Male Circumcision Programmes As Part Of Combination HIV Prevention In Sub-Saharan Africa Are Cost Effective, Says UNAIDS

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Men's health
Article Date: 15 Sep 2009 - 0:00 PDT


Male circumcision among heterosexual men in low male circumcision, high HIV prevalence settings is beneficial and cost effective, says a new article in the open access journal PLoS Medicine. Male circumcision should be considered as part of a combination HIV prevention package and not as an isolated measure. One HIV infection can be averted for every five to 15 male circumcisions performed, and the costs to avert one HIV infection ranging from US$150 to $900 using a 10-y time horizon, say the authors. The report is based upon a series of meetings of experts convened by UNAIDS, the World Health Organization (WHO), and the South African Centre for Epidemiological Modelling and Analysis (SACEMA) that reviewed the outcomes of six simulation models on key policy and programmatic decision-making questions related to male circumcision.

The models predicted that both premature postoperative resumption of sexual intercourse and behavioural risk compensation, if confined to newly or already circumcised men and their partners, have only small population level effects on the anticipated impact of male circumcision service scale-up on HIV incidence. Women benefit indirectly from reduced HIV prevalence in circumcised male partners and male circumcision service scale-up acts synergistically with other strategies to reduce HIV disease burden, says the group. Male circumcision has minimal impact on reducing HIV transmission among men who have sex with men.

The group, called UNAIDS/WHO/SACEMA Expert Group on Modelling the Impact and Cost of Male Circumcision for HIV Prevention, was led by Dr. Catherine Hankins, Chief Scientific Advisor at UNAIDS.

Funding:
The three UNAIDS/WHO/SACEMA modelling meetings were funded through the First UN Work Plan on Male Circumcision and HIV, which was supported by the Bill & Melinda Gates Foundation, the United States National Institutes of Health, the French Agence nationale de recherches sur le sida, and the Joint United Nations Programme on HIV/AIDS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Citation:
"Male Circumcision for HIV Prevention in High HIV Prevalence Settings: What Can Mathematical Modelling Contribute to Informed Decision Making?"
UNAIDS/WHO/SACEMA Expert Group on Modelling the Impact and Cost of Male Circumcision for HIV Prevention (2009)
PLoS Med 6(9): e1000109. doi:10.1371/journal.pmed.1000109

Source
PLoS Medicine

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