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

PloS One
Jessica B McGillenEline L Korenromp

Abstract

Zimbabwe adopted voluntary medical male circumcision (VMMC) as a priority HIV prevention strategy in 2007 and began implementation in 2009. We evaluated the costs and impact of this VMMC program to date and in future. Three mathematical models describing Zimbabwe's HIV epidemic and program evolution were calibrated to household survey data on prevalence and risk behaviors, with circumcision coverage calibrated to program-reported VMMCs. We compared trends in new infections and costs to a counterfactual without VMMC. Input assumptions were agreed in workshops with national stakeholders in 2015 and 2017. The VMMC program averted 2,600-12,200 infections (among men and women combined) by the end of 2016. This impact will grow as circumcised men are protected lifelong, and onward dynamic transmission effects, which protect women via reduced incidence and prevalence in their male partners, increase over time. If other prevention interventions remain at 2016 coverages, the VMMCs already performed will avert 24,400-69,800 infections (2.3-5% of all new infections) through 2030. If coverage targets are achieved by 2021 and maintained, the program will avert 108,000-171,000 infections (10-13% of all new infections) by 2030, costing $2,100...Continue Reading

Citations

Sep 10, 2019·Journal of Evidence-based Medicine·Brian J MorrisJohn N Krieger
Oct 13, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Gideon LoevinsohnUNKNOWN Rakai Health Sciences Program

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Methods Mentioned

BETA
circumcision
circumcisions

Software Mentioned

EMOD
Decision Makers Program Planning Tool ( DMPPT )

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