Meta-analysis of average costs of HIV testing and counselling and voluntary medical male circumcision across thirteen countries

Background: With the rapidly-increased HIV epidemic among men who have sex with men worldwide, the effectiveness of voluntary medical male circumcision as the tool of HIV prevention still remains undetermined. Purpose: In the current study, we conducted a systematic review and meta-analysis to assess the association between voluntary medical male circumcision and HIV risk among men who have sex with men. Methods and Conclusion: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline, we conducted a comprehensive literature search through multiple databases. A total of 37 articles/abstracts were included in the analysis. We employed random-effects models and subgroup analyses based upon key study characteristics derived from empirical studies. A total of 117,293 men who have sex with men were included in the meta-analysis, and no randomized control trials have been identified. The odds of being HIV positive were 7% lower among men who have sex with men who were circumcised than among men who have sex with men who were uncircumcised (adjusted odds ratio, 0.93; 95% confidence interval, 0.88–0.99). The evidence for the potential protective effect of voluntary medical male circumcision was stronger among men who have sex with men in Asia and Africa (adjusted odds ratio, 0.62; 95% confidence interval, 0.53–0.73). Our meta-analyses may suggest a protective effect of voluntary medical male circumcision against HIV infection among men who have sex with men, especially in settings like Asia/Africa.

Download Full-text

Voluntary Medical Male Circumcision Programs Can Address Low HIV Testing and Counseling Usage and ART Enrollment among Young Men: Lessons from Lesotho

PLoS ONE ◽

10.1371/journal.pone.0083614 ◽

2014 ◽

Vol 9 (5) ◽

pp. e83614 ◽

Cited By ~ 5

Author(s):

Virgile Kikaya ◽

Laura Skolnik ◽

Macarena C. García ◽

John Nkonyana ◽

Kelly Curran ◽

...

Keyword(s):

Hiv Testing ◽

Male Circumcision ◽

Young Men ◽

Voluntary Medical Male Circumcision ◽

Medical Male Circumcision ◽

Hiv Testing And Counseling ◽

Testing And Counseling

Download Full-text

Economic compensation interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0227623 ◽

2020 ◽

Vol 15 (1) ◽

pp. e0227623 ◽

Cited By ~ 2

Author(s):

Caitlin E. Kennedy ◽

Ping Teresa Yeh ◽

Kaitlyn Atkins ◽

Virginia A. Fonner ◽

Michael D. Sweat ◽

...

Keyword(s):

Systematic Review ◽

Hiv Prevention ◽

Male Circumcision ◽

Meta Analysis ◽

Voluntary Medical Male Circumcision ◽

Medical Male Circumcision

Download Full-text

Messaging Circumstances and Economic Pressures as Influences on Linkage to Medical Male Circumcision following Community-Based HIV Testing for Men in Rural Southwest Uganda: A Qualitative Study

AIDS Research and Treatment ◽

10.1155/2018/8387436 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hannah N. Gilbert ◽

Monique A. Wyatt ◽

Stephen Asiimwe ◽

Bosco Turyamureeba ◽

Elioda Tumwesigye ◽

...

Keyword(s):

Qualitative Study ◽

Hiv Testing ◽

Male Circumcision ◽

Sub Saharan Africa ◽

Voluntary Medical Male Circumcision ◽

Hiv Education ◽

Community Based ◽

Medical Male Circumcision ◽

Demand Creation

Voluntary medical male circumcision (MMC) reduces risk of HIV infection, but uptake remains suboptimal among certain age groups and locations in sub-Saharan Africa. We analysed qualitative data as part of the Linkages Study, a randomized controlled trial to evaluate community-based HIV testing and follow-up as interventions promoting linkage to HIV treatment and prevention in Uganda and South Africa. Fifty-two HIV-negative uncircumcised men participated in the qualitative study. They participated in semistructured individual interviews exploring (a) home HTC experience; (b) responses to test results; (c) efforts to access circumcision services; (d) outcomes of efforts; (e) experiences of follow-up support; and (f) local HIV education and support. Interviews were audio-recorded, translated, transcribed, and summarized into “linkage summaries.” Summaries were analysed inductively to identify the following three thematic experiences shaping men’s circumcision choices: (1) intense relief upon receipt of an unanticipated seronegative diagnosis, (2) the role of peer support in overcoming fear, and (3) anticipation of missed economic productivity. Increased attention to the timing of demand creation activities, to who delivers information about the HIV prevention benefits of MMC, and to the importance of missed income during recovery as a barrier to uptake promises to strengthen and sharpen future MMC demand creation strategies.

Download Full-text