Congress must treat Zika as a women's health issue

Photo by U.S. Department of Health and Human Services

The news of the first child in Texas born with Zika virus-related microcephaly puts into perspective the public health crisis our state faces. Texas has reported 55 known cases of the Zika virus, the fourth most in the United States, and a reported half a million pregnant Texan women are at risk of infection — the most in the country.

We as Texans should have a special investment in preventing Zika, but preoccupation with partisan interests has stymied legislative progress. Congress looks unlikely to agree upon a bill to fund the fight against Zika before its summer recess, in part due to Republicans' insistence that none of the funding go to women's health organizations such as Planned Parenthood.

The Center for Disease Control highlights three primary modes of Zika transmission: bites from an infected mosquito, sex with an infected male and mother-to-fetus. In spite of the fact that the latter two are intricately intertwined with reproductive health, legislators spared no funding for those avenues in the most recent conference appropriations bill.

Skeptics cite the relatively low occurrence of sexual transmission as reason to refuse to fund family planning as part of the emergency appropriations bill. However, as of June 6 there had been 14 reported sexually transmitted cases of Zika in the United States — and zero attributed to local mosquitoes. In the United States, the mode of infection that poses the primary threat to Americans is sexual transmission.

For whom is that threat most menacing? For most people, the virus tends to manifest as a mild flu. The stakes for families are much higher, however, because infants born to infected mothers are at risk of microcephaly, which consists of stunted brain development, small head size and, sometimes, early death. The potential for greatest harm from Zika lies in the demographic of infants and thus women of reproductive age.

Furthermore, growing evidence suggests that sexual transmission may in fact be a greater threat than initially thought. Last month, a study conducted at the Getulio Vargas Foundation produced compelling evidence that sexual transmission poses a heightened risk to women as compared to men. Even after adjustment for potential biasing factors, the findings demonstrated that infected sexually active women outnumber their male counterparts by 90 percent.

Researchers presume that because mosquitoes don't choose whom they bite based on sex, the most likely explanation for this discrepancy is sexual transmission.

This data certainly requires further exploration, but another study from the New England Journal of Medicine has already produced similar results, which demonstrate not only the discrepancy of infections by sex but also reinforce the hypothesis by pinpointing age 15, roughly the average age of sexual initiation, as the age when more women than men begin contracting the virus.

If the secondary mode of transmission were anything but sex, a hot button for stigma, we would not have seen a zero in the funding proposal for that category. Texas, a state that neither mandates HIV and sex education in schools nor requires it to be grounded in fact when provided, harbors a particularly pointed opposition to sexual activity before marriage. One adverse effect of this ideology is the suppression of information around maintaining sexual health, which perpetuates stigma and poises society for lower sexual health outcomes. Together, these sentiments impede public recognition of sexual activity as a contributor to health epidemics and thus disincentivize sex-focused interventions.

Prior to Zika, contraceptive need among Texas women was already high, and 25 percent of poor Texas women who gained access to contraception did so through the very clinics that the proposed funding bill expressly barred from funding.

Now, need has skyrocketed, but congressional Republicans are digging in their heels, refusing to promote commonsense funding for sexual health services in addition to research and development, all for the sake of political grandstanding. This health crisis has played out along party lines, but Zika and the microcephaly it incites in infants know no boundaries. It is in the best interest of all Texas women, infants and families that we press our legislators for swift and appropriate action.

Sarah Nesbitt

Senior, Washington University