BACKGROUND: Because infection with Zika virus during pregnancy can cause microcephaly and other birth defects, women of childbearing age are an important population for targeting of Zika-related public health messaging. In February 2016, the Kentucky Department for Public Health began efforts to educate the public about the risks and prevention of Zika infection. To improve Zika-related communication and outreach in Kentucky, we conducted a survey to assess Zika knowledge, attitudes, and practices (KAP) among women of childbearing age who received a negative Zika test result from the state public health laboratory.
METHODS: In October and November 2016, we conducted a phone-based survey of women ages 18–49 years who received a negative Zika test result in Kentucky during February–July 2016. Women who travelled to a Zika-affected area who were pregnant and/or experienced Zika symptoms were eligible to receive testing. The survey instrument was designed to assess KAP related to Zika virus and prevention of infection. The survey was pre-tested and conducted in English and Spanish.
RESULTS: Fifty-five of 99 eligible women completed the survey (response rate=56%); the most frequently reported reason for travel to a Zika-affected area was vacation (56%). Nearly two thirds (64%; 35/55) of the respondents reported taking action to prevent Zika infection while travelling or living in a Zika-affected area; use of mosquito repellent was the most frequently reported method of prevention (53%; 29/55), followed by wearing protective clothing (18%; 10/55). Of the 20 women who took no action, 15 (75%) were unaware of Zika virus or of local Zika transmission at the time of travelling to or living in an affected area. Although >90% of the 55 respondents knew the virus could be transmitted by mosquitoes and caused birth defects, and 84% (46/55) knew the infection could be asymptomatic, just 56% (31/55) knew the virus could be sexually transmitted. The internet was the most frequently reported source of Zika knowledge (76%; 42/55); 35% (19/55) of women got Zika information from their primary care provider.
CONCLUSIONS: These findings underscore the importance of continued efforts by CDC and state and local health departments to educate female travelers of childbearing age about risks for and prevention of Zika virus infection, particularly online. The low level of awareness of sexual transmission of the virus highlights the need for additional public health messaging emphasizing use of condoms and abstinence to prevent transmission between potentially Zika-exposed individuals and their sexual partners.