Age targeting and scale-up of voluntary medical male circumcision in Mozambique
The voluntary medical male circumcision (VMMC) program in Mozambique aimed to increase male circumcision (MC) coverage to 80 percent among males ages 10 to 49 by 2018. Given the difficulty in attracting adult men over age 20 for circumcision, Mozambique became interested in assessing its age-targeti...
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| description | The voluntary medical male circumcision (VMMC) program in Mozambique aimed to increase male circumcision (MC) coverage to 80 percent among males ages 10 to 49 by 2018. Given the difficulty in attracting adult men over age 20 for circumcision, Mozambique became interested in assessing its age-targeting strategy and progress at the provincial level to inform program planning.
We examined the impact and cost-effectiveness of circumcising different age groups of men using the Decision Makers' Program Planning Toolkit, Version 2.1 (DMPPT 2). We also applied the model to assess the scale-up efforts through the end of September 2017 and project their impact on HIV incidence through 2030. The DMPPT 2 is a compartmental Excel-based model that analyzes the effects of age at circumcision on program impact and cost-effectiveness. The model tracks changes in age-specific MC coverage due to VMMC program circumcisions. Baseline MC prevalence was based on data from the 2011 Demographic and Health Survey. The DMPPT 2 was populated with HIV incidence projections from Spectrum/Goals under an assumption that Mozambique would reach its national targets for HIV treatment and prevention by 2022.
We estimate the VMMC program increased MC coverage among males ages 10 to 49 from 27 percent in 2009 to 48 percent by end of September 2017. Coverage increased primarily in males ages 10 to 29. VMMCs conducted in the national program through the end of September 2017 are projected to avert 67,076 HIV infections from 2010 to 2030. Scaling up circumcisions in males ages 20 to 29 will have the most immediate impact on HIV incidence, while the greatest impact over a 15-year period is obtained by circumcising males ages 15 to 24 in the majority of priority provinces. Circumcising 80 percent of males ages 10 to 29 can achieve 77 percent of the impact through 2030 compared with circumcising 80 percent of males ages 10 to 49.
The VMMC program in Mozambique has made great strides in increasing MC coverage, particularly for males ages 10 to 29. Scaling up and maintaining MC coverage in this age group offers an attainable and cost-effective target for VMMC in Mozambique. |
| doi_str_mv | 10.1371/journal.pone.0211958 |
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We examined the impact and cost-effectiveness of circumcising different age groups of men using the Decision Makers' Program Planning Toolkit, Version 2.1 (DMPPT 2). We also applied the model to assess the scale-up efforts through the end of September 2017 and project their impact on HIV incidence through 2030. The DMPPT 2 is a compartmental Excel-based model that analyzes the effects of age at circumcision on program impact and cost-effectiveness. The model tracks changes in age-specific MC coverage due to VMMC program circumcisions. Baseline MC prevalence was based on data from the 2011 Demographic and Health Survey. The DMPPT 2 was populated with HIV incidence projections from Spectrum/Goals under an assumption that Mozambique would reach its national targets for HIV treatment and prevention by 2022.
We estimate the VMMC program increased MC coverage among males ages 10 to 49 from 27 percent in 2009 to 48 percent by end of September 2017. Coverage increased primarily in males ages 10 to 29. VMMCs conducted in the national program through the end of September 2017 are projected to avert 67,076 HIV infections from 2010 to 2030. Scaling up circumcisions in males ages 20 to 29 will have the most immediate impact on HIV incidence, while the greatest impact over a 15-year period is obtained by circumcising males ages 15 to 24 in the majority of priority provinces. Circumcising 80 percent of males ages 10 to 29 can achieve 77 percent of the impact through 2030 compared with circumcising 80 percent of males ages 10 to 49.
The VMMC program in Mozambique has made great strides in increasing MC coverage, particularly for males ages 10 to 29. Scaling up and maintaining MC coverage in this age group offers an attainable and cost-effective target for VMMC in Mozambique.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0211958</identifier><identifier>PMID: 30794561</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adolescent ; Adult ; Age ; Age Distribution ; Age factors ; AIDS ; AIDS treatment ; Analysis ; Biology and Life Sciences ; Care and treatment ; Child ; Circumcision ; Circumcision, Male - economics ; Circumcision, Male - statistics & numerical data ; Cost-Benefit Analysis ; Demographics ; Government Programs ; Health aspects ; Health surveys ; HIV ; HIV infections ; HIV Infections - epidemiology ; HIV Infections - prevention & control ; Human immunodeficiency virus ; Humans ; Incidence ; Male ; Males ; Medicine and Health Sciences ; Middle Aged ; Mozambique - epidemiology ; People and Places ; Scaling ; Scaling up ; Social Sciences ; Spreadsheet software ; Voluntary Programs ; Young Adult</subject><ispartof>PloS one, 2019-02, Vol.14 (2), p.e0211958</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6ac10a805878016318d39926ad34236ca76a4f5038c8636e3393b9b1e40bb13c3</citedby><cites>FETCH-LOGICAL-c692t-6ac10a805878016318d39926ad34236ca76a4f5038c8636e3393b9b1e40bb13c3</cites><orcidid>0000-0001-8228-4577</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386365/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386365/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30794561$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wester, C. William</contributor><creatorcontrib>Dent, Juan</creatorcontrib><creatorcontrib>Gaspar, Nuno</creatorcontrib><creatorcontrib>Njeuhmeli, Emmanuel</creatorcontrib><creatorcontrib>Kripke, Katharine</creatorcontrib><title>Age targeting and scale-up of voluntary medical male circumcision in Mozambique</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The voluntary medical male circumcision (VMMC) program in Mozambique aimed to increase male circumcision (MC) coverage to 80 percent among males ages 10 to 49 by 2018. Given the difficulty in attracting adult men over age 20 for circumcision, Mozambique became interested in assessing its age-targeting strategy and progress at the provincial level to inform program planning.
We examined the impact and cost-effectiveness of circumcising different age groups of men using the Decision Makers' Program Planning Toolkit, Version 2.1 (DMPPT 2). We also applied the model to assess the scale-up efforts through the end of September 2017 and project their impact on HIV incidence through 2030. The DMPPT 2 is a compartmental Excel-based model that analyzes the effects of age at circumcision on program impact and cost-effectiveness. The model tracks changes in age-specific MC coverage due to VMMC program circumcisions. Baseline MC prevalence was based on data from the 2011 Demographic and Health Survey. The DMPPT 2 was populated with HIV incidence projections from Spectrum/Goals under an assumption that Mozambique would reach its national targets for HIV treatment and prevention by 2022.
We estimate the VMMC program increased MC coverage among males ages 10 to 49 from 27 percent in 2009 to 48 percent by end of September 2017. Coverage increased primarily in males ages 10 to 29. VMMCs conducted in the national program through the end of September 2017 are projected to avert 67,076 HIV infections from 2010 to 2030. Scaling up circumcisions in males ages 20 to 29 will have the most immediate impact on HIV incidence, while the greatest impact over a 15-year period is obtained by circumcising males ages 15 to 24 in the majority of priority provinces. Circumcising 80 percent of males ages 10 to 29 can achieve 77 percent of the impact through 2030 compared with circumcising 80 percent of males ages 10 to 49.
The VMMC program in Mozambique has made great strides in increasing MC coverage, particularly for males ages 10 to 29. Scaling up and maintaining MC coverage in this age group offers an attainable and cost-effective target for VMMC in Mozambique.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Age Distribution</subject><subject>Age factors</subject><subject>AIDS</subject><subject>AIDS treatment</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Circumcision</subject><subject>Circumcision, Male - economics</subject><subject>Circumcision, Male - statistics & numerical data</subject><subject>Cost-Benefit Analysis</subject><subject>Demographics</subject><subject>Government Programs</subject><subject>Health aspects</subject><subject>Health surveys</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - prevention & control</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Males</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mozambique - epidemiology</subject><subject>People and Places</subject><subject>Scaling</subject><subject>Scaling up</subject><subject>Social Sciences</subject><subject>Spreadsheet software</subject><subject>Voluntary Programs</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7rr6D0QLgujFjElPkzY3wrD4MbAy4NdtSNOkk6VNZpt2UX-9Z3a6y1T2QnqRkvOc9yRv3iR5TsmSQkHfXYax96pd7oI3S5JRKlj5IDmlArIFzwg8PPo_SZ7EeEkIg5Lzx8kJkELkjNPTZLNqTDqovjGD802qfJ1GrVqzGHdpsOl1aEeP5d9pZ2qHhbTDYqpdr8dOu-iCT51Pv4Q_qqvc1WieJo-saqN5Nq1nyY-PH76ff15cbD6tz1cXC81FNiy40pSokrCyKAnlQMsahMi4qiHPgGtVcJVbRqDUJQduAARUoqImJ1VFQcNZ8vKgu2tDlJMXUWYUccqYEEisD0Qd1KXc9a7Da8ignLzZCH0jVT843RpZEGVFxqpCcMgtscLkuTC2KjiOtDxDrffTtLFCI7TxQ6_amei84t1WNuFactgfn6HAm0mgD-hSHGTnojZtq7wJ4825GeMlp4Doq3_Q-283UQ2-h3TeBpyr96JyxQoGhEC-H7u8h8KvNp3TGBzrcH_W8HbWgMxgfg2NGmOU629f_5_d_Jyzr4_YrVHtsI2YrQEDFOdgfgB1H2Lsjb0zmRK5z_2tG3KfeznlHtteHD_QXdNt0OEvJ2D7Ng</recordid><startdate>20190222</startdate><enddate>20190222</enddate><creator>Dent, Juan</creator><creator>Gaspar, Nuno</creator><creator>Njeuhmeli, Emmanuel</creator><creator>Kripke, Katharine</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8228-4577</orcidid></search><sort><creationdate>20190222</creationdate><title>Age targeting and scale-up of voluntary medical male circumcision in Mozambique</title><author>Dent, Juan ; Gaspar, Nuno ; Njeuhmeli, Emmanuel ; Kripke, Katharine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-6ac10a805878016318d39926ad34236ca76a4f5038c8636e3393b9b1e40bb13c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Distribution</topic><topic>Age factors</topic><topic>AIDS</topic><topic>AIDS treatment</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Circumcision</topic><topic>Circumcision, Male - 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William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age targeting and scale-up of voluntary medical male circumcision in Mozambique</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-02-22</date><risdate>2019</risdate><volume>14</volume><issue>2</issue><spage>e0211958</spage><pages>e0211958-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The voluntary medical male circumcision (VMMC) program in Mozambique aimed to increase male circumcision (MC) coverage to 80 percent among males ages 10 to 49 by 2018. Given the difficulty in attracting adult men over age 20 for circumcision, Mozambique became interested in assessing its age-targeting strategy and progress at the provincial level to inform program planning.
We examined the impact and cost-effectiveness of circumcising different age groups of men using the Decision Makers' Program Planning Toolkit, Version 2.1 (DMPPT 2). We also applied the model to assess the scale-up efforts through the end of September 2017 and project their impact on HIV incidence through 2030. The DMPPT 2 is a compartmental Excel-based model that analyzes the effects of age at circumcision on program impact and cost-effectiveness. The model tracks changes in age-specific MC coverage due to VMMC program circumcisions. Baseline MC prevalence was based on data from the 2011 Demographic and Health Survey. The DMPPT 2 was populated with HIV incidence projections from Spectrum/Goals under an assumption that Mozambique would reach its national targets for HIV treatment and prevention by 2022.
We estimate the VMMC program increased MC coverage among males ages 10 to 49 from 27 percent in 2009 to 48 percent by end of September 2017. Coverage increased primarily in males ages 10 to 29. VMMCs conducted in the national program through the end of September 2017 are projected to avert 67,076 HIV infections from 2010 to 2030. Scaling up circumcisions in males ages 20 to 29 will have the most immediate impact on HIV incidence, while the greatest impact over a 15-year period is obtained by circumcising males ages 15 to 24 in the majority of priority provinces. Circumcising 80 percent of males ages 10 to 29 can achieve 77 percent of the impact through 2030 compared with circumcising 80 percent of males ages 10 to 49.
The VMMC program in Mozambique has made great strides in increasing MC coverage, particularly for males ages 10 to 29. Scaling up and maintaining MC coverage in this age group offers an attainable and cost-effective target for VMMC in Mozambique.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30794561</pmid><doi>10.1371/journal.pone.0211958</doi><tpages>e0211958</tpages><orcidid>https://orcid.org/0000-0001-8228-4577</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adolescent Adult Age Age Distribution Age factors AIDS AIDS treatment Analysis Biology and Life Sciences Care and treatment Child Circumcision Circumcision, Male - economics Circumcision, Male - statistics & numerical data Cost-Benefit Analysis Demographics Government Programs Health aspects Health surveys HIV HIV infections HIV Infections - epidemiology HIV Infections - prevention & control Human immunodeficiency virus Humans Incidence Male Males Medicine and Health Sciences Middle Aged Mozambique - epidemiology People and Places Scaling Scaling up Social Sciences Spreadsheet software Voluntary Programs Young Adult |
| title | Age targeting and scale-up of voluntary medical male circumcision in Mozambique |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T08%3A28%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Age%20targeting%20and%20scale-up%20of%20voluntary%20medical%20male%20circumcision%20in%20Mozambique&rft.jtitle=PloS%20one&rft.au=Dent,%20Juan&rft.date=2019-02-22&rft.volume=14&rft.issue=2&rft.spage=e0211958&rft.pages=e0211958-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0211958&rft_dat=%3Cgale_plos_%3EA575300345%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2186315599&rft_id=info:pmid/30794561&rft_galeid=A575300345&rft_doaj_id=oai_doaj_org_article_70af925b79634f0f9e449efb769b1f62&rfr_iscdi=true |