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 âbudget-impactâ analyses. The VMMC would be an effective and economic intervention strategy to curb the HIV epidemic in China.
| Identifer | oai:union.ndltd.org:VANDERBILT/oai:VANDERBILTETD:etd-03112017-080150 |
| Date | 27 March 2017 |
| Creators | Zhang, Chen |
| Contributors | Sten Vermund, Han-zhu Qian, Byran Shepherd, David Penson, Glenn Webb |
| Publisher | VANDERBILT |
| Source Sets | Vanderbilt University Theses |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.vanderbilt.edu/available/etd-03112017-080150/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Vanderbilt University or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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