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: 10006896
• 负责人: Leticia J Marteleto
• 金额: $ 68.32万
• 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/10006896
• 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.

项目摘要/摘要 拟议的研究的目的是提供有关Zika病毒如何的第一个深入分析之一 （ZIKV）流行病已经影响，并可能继续影响巴西的复制过程。这些 分析将包括对不同类型的身体和社会接触病毒形状的投资 妇女对怀孕和避孕，避孕药使用和性频率的渴望，产前 医疗保健使用，堕胎以及怀孕和出生结果。了解女性的生殖反应 ZIKV暴露是对人口健康冲击对人群健康的影响的细微了解的关键 家庭健康和健康差异更广泛，在发展中尤为重要 国家环境，医疗保健方面的巨大不平等，意外怀孕和发病率和 死亡率持续。当前，关于寨卡病毒的次要影响的数据或研究很少 巴西生殖健康。为了解决这一差距，拟议的研究将收集一个新的面板数据 从种族和社会经济上，人口代表性的繁殖年龄妇女样本 两个巴西国家。这些数据将被收集两次（一次一次），并将具有广泛的范围 个人和市政寨卡病毒的测量以及妇女生殖的测量 意图，行为和结果；以及一系列潜在的调解人，例如风险感知，知识 关于Zika，医疗保健的访问以及避孕自我效能等生育能力的社会心理维度 性别构想。样本中的重复测量将使我们能够观察到动态变化 随着医学科学的预防，妇女的思想和行为反应可以预防寨卡病毒和/或Zika 在巴西的流行病重新出现。更好地了解寨卡暴露在社区中的影响 州一级，我们将纵向调查数据与市政，州和国家行政数据合并 和气候数据。除了这些分析外，我们还将研究有关活产的行政数据 估计对ZIKV流行病的生育能力。该项目的具体目的是：（1）收集 关于身体和社会ZIKV暴露，生殖过程和潜在介体的纵向数据； （2） 估计社会人口统计学，市政和国家特征在多大程度上影响妇女的身体 和ZIKV暴露的社会经历； （3）研究如何以及为什么复制意图，行为， 随着ZIKV的暴露，结果有所不同。多级固定和随机效果回归，回归 不连续性和差异差异模型将用于评估不同类型和强度的方式 ZIKV暴露会影响妇女的生殖策略，并研究基本机制 对流行病的生殖反应。