Access to Contraceptive Services in Puerto Rico: An Analysis of Policy and Practice Change Strategies, 2015-2018.

CONTEXT: During the 2016-2017 Zika virus outbreak in Puerto Rico, preventing unintended pregnancy was a primary strategy to reduce Zika-related adverse birth outcomes. The Zika Contraception Access Network (Z-CAN) was a short-term emergency response intervention that used contraception to prevent unintended pregnancy among women who chose to delay or avoid pregnancy. OBJECTIVE: This analysis reports on the identified policy and practice change strategies to increase access to or provision of contraceptive services in Puerto Rico between 2015 and 2018. METHODS: A policy review was conducted to document federal- and territorial-level programs with contraceptive coverage and payment policies in Puerto Rico and to identify policy and practice change. Semistructured interviews with key stakeholders in Puerto Rico were also conducted to understand perceptions of policy and practice change efforts following the Zika virus outbreak, including emergency response, local, and policy efforts to improve contraception access in Puerto Rico. RESULTS: Publicly available information on federal and territorial programs with policies that facilitate access, delivery, and utilization of contraceptive coverage and family planning services in Puerto Rico to support contraceptive access was documented; however, interview results indicated that the implementation of the policies was often limited by barriers and that policy and practice changes as the result of the Zika virus outbreak were short-term. CONCLUSION: Consideration of long-term policy and practice changes related to contraceptive access is warranted. Similar analyses can be used to identify policies, practices, and perceptions in other settings in which the goal is to increase access to contraception or reduce unintended pregnancy.

Relationship Satisfaction and Infidelity-Related Behaviors on Social Networks: A Preliminary Online Study of Hispanic Women.

The purpose of this online study was to develop an explicative model regarding the origin of infidelity-related behaviors on social networks for Hispanic women. We propose that sexual satisfaction and emotional intimacy have a direct impact on the satisfaction of couple relationships, and an indirect impact in the development of infidelity-related behaviors on social networks. To investigate this proposal, we used a non-probabilistic sample of 341 Hispanic women living in Puerto Rico. Statistical analyses confirmed that satisfaction and ambivalence in couple relationship completely mediate the association between sexual satisfaction and infidelity-related behaviors on social networks, as well as the relationship between emotional intimacy and infidelity-related behaviors on social networks. Overall, women who practice infidelity-related behaviors on social networks showed less sexual satisfaction, less emotional intimacy, less relationship satisfaction, and greater ambivalence. Our results provide theoretical and empirical evidence on how infidelity-related behaviors on social networks develop in couple relationships, and these results could help to inform possible forms of prevention and intervention.