Over the course of 16 months, more than 35400 cases of Zika virus infection have been confirmed in Puerto Rico. This represents 85% of all cases reported in the USA and its territories. The Zika epidemic is exposing the profound failure of socioeconomic policies, as well as the failure to protect sexual and reproductive health rights in Puerto Rico. Considering the high poverty rates, high levels of sexuality-related stigma, poor quality sex education, limited access to contraception, and limited participation in the allocation of resources for prevention, it is unreasonable to focus public health efforts to prevent Zika virus infection on vector control. The allocation and equitable management of resources for research and intervention are required in order to understand and address the barriers to and facilitators of prevention at the individual, social, and structural levels. Further, the impact of efforts to tackle the social determinants of the Zika virus epidemic on the island should be assessed.
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