IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0140818.html
   My bibliography  Save this article

A Reevaluation of the Voluntary Medical Male Circumcision Scale-Up Plan in Zimbabwe

Author

Listed:
  • Susanne F Awad
  • Sema K Sgaier
  • Gertrude Ncube
  • Sinokuthemba Xaba
  • Owen M Mugurungi
  • Mutsa M Mhangara
  • Fiona K Lau
  • Yousra A Mohamoud
  • Laith J Abu-Raddad

Abstract

Background: The voluntary medical male circumcision (VMMC) program in Zimbabwe aims to circumcise 80% of males aged 13–29 by 2017. We assessed the impact of actual VMMC scale-up to date and evaluated the impact of potential alterations to the program to enhance program efficiency, through prioritization of subpopulations. Methods and Findings: We implemented a recently developed analytical approach: the age-structured mathematical (ASM) model and accompanying three-level conceptual framework to assess the impact of VMMC as an intervention. By September 2014, 364,185 males were circumcised, an initiative that is estimated to avert 40,301 HIV infections by 2025. Through age-group prioritization, the number of VMMCs needed to avert one infection (effectiveness) ranged between ten (20–24 age-group) and 53 (45–49 age-group). The cost per infection averted ranged between $811 (20–24 age-group) and $5,518 (45–49 age-group). By 2025, the largest reductions in HIV incidence rate (up to 27%) were achieved by prioritizing 10–14, 15–19, or 20–24 year old. The greatest program efficiency was achieved by prioritizing 15–24, 15–29, or 15–34 year old. Prioritizing males 13–29 year old was programmatically efficient, but slightly inferior to the 15–24, 15–29, or 15–34 age groups. Through geographic prioritization, effectiveness varied from 9–12 VMMCs per infection averted across provinces. Through risk-group prioritization, effectiveness ranged from one (highest sexual risk-group) to 60 (lowest sexual risk-group) VMMCs per infection averted. Conclusion: The current VMMC program plan in Zimbabwe is targeting an efficient and impactful age bracket (13–29 year old), but program efficiency can be improved by prioritizing a subset of males for demand creation and service availability. The greatest program efficiency can be attained by prioritizing young sexually active males and males whose sexual behavior puts them at higher risk for acquiring HIV.

Suggested Citation

  • Susanne F Awad & Sema K Sgaier & Gertrude Ncube & Sinokuthemba Xaba & Owen M Mugurungi & Mutsa M Mhangara & Fiona K Lau & Yousra A Mohamoud & Laith J Abu-Raddad, 2015. "A Reevaluation of the Voluntary Medical Male Circumcision Scale-Up Plan in Zimbabwe," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-16, November.
    • Handle: RePEc:plo:pone00:0140818
    DOI: 10.1371/journal.pone.0140818
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140818
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0140818&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0140818?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Susanne F Awad & Sema K Sgaier & Bushimbwa C Tambatamba & Yousra A Mohamoud & Fiona K Lau & Jason B Reed & Emmanuel Njeuhmeli & Laith J Abu-Raddad, 2015. "Investigating Voluntary Medical Male Circumcision Program Efficiency Gains through Subpopulation Prioritization: Insights from Application to Zambia," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-25, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Susanne F Awad & Sema K Sgaier & Bushimbwa C Tambatamba & Yousra A Mohamoud & Fiona K Lau & Jason B Reed & Emmanuel Njeuhmeli & Laith J Abu-Raddad, 2015. "Investigating Voluntary Medical Male Circumcision Program Efficiency Gains through Subpopulation Prioritization: Insights from Application to Zambia," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-25, December.
    2. Jessica B McGillen & John Stover & Daniel J Klein & Sinokuthemba Xaba & Getrude Ncube & Mutsa Mhangara & Geraldine N Chipendo & Isaac Taramusi & Leo Beacroft & Timothy B Hallett & Patrick Odawo & Rumb, 2018. "The emerging health impact of voluntary medical male circumcision in Zimbabwe: An evaluation using three epidemiological models," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-17, July.
    3. Katharine Kripke & Karin Hatzold & Owen Mugurungi & Gertrude Ncube & Sinokuthemba Xaba & Elizabeth Gold & Kim Seifert Ahanda & Natalie Kruse-Levy & Emmanuel Njeuhmeli, 2016. "Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20–29 in Zimbabwe," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.
    4. Katharine Kripke & Frank Chimbwandira & Zebedee Mwandi & Faustin Matchere & Melissa Schnure & Jason Reed & Delivette Castor & Sema Sgaier & Emmanuel Njeuhmeli, 2016. "Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Katharine Kripke & Frank Chimbwandira & Zebedee Mwandi & Faustin Matchere & Melissa Schnure & Jason Reed & Delivette Castor & Sema Sgaier & Emmanuel Njeuhmeli, 2016. "Voluntary Medical Male Circumcision for HIV Prevention in Malawi: Modeling the Impact and Cost of Focusing the Program by Client Age and Geography," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.
    2. Katharine Kripke & Karin Hatzold & Owen Mugurungi & Gertrude Ncube & Sinokuthemba Xaba & Elizabeth Gold & Kim Seifert Ahanda & Natalie Kruse-Levy & Emmanuel Njeuhmeli, 2016. "Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20–29 in Zimbabwe," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0140818. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.