Significant reduction in HIV prevalence according to male circumcision intervention in sub-Saharan Africa

被引:32
作者
Londish, Gregory J. [2 ]
Murray, John M. [1 ,2 ]
机构
[1] Natl Ctr HIV Epidemiol & Clin Res, Darlinghurst, NSW 2010, Australia
[2] Univ New S Wales, Sch Math & Stat, Sydney, NSW 2052, Australia
关键词
D O I
10.1093/ije/dyn038
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Observations that reduced adult HIV prevalence in sub-Saharan Africa correlated with levels of male circumcision (MC), have suggested that MC could be used as a preventative measure against HIV infection. The exact benefits of this intervention are uncertain. Moreover if MC is not feasible for the whole male population, which groups should be targeted Methods A mathematical model simulated observed levels of HIV prevalence under the complete range of current levels of circumcision. Increased MC from 2007 was incorporated in this model and used to simulate HIV prevalence in 2020. Results Complete coverage by MC could reduce HIV prevalence from 12 to 6 for an average population country in sub-Saharan Africa in 2020. This reduction is scaled proportionally when lower circumcision levels are achieved. These benefits are achieved mostly by circumcising men between 20 and 30 years of age (adult prevalence reduced from 12 to 10), and those with riskier behaviour (8 to 6.9). Complete negation of these benefits requires at least 40 of circumcised males to significantly increase risky behaviour. Conclusions MC provides an effective intervention in sub-Saharan Africa to reduce HIV prevalence. It is most effective when applied to 2030 year old risky males with diminishing returns with application to the wider male population.
引用
收藏
页码:1246 / 1253
页数:8
相关论文
共 34 条
[31]   Male circumcision and susceptibility to HIV infection among men in Tanzania [J].
Urassa, M ;
Todd, J ;
Boerma, JT ;
Hayes, R ;
Isingo, R .
AIDS, 1997, 11 (01) :73-79
[32]   Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis [J].
Weiss, HA ;
Quigley, MA ;
Hayes, RJ .
AIDS, 2000, 14 (15) :2361-2370
[33]   The potential impact of male circumcision on HIV in sub-Saharan Africa [J].
Williams, Brian G. ;
Lloyd-Smith, James O. ;
Gouws, Eleanor ;
Hankins, Catherine ;
Getz, Wayne M. ;
Hargrove, John ;
de Zoysa, Isabelle ;
Dye, Christopher ;
Auvert, Bertran .
PLOS MEDICINE, 2006, 3 (07) :1032-1040
[34]  
2005, INDIAN J MED SCI, V59, P323