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Understanding Zika virus as an STI: findings from a qualitative study of pregnant women in the Bronx
  1. Miguel Rodriguez1,
  2. Ayla Lord2,
  3. Carolina C Sanabia2,
  4. Abigail Silverio2,
  5. Meleen Chuang2,
  6. Siobhan M Dolan1,2
  1. 1Albert Einstein College of Medicine, Bronx, New York, USA
  2. 2Obstetrics & Gynecology and Women's Health, Montefiore Health System, Bronx, New York, USA
  1. Correspondence to Dr Siobhan M Dolan, Albert Einstein College of Medicine, Bronx, NY 10461, USA; sdolan{at}


Objectives Pregnant women in the Bronx were at risk for travel-related Zika exposure in the USA between 2016 and 2017. This qualitative study explored the experiences of 13 pregnant women to learn about their knowledge of Zika and prevention measures.

Methods In the summer of 2017, pregnant women at risk of travel-related Zika exposure were interviewed in either Spanish or English to learn about their experiences and transcripts were analysed using a grounded theory approach.

Results Most participants were Latinas living in the Bronx, median age of 29 years and median household income between $26 000 and $50 000. Participants displayed a strong understanding of Zika transmission via mosquito bites yet lacked knowledge about its sexual transmission. Interviews revealed three key themes: (1) Zika as a new disease, (2) denial as a coping mechanism and (3) the recommendation to treat Zika as an STI. Women observed Zika as a brand new disease with early messages emphasising mosquito-borne transmission. They lacked awareness of newer messaging about sexual transmission. Furthermore, if women did read about risk of sexual transmission, many stated being in denial and struggling with recommendations to prevent sexual transmission. Barriers included problems changing travel plans and rejection of condom use. Women unanimously suggested labelling Zika as an STI and adding it to existing lists of STIs for messaging and outreach in community-based and clinical prevention.

Conclusion Many pregnant women were unaware that Zika virus can be sexually transmitted due to: (1) novelty of Zika, (2) denial as a coping mechanism and (3) Zika not being listed along with well-known STIs. Overcoming these barriers via community-based as well as clinical education for pregnant women in the Bronx would be helpful in 2019 and beyond when the risk of travel-related Zika exposure remains a public health threat to optimal pregnancy outcomes.

  • modes of transmission
  • public health
  • sexual behaviour
  • communication skills
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  • Handling editor Anna Maria Geretti

  • Contributors Conception and design of the work (MR and SMD). Acquisition, analysis and interpretation of data (all authors). Drafting the work (MR and SMD). Revising critically for important intellectual content and final approval of the version published (all authors). Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved (SMD).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval IRB Number: 2017-7845

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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