Kroelinger Charlan D, Romero Lisa, Lathrop Eva, Cox Shanna, Morgan Isabel, Frey Meghan T, Warner Lee, Curtis Kathryn M, Pazol Karen, Barfield Wanda D, Meaney-Delman Dana, Jamieson Denise J
MMWR Morb Mortal Wkly Rep. 2017 Nov 10;66(44):1230-1235. doi: 10.15585/mmwr.mm6644a6.
Zika virus infection during pregnancy is a cause of microcephaly and other serious brain abnormalities (1). To support state and territory response to the threat of Zika, CDC's Interim Zika Response Plan outlined activities for vector control; clinical management of exposed pregnant women and infants; targeted communication about Zika virus transmission among women and men of reproductive age; and primary prevention of Zika-related adverse pregnancy and birth outcomes by prevention of unintended pregnancies through increased access to contraception.* The most highly effective, reversible contraception includes intrauterine devices and implants, known as long-acting reversible contraception (LARC). On September 28, 2016, the Association of Maternal and Child Health Programs (AMCHP) and CDC facilitated a meeting in Atlanta, Georgia, of representatives from 15 states to identify state-led efforts to implement seven CDC-published strategies aimed at increasing access to contraception in the context of Zika virus (2). Qualitative data were collected from participating jurisdictions. The number of states reporting implementation of each strategy ranged from four to 11. Participants identified numerous challenges, particularly for strategies implemented less frequently. Examples of barriers were discussed and presented with corresponding approaches to address each barrier. Addressing these barriers could facilitate increased access to contraception, which might decrease the number of unintended pregnancies affected by Zika virus.
孕期感染寨卡病毒是导致小头畸形和其他严重脑部异常的原因之一(1)。为支持各州和各领地应对寨卡病毒威胁，美国疾病控制与预防中心（CDC）的《寨卡病毒应对临时计划》概述了病媒控制活动；对暴露的孕妇和婴儿进行临床管理；针对育龄男女开展关于寨卡病毒传播的定向宣传；以及通过增加避孕措施的可及性来预防意外怀孕，从而对寨卡病毒相关不良妊娠和分娩结局进行一级预防*。最有效的可逆避孕方法包括宫内节育器和植入物，即长效可逆避孕法（LARC）。2016年9月28日，母婴健康项目协会（AMCHP）和美国疾病控制与预防中心在佐治亚州亚特兰大促成了一次会议，来自15个州的代表参加会议，以确定由各州牵头实施美国疾病控制与预防中心发布的七项战略的努力，这些战略旨在在寨卡病毒背景下增加避孕措施的可及性(2)。从参与的司法管辖区收集了定性数据。报告实施每项战略的州数量从4个到11个不等。与会者确定了众多挑战，尤其是对于实施频率较低的战略。讨论了障碍的实例，并提出了应对每个障碍的相应方法。克服这些障碍有助于增加避孕措施的可及性，这可能会减少受寨卡病毒影响的意外怀孕数量。
