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The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models

Citation

Stover, John (2021), The impact of the program for medical male circumcision on HIV in South Africa: analysis using three epidemiological models, Dryad, Dataset, https://doi.org/10.5061/dryad.b8gtht7bp

Abstract

Background: South Africa began offering medical male circumcision (MMC) in 2010. We evaluated the current and future impact of this program to see if it is effective in preventing new HIV infections.

Methods: The Thembisa, Goals and EMOD HIV transmission models were calibrated to South Africa’s HIV epidemic, fitting to household survey data on HIV prevalence, risk behaviors, and proportions of men circumcised, and to programmatic data on intervention roll-out including program-reported MMCs over 2009-2017. We compared the actual program accomplishments through 2017 and program targets through 2021 with a counterfactual scenario of no MMC program.

Results: The MMC program averted 71,000-83,000 new HIV infections from 2010 to 2017. The future benefit of the circumcision already conducted will grow to 496,000-518,000 infections (6-7% of all new infections) by 2030. If program targets are met by 2021 the benefits will increase to 723,000-760,000 infections averted by 2030. The cost would be $1,070-1,220 per infection averted relative to no MMC. The savings from averted treatment needs would become larger than the costs of the MMC program around 2034-2039. In the Thembisa model, when modelling South Africa’s 9 provinces individually, the 9-provinces-aggregate results were similar to those of the single national model. Across provinces, projected long-term impacts were largest in Free State, KwaZulu-Natal and Mpumalanga (23-27% reduction over 2017-2030), reflecting these provinces’ greater MMC scale-up.

Conclusions: MMC has already had a modest impact on HIV incidence in South Africa and can substantially impact South Africa’s HIV epidemic in the coming years.

Methods

The data files show the results from three different HIV simulation models used to project the expected effects of medical male circumcison on the HIV epidemic in South Africa. The data are organized in worksheets by indicator: new HIV infections, HIV prevalence, population size, people living with HIV (PLHIV), the number circumcised (VMMC) and the number receiving antiretroviral therapy (ART).

Usage Notes

The data are internally documented.

Funding

Bill and Melinda Gates Foundation, Award: OPP1118702