Evidence map›Paper›PMID 32631314›Full record

ArticleBMC medicine2020

Mapping male circumcision for HIV prevention efforts in sub-Saharan Africa.

Michael A Cork, Kate F Wilson, Samantha Perkins, Michael L Collison, Aniruddha Deshpande, Jeffrey W Eaton, Lucas Earl, Emily Haeuser, Jessica E Justman, Damaris K Kinyoki and 16 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Michael A CorkInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Kate F WilsonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Samantha PerkinsInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Michael L CollisonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Aniruddha DeshpandeInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Jeffrey W EatonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Lucas EarlInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Emily HaeuserInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Jessica E JustmanICAP, Mailman School of Public Health, Columbia University, New York, NY, USA.
Damaris K KinyokiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Benjamin K MayalaDHS program, ICF International, Rockville, MD, USA.
Jonathan F MosserInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Christopher J L MurrayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
John N NkengasongAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia.
Peter PiotLondon School of Hygiene & Tropical Medicine, London, UK.
Benn SartoriusDepartment of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
Lauren E SchaefferInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Audrey L SerfesInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Amber SligarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Krista M SteubenInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Frank C TanserSchool of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
John D VanderHeideInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Mingyou YangInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Njeri WabiriHIV/AIDS, STIs & TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.
Simon I HayInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
Laura Dwyer-LindgrenInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. ladwyer@uw.edu.ORCID 0000-0002-3872-6451

Funding

Bill and Melinda Gates Foundation OPP1132415Medical Research Council MR/R015600/1
6 · The paper itself

Abstract

backgroundHIV remains the largest cause of disease burden among men and women of reproductive age in sub-Saharan Africa. Voluntary medical male circumcision (VMMC) reduces the risk of female-to-male transmission of HIV by 50-60%. The World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) identified 14 priority countries for VMMC campaigns and set a coverage goal of 80% for men ages 15-49. From 2008 to 2017, over 18 million VMMCs were reported in priority countries. Nonetheless, relatively little is known about local variation in male circumcision (MC) prevalence.

methodsWe analyzed geo-located MC prevalence data from 109 household surveys using a Bayesian geostatistical modeling framework to estimate adult MC prevalence and the number of circumcised and uncircumcised men aged 15-49 in 38 countries in sub-Saharan Africa at a 5 × 5-km resolution and among first administrative level (typically provinces or states) and second administrative level (typically districts or counties) units.

resultsWe found striking within-country and between-country variation in MC prevalence; most (12 of 14) priority countries had more than a twofold difference between their first administrative level units with the highest and lowest estimated prevalence in 2017. Although estimated national MC prevalence increased in all priority countries with the onset of VMMC campaigns, seven priority countries contained both subnational areas where estimated MC prevalence increased and areas where estimated MC prevalence decreased after the initiation of VMMC campaigns. In 2017, only three priority countries (Ethiopia, Kenya, and Tanzania) were likely to have reached the MC coverage target of 80% at the national level, and no priority country was likely to have reached this goal in all subnational areas.

conclusionsDespite MC prevalence increases in all priority countries since the onset of VMMC campaigns in 2008, MC prevalence remains below the 80% coverage target in most subnational areas and is highly variable. These mapped results provide an actionable tool for understanding local needs and informing VMMC interventions for maximum impact in the continued effort towards ending the HIV epidemic in sub-Saharan Africa.

Indexed as

AdolescentAdultAfricaCircumcision, MaleFemaleHIV InfectionsHumansMaleMiddle AgedPrevalenceYoung AdultAfricaGeospatialGeostatisticsHIVHIV preventionInterventionMale circumcisionMappingMedical male circumcisionSpatial statisticsVoluntary medical male circumcision

Identifiers

PMID32631314
PMCPMC7339571

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.