20,000 HIV Infections Averted

SMC Small LogoThe SMC Programme in Uganda started in the second half of 2010. In the twelve months October 2010 to September 2011, a total of 40,000 SMCs were performed. From October 2011 to September 30th, 2012, PEPFAR reports a total of 348,000; which is a significant year-on-year increase. So, to date, the SMC programme in Uganda has reached a total of 388,000.

In 2011, DMPPT modelling for Uganda showed that in order to reach the target 80% prevalence of adult males circumcised by 2015, it needed to perform 4.25m circumcisions and an additional 2.1m in the years 2016 to 2025 to maintain that degree of prevalence. The total discounted cost of doing so was estimated at just over $350m. The number of SMCs required to avert one future infection varies from country to country; this modelling indicated that Uganda needs 19. This suggests that such a programme would avert 350,000 new infections, 25% of the total expected over that 14 year period, at a cost of $1,408 for each HIA, which in turn would generate future savings of $5,992.

In summary, 6.35m SMCs over the years 2011 – 2025, at a discounted cost of $350m, could generate total future savings of $1.52 billion.

The country still has a long way to go in the national scale-up of the programme. It has set a challenging target of 1m SMCs for the 12 months to the end of September 2013, a 250% increase in the current rate of output.

The good news is that these 388,000 SMCs may potentially avert some 20,000 new HIV infections, saving the country more than $100m in the cost of future treatments.

SMC is not an invisible condom, it is only partially protective against infection (60%) and men must continue to be serious about protecting themselves and their partner(s).