05) 88.9 0.96 (0.93–1.00)
≥35
82.4
Referent

84.4
Referent

91.3
Referent

92.6
Referent
Education level
<HS diploma 86.7 0.99 (0.94–1.06) 77.2 0.97 (0.88–1.06) 93.4 1.02 (0.98–1.05) 84.2 0.93 (0.85–1.01)
HS diploma 86.7 0.99 (0.96–1.03) 80.8 1.01 (0.96–1.07) 92.1 1.00 (0.98–1.03) 89.9 0.99 (0.96–1.03)
>HS
87.2
Referent

79.7
Referent

91.8
Referent

90.6
Referent
Marital status during pregnancy
Unmarried 86.6 0.99 (0.95–1.02) 79.5 0.99 (0.95–1.04) 92.1 1.00 (0.98–1.03) 90.0 0.99 (0.96–1.02)
Married
87.9
Referent

80.3
Referent

91.8
Referent

90.6
Referent
Prenatal WIC participation
Yes 88.0 1.11 (1.03–1.19)¶ 81.0 1.11 (1.03–1.20)¶ 92.3 1.04 (0.99–1.10) 90.7 1.04 (1.00–1.09)
No 79.5 Referent 73.0 Referent 88.7 Referent 87.1 Referent

*On the 2016 PRAMS-ZPER survey, women were asked about receiving counseling from a healthcare provider about using mosquito repellent on their skin only. On the 2017 PRAMS-ZPER survey, the question was expanded to ask about mosquito repellent on their skin or clothing. aPR, adjusted prevalence ratio; HS, high school; NA, not applicable; PRAMS-ZPER, Pregnancy Risk Assessment Monitoring System–Zika Postpartum Emergency Response Study; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.
†Unweighted sample size; sample size varies because of missing responses.
‡Prevalence and prevalence ratio estimates adjusted for maternal age, education, marital status, prenatal WIC participation, infant birth month, and health district region (Aguadilla, Arecibo, Bayamon, Caguas, Fajardo, Mayaguez, Metro, or Ponce).
§Unadjusted prevalence estimates. 
¶Statistically significant result.

Main Article

1Presented in part at the 2018 CityMatCH Leadership and MCH Epidemiology Conference, Portland, Oregon, September 12–14, 2018.

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