Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness - United States, 2011-2013 and 2015.

What is already known on this topic? Zika virus is transmitted through the bite of an Aedes species mosquito, sex with an infected partner, or from a pregnant woman to her fetus. Zika virus infection during pregnancy is a cause of congenital microcephaly and other severe fetal brain defects. It has also been associated with eye defects, hearing loss, and impaired growth. Nearly half of all pregnancies in the United States are unintended. Among nonpermanent contraceptive methods, long-acting reversible contraception (LARC) is the most effective contraceptive option for preventing unintended pregnancy. What is added by this report? State-based estimates of contraception use are provided for nonpregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students. Among these populations, use of moderate and less effective contraception was most common; use of no contraceptive method and use of LARC varied by state, age group, and race/ethnicity. What are the implications for public health practice? State and local strategies are needed to increase access to contraceptive methods and related services, reduce the risk for unintended pregnancy, and minimize the number of pregnancies affected by Zika infection. Potentially effective strategies include addressing policies on high device costs and provider reimbursement, comprehensive provider training on insertion and removal of LARC, provision of youth-friendly services, support to resource-challenged jurisdictions, client-centered counseling and assessment of patient satisfaction, and increased consumer awareness of the full range of contraceptive methods to delay or avoid pregnancy.