Cost-Effectiveness of Newborn Circumcision in Reducing Lifetime HIV Risk among U.S. Males

• DOI: 10.1371/journal.pone.0008723
• Publication Date: 2010-01-15T23:39:31Z
• Authors: Stephanie L. Sansom; Vimalanand S. Prabhu; Angela B. Hutchinson; Qian An; H. Irene Hall; Ram K. Shrestha; Arielle Lasry; Allan W. Taylor
• Keywords: Male Circumcision

HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision a U.S. male's lifetime risk HIV, including associated costs and quality-adjusted life-years saved.Given published estimates males' risk, calculated fraction attributable to behavior from 2005-2006 surveillance data. We assumed 60% efficacy reducing heterosexually-acquired over lifetime, varied sensitivity analyses. differences expected treatment life years (QALYs) males. The main outcome measure cost per HIV-related QALY saved. Circumcision reduced all males by 15.7% base case analysis, ranging 7.9% for white 20.9% black Newborn cost-saving prevention intervention all, Hispanic net saved $87,792 Results were most sensitive discount rate, cost.Newborn resulted slight increase QALYs. It 1.87% about 16%. race ethnicity. Racial ethnic groups who could benefit may have least access it due insurance coverage state Medicaid policies, these financial barriers should be addressed. More data long-term protective as well its preventing MSM would useful.