Reproductive Responses to the Zika Virus Epidemic in Brazil

巴西对寨卡病毒流行的生殖反应

• 批准号: 10318074
• 负责人: Leticia J Marteleto
• 金额: $ 67.66万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10318074
• 关键词: Address; Adopted; Aedes; Affect; Age; American; Americas; Area; Attention; Attitude; Behavior; Birth; Brazil; Characteristics; Clinical; Communities; Community Health; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Country; Data; Developing Countries; Dimensions; Disease; Economic Development; Epidemic; Epidemiology; Exposure to; Family health status; Fertility; Frequencies; Gender; Health; Health Surveys; Healthcare; Household; Immunologics; Incidence; Individual; Inequality; Infection; Infrastructure; Interruption; Investigation; Knowledge; Light; Link; Live Birth; Long-Term Effects; Longitudinal Surveys; Measurement; Measures; Mediator of activation protein; Medical; Microcephaly; Modeling; Morbidity - disease rate; Municipalities; Neurologic; Outcome; Pattern; Periodicity; Personal Satisfaction; Persons; Policies; Population Heterogeneity; Pregnancy; Prenatal care; Prevalence; Prevention; Public Health; Records; Reporting; Reproductive Behavior; Reproductive Health; Reproductive Process; Research; Resources; Risk; Sampling; Science; Self Efficacy; Sex Behavior; Shapes; Shock; Stratification; Surveys; Time; Touch sensation; Variant; Virus; Water; Woman; Work; World Health Organization; ZIKA; Zika Virus; abortion; behavioral outcome; behavioral response; climate data; design; experience; fetal; health care availability; health disparity; hookah; insight; mortality; multilevel analysis; outreach; population health; prenatal; prevent; psychosocial; reproductive; response; risk perception; self reported behavior; social; sociodemographics; socioeconomics; theories; transmission process; unintended pregnancy

PROJECT SUMMARY/ ABSTRACT The objective of the proposed research is to provide one of the first in-depth analyses of how the Zika virus (ZIKV) epidemic has affected and potentially continues to affect reproductive processes in Brazil. These analyses will include investigations into how different types of physical and social exposure to the virus shape women's desires for pregnancy and contraception, contraceptive use and sexual frequency, prenatal healthcare use, abortion, and pregnancy and birth outcomes. Understanding women's reproductive responses to ZIKV exposure is key to developing a nuanced understanding of the effects of population health shocks on family health and health disparities more broadly, and is especially important to consider in a developing country context where vast inequalities in healthcare access, unintended pregnancy, and morbidity and mortality persist. Currently, little data or research is available on the secondary effects of the Zika epidemic on reproductive health in Brazil. To address this gap the proposed study will collect new panel data among a racially and socioeconomically diverse, population-representative sample of women of reproductive age from two Brazilian states. These data will be collected twice—once every two years—and will feature a wide range of measures of individual and municipal Zika exposure as well as measures of women's reproductive intentions, behaviors, and outcomes; and a range of potential mediators such as risk perceptions, knowledge about Zika, healthcare access, and psychosocial dimensions of fertility like contraceptive self-efficacy and gender ideology. Repeated measurement among the sample will allow us to observe dynamic changes in women's ideational and behavioral responses as medical science advances the prevention of Zika and/or Zika reemerges as an epidemic in Brazil. To better understand the effects of Zika exposure at the community and state level, we will merge our longitudinal survey data with municipal, state, and national administrative data and climate data. In addition to these analyses, we will also examine administrative data on live births to estimate fertility responses to the ZIKV epidemic. The specific aims of this project will be to: (1) collect longitudinal data on physical and social ZIKV exposure, reproductive processes, and potential mediators; (2) estimate the extent to which sociodemographic, municipal, and state characteristics affect women's physical and social experiences of ZIKV exposure; and (3) investigate how and why reproductive intentions, behaviors, and outcomes vary with ZIKV exposure. Multilevel fixed and random effects regressions, regression discontinuities, and difference-in-difference models will be used to assess how different types and intensities of ZIKV exposure influence women's reproductive strategies and to investigate the mechanisms underlying reproductive responses to the epidemic.

项目概要/摘要 拟议研究的目的是首次深入分析寨卡病毒如何传播 （寨卡病毒）流行已经影响并可能继续影响巴西的生殖过程。 分析将包括调查不同类型的身体和社会接触病毒的情况如何形成 妇女怀孕和避孕的愿望、避孕药具的使用和性频率、产前 了解妇女的生殖反应。 ZIKV 暴露对于深入了解人口健康冲击对健康的影响至关重要 家庭健康和更广泛的健康差异，在发展中国家尤为重要。 医疗保健获取、意外怀孕和发病率方面存在巨大不平等的国家背景 目前，关于寨卡疫情对人的二次影响的数据或研究很少。 为了解决这一差距，拟议的研究将收集巴西生殖健康的新面板数据。 具有种族和社会多样性、具有人口代表性的育龄妇女样本 这些数据将收集两次（每两年一次），并且范围广泛。 个人和城市寨卡暴露的测量以及妇女生殖的测量 意图、行为和结果；以及一系列潜在的中介因素，例如风险认知、知识 关于寨卡、医疗保健获取和生育的心理社会维度，如避孕自我效能和 样本中的重复测量将使我们能够观察到性别意识形态的动态变化。 随着医学科学推动寨卡病毒和/或寨卡病毒的预防，女性的观念和行为反应 寨卡病毒在巴西重新流行，以更好地了解寨卡病毒暴露对社区和社区的影响。 州一级，我们将把纵向调查数据与市、州和国家行政数据合并 除了这些分析之外，我们还将检查有关活产的行政数据。 估计生育率对 ZIKV 流行的反应 该项目的具体目标是：(1) 收集数据。 (2) 关于身体和社会 ZIKV 暴露、生殖过程和潜在介质的纵向数据； 估计社会人口统计、城市和州特征对女性身体的影响程度 (3) 调查生殖意图、行为如何以及为何 多水平固定和随机效应回归、回归结果随 ZIKV 暴露而变化。 不连续性和双重差分模型将用于评估不同类型和强度的 ZIKV 暴露影响女性的生殖策略并调查其潜在机制 对流行病的生殖反应。