The Impact of the Zika Epidemic on Women’s Reproductive Intentions and Behaviors in Brazil
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The epidemic caused by the Zika virus has been a major public health shock for Brazil, particularly for reproductive-age women. The virus is transmitted via mosquito, sexual intercourse, blood transfusions and amniotic fluid. Infection at any point during pregnancy can have deleterious effects on fetal development and lead to birth defects such as microcephaly and other types of congenital Zika syndrome. Despite its wide range of potential symptoms, Zika virus infection can often be asymptomatic, allowing it to go unnoticed or to be unknowingly transmitted. The only ways to guarantee against Zika-related birth defect, at least until a vaccine is developed, the epidemic subsides, or an effective treatment becomes available are to avoid becoming pregnant or to terminate a pregnancy. However, the ability to prevent pregnancy is not equally shared among women of different social statuses. Indeed, women of lower socioeconomic status (SES) are more likely to have an unintended pregnancy while women with greater economic resources are typically more successful in preventing unwanted pregnancy, regardless of the Zika epidemic. Likewise, abortion in Brazil, where its access is highly restricted, is easier for wealthier women to obtain. Moreover, women living in the Northeast region of Brazil may be at higher risk of contracting the Zika virus than those living in other regions; they are also more likely to know others who have been affected by the virus. A combination of lower overall levels of economic development than in richer parts of the country such as the Southeast region, high temperatures, stagnant water, and sanitation problems are possible explanations for why the Northeastern region was affected first and most severely by the Zika virus epidemic. This research brief reports on a study that explores how and why the Zika virus affects reproductive processes in Brazil. The authors pay special attention to the ways women’s socioeconomic status and geographic location are related to their responses to the epidemic. In eight focus groups conducted with women in Recife, Pernambuco (Northeast region) and eight focus groups in Belo Horizonte, Minas Gerais (Southeast region) approximately 18 months after the epidemic began in Brazil, the interplay of women’s desires, behaviors, and healthcare access and use are examined. Within each city, half of the focus groups were conducted with women of low socioeconomic status and half with women of high socioeconomic status. Each focus group consisted of six to eight women between the ages of 18 and 49 years for a total of 114 women in the study.