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Circumcising newborn males is a cost effective strategy for HIV prevention in Rwanda, study finds

Date:
January 21, 2010
Source:
Public Library of Science
Summary:
Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study.

Circumcising newborn boys as a way to prevent HIV infection in later life is more cost-effective than circumcising adult males, finds a new Rwandan study in PLoS Medicine.

It has already been conclusively shown, from three randomized clinical trials in Uganda, Kenya, and South Africa, that adult male circumcision (MC) roughly halves the HIV transmission rate from women to men. Many African countries hit hard by HIV are therefore offering men the procedure as way to control the epidemic. Rwanda is one such country -- about 3% of adults in Rwanda are infected with HIV but only 15% of men are currently circumcised.

But performing the operation in adolescents and adults is linked with a higher risk of complications than circumcising newborns. And the operation is quicker and simpler to perform in newborns. The new study, by Agnes Binagwaho (Rwanda Ministry of Health) and colleagues, therefore set out to compare three different strategies as applied to Rwanda: circumcising newborns (neonates), adolescents, or adults.

The researchers used a technique called "cost-effective analysis," which looks at the balance between the costs of a medical intervention and its benefits. They estimated that each neonatal MC would cost just US$15 whereas each adolescent or adult MC would cost US$59. They found that neonatal MC would in fact save more money than it costs, because the operation is cheap to perform and would prevent HIV infections that are expensive to treat.

The study findings, say the authors, "suggest that Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young."

In an expert commentary on the new study, Seth Kalichman (University of Connecticut) says: "The cost-savings of neonatal MC are compelling and suggest that implementation is economically feasible in developing countries hit hardest by HIV/AIDS. Neonatal MC should therefore be considered a priority in comprehensive HIV prevention plans for southern Africa."



Story Source:

The above story is based on materials provided by Public Library of Science. Note: Materials may be edited for content and length.


Journal References:

  1. Binagwaho A, Pegurri E, Muita J, Bertozzi S. Male Circumcision at Different Ages in Rwanda: A Cost-Effectiveness Study. PLoS Medicine, 2010; 7 (1): e1000211 DOI: 10.1371/journal.pmed.1000211
  2. Kalichman SC. Neonatal Circumcision for HIV Prevention: Cost, Culture, and Behavioral Considerations. PLoS Medicine, 2010; 7 (1): e1000219 DOI: 10.1371/journal.pmed.1000219

Cite This Page:

Public Library of Science. "Circumcising newborn males is a cost effective strategy for HIV prevention in Rwanda, study finds." ScienceDaily. ScienceDaily, 21 January 2010. <www.sciencedaily.com/releases/2010/01/100119133502.htm>.
Public Library of Science. (2010, January 21). Circumcising newborn males is a cost effective strategy for HIV prevention in Rwanda, study finds. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2010/01/100119133502.htm
Public Library of Science. "Circumcising newborn males is a cost effective strategy for HIV prevention in Rwanda, study finds." ScienceDaily. www.sciencedaily.com/releases/2010/01/100119133502.htm (accessed October 23, 2014).

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