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Title page for ETD etd-03112017-080150


Type of Document Dissertation
Author Zhang, Chen
URN etd-03112017-080150
Title Voluntary Medical Male Circumcision for Reducing HIV Incidence among Men Who Have Sex with Men
Degree PhD
Department Epidemiology
Advisory Committee
Advisor Name Title
Sten Vermund Committee Chair
Byran Shepherd Committee Member
David Penson Committee Member
Glenn Webb Committee Member
Han-zhu Qian Committee Member
Keywords
  • MSM
  • circumcision
  • HIV prevention
Date of Defense 2017-01-25
Availability restricted
Abstract
The primary objective of this research project is to evaluate the protective efficacy, epidemiological and economic impacts of voluntary medical male circumcision (VMMC) as an intervention strategy to reduce HIV infection among men who have sex with men (MSM) population in China. Therefore, (1) we conducted a systematic review and meta-analysis to evaluate the protective efficacy of the association between male circumcision and HIV infection among MSM with a series of sensitivity analyses. Our findings suggested a statistically significant protective efficacy of VMMC among MSM (aOR=0.93, 95%=0.88,0.99), especially among MSM with moderate risk profiles; (2) we employed a transmission model to assess the epidemiological impact of VMMC by projecting numbers of new HIV cases for the next decade among MSM in Beijing, China. Our model suggested even at 15% VMMC annual uptake rate, the reduction in new infection is substantial; and (3) we assessed the economic impact of VMMC program in China by a series of “budget-impact” analyses. The VMMC would be an effective and economic intervention strategy to curb the HIV epidemic in China.
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