Due to mounting evidence supporting a link between the Zika virus and microcephaly, the Centers for Disease Control and Prevention released new guidance this week related to pregnancy planning and preventing the transmission of the virus.
Guidance for Pregnant and Reproductive-Age Women
For women and men who have been diagnosed with Zika virus or who have symptoms of Zika including fever, rash, joint pain or red eyes after possible exposure to Zika virus, CDC recommends healthcare providers advise:
- Women wait at least 8 weeks after their symptoms first appeared before trying to get pregnant.
- Men wait at least 6 months after their symptoms first appeared to have unprotected sex.
- In making these recommendations, we considered the longest known risk period for these categories. We then allowed for three times the known period of time.
Those who have shown no symptoms of Zika but who have been exposed to the virus through travel or intercourse are encouraged to wait eight weeks before attempting to conceive.
Those who have shown no symptoms of Zika who live in an area with active transmission of the virus are recommended to speak with their healthcare providers about their pregnancy plans.
"These are very complex, deeply personal decisions, and we are communicating the potential risks of Zika virus infection during pregnancy for people who live in areas with active transmission. We are encouraging health care providers to have conversations with women and their partners about pregnancy planning, their individual circumstances and strategies to prevent unintended pregnancies," the CDC said in a news release.
Updated Guidance for Preventing Sexual Transmission of Zika
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"The recommendations for men who live in or travel to an area with active Zika virus transmission who have a pregnant partner remain the same: CDC recommends that men with a pregnant partner should use condoms every time they have sex or not have sex for the duration of the pregnancy. To be effective, condoms must be used correctly from start to finish, every time during sex. This includes vaginal, anal or oral (mouth-to-penis) sex," the CDC said.
The CDC changed the time frame for men and their non-pregnant partners based available information about how long the virus remains in semen and the risks associated with Zika based on whether or not men had symptoms of infection.
- Couples with men who have confirmed Zika or symptoms of Zika should consider using condoms or not having sex for at least 6 months after symptoms begin. This includes men who live in and men who traveled to areas with Zika.
- Couples with men who traveled to an area with Zika but did not develop symptoms of Zika should consider using condoms or not having sex for at least 8 weeks after their return in order to minimize risk.
- Couples with men who live in an area with Zika but have not developed symptoms might consider using condoms or not having sex while there is active Zika transmission in the area.
The CDC said couples who do not want to get pregnant should use the most effective contraceptive methods available. Those who are trying to get pregnant should talk with their doctor.
Increasing Access to Contraception in Zika Transmission Areas
Earlier this month, a top doctor with the CDC, Dr. Tom Frieden, said they expect hundreds of thousands of people in Puerto Rico will contract Zika this year, including thousands of pregnant women.
"Because of the potential for Zika to affect pregnant women and their fetuses, strategies to prevent unintended pregnancy are a critical part of current efforts to prevent Zika-related health effects," the CDC said. "Based on Puerto Rico's experience, CDC has identified considerations and challenges in reducing unintended pregnancies in areas with active Zika transmission."
According to the CDC, about two-thirds of Puerto Rican pregnancies are unintended. Further, researchers estimated 138,000 women in Puerto Rico may be at risk of an unintended pregnancy because they aren't using birth control.
In areas where Zika transmission is known to occur, such as Puerto Rico, the CDC said women and their partners who do not want to get pregnant should consistently make use of effective birth control methods.
The Department of Health and Human Services (HHS) is coordinating with federal, local, and private partners to identify resources to support increased access in Puerto Rico to the most effective forms of contraception.
"HRSA has 20 health center grantees that operate 84 sites in Puerto Rico, which serve over 330,000 people, including nearly 80,000 women ages 15 to 45. HHS is exploring possible expansion of services at these centers, which currently include prenatal care and other voluntary family planning services," the CDC said. "OPA is working to provide additional funds for contraceptive services, as well as facilitate the training of providers in long-acting reversible contraception methods.
Earlier this month, about 100 CDC staff members were on the ground in Puerto Rico handing out repellent and condoms ahead of the island's rainy season.
