The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

Table 3

Explanation of calculated increased race/gender specific HIV rates.

Race/gender	Current circumcision rate^a	Expected HIV cases due to heterosexual contact at current circumcision rates^b	Additional expected HIV cases due to heterosexual contact if circumcision rates drop to zero	Total expected HIV cases due to heterosexual contact if circumcision rates drop to zero	Calculated factor^c
Black male	73%	60.5	47.1	107.6	1.8
White male	88%	1.8	2.0	3.8	2.1
Other male	46%	12.8	4.9	17.7	1.4
Black female	73%	69.5	35.1	104.6	1.5
White female	88%	7.0	4.8	11.8	1.7
Other female	46%	24.4	6.5	30.9	1.3

^aAs reported in 1999–2004 national health and nutrition examination survey. We applied the race specific male circumcision rate to the concordant race females.
^bSee Table 2 for explanation of calculation of expected HIV cases at current circumcision rates.
^cThe relationship between expected cases (at current circumcision rates) and the total number of cases that would be observed in the absence of any circumcision is: Expected cases = Total cases (1 − rate) + Total cases * rate * (1 − eff), where “rate” is the proportion of individuals in the population who are circumcised and “eff” is effectiveness—that is, the amount by which circumcision reduces disease transmission. Total cases − expected cases is the number of additional cases that would be added in the absence of circumcision. The calculated factor is total cases/expected cases.