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The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models.

作者信息

Korenromp Eline L, Bershteyn Anna, Mudimu Edina, Weiner Renay, Bonecwe Collen, Loykissoonlal Dayanund, Manuhwa Clarence, Pretorius Carel, Teng Yu, Stover John, Johnson Leigh F

机构信息

Center for Modeling and Analysis, Avenir Health, Geneva, Switzerland.

Department of Population and Health, NYU Langone Medical Center, New York, NY, 11016, USA.

出版信息

Gates Open Res. 2021 Jan 25;5:15. doi: 10.12688/gatesopenres.13220.1. eCollection 2021.


DOI:10.12688/gatesopenres.13220.1
PMID:33615145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7878969/
Abstract

: South Africa began offering medical male circumcision (MMC) in 2010. We evaluated the current and future impact of this program to see if it is effective in preventing new HIV infections. : The Thembisa, Goals and Epidemiological Modeling Software (EMOD) HIV transmission models were calibrated to South Africa's HIV epidemic, fitting to household survey data on HIV prevalence, risk behaviors, and proportions of men circumcised, and to programmatic data on intervention roll-out including program-reported MMCs over 2009-2017. We compared the actual program accomplishments through 2017 and program targets through 2021 with a counterfactual scenario of no MMC program. : The MMC program averted 71,000-83,000 new HIV infections from 2010 to 2017. The future benefit of the circumcision already conducted will grow to 496,000-518,000 infections (6-7% of all new infections) by 2030. If program targets are met by 2021 the benefits will increase to 723,000-760,000 infections averted by 2030. The cost would be $1,070-1,220 per infection averted relative to no MMC. The savings from averted treatment needs would become larger than the costs of the MMC program around 2034-2039. In the Thembisa model, when modelling South Africa's 9 provinces individually, the 9-provinces-aggregate results were similar to those of the single national model. Across provinces, projected long-term impacts were largest in Free State, KwaZulu-Natal and Mpumalanga (23-27% reduction over 2017-2030), reflecting these provinces' greater MMC scale-up. : MMC has already had a modest impact on HIV incidence in South Africa and can substantially impact South Africa's HIV epidemic in the coming years.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/580cd4345903/gatesopenres-5-14439-g0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/e6267175a402/gatesopenres-5-14439-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/c4f1880c47e4/gatesopenres-5-14439-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/6c609bbf0eb8/gatesopenres-5-14439-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/c7d513b2163a/gatesopenres-5-14439-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/ecf31782392e/gatesopenres-5-14439-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/cb984fc8db96/gatesopenres-5-14439-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/b01b8a3cee8c/gatesopenres-5-14439-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/99fa0efedf7d/gatesopenres-5-14439-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/580cd4345903/gatesopenres-5-14439-g0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/e6267175a402/gatesopenres-5-14439-g0000.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/c4f1880c47e4/gatesopenres-5-14439-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/6c609bbf0eb8/gatesopenres-5-14439-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/c7d513b2163a/gatesopenres-5-14439-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/ecf31782392e/gatesopenres-5-14439-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/cb984fc8db96/gatesopenres-5-14439-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/b01b8a3cee8c/gatesopenres-5-14439-g0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/99fa0efedf7d/gatesopenres-5-14439-g0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e2/7878969/580cd4345903/gatesopenres-5-14439-g0008.jpg

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[1]
The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models.

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[2]
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[3]
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[4]
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[10]
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[1]
Uncovering the impact of randomness in HIV hotspot formation: A mathematical modeling study.

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[2]
A quantitative assessment of the consistency of projections from five mathematical models of the HIV epidemic in South Africa: a model comparison study.

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[3]
Cost-effectiveness of the dual prevention pill for contraception and HIV pre-exposure prophylaxis.

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[4]
Conceptualizing safer sex in a new era: Risk perception and decision-making process among highly sexually active men who have sex with men.

PLOS Glob Public Health. 2022-5-6

[5]
Cost-effectiveness of voluntary medical male circumcision for HIV prevention across sub-Saharan Africa: results from five independent models.

Lancet Glob Health. 2023-2

[6]
Understanding the Evolving Role of Voluntary Medical Male Circumcision as a Public Health Strategy in Eastern and Southern Africa: Opportunities and Challenges.

Curr HIV/AIDS Rep. 2022-12

[7]
A review of public health, social and ethical implications of voluntary medical male circumcision programs for HIV prevention in sub-Saharan Africa.

Int J Impot Res. 2023-5

[8]
Reductions in HIV incidence are likely to increase the importance of key population programmes for HIV control in sub-Saharan Africa.

J Int AIDS Soc. 2021-7

本文引用的文献

[1]
Does Incident Circumcision Lead to Risk Compensation? Evidence From a Population Cohort in KwaZulu-Natal, South Africa.

J Acquir Immune Defic Syndr. 2019-3-1

[2]
The emerging health impact of voluntary medical male circumcision in Zimbabwe: An evaluation using three epidemiological models.

PLoS One. 2018-7-18

[3]
The Association Between Male Circumcision and Condom Use Behavior - a Meta-Analysis.

Mater Sociomed. 2018-3

[4]
Male circumcision for HIV prevention: Awareness, risk compensation, and risk perceptions among South African women.

Glob Public Health. 2018-1-25

[5]
Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis.

BJU Int. 2018-1-29

[6]
Effect of male circumcision on risk of sexually transmitted infections and cervical cancer in women.

Lancet Glob Health. 2017-11

[7]
Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness.

PLoS One. 2017-8-10

[8]
Risk Compensation Following Medical Male Circumcision: Results from a 1-Year Prospective Cohort Study of Young School-Going Men in KwaZulu-Natal, South Africa.

Int J Behav Med. 2018-2

[9]
Cutting the cost of South African antiretroviral therapy using newer, safer drugs.

S Afr Med J. 2016-12-21

[10]
Correction: The Cost of Voluntary Medical Male Circumcision in South Africa.

PLoS One. 2017-1-3

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