TABLE 1.
Summary of Key Parameters and Values for the Model
| Key Assumptions | ||
| Parameter | Value | Source |
| Basic CC model, demographics, and epidemiology | ||
| Ugandan demographics (age structure) | Multiple | UN World Population Prospects, 201734 |
| 2018 Uganda CC crude rate | 28.8 per 100,000 | WHO-affiliated HPV Information Centre15 |
| 2018 Uganda HPV 16/18 prevalence | 3.6% | WHO-affiliated HPV Information Centre15 |
| Intervention impacts | ||
| Impact of VMMC on HPV acquisition by HIV-negative men | 53% reduction | Published literature35–37 |
| Impact of VMMC on HPV clearance by HIV-negative men | 56% increase | Published literature36,38 |
| Impact of VMMC on HPV acquisition and clearance by HIV-positive men | None | Published literature10 |
| Impact of HPV9 vaccine on acquisition and CC | 100% efficacy against 16/18 and other HR HPV, ie, against CC | Idealized theoretical—WHO modeling meeting20 |
| Impact of HPV screen-and-treat | 88% sensitivity; CC mortality reduction by stage: 99% at 0, 87% at 1, 74% at 2, 46% at 3, 0% at 4 | Details in basic CC model,22 primary data in published literature39 |
| Intervention coverage (baseline and scale-up scenario) | ||
| HPV vaccination coverage | Baseline: 5% among all women “substantial control” scale-up: Immediate, sustained 90% coverage of 9–24-year-old adolescent girls and young women “Moderate aggressive” scaleup: same structure, 45% coverage |
2018 UNICEF reported HPV coverage: 15-year-olds27 Idealized theoretical—WHO modeling meeting18 Author conjecture, bounded by ranges of HPV coverage elsewhere in East Africa (17%–85%)27 and Ugandan girl primary school attendance (84%)24 |
| HPV screen-and-treat coverage | Baseline: 9% Scale-up: 25% coverage by 2029, 35% by 2044, 60% thereafter (among the 90% of women ever possibly accessing screening) |
WHO modeling meeting20 |
| VMMC coverage | Baseline: coverage by 5-year age band ranging: 45.5% in 15–19 through 33.7% in 50–54; overall 15–49 years 45.9% Scale-up: linear to 90% of 15–49 years-old males by 2023 (consistent with current WHO/UNAIDS guidance) |
2016 Demographic health survey for baseline24; idealized target for final |