Table 2.
Sensitivity analysis on potential risk behavior change and protective circumcision effect: total infections prevented and percentage of cumulative infections prevented after 20 years by various 5-year expanded circumcision programsa
| Protective effect on HIV transmission due to circumcision | ||||
|---|---|---|---|---|
| Change in condom use post-circumcisionb | 20(%)c | 40(%)c | 60(%)c | 80(%)c |
| Programs with 10% coverage goals | ||||
| Condom use increases by 100% | 145,000 (49) | 126,000 (47) | 107,000 (43) | 87,000 (39) |
| Condom use increases by 50% | 87,000 (30) | 81,000 (30) | 74,000 (30) | 66,000 (30) |
| Condom use increases by 25% | 51,000 (17) | 53,000 (20) | 54,000 (22)d | 54,000 (25) |
| No change in condom use | 11,000 (4) | 21,000 (8) | 32,000 (13)d | 41,000 (19) |
| Condom use decreases by 25% | [34,000 (12)] | [14,000 (5)] | 7,000 (3)d | 27,000 (12) |
| Condom use decreases by 50% | [83,000 (28)] | [53,000 (20)] | [21,000 (8)] | 12,000 (5) |
| Condom use decreases by 100% | [186,000 (63)] | [139,000 (51)] | [84,000 (34)] | [23,000 (11)] |
| Programs with 20% coverage goals | ||||
| Condom use increases by 100% | 175,000 (59) | 158,000 (58) | 139,000 (57) | 119,000 (54) |
| Condom use increases by 50% | 109,000 (37) | 106,000 (39) | 102,000 (41) | 96,000 (44) |
| Condom use increases by 25% | 67,000 (23) | 73,000 (27) | 79,000 (32)d | 83,000 (38) |
| No change in condom use | 18,000 (6) | 36,000 (13) | 52,000 (21)d | 68,000 (31) |
| Condom use decreases by 25% | [37,000 (13)] | [7,000 (3)] | 23,000 (9)d | 51,000 (23) |
| Condom use decreases by 50% | [97,000 (33)] | [55,000 (20)] | [10,000 (4)] | 33,000 (15) |
| Condom use decreases by 100% | [222,000 (75)] | [161,000 (59)] | [87,000 (35)] | [9,000 (4)] |
Total infections prevented for male and female populations. Percentages reflect the proportion of expected infections prevented by each program scenario. Numbers in brackets represent negative values, which indicate the number and percentage of additional infections caused by a particular program
Considering an increase or decrease from baseline condom use levels of 50%. A 25% difference implies an absolute increase to 62.5% or decrease to 37.5% in condom use levels. A 50% difference implies an absolute increase to 75% or decrease to 25% in condom use levels. A 100% difference implies an absolute increase to 100% or decrease to 0% in condom use levels
Total expected infections over 20 years for various circumcision protective effects in the absence of expanded circumcision programs: 295,000 (20); 271,000 (40); 246,000 (60); and 220,000 (80%)
Outcomes for these simulations are examined in further detail in Fig. 2, which demonstrates infections prevented over time and stratified by gender for each of these scenarios