ArticlePloS one2015
Investigating Voluntary Medical Male Circumcision Program Efficiency Gains through Subpopulation Prioritization: Insights from Application to Zambia.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 5 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 5 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia.BMC health services research · 2024Pooled it
- Evidence Gaps in Economic Evaluations of HIV Interventions Targeting Young People: A Systematic Review.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2024Pooled it
- Infectious Disease Modelling of HIV Prevention Interventions: A Systematic Review and Narrative Synthesis of Compartmental Models.PharmacoEconomics · 2023Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review.PloS one · 2020Pooled it
- Projected public health benefits of a hypothetical HSV-1 vaccine in the United States: A mathematical modeling analysis.Science advances · 2026Article
- Mathematical modeling of the population-level impact of hypothetical herpes simplex virus type 2 curative therapy.Communications medicine · 2026Article
- Quantifying population-level sexual risk behavior through HSV-2 transmission dynamics in the United States, 1950-2020.Scientific reports · 2025Article
- Cost-Effectiveness Analyses of Adolescent- and Young-Adult-Focused HIV Interventions Incorporating HIV Transmission: a Scoping Review of Modeling Methods and Proposed Guidance.PharmacoEconomics - open · 2025Review
- Vaccination as a strategy for Chlamydia trachomatis control: a global mathematical modeling analysis.BMC global and public health · 2025Article
- Impact of a potential Chlamydia vaccine in the USA: mathematical modelling analyses.BMJ public health · 2024Article
- Understanding dynamics and overlapping epidemiologies of HIV, HSV-2, chlamydia, gonorrhea, and syphilis in sexual networks of men who have sex with men.Frontiers in public health · 2024Article
- Maximizing the Impact of Voluntary Medical Male Circumcision for HIV Prevention in Zambia by Targeting High-Risk Men: A Pre/Post Program Evaluation.AIDS and behavior · 2022Article
- Article
- Sexually transmitted infections (STI) and antenatal care (ANC) clinics in Malawi: effective platforms for improving engagement of men at high HIV risk with voluntary medical male circumcision services.Sexually transmitted infections · 2021Article
- Analytic Characterization of the Herpes Simplex Virus Type 2 Epidemic in the United States, 1950-2050.Open forum infectious diseases · 2021Article
- Epidemiological Impact of Novel Preventive and Therapeutic HSV-2 Vaccination in the United States: Mathematical Modeling Analyses.Vaccines · 2020Article
- Article
- Treatment as prevention for hepatitis C virus in Pakistan: mathematical modelling projections.BMJ open · 2019Article
- Cost-effectiveness of HIV Prevention Interventions in Sub-Saharan Africa: A Systematic Review.EClinicalMedicine · 2019Article
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCountries in sub-Saharan Africa are scaling-up voluntary male medical circumcision (VMMC) as an HIV intervention. Emerging challenges in these programs call for increased focus on program efficiency (optimizing program impact while minimizing cost). A novel analytic approach was developed to determine how subpopulation prioritization can increase program efficiency using an illustrative application for Zambia. METHODS AND
findingsA population-level mathematical model was constructed describing the heterosexual HIV epidemic and impact of VMMC programs (age-structured mathematical (ASM) model). The model stratified the population according to sex, circumcision status, age group, sexual-risk behavior, HIV status, and stage of infection. A three-level conceptual framework was also developed to determine maximum epidemic impact and program efficiency through subpopulation prioritization, based on age, geography, and risk profile. In the baseline scenario, achieving 80% VMMC coverage by 2017 among males 15-49 year old, 12 VMMCs were needed per HIV infection averted (effectiveness). The cost per infection averted (cost-effectiveness) was USD $1,089 and 306,000 infections were averted. Through age-group prioritization, effectiveness ranged from 11 (20-24 age-group) to 36 (45-49 age-group); cost-effectiveness ranged from $888 (20-24 age-group) to $3,300 (45-49 age-group). Circumcising 10-14, 15-19, or 20-24 year old achieved the largest incidence rate reduction; prioritizing 15-24, 15-29, or 15-34 year old achieved the greatest program efficiency. Through geographic prioritization, effectiveness ranged from 9-12. Prioritizing Lusaka achieved the highest effectiveness. Through risk-group prioritization, prioritizing the highest risk group achieved the highest effectiveness, with only one VMMC needed per infection averted; the lowest risk group required 80 times more VMMCs.
conclusionEpidemic impact and efficiency of VMMC programs can be improved by prioritizing young males (sexually active or just before sexual debut), geographic areas with higher HIV prevalence than the national, and high sexual-risk groups.
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