Women's Awareness and Healthcare Provider Discussions About Zika Virus During Pregnancy, United States, 2016–2017

Letitia Williams; Denise V. D'Angelo; Brenda Bauman; Ada C. Dieke; Sascha R. Ellington; Carrie K. Shapiro-Mendoza; Shanna Cox; Philip Hastings; Holly Shulman; Leslie Harrison; Martha Kapaya; Wanda D. Barfield; Lee Warner


Emerging Infectious Diseases. 2020;26(5):998-1001. 

In This Article


These findings highlight interactions between pregnant women and their healthcare providers in 17 sites during the height of the 2016 Zika outbreak. Awareness of ZIKV was found to be high, as was awareness of CDC travel advisories to avoid travel to Zika-affected areas during pregnancy (both >90%). This awareness was likely obtained from multiple sources, given that only half of women who heard of ZIKV reported discussing it with their healthcare provider during pregnancy. Similar results have been reported in other studies.[9,10] Even though awareness was high, disparities existed, related to the smaller proportion of Hispanic and non-Hispanic black women who reported initiating discussions with providers about ZIKV. These differences suggest the opportunity to promote patient advocacy so that patients of all backgrounds feel comfortable asking about key topics if they are not raised by the provider, especially in the case of public health threats.

Our assessment is not without limitations. Data represent only women who recently gave birth to live infants in the 17 sites included in this analysis. Women seen in practices that conducted screening for travel history before a woman talked to her provider may not have reported counseling, especially if they were determined to be at low risk during the screening. Information is self-reported by the mother 2–6 months following the birth of her infant and may be subject to recall and social desirability bias.

PRAMS is the largest state- and population-based surveillance system in the United States that samples women who delivered live infants. PRAMS was augmented to collect timely data regarding patient and provider interactions related to ZIKV. Information from this analysis can fill data gaps and address the need to understand interactions between pregnant women and their healthcare providers regarding ZIKV.