Final Program Data and Factors Associated With Long-Acting Reversible Contraception Removal: The Zika Contraception Access Network Eva Lathrop, MD, MPH, Stacey Hurst, MPH, Zipatly Mendoza, MPH, Lauren B. Zapata, PhD, MPH, Pierina Cordero, MPH, Rachel Powell, PhD, MPH, Caitlin Green, MPH, Nilda Moreno, MD, Denise J. Jamieson, MD, MPH, Lisa Romero, DrPH, MPH Emory University School of Medicine, the Centers for Disease Control and Prevention, the CDC Foundation, and the Zika Contraception Access Network Puerto Rico, San Juan, Puerto Rico. Abstract OBJECTIVE: To describe characteristics of the full population of women who participated in the Zika Contraception Access Network program in Puerto Rico during the virus outbreak and to examine factors associated with removal of a long-acting reversible contraception (LARC) method by a Zika Contraception Access Network provider during the program’s duration (May 2016– September 2017). METHODS: We conducted an observational cohort study. The Zika Contraception Access Network program was designed to increase access to contraception services in Puerto Rico for women who chose to prevent pregnancy during the Zika virus outbreak as a primary strategy to reduce adverse Zika virus–related pregnancy and birth outcomes. Among program participants, an observational cohort of women served by the Zika Contraception Access Network Program, we describe their demographic and program-specific characteristics, including contraceptive method mix before and after the program. We also report on LARC removals by Zika Contraception Access Network providers during the program. We examined factors associated with LARC removal using multivariable logistic regression. RESULTS: A total of 29,221 women received an initial Zika Contraception Access Network visit during the program. Ninety-six percent (27,985) of women received same-day provision of a contraceptive method and 70% (20,381) chose a LARC method. While the program was active, 719 (4%) women who chose a LARC at the initial visit had it removed. Women with a college degree or higher were more likely to have their LARC removed (adjusted prevalence ratio [aPR] 1.24); breastfeeding women (aPR 0.67) and those using a LARC method before Zika Contraception Access Network (aPR 0.55) were less likely to have their LARC removed. CONCLUSION: The Zika Contraception Access Network program was designed as a short-term response for rapid implementation of contraceptive services in a complex emergency setting in Corresponding author: Eva Lathrop, MD, MPH, Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA; elathro@emory.edu. Financial Disclosure The authors did not report any potential conflicts of interest. Each author has confirmed compliance with the journal’s requirements for authorship. HHS Public Access Author manuscript Obstet Gynecol. Author manuscript; available in PMC 2020 December 10. Published in final edited form as: Obstet Gynecol. 2020 May ; 135(5): 1095–1103. doi:10.1097/AOG.0000000000003835. Author Manuscript Author Manuscript Author Manuscript Author Manuscript