%PDF-1.6
%
1 0 obj
<>
endobj
2 0 obj
<>stream
Susanne F. Awad, Sema K. Sgaier, Fiona K. Lau, Yousra A. Mohamoud, Bushimbwa C. Tambatamba, Katharine E. Kripke, Anne G. Thomas, Naomi Bock, Jason B. Reed, Emmanuel Njeuhmeli, Laith J. Abu-Raddad
Could Circumcision of HIV-Positive Males Benefit Voluntary Medical Male Circumcision Programs in Africa? Mathematical Modeling Analysis
www.plosone.org
www.plosone.org
endstream
endobj
3 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 12 0 R/Annots 13 0 R/Contents 14 0 R/TrimBox[0 0 612 792]>>
endobj
13 0 obj
[15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R]
endobj
15 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref001)>>
endobj
16 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref003)>>
endobj
17 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref004)>>
endobj
18 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref010)>>
endobj
19 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref011)>>
endobj
20 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref012)>>
endobj
21 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref011)>>
endobj
22 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref011)>>
endobj
23 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref011)>>
endobj
24 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref013)>>
endobj
25 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref013)>>
endobj
26 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref014)>>
endobj
27 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref015)>>
endobj
28 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref016)>>
endobj
29 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref017)>>
endobj
30 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref018)>>
endobj
31 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref025)>>
endobj
32 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref018)>>
endobj
33 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref022)>>
endobj
34 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref026)>>
endobj
35 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref021)>>
endobj
36 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref023)>>
endobj
37 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref027)>>
endobj
38 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref029)>>
endobj
39 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref018)>>
endobj
40 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref030)>>
endobj
41 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref031)>>
endobj
42 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref019)>>
endobj
43 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref020)>>
endobj
14 0 obj
[44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R]
endobj
44 0 obj
<>stream
q
0.45 0.36 0.35 0.01 k
0 w
575.9997 452.6144 m
199.9998 452.6144 l
199.9998 453.1144 l
575.9997 453.1144 l
f*
0.83 0.64 0.02 0 k
426.5008 367.937 m
431.263 367.937 l
h
f*
436.422 367.937 m
441.1843 367.937 l
h
f*
321.1654 341.915 m
325.9276 341.915 l
h
f*
331.1433 341.915 m
340.611 341.915 l
h
f*
540.5102 315.9496 m
549.978 315.9496 l
h
f*
554.4567 315.9496 m
563.9811 315.9496 l
h
f*
224.9008 276.9449 m
234.4252 276.9449 l
h
f*
203.4142 237.9402 m
212.9386 237.9402 l
h
f*
448.4976 237.9402 m
457.9654 237.9402 l
h
f*
462.4441 237.9402 m
471.9685 237.9402 l
h
f*
554.5134 224.9008 m
564.0378 224.9008 l
h
f*
200.0126 211.9181 m
209.537 211.9181 l
h
f*
518.2866 211.9181 m
527.811 211.9181 l
h
f*
545.4425 172.9134 m
554.9669 172.9134 l
h
f*
559.389 172.9134 m
568.9134 172.9134 l
h
f*
222.9732 107.9433 m
232.4976 107.9433 l
h
f*
237.6567 107.9433 m
247.1811 107.9433 l
h
f*
533.4236 107.9433 m
542.948 107.9433 l
h
f*
547.3701 107.9433 m
556.8945 107.9433 l
h
f*
200.0126 94.9039 m
209.537 94.9039 l
h
f*
245.3102 94.9039 m
254.778 94.9039 l
h
f*
259.2567 94.9039 m
268.7811 94.9039 l
h
f*
273.2031 94.9039 m
282.7276 94.9039 l
h
f*
287.8866 94.9039 m
297.411 94.9039 l
h
f*
347.6976 94.9039 m
357.222 94.9039 l
h
f*
361.6441 94.9039 m
371.1685 94.9039 l
h
f*
375.5906 94.9039 m
385.115 94.9039 l
h
f*
527.4142 81.9213 m
536.8819 81.9213 l
h
f*
541.3606 81.9213 m
550.885 81.9213 l
h
f*
0 g
1 j
1 J
9.5 0 0 9.5 200.0125 707.7543 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(males)Tj
2.8585 0 Td
(was)Tj
1.9812 0 Td
(based)Tj
2.9122 0 Td
(on)Tj
1.3129 0 Td
(their)Tj
2.1424 0 Td
(representation)Tj
6.5346 0 Td
(in)Tj
0.9847 0 Td
(the)Tj
1.5933 0 Td
(population)Tj
4.7682 0 Td
(\(e.g.)Tj
2.202 0 Td
(12.6%)Tj
3.0256 0 Td
(of)Tj
1.0503 0 Td
(those)Tj
2.6377 0 Td
(circumcised)Tj
-34.0036 -1.474 Td
(in)Tj
0.9846 0 Td
(2010)Tj
2.4109 0 Td
(would)Tj
2.7989 0 Td
(be)Tj
1.3188 0 Td
(HIV-positive)Tj
5.5499 0 Td
(based)Tj
2.9123 0 Td
(on)Tj
1.3188 0 Td
(HIV)Tj
1.8739 0 Td
(prevalence)Tj
5.0486 0 Td
(among)Tj
3.2464 0 Td
(males)Tj
2.8585 0 Td
(of)Tj
1.0503 0 Td
(12.6%)Tj
3.0256 0 Td
(in)Tj
0.9847 0 Td
(2010\).)Tj
-35.3822 -1.474 Td
(However,)Tj
4.3981 0 Td
(if)Tj
0.7161 0 Td
(a)Tj
0.7639 0 Td
(program)Tj
3.9088 0 Td
(that)Tj
1.8679 0 Td
(only)Tj
2.029 0 Td
(reaches)Tj
3.7417 0 Td
(out)Tj
1.5934 0 Td
(to)Tj
1.0443 0 Td
(HIV-negative)Tj
5.9438 0 Td
(males)Tj
2.8585 0 Td
(is)Tj
0.931 0 Td
(associated)Tj
4.9412 0 Td
(with)Tj
1.9812 0 Td
(20%)Tj
-36.7189 -1.474 Td
(lower)Tj
2.578 0 Td
(uptake)Tj
3.1867 0 Td
(among)Tj
3.2464 0 Td
(higher-risk)Tj
4.8278 0 Td
(males,)Tj
3.1331 0 Td
(the)Tj
1.5993 0 Td
(effectiveness)Tj
5.9975 0 Td
(would)Tj
2.7928 0 Td
(be)Tj
1.3189 0 Td
(13.2)Tj
2.1424 0 Td
(VMMCs)Tj
3.7596 0 Td
(per)Tj
1.6471 0 Td
(infec-)Tj
-36.2296 -1.474 Td
(tion)Tj
1.8081 0 Td
(averted.)Tj
3.7955 0 Td
(If)Tj
0.7758 0 Td
(improved)Tj
4.2848 0 Td
(inclusivity)Tj
4.4399 0 Td
(of)Tj
1.0503 0 Td
(HIV-positive)Tj
5.5499 0 Td
(males)Tj
2.8585 0 Td
(is)Tj
0.931 0 Td
(associated)Tj
4.9472 0 Td
(with)Tj
1.9753 0 Td
(20%)Tj
2.202 0 Td
(higher)Tj
-34.6183 -1.474 Td
(uptake)Tj
3.1867 0 Td
(among)Tj
3.2464 0 Td
(higher-risk)Tj
4.8278 0 Td
(males,)Tj
3.133 0 Td
(the)Tj
1.5994 0 Td
(effectiveness)Tj
5.9975 0 Td
(would)Tj
2.7928 0 Td
(be)Tj
1.3189 0 Td
(12.4.)Tj
2.4228 0 Td
(As)Tj
1.3786 0 Td
(the)Tj
1.5933 0 Td
(assumed)Tj
4.2371 0 Td
(VMMC)Tj
-35.7343 -1.474 Td
(efficacy)Tj
3.5746 0 Td
(against)Tj
3.4075 0 Td
(male-to-female)Tj
6.8151 0 Td
(HIV)Tj
1.8738 0 Td
(transmission)Tj
5.7767 0 Td
(was)Tj
1.9753 0 Td
(increased)Tj
4.5056 0 Td
(from)Tj
2.202 0 Td
(0%)Tj
1.6531 0 Td
(to)Tj
1.0443 0 Td
(20%)Tj
2.2021 0 Td
(and)Tj
1.8679 0 Td
(46%,)Tj
-36.898 -1.474 Td
(the)Tj
1.5933 0 Td
(effectiveness)Tj
5.9975 0 Td
(of)Tj
1.0443 0 Td
(circumcising)Tj
5.6574 0 Td
(regardless)Tj
4.8338 0 Td
(of)Tj
1.0443 0 Td
(HIV)Tj
1.8798 0 Td
(status)Tj
2.8645 0 Td
(improved)Tj
4.2848 0 Td
(from)Tj
2.208 0 Td
(14.0)Tj
2.1424 0 Td
(to)Tj
1.0443 0 Td
(11.5)Tj
2.1424 0 Td
(and)Tj
-36.7368 -1.474 Td
(9.1,)Tj
1.8738 0 Td
(respectively.)Tj
5.711 0 Td
(The)Tj
1.9276 0 Td
(reduction)Tj
4.2848 0 Td
(in)Tj
0.9846 0 Td
(the)Tj
1.5934 0 Td
(HIV)Tj
1.8798 0 Td
(incidence)Tj
4.3862 0 Td
(rate)Tj
1.9216 0 Td
(among)Tj
3.2464 0 Td
(females)Tj
3.688 0 Td
(increased)Tj
4.4996 0 Td
(accord-)Tj
-35.9968 -1.474 Td
(ingly,)Tj
2.5183 0 Td
(from)Tj
2.208 0 Td
(24.7%)Tj
3.0256 0 Td
(to)Tj
1.0444 0 Td
(34.8%)Tj
3.0256 0 Td
(and)Tj
1.8679 0 Td
(50.4%,)Tj
3.306 0 Td
(respectively.)Tj
ET
Q
q
1 j
1 J
0 w
11.4998 0 0 11.4998 200.0125 553.096 cm
BT
/F2 1 Tf
1 TL
-0.0035 Tc
0 0 Td
(Conclusion)Tj
ET
Q
q
1 j
1 J
0 w
9.5 0 0 9.5 200.0125 536.0881 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(Improving)Tj
4.5652 0 Td
(inclusivity)Tj
4.4399 0 Td
(of)Tj
1.0444 0 Td
(males)Tj
2.8585 0 Td
(in)Tj
0.9847 0 Td
(VMMC)Tj
3.2583 0 Td
(programs)Tj
4.4041 0 Td
(regardless)Tj
4.8279 0 Td
(of)Tj
1.0443 0 Td
(HIV)Tj
1.8798 0 Td
(status)Tj
2.8645 0 Td
(increases)Tj
-32.1716 -1.468 Td
(VMMC)Tj
3.2583 0 Td
(effectiveness,)Tj
6.272 0 Td
(if)Tj
0.7161 0 Td
(there)Tj
2.4706 0 Td
(is)Tj
0.931 0 Td
(moderate)Tj
4.4041 0 Td
(increase)Tj
3.9506 0 Td
(in)Tj
0.9847 0 Td
(VMMC)Tj
3.2583 0 Td
(uptake)Tj
3.1927 0 Td
(among)Tj
3.2404 0 Td
(higher-risk)Tj
-32.6788 -1.474 Td
(males)Tj
2.8585 0 Td
(and/or)Tj
3.0196 0 Td
(if)Tj
0.7161 0 Td
(there)Tj
2.4706 0 Td
(is)Tj
0.931 0 Td
(moderate)Tj
4.4041 0 Td
(efficacy)Tj
3.5746 0 Td
(for)Tj
1.3786 0 Td
(VMMC)Tj
3.2583 0 Td
(against)Tj
3.4016 0 Td
(male-to-femal)Tj
6.0512 0 Td
(e)Tj
0.7698 0 Td
(transmission.)Tj
-32.834 -1.474 Td
(In)Tj
1.0443 0 Td
(these)Tj
2.6437 0 Td
(circumstances,)Tj
6.827 0 Td
(VMMC)Tj
3.2583 0 Td
(programs)Tj
4.3982 0 Td
(can)Tj
1.8141 0 Td
(reduce)Tj
3.2405 0 Td
(the)Tj
1.5993 0 Td
(HIV)Tj
1.8738 0 Td
(incidence)Tj
4.3863 0 Td
(rate)Tj
1.9275 0 Td
(in)Tj
0.9847 0 Td
(males)Tj
2.8585 0 Td
(by)Tj
-36.8562 -1.474 Td
(nearly)Tj
2.9062 0 Td
(as)Tj
1.2651 0 Td
(much)Tj
2.6437 0 Td
(as)Tj
1.2652 0 Td
(expected)Tj
4.237 0 Td
(by)Tj
1.2651 0 Td
(some)Tj
2.6437 0 Td
(ART)Tj
2.208 0 Td
(programs,)Tj
4.6787 0 Td
(and)Tj
1.8679 0 Td
(additionally,)Tj
5.4246 0 Td
(females)Tj
3.682 0 Td
(can)Tj
1.8142 0 Td
(benefit)Tj
-35.9014 -1.474 Td
(from)Tj
2.202 0 Td
(the)Tj
1.5993 0 Td
(intervention)Tj
5.3232 0 Td
(nearly)Tj
2.9062 0 Td
(as)Tj
1.2652 0 Td
(much)Tj
2.6437 0 Td
(as)Tj
1.2651 0 Td
(males.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 399.0047 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Introduction)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 381.9968 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Randomized)Tj
5.3064 0 Td
(controlled)Tj
4.3199 0 Td
(trials)Tj
2.1997 0 Td
(\(RCT\))Tj
2.795 0 Td
(reported)Tj
3.6623 0 Td
(approximately)Tj
5.9754 0 Td
(60%)Tj
1.9275 0 Td
(efficacy)Tj
3.2202 0 Td
(for)Tj
1.3889 0 Td
(male)Tj
2.143 0 Td
(circumci-)Tj
-32.9383 -1.2982 Td
(sion)Tj
1.9048 0 Td
(against)Tj
3.0274 0 Td
(heterosexual)Tj
5.2271 0 Td
(HIV)Tj
2.0239 0 Td
(acquisition)Tj
4.6261 0 Td
(among)Tj
2.9934 0 Td
(males)Tj
2.5058 0 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(].)Tj
2.5908 0 Td
(Current)Tj
3.4243 0 Td
(evidence)Tj
3.7133 0 Td
(suggests)Tj
3.4866 0 Td
(that)Tj
-35.5235 -1.3039 Td
(voluntary)Tj
4.0591 0 Td
(male)Tj
2.143 0 Td
(medical)Tj
3.3619 0 Td
(circumcision)Tj
5.4311 0 Td
(\(VMMC\))Tj
4.0422 0 Td
(is)Tj
0.8447 0 Td
(an)Tj
1.2076 0 Td
(effective,)Tj
3.7304 0 Td
(cost-effective,)Tj
5.6805 0 Td
(and)Tj
1.7292 0 Td
(cost-saving)Tj
-32.2297 -1.2983 Td
(HIV)Tj
2.0182 0 Td
(prevention)Tj
4.5808 0 Td
(intervention)Tj
5.176 0 Td
([)Tj
0.83 0.64 0.02 0 k
(4)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(10)Tj
0 g
(].)Tj
3.0727 0 Td
(The)Tj
1.7802 0 Td
(World)Tj
2.8403 0 Td
(Health)Tj
2.914 0 Td
(Organization)Tj
5.5218 0 Td
(\(WHO\))Tj
3.3846 0 Td
(and)Tj
1.7291 0 Td
(the)Tj
1.4683 0 Td
(Joint)Tj
-34.486 -1.2983 Td
(United)Tj
3.0217 0 Td
(Nations)Tj
3.3732 0 Td
(Programme)Tj
4.9889 0 Td
(on)Tj
1.2756 0 Td
(HIV/AIDS)Tj
4.5864 0 Td
(\(UNAIDS\))Tj
4.6091 0 Td
(recommend)Tj
5.0854 0 Td
(VMMC)Tj
3.3618 0 Td
(as)Tj
1.0148 0 Td
(part)Tj
1.8425 0 Td
(of)Tj
1.0148 0 Td
(a)Tj
0.652 0 Td
(com-)Tj
-34.8262 -1.2982 Td
(prehensive)Tj
4.5354 0 Td
(HIV)Tj
2.0239 0 Td
(prevention)Tj
4.5807 0 Td
(package)Tj
3.4129 0 Td
(in)Tj
1.0375 0 Td
(several)Tj
2.931 0 Td
(countries)Tj
3.9515 0 Td
(in)Tj
1.0318 0 Td
(East)Tj
1.8822 0 Td
(and)Tj
1.7348 0 Td
(Southern)Tj
3.9004 0 Td
(Africa)Tj
2.6872 0 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(12)Tj
0 g
(].)Tj
-34.2479 -1.3039 Td
(WHO)Tj
2.7042 0 Td
(and)Tj
1.7291 0 Td
(UNAIDS)Tj
3.9288 0 Td
(recommend)Tj
5.0853 0 Td
(that)Tj
1.7745 0 Td
(HIV)Tj
2.0239 0 Td
(testing)Tj
2.88 0 Td
(and)Tj
1.7348 0 Td
(counseling)Tj
4.5354 0 Td
(\(HTC\))Tj
2.9424 0 Td
(be)Tj
1.1508 0 Td
(offered)Tj
3.0501 0 Td
(to)Tj
1.0261 0 Td
(all)Tj
-35.7616 -1.2983 Td
(clients)Tj
2.7892 0 Td
(presenting)Tj
4.4447 0 Td
(for)Tj
1.3833 0 Td
(VMMC,)Tj
3.5887 0 Td
(as)Tj
1.0148 0 Td
(part)Tj
1.8425 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(comprehensive)Tj
6.2872 0 Td
(package)Tj
3.4129 0 Td
(of)Tj
1.0148 0 Td
(HIV)Tj
2.0239 0 Td
(prevention)Tj
4.5808 0 Td
(ser-)Tj
-34.8659 -1.2983 Td
(vices)Tj
2.1486 0 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
(].)Tj
2.0749 0 Td
(While)Tj
2.6533 0 Td
(VMMC)Tj
3.3618 0 Td
(for)Tj
1.389 0 Td
(HIV)Tj
2.0182 0 Td
(prevention)Tj
4.5808 0 Td
(purposes)Tj
3.8041 0 Td
(is)Tj
0.8504 0 Td
(not)Tj
1.576 0 Td
(recommended)Tj
6.0321 0 Td
(for)Tj
1.389 0 Td
(uncircum-)Tj
-31.8782 -1.3039 Td
(cised)Tj
2.2223 0 Td
(HIV-positive)Tj
5.4652 0 Td
(males,)Tj
2.7325 0 Td
(WHO)Tj
2.6986 0 Td
(and)Tj
1.7291 0 Td
(UNAIDS)Tj
3.9288 0 Td
(stipulate)Tj
3.5943 0 Td
(that)Tj
1.7802 0 Td
(HIV)Tj
2.0239 0 Td
(positive)Tj
3.3108 0 Td
(individuals)Tj
-29.4857 -1.2983 Td
(requesting)Tj
4.4106 0 Td
(VMMC)Tj
3.3619 0 Td
(should)Tj
2.9197 0 Td
(not)Tj
1.576 0 Td
(be)Tj
1.1509 0 Td
(denied)Tj
2.9367 0 Td
(the)Tj
1.4683 0 Td
(service)Tj
2.9423 0 Td
(solely)Tj
2.4605 0 Td
(due)Tj
1.7008 0 Td
(to)Tj
1.0261 0 Td
(HIV)Tj
2.0183 0 Td
(status,)Tj
2.7269 0 Td
(to)Tj
1.0261 0 Td
(avoid)Tj
2.4094 0 Td
(stigma)Tj
-34.1345 -1.2982 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
(].)Tj
2.0749 0 Td
(To)Tj
1.3379 0 Td
(date,)Tj
2.1317 0 Td
(HTC)Tj
2.262 0 Td
(acceptance)Tj
4.5694 0 Td
(rates)Tj
2.109 0 Td
(have)Tj
2.0579 0 Td
(generally)Tj
3.8325 0 Td
(been)Tj
2.1203 0 Td
(high)Tj
2.0125 0 Td
([)Tj
0.83 0.64 0.02 0 k
(11)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(13)Tj
0 g
(].)Tj
1.7348 0 Td
(This)Tj
1.9899 0 Td
(is)Tj
0.8448 0 Td
(a)Tj
0.6576 0 Td
(positive)Tj
3.3165 0 Td
(out-)Tj
-34.7865 -1.3039 Td
(come)Tj
2.3924 0 Td
(given)Tj
2.3811 0 Td
(that)Tj
1.7744 0 Td
(awareness)Tj
4.2633 0 Td
(of)Tj
1.0148 0 Td
(HIV)Tj
2.0239 0 Td
(status)Tj
2.5002 0 Td
(is)Tj
0.8447 0 Td
(an)Tj
1.2019 0 Td
(important)Tj
4.2859 0 Td
(component)Tj
4.8132 0 Td
(of)Tj
1.0148 0 Td
(HIV)Tj
2.0183 0 Td
(prevention)Tj
4.5808 0 Td
([)Tj
0.83 0.64 0.02 0 k
(13)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
-35.1097 -1.2983 Td
(14)Tj
0 g
(],)Tj
1.7347 0 Td
(and)Tj
1.7292 0 Td
(that)Tj
1.7801 0 Td
(HIV-positive)Tj
5.4708 0 Td
(males)Tj
2.5002 0 Td
(are)Tj
1.4513 0 Td
(linked)Tj
2.7269 0 Td
(to)Tj
1.0262 0 Td
(HIV)Tj
2.0239 0 Td
(care)Tj
1.8708 0 Td
(and)Tj
1.7292 0 Td
(treatment)Tj
4.1385 0 Td
(services)Tj
3.3052 0 Td
([)Tj
0.83 0.64 0.02 0 k
(15)Tj
0 g
(].)Tj
2.0749 0 Td
(At)Tj
1.2019 0 Td
(the)Tj
-34.7638 -1.2983 Td
(same)Tj
2.2563 0 Td
(time,)Tj
2.2564 0 Td
(though,)Tj
3.2995 0 Td
(qualitative)Tj
4.3766 0 Td
(analyses)Tj
3.481 0 Td
(suggested)Tj
4.0762 0 Td
(that)Tj
1.7744 0 Td
(there)Tj
2.2677 0 Td
(is)Tj
0.8448 0 Td
(a)Tj
0.6576 0 Td
(risk)Tj
1.7121 0 Td
(that)Tj
1.7802 0 Td
(higher-risk)Tj
4.6488 0 Td
(HIV-neg-)Tj
-33.4316 -1.3039 Td
(ative)Tj
2.0976 0 Td
(males)Tj
2.5058 0 Td
(might)Tj
2.5965 0 Td
(forgo)Tj
2.3584 0 Td
(VMMC)Tj
3.3619 0 Td
(if)Tj
0.7767 0 Td
(they)Tj
1.9218 0 Td
(perceive)Tj
3.5263 0 Td
(that)Tj
1.7802 0 Td
(HTC)Tj
2.262 0 Td
(is)Tj
0.8447 0 Td
(mandatory,)Tj
4.8416 0 Td
(for)Tj
1.3833 0 Td
(fear)Tj
1.7404 0 Td
(of)Tj
1.0148 0 Td
(an)Tj
1.2019 0 Td
(HIV-)Tj
-34.2139 -1.2982 Td
(positive)Tj
3.3165 0 Td
(diagnosis)Tj
3.9571 0 Td
(or)Tj
1.0998 0 Td
(that)Tj
1.7745 0 Td
(they)Tj
1.9276 0 Td
(will)Tj
1.6611 0 Td
(be)Tj
1.1508 0 Td
(identified)Tj
4.0592 0 Td
(as)Tj
1.0148 0 Td
(HIV-positive)Tj
5.4708 0 Td
(by)Tj
1.1792 0 Td
(their)Tj
2.109 0 Td
(communities)Tj
5.4822 0 Td
([)Tj
0.83 0.64 0.02 0 k
(16)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(17)Tj
0 g
(].)Tj
-34.7412 -1.2983 Td
(A)Tj
0.907 0 Td
(factor)Tj
2.5399 0 Td
(for)Tj
1.3889 0 Td
(policymakers)Tj
5.5389 0 Td
(to)Tj
1.0261 0 Td
(consider)Tj
3.651 0 Td
(when)Tj
2.4038 0 Td
(determining)Tj
5.1817 0 Td
(whether)Tj
3.4753 0 Td
(VMMC)Tj
3.3618 0 Td
(recruitment)Tj
-30.6706 -1.2983 Td
(activities)Tj
3.7133 0 Td
(should)Tj
2.9197 0 Td
(include)Tj
3.1804 0 Td
(all)Tj
1.1452 0 Td
(males,)Tj
2.7326 0 Td
(regardless)Tj
4.2066 0 Td
(of)Tj
1.0148 0 Td
(HIV)Tj
2.0182 0 Td
(status/awareness,)Tj
7.0979 0 Td
(is)Tj
0.8504 0 Td
(the)Tj
1.4684 0 Td
(potential)Tj
3.7587 0 Td
(efficacy)Tj
-34.1062 -1.3039 Td
(of)Tj
1.0147 0 Td
(male)Tj
2.143 0 Td
(circumcision)Tj
5.4255 0 Td
(against)Tj
3.0274 0 Td
(HIV)Tj
2.0239 0 Td
(transmission)Tj
5.3631 0 Td
(from)Tj
2.2054 0 Td
(a)Tj
0.6576 0 Td
(circumcised)Tj
5.0513 0 Td
(HIV-positive)Tj
5.4708 0 Td
(male)Tj
2.143 0 Td
(to)Tj
1.0262 0 Td
(his)Tj
-35.5519 -1.2983 Td
(female)Tj
2.8516 0 Td
(sexual)Tj
2.6815 0 Td
(partners)Tj
3.5433 0 Td
(\()Tj
/F9 1 Tf
[()6()11()4()11()9()2()6()11()4()]TJ
6.429 0 Td
[( \n)]TJ
1.9445 0 Td
[()7()20()16(\r)10()18()-4()10()10()4()11(\r)]TJ
/F5 1 Tf
(\).)Tj
5.7543 0 Td
(The)Tj
1.7802 0 Td
(evidence)Tj
3.7133 0 Td
(is)Tj
0.8504 0 Td
(mixed)Tj
2.7213 0 Td
(on)Tj
1.2755 0 Td
(this)Tj
1.6725 0 Td
(effi-)Tj
-35.2174 -1.2982 Td
(cacy)Tj
1.9558 0 Td
([)Tj
0.83 0.64 0.02 0 k
(18)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(25)Tj
0 g
(].)Tj
3.5433 0 Td
(Females)Tj
3.4583 0 Td
(with)Tj
1.9956 0 Td
(circumcised)Tj
5.0569 0 Td
(partners)Tj
3.5433 0 Td
(have)Tj
2.058 0 Td
(been)Tj
2.1259 0 Td
(found)Tj
2.6192 0 Td
(to)Tj
1.0262 0 Td
(have)Tj
2.0579 0 Td
(an)Tj
1.2019 0 Td
(equal)Tj
2.3584 0 Td
([)Tj
0.83 0.64 0.02 0 k
(18)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(22)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
-34.7355 -1.3039 Td
(26)Tj
0 g
(],)Tj
1.7347 0 Td
(lower)Tj
2.4548 0 Td
([)Tj
0.83 0.64 0.02 0 k
(21)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(23)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3947 0 Td
(27)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(29)Tj
0 g
(],)Tj
3.2088 0 Td
(or)Tj
1.0941 0 Td
(higher)Tj
2.8063 0 Td
([)Tj
0.83 0.64 0.02 0 k
(18)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(30)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3946 0 Td
(31)Tj
0 g
(])Tj
1.5137 0 Td
(risk)Tj
1.7178 0 Td
(of)Tj
1.0148 0 Td
(acquiring)Tj
4.0308 0 Td
(HIV)Tj
2.0183 0 Td
(than)Tj
2.0296 0 Td
(those)Tj
2.3414 0 Td
(with)Tj
1.9956 0 Td
(uncir-)Tj
-34.2196 -1.2983 Td
(cumcised)Tj
3.9911 0 Td
(partners.)Tj
3.7701 0 Td
(Two)Tj
2.0239 0 Td
(studies)Tj
2.9877 0 Td
(attempted)Tj
4.2576 0 Td
(to)Tj
1.0261 0 Td
(pool)Tj
2.0013 0 Td
(existing)Tj
3.3108 0 Td
(evidence)Tj
3.7134 0 Td
(on)Tj
1.2756 0 Td
(this)Tj
1.6724 0 Td
(effect)Tj
2.3697 0 Td
([)Tj
0.83 0.64 0.02 0 k
(19)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(20)Tj
0 g
(].)Tj
1.7348 0 Td
(The)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 411.6472 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Implications)Tj
5.4 0 Td
(of)Tj
1.0417 0 Td
(Circumcis)Tj
4.3158 0 Td
(ing)Tj
1.5236 0 Td
(HIV-Positive)Tj
5.634 0 Td
(Males)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0170)Tj
3.5434 0 Td
(641)Tj
2.6362 0 Td
(January)Tj
3.7134 0 Td
(24,)Tj
1.5874 0 Td
(2017)Tj
37.8003 0 Td
(2)Tj
0.7654 0 Td
(/)Tj
0.496 0 Td
(20)Tj
/F8 1 Tf
-0.025 Tc
-66.402 84.0904 Td
(E.)Tj
0.9141 0 Td
(Njeuhmeli,)Tj
4.1599 0 Td
(study)Tj
2.2607 0 Td
(co-author,)Tj
4.0535 0 Td
(had)Tj
1.5874 0 Td
(a)Tj
0.6449 0 Td
(role)Tj
1.6158 0 Td
(in)Tj
0.8858 0 Td
(study)Tj
-16.1221 -1.3748 Td
(design)Tj
2.6787 0 Td
(and)Tj
1.5874 0 Td
(manuscript)Tj
4.415 0 Td
(prepara)Tj
2.8205 0 Td
(tion.)Tj
/F7 1 Tf
-11.5016 -2.126 Td
(Competing)Tj
4.3795 0 Td
(Interests)Tj
3.3307 0 Td
(:)Tj
/F8 1 Tf
0.4819 0 Td
(The)Tj
1.5875 0 Td
(authors)Tj
3.0401 0 Td
(have)Tj
1.963 0 Td
(declared)Tj
-14.7827 -1.3749 Td
(that)Tj
1.6228 0 Td
(no)Tj
1.1693 0 Td
(competing)Tj
4.1599 0 Td
(interests)Tj
3.3874 0 Td
(exist.)Tj
/F7 1 Tf
-10.3394 -2.126 Td
(Abbreviati)Tj
3.9118 0 Td
(ons:)Tj
/F8 1 Tf
1.8425 0 Td
(ART,)Tj
2.0339 0 Td
(antiretrovi)Tj
3.7205 0 Td
(ral)Tj
1.141 0 Td
(therapy;)Tj
3.2173 0 Td
(ASM,)Tj
-15.867 -1.3748 Td
(Age-Structu)Tj
4.4362 0 Td
(red)Tj
1.4244 0 Td
(Mathemati)Tj
3.9473 0 Td
(cal;)Tj
1.4811 0 Td
(HTC,)Tj
2.0339 0 Td
(HIV)Tj
1.5874 0 Td
(testing)Tj
-14.9103 -1.3748 Td
(and)Tj
1.5874 0 Td
(counseling;)Tj
4.4646 0 Td
(RCT,)Tj
2.0268 0 Td
(Randomized)Tj
4.8543 0 Td
(controll)Tj
2.7851 0 Td
(ed)Tj
1.1197 0 Td
(trial;)Tj
-16.8379 -1.3748 Td
(SSA,)Tj
2.0197 0 Td
(sub-Sahara)Tj
4.2449 0 Td
(n)Tj
0.6945 0 Td
(Africa;)Tj
2.5653 0 Td
(UNAIDS,)Tj
3.515 0 Td
(Joint)Tj
2.041 0 Td
(United)Tj
-15.0804 -1.3748 Td
(Nations)Tj
3.0472 0 Td
(Programm)Tj
4.0111 0 Td
(e)Tj
0.6449 0 Td
(on)Tj
1.1693 0 Td
(HIV/AIDS;)Tj
3.9614 0 Td
(VMMC,)Tj
-12.8339 -1.3748 Td
(voluntary)Tj
3.6638 0 Td
(medica)Tj
2.6787 0 Td
(l)Tj
0.4181 0 Td
(male)Tj
2.0056 0 Td
(circumcision)Tj
4.748 0 Td
(;)Tj
0.4465 0 Td
(WHO,)Tj
2.4236 0 Td
(World)Tj
-16.3843 -1.3748 Td
(Health)Tj
ET
endstream
endobj
45 0 obj
<>stream
endstream
endobj
46 0 obj
<>stream
endstream
endobj
47 0 obj
<>stream
endstream
endobj
48 0 obj
<>stream
endstream
endobj
49 0 obj
<>stream
endstream
endobj
50 0 obj
<>stream
endstream
endobj
51 0 obj
<>stream
endstream
endobj
52 0 obj
<>stream
endstream
endobj
53 0 obj
<>stream
endstream
endobj
54 0 obj
<>stream
endstream
endobj
55 0 obj
<>stream
endstream
endobj
56 0 obj
<>stream
endstream
endobj
57 0 obj
<>stream
endstream
endobj
58 0 obj
<>stream
endstream
endobj
59 0 obj
<>stream
endstream
endobj
60 0 obj
<>stream
endstream
endobj
61 0 obj
<>stream
endstream
endobj
62 0 obj
<>stream
endstream
endobj
63 0 obj
<>stream
endstream
endobj
64 0 obj
<>stream
endstream
endobj
65 0 obj
<>stream
endstream
endobj
66 0 obj
<>stream
endstream
endobj
67 0 obj
<>stream
endstream
endobj
68 0 obj
<>stream
BT
2.5724 68.8399 Td
(Organization.)Tj
ET
Q
endstream
endobj
69 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 12 0 R/Annots 70 0 R/Contents 71 0 R/TrimBox[0 0 612 792]>>
endobj
70 0 obj
[72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R 91 0 R]
endobj
72 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref019)>>
endobj
73 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref020)>>
endobj
74 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref018)>>
endobj
75 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref018)>>
endobj
76 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref025)>>
endobj
77 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref031)>>
endobj
78 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref034)>>
endobj
79 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref034)>>
endobj
80 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref034)>>
endobj
81 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref007)>>
endobj
82 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref008)>>
endobj
83 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref010)>>
endobj
84 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref020)>>
endobj
85 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref025)>>
endobj
86 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref034)>>
endobj
87 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref035)>>
endobj
88 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref036)>>
endobj
89 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref037)>>
endobj
90 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref038)>>
endobj
91 0 obj
<>/Border[0 0 0]/Dest(Rpone.0170641.ref039)>>
endobj
71 0 obj
[92 0 R 93 0 R 94 0 R 95 0 R 96 0 R 97 0 R 98 0 R 99 0 R 100 0 R 101 0 R 102 0 R 103 0 R 104 0 R 105 0 R 106 0 R 107 0 R 108 0 R]
endobj
92 0 obj
<>stream
q
0.83 0.64 0.02 0 k
203.4142 680.315 m
212.9386 680.315 l
h
f*
257.6693 654.3496 m
267.1937 654.3496 l
h
f*
426.8409 628.3276 m
436.3654 628.3276 l
h
f*
355.8047 576.3402 m
365.3291 576.3402 l
h
f*
221.8961 550.3181 m
231.4205 550.3181 l
h
f*
235.8992 550.3181 m
245.3669 550.3181 l
h
f*
250.5827 550.3181 m
260.1071 550.3181 l
h
f*
265.3795 511.3134 m
274.9039 511.3134 l
h
f*
350.6457 472.3087 m
360.1701 472.3087 l
h
f*
277.6819 420.3213 m
282.4441 420.3213 l
h
f*
286.9228 420.3213 m
291.685 420.3213 l
h
f*
296.1071 420.3213 m
305.6315 420.3213 l
h
f*
310.1102 420.3213 m
319.578 420.3213 l
h
f*
324.0567 420.3213 m
333.5811 420.3213 l
h
f*
338.0031 420.3213 m
347.5276 420.3213 l
h
f*
497.8772 251.3197 m
507.4016 251.3197 l
h
f*
341.4047 186.3496 m
350.9291 186.3496 l
h
f*
356.4283 160.3276 m
365.9528 160.3276 l
h
f*
432.8504 94.9039 m
442.3181 94.9039 l
h
f*
446.7969 94.9039 m
456.3213 94.9039 l
h
f*
0 g
1 j
1 J
0 w
10 0 0 10 200.0125 707.4141 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(first)Tj
1.8028 0 Td
(study,)Tj
2.6192 0 Td
(a)Tj
0.6519 0 Td
(systematic)Tj
4.3597 0 Td
(review)Tj
2.846 0 Td
(and)Tj
1.7291 0 Td
(meta-analysis)Tj
5.6522 0 Td
(in)Tj
1.0375 0 Td
(2009,)Tj
2.3471 0 Td
(reported)Tj
3.6566 0 Td
(that)Tj
1.7802 0 Td
(male)Tj
2.143 0 Td
(circumcision)Tj
5.4311 0 Td
(had)Tj
-36.0564 -1.3039 Td
(a)Tj
0.6519 0 Td
(20%)Tj
1.9276 0 Td
(efficacy)Tj
3.2258 0 Td
(against)Tj
3.0274 0 Td
(male-to-female)Tj
6.2815 0 Td
(HIV)Tj
2.0239 0 Td
(transmission,)Tj
5.5899 0 Td
(but)Tj
1.5534 0 Td
(with)Tj
1.9955 0 Td
(no)Tj
1.2756 0 Td
(statistical)Tj
3.9118 0 Td
(significance)Tj
-31.4643 -1.2982 Td
([)Tj
0.83 0.64 0.02 0 k
(19)Tj
0 g
(].)Tj
2.0749 0 Td
(The)Tj
1.7801 0 Td
(second)Tj
3.0161 0 Td
(study,)Tj
2.6135 0 Td
(a)Tj
0.652 0 Td
(meta-analysis)Tj
5.6522 0 Td
(in)Tj
1.0375 0 Td
(2010,)Tj
2.3471 0 Td
(pooled)Tj
2.948 0 Td
(the)Tj
1.4683 0 Td
(outcome)Tj
3.7304 0 Td
(of)Tj
1.0148 0 Td
(two)Tj
1.7064 0 Td
(quality)Tj
2.9537 0 Td
(measures)Tj
-32.995 -1.2983 Td
(from)Tj
2.2053 0 Td
(two)Tj
1.7064 0 Td
(observational)Tj
5.5843 0 Td
(cohorts)Tj
3.2144 0 Td
(and)Tj
1.7291 0 Td
(reported)Tj
3.6624 0 Td
(a)Tj
0.6519 0 Td
(statistically)Tj
4.6092 0 Td
(significant)Tj
4.388 0 Td
(46%)Tj
1.9275 0 Td
(efficacy)Tj
3.2258 0 Td
(for)Tj
1.3833 0 Td
(male)Tj
-34.2876 -1.2983 Td
(circumcision)Tj
5.4254 0 Td
([)Tj
0.83 0.64 0.02 0 k
(20)Tj
0 g
(].)Tj
-4.2292 -1.3039 Td
(The)Tj
1.7858 0 Td
(only)Tj
1.9729 0 Td
(RCT)Tj
2.1203 0 Td
(to)Tj
1.0261 0 Td
(directly)Tj
3.2315 0 Td
(test)Tj
1.5987 0 Td
(for)Tj
1.389 0 Td
(a)Tj
0.652 0 Td
(difference)Tj
4.2065 0 Td
(in)Tj
1.0318 0 Td
(HIV)Tj
2.024 0 Td
(transmission)Tj
5.3631 0 Td
(risk)Tj
1.7178 0 Td
(to)Tj
1.0261 0 Td
(females)Tj
3.2145 0 Td
(based)Tj
2.4718 0 Td
(on)Tj
-36.0281 -1.2982 Td
(males')Tj
2.7155 0 Td
(circumcision)Tj
5.4312 0 Td
(status)Tj
2.5001 0 Td
(was)Tj
1.6951 0 Td
(stopped)Tj
3.3732 0 Td
(early,)Tj
2.3754 0 Td
(for)Tj
1.389 0 Td
(futility)Tj
2.863 0 Td
([)Tj
0.83 0.64 0.02 0 k
(18)Tj
0 g
(].)Tj
2.0806 0 Td
(The)Tj
1.7801 0 Td
(study)Tj
2.3925 0 Td
(demonstrated)Tj
5.7599 0 Td
(a)Tj
0.652 0 Td
(statis-)Tj
-35.0076 -1.2983 Td
(tically)Tj
2.5908 0 Td
(insignificant)Tj
5.2044 0 Td
(increased)Tj
3.9968 0 Td
(risk)Tj
1.7178 0 Td
(of)Tj
1.0148 0 Td
(infection)Tj
3.7927 0 Td
(in)Tj
1.0318 0 Td
(females)Tj
3.2202 0 Td
(who)Tj
1.9388 0 Td
(resumed)Tj
3.6737 0 Td
(sex)Tj
1.4684 0 Td
(before)Tj
2.7382 0 Td
(the)Tj
1.4683 0 Td
(circum-)Tj
-33.8567 -1.3039 Td
(cision)Tj
2.5908 0 Td
(wounds)Tj
3.3789 0 Td
(of)Tj
1.0148 0 Td
(their)Tj
2.1089 0 Td
(partners)Tj
3.5433 0 Td
(had)Tj
1.7121 0 Td
(healed,)Tj
3.0274 0 Td
(in)Tj
1.0318 0 Td
(comparison)Tj
4.9776 0 Td
(with)Tj
1.9956 0 Td
(the)Tj
1.474 0 Td
(HIV)Tj
2.0183 0 Td
(transmission)Tj
5.3688 0 Td
(risk)Tj
1.7121 0 Td
(of)Tj
-35.9544 -1.2983 Td
(females)Tj
3.2144 0 Td
(with)Tj
1.9956 0 Td
(uncircumcised)Tj
6.1341 0 Td
(partners)Tj
3.5433 0 Td
(and)Tj
1.7348 0 Td
(of)Tj
1.0148 0 Td
(females)Tj
3.2145 0 Td
(who)Tj
1.9389 0 Td
(did)Tj
1.542 0 Td
(not)Tj
1.5704 0 Td
(resume)Tj
3.1464 0 Td
(sex)Tj
1.474 0 Td
(before)Tj
2.7383 0 Td
(their)Tj
2.1089 0 Td
(part-)Tj
-35.3704 -1.2983 Td
(ners)Tj
1.9218 0 Td
(circumcision)Tj
5.4255 0 Td
(wounds)Tj
3.3789 0 Td
(had)Tj
1.7121 0 Td
(healed)Tj
2.8006 0 Td
([)Tj
0.83 0.64 0.02 0 k
(18)Tj
0 g
(].)Tj
2.075 0 Td
(There)Tj
2.5795 0 Td
(is)Tj
0.8447 0 Td
(evidence)Tj
3.7133 0 Td
(that)Tj
1.7802 0 Td
(4%)Tj
1.4513 0 Td
(to)Tj
1.0262 0 Td
(31%)Tj
1.9275 0 Td
(of)Tj
1.0148 0 Td
(males)Tj
-31.6514 -1.3039 Td
(including)Tj
4.0421 0 Td
(those)Tj
2.3358 0 Td
(identified)Tj
4.0591 0 Td
(as)Tj
1.0148 0 Td
(HIV-positive)Tj
5.4709 0 Td
(prior)Tj
2.2507 0 Td
(to)Tj
1.0261 0 Td
(VMMCresume)Tj
7.2113 0 Td
(sex)Tj
1.474 0 Td
(before)Tj
2.7383 0 Td
(their)Tj
2.1089 0 Td
(wounds)Tj
-33.732 -1.2982 Td
(heal)Tj
1.8481 0 Td
([)Tj
0.83 0.64 0.02 0 k
(25)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7405 0 Td
(31)Tj
0 g
()Tj
0.83 0.64 0.02 0 k
(34)Tj
0 g
(].)Tj
3.2031 0 Td
(If)Tj
0.8504 0 Td
(more)Tj
2.3414 0 Td
(than)Tj
2.0239 0 Td
(30%)Tj
1.9332 0 Td
(of)Tj
1.0148 0 Td
(males)Tj
2.5002 0 Td
(resume)Tj
3.1464 0 Td
(sexual)Tj
2.6816 0 Td
(activity)Tj
3.1181 0 Td
(too)Tj
1.5307 0 Td
(soon,)Tj
2.3697 0 Td
(one)Tj
1.6951 0 Td
(model)Tj
2.7439 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
-35.7559 -1.2983 Td
(impact)Tj
2.9763 0 Td
(suggests)Tj
3.4866 0 Td
(that)Tj
1.7745 0 Td
(there)Tj
2.2677 0 Td
(could)Tj
2.4491 0 Td
(be)Tj
1.1509 0 Td
(a)Tj
0.6576 0 Td
(net)Tj
1.491 0 Td
(negative)Tj
3.532 0 Td
(effect)Tj
2.364 0 Td
(on)Tj
1.2756 0 Td
(their)Tj
2.109 0 Td
(female)Tj
2.8573 0 Td
(partners)Tj
3.5433 0 Td
(within)Tj
2.8119 0 Td
(the)Tj
-34.7468 -1.3039 Td
(first)Tj
1.8028 0 Td
(year)Tj
1.9048 0 Td
(post-circumcision:)Tj
7.6876 0 Td
(that)Tj
1.7801 0 Td
(is,)Tj
1.0715 0 Td
(the)Tj
1.4683 0 Td
(intervention)Tj
5.1761 0 Td
(would)Tj
2.7155 0 Td
(generate)Tj
3.6057 0 Td
(more)Tj
2.3414 0 Td
(new)Tj
1.8765 0 Td
(infections)Tj
-31.4303 -1.2983 Td
(among)Tj
2.9876 0 Td
(females)Tj
3.2088 0 Td
([)Tj
0.83 0.64 0.02 0 k
(34)Tj
0 g
(].)Tj
2.0693 0 Td
(This)Tj
1.9843 0 Td
(model,)Tj
2.965 0 Td
(however,)Tj
3.8267 0 Td
(only)Tj
1.9729 0 Td
(assessed)Tj
3.4696 0 Td
(the)Tj
1.4627 0 Td
(impact)Tj
2.9707 0 Td
(of)Tj
1.0091 0 Td
(VMMC)Tj
3.3619 0 Td
(on)Tj
1.2699 0 Td
(the)Tj
1.4627 0 Td
(HIV)Tj
2.0125 0 Td
(epi-)Tj
-36.0337 -1.2982 Td
(demic)Tj
2.6815 0 Td
(over)Tj
1.9729 0 Td
(one)Tj
1.7008 0 Td
(year)Tj
1.9049 0 Td
(and)Tj
1.7291 0 Td
(did)Tj
1.542 0 Td
(not)Tj
1.5761 0 Td
(capture)Tj
3.2144 0 Td
(longer)Tj
2.7836 0 Td
(term)Tj
2.1317 0 Td
(impact.)Tj
3.2031 0 Td
(The)Tj
1.7858 0 Td
(model's)Tj
3.3165 0 Td
(finding)Tj
3.1351 0 Td
(was)Tj
1.6951 0 Td
(also)Tj
-34.3726 -1.2983 Td
(generated)Tj
4.1328 0 Td
(assuming)Tj
4.0025 0 Td
(high)Tj
2.0069 0 Td
(relative)Tj
3.1351 0 Td
(risk)Tj
1.7178 0 Td
(of)Tj
1.0092 0 Td
(male-to-female)Tj
6.2872 0 Td
(HIV)Tj
2.0182 0 Td
(transmission)Tj
5.3631 0 Td
(during)Tj
2.9254 0 Td
(wound)Tj
3.016 0 Td
(heal-)Tj
-35.6142 -1.3039 Td
(ing)Tj
1.5023 0 Td
(and)Tj
1.7291 0 Td
(a)Tj
0.652 0 Td
(consistent)Tj
4.2576 0 Td
(coital)Tj
2.3981 0 Td
(frequency)Tj
4.1839 0 Td
([)Tj
0.83 0.64 0.02 0 k
(34)Tj
0 g
(].)Tj
2.0806 0 Td
(These)Tj
2.5625 0 Td
(two)Tj
1.7121 0 Td
(assumptions)Tj
5.2214 0 Td
(may)Tj
1.9276 0 Td
(be)Tj
1.1508 0 Td
(unrealistic,)Tj
4.6148 0 Td
(and)Tj
1.7291 0 Td
(lead)Tj
-35.7219 -1.2983 Td
(to)Tj
1.0261 0 Td
(an)Tj
1.2019 0 Td
(underestimation)Tj
6.8428 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(beneficial)Tj
4.0478 0 Td
(impact)Tj
2.9821 0 Td
(of)Tj
1.0148 0 Td
(VMMC)Tj
3.3618 0 Td
(and)Tj
1.7292 0 Td
(an)Tj
1.2018 0 Td
(overestimation)Tj
6.2022 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(nega-)Tj
-34.5767 -1.2983 Td
(tive)Tj
1.661 0 Td
(impact)Tj
2.9821 0 Td
(on)Tj
1.2756 0 Td
(females.)Tj
3.4412 0 Td
(Regardless,)Tj
4.6771 0 Td
(this)Tj
1.6781 0 Td
(modeling)Tj
4.0252 0 Td
(study)Tj
2.3868 0 Td
(and)Tj
1.7291 0 Td
(other)Tj
2.347 0 Td
(studies)Tj
2.9877 0 Td
(show)Tj
2.3018 0 Td
(that)Tj
1.7801 0 Td
(even)Tj
2.0693 0 Td
(in)Tj
-35.3421 -1.3039 Td
(the)Tj
1.4683 0 Td
(first)Tj
1.8085 0 Td
(year,)Tj
2.126 0 Td
(early)Tj
2.1486 0 Td
(resumption)Tj
4.8642 0 Td
(of)Tj
1.0148 0 Td
(sex)Tj
1.4684 0 Td
(will)Tj
1.661 0 Td
(not)Tj
1.5761 0 Td
(offset)Tj
2.3868 0 Td
(the)Tj
1.4683 0 Td
(overall)Tj
2.9027 0 Td
(epidemiological)Tj
6.5649 0 Td
(benefits)Tj
3.3336 0 Td
(of)Tj
-34.7922 -1.2982 Td
(VMMC)Tj
3.3618 0 Td
(programs)Tj
4.0649 0 Td
([)Tj
0.83 0.64 0.02 0 k
(7)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.2642 0 Td
(8)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
0.9184 0 Td
(10)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.4003 0 Td
(20)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3947 0 Td
(25)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3946 0 Td
(34)Tj
0 g
(].)Tj
-12.6027 -1.2983 Td
(In)Tj
1.1111 0 Td
(this)Tj
1.6725 0 Td
(study,)Tj
2.6192 0 Td
(we)Tj
1.3266 0 Td
(used)Tj
2.0579 0 Td
(mathematical)Tj
5.6466 0 Td
(modeling)Tj
4.0252 0 Td
(to)Tj
1.0261 0 Td
(assess)Tj
2.5171 0 Td
(the)Tj
1.4741 0 Td
(epidemiological)Tj
6.5593 0 Td
(and)Tj
1.7291 0 Td
(some)Tj
2.3357 0 Td
(pro-)Tj
-35.2967 -1.3039 Td
(grammatic)Tj
4.5524 0 Td
(implications)Tj
5.176 0 Td
(of)Tj
1.0148 0 Td
(including)Tj
4.0422 0 Td
(HIV-positive)Tj
5.4708 0 Td
(males)Tj
2.5001 0 Td
(in)Tj
1.0375 0 Td
(VMMC)Tj
3.3619 0 Td
(programs.)Tj
4.2916 0 Td
(The)Tj
1.7858 0 Td
(primary)Tj
-33.2331 -1.2983 Td
(outcome)Tj
3.7247 0 Td
(of)Tj
1.0147 0 Td
(interest)Tj
3.2145 0 Td
(was)Tj
1.6951 0 Td
(the)Tj
/F9 1 Tf
1.474 0 Td
[()1()9()7()-4()7()15()3()2(\r)6()8()10()]TJ
/F5 1 Tf
4.8756 0 Td
(of)Tj
1.0148 0 Td
(VMMC)Tj
3.3675 0 Td
(as)Tj
1.0148 0 Td
(an)Tj
1.2019 0 Td
(HIV)Tj
2.0239 0 Td
(intervention,)Tj
5.3972 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
-34.2593 -1.2983 Td
(number)Tj
3.4185 0 Td
(of)Tj
1.0148 0 Td
(VMMCs)Tj
3.7247 0 Td
(needed)Tj
3.0898 0 Td
(per)Tj
1.5363 0 Td
(HIV)Tj
2.0183 0 Td
(infection)Tj
3.7927 0 Td
(averted.)Tj
3.3789 0 Td
(The)Tj
1.7801 0 Td
(lower)Tj
2.4548 0 Td
(the)Tj
1.4684 0 Td
(number)Tj
3.4185 0 Td
(of)Tj
1.0148 0 Td
(VMMCs)Tj
-32.1106 -1.2982 Td
(required)Tj
3.6396 0 Td
(to)Tj
1.0261 0 Td
(avert)Tj
2.1997 0 Td
(one)Tj
1.7008 0 Td
(infection,)Tj
4.0138 0 Td
(the)Tj
1.4684 0 Td
(better)Tj
2.5455 0 Td
(the)Tj
1.4683 0 Td
(effectiveness)Tj
5.2044 0 Td
(of)Tj
1.0148 0 Td
(VMMC)Tj
3.3618 0 Td
(in)Tj
1.0375 0 Td
(that)Tj
1.7802 0 Td
(scenario.)Tj
3.7814 0 Td
(The)Tj
1.7801 0 Td
(sec-)Tj
-36.0224 -1.3039 Td
(ondary)Tj
3.0613 0 Td
(outcome)Tj
3.7247 0 Td
(of)Tj
1.0148 0 Td
(interest)Tj
3.2145 0 Td
(was)Tj
1.7008 0 Td
(the)Tj
/F9 1 Tf
1.4683 0 Td
[()-3()7()11()4()]TJ
2.0353 0 Td
[()11()]TJ
0.9524 0 Td
[()20()7()12()4()-4()7()4()11(\r)]TJ
3.9288 0 Td
[()12(\r)]TJ
1.0148 0 Td
[()10()6()]TJ
1.4173 0 Td
[()-9()-4()12()]TJ
1.6384 0 Td
[()11()]TJ
0.9525 0 Td
[( \n)]TJ
1.9502 0 Td
[()1()4()7()10()12()20()]TJ
/F5 1 Tf
(,)Tj
3.8551 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
-35.155 -1.2983 Td
(HIV)Tj
2.0182 0 Td
(incidence)Tj
4.0762 0 Td
(rate)Tj
1.7461 0 Td
(reduction.)Tj
4.3427 0 Td
(This)Tj
1.9842 0 Td
(measure)Tj
3.583 0 Td
(was)Tj
1.6951 0 Td
(calculated)Tj
4.2066 0 Td
(by)Tj
1.1849 0 Td
(comparing)Tj
4.5694 0 Td
(the)Tj
1.4683 0 Td
(population-level)Tj
-30.8747 -1.2983 Td
(HIV)Tj
2.0182 0 Td
(incidence)Tj
4.0705 0 Td
(rate)Tj
1.7405 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.4683 0 Td
(presence)Tj
3.7077 0 Td
(of)Tj
1.0092 0 Td
(the)Tj
1.4683 0 Td
(VMMC)Tj
3.3562 0 Td
(scale-up)Tj
3.5036 0 Td
(program)Tj
3.702 0 Td
(with)Tj
1.9899 0 Td
(a)Tj
0.652 0 Td
(counter-factual)Tj
6.3155 0 Td
(sce-)Tj
-36.0337 -1.3039 Td
(nario)Tj
2.347 0 Td
(with)Tj
1.9956 0 Td
(no)Tj
1.2756 0 Td
(VMMC)Tj
3.3619 0 Td
(scale-up)Tj
3.5036 0 Td
(program.)Tj
-11.2875 -1.2982 Td
(The)Tj
1.7858 0 Td
(intervention's)Tj
5.7543 0 Td
(impact)Tj
2.9763 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4684 0 Td
(HIV)Tj
2.0239 0 Td
(epidemic)Tj
3.8891 0 Td
(was)Tj
1.7008 0 Td
(evaluated)Tj
3.9911 0 Td
(in)Tj
1.0318 0 Td
(two)Tj
1.7121 0 Td
(time)Tj
2.0296 0 Td
(horizons:)Tj
3.9458 0 Td
(an)Tj
-34.7808 -1.2983 Td
(intermediate-term)Tj
7.5854 0 Td
(time)Tj
2.0296 0 Td
(horizon)Tj
3.3619 0 Td
(\(20102025\),)Tj
5.4481 0 Td
(and)Tj
1.7292 0 Td
(a)Tj
0.6519 0 Td
(long-term)Tj
4.252 0 Td
(time)Tj
2.0296 0 Td
(horizon)Tj
3.3618 0 Td
(\(20102035\).)Tj
5.4482 0 Td
(We)Tj
-35.8977 -1.3039 Td
(mainly)Tj
2.9876 0 Td
(focused)Tj
3.2769 0 Td
(in)Tj
1.0375 0 Td
(our)Tj
1.627 0 Td
(analyses)Tj
3.481 0 Td
(on)Tj
1.2755 0 Td
(the)Tj
1.474 0 Td
(intermediate)Tj
5.3178 0 Td
(time)Tj
2.0296 0 Td
(horizon,)Tj
3.5886 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(goal)Tj
1.8708 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.474 0 Td
(VMMC)Tj
-32.9383 -1.2983 Td
(program)Tj
3.702 0 Td
(is)Tj
0.8504 0 Td
(to)Tj
1.0261 0 Td
(impact)Tj
2.9764 0 Td
(the)Tj
1.474 0 Td
(HIV)Tj
2.0182 0 Td
(epidemic)Tj
3.8891 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(near)Tj
2.0013 0 Td
(to)Tj
1.0261 0 Td
(intermediate)Tj
5.3178 0 Td
(future)Tj
2.6589 0 Td
([)Tj
0.83 0.64 0.02 0 k
(35)Tj
0 g
(].)Tj
-28.2499 -1.2983 Td
(Our)Tj
1.8708 0 Td
(analysis)Tj
3.3222 0 Td
(focused)Tj
3.2825 0 Td
(on)Tj
1.2756 0 Td
(Zambia)Tj
3.2768 0 Td
(as)Tj
1.0148 0 Td
(an)Tj
1.2076 0 Td
(illustrative)Tj
4.4106 0 Td
(example,)Tj
3.7758 0 Td
(with)Tj
2.0012 0 Td
(the)Tj
1.4684 0 Td
(purpose)Tj
3.4469 0 Td
(of)Tj
1.0148 0 Td
(assessing)Tj
-32.5642 -1.3039 Td
(the)Tj
1.4683 0 Td
(implications)Tj
5.176 0 Td
(of)Tj
1.0148 0 Td
(including)Tj
4.0422 0 Td
(HIV-positive)Tj
5.4708 0 Td
(males)Tj
2.5002 0 Td
(in)Tj
1.0374 0 Td
(VMMC)Tj
3.3619 0 Td
(programs)Tj
4.0705 0 Td
(in)Tj
1.0318 0 Td
(countries)Tj
3.9515 0 Td
(with)Tj
1.9956 0 Td
(high)Tj
-35.121 -1.2982 Td
(HIV)Tj
2.0182 0 Td
(prevalence)Tj
4.4901 0 Td
(and)Tj
1.7291 0 Td
(low)Tj
1.6554 0 Td
(circumcision)Tj
5.4311 0 Td
(rates.)Tj
2.3301 0 Td
(The)Tj
1.7858 0 Td
(VMMC)Tj
3.3619 0 Td
(program)Tj
3.702 0 Td
(in)Tj
1.0375 0 Td
(Zambia)Tj
3.2825 0 Td
(aims)Tj
2.1033 0 Td
(to)Tj
1.0261 0 Td
(reduce)Tj
-33.9531 -1.2983 Td
(HIV)Tj
2.0182 0 Td
(incidence)Tj
4.0762 0 Td
(by)Tj
1.1792 0 Td
(circumcising)Tj
5.3858 0 Td
(80%)Tj
1.9275 0 Td
(of)Tj
1.0148 0 Td
(1549)Tj
2.6419 0 Td
(year)Tj
1.9049 0 Td
(old)Tj
1.5023 0 Td
(males)Tj
2.5002 0 Td
(between)Tj
3.5319 0 Td
(2010)Tj
2.1203 0 Td
(and)Tj
1.7291 0 Td
(2017,)Tj
2.3471 0 Td
(for)Tj
1.389 0 Td
(a)Tj
-35.2684 -1.2983 Td
(total)Tj
2.0012 0 Td
(of)Tj
1.0148 0 Td
(1.95)Tj
1.8708 0 Td
(million)Tj
3.1238 0 Td
(circumcisions)Tj
5.7883 0 Td
([)Tj
0.83 0.64 0.02 0 k
(36)Tj
0 g
(].)Tj
2.075 0 Td
(While)Tj
2.6532 0 Td
(Zambia's)Tj
3.8551 0 Td
(VMMC)Tj
3.3675 0 Td
(program)Tj
3.702 0 Td
(does)Tj
2.041 0 Td
(not)Tj
1.576 0 Td
(exclude)Tj
-33.0687 -1.3039 Td
(HIV-positive)Tj
5.4651 0 Td
(males)Tj
2.5058 0 Td
(who)Tj
1.9389 0 Td
(meet)Tj
2.1883 0 Td
(the)Tj
1.4684 0 Td
(other)Tj
2.3471 0 Td
(eligibility)Tj
3.9287 0 Td
(requirements,)Tj
5.7884 0 Td
(about)Tj
2.4944 0 Td
(99%)Tj
1.9276 0 Td
(of)Tj
1.0148 0 Td
(VMMC)Tj
3.3618 0 Td
(clients)Tj
-34.4293 -1.2983 Td
(to)Tj
1.0261 0 Td
(date)Tj
1.8992 0 Td
(have)Tj
2.0636 0 Td
(been)Tj
2.1203 0 Td
(HIV-negative)Tj
5.6863 0 Td
(males)Tj
2.5058 0 Td
([)Tj
0.83 0.64 0.02 0 k
(37)Tj
0 g
(].)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 131.0173 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Methods)Tj
/F0 1 Tf
0 -1.5023 Td
(Modeling)Tj
4.2189 0 Td
(Approach)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 95.9811 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(We)Tj
1.61 0 Td
(used)Tj
2.058 0 Td
(the)Tj
1.4683 0 Td
(Age-Structured)Tj
6.3892 0 Td
(Mathematical)Tj
5.7203 0 Td
(\(ASM\))Tj
2.9537 0 Td
(model)Tj
2.7439 0 Td
([)Tj
0.83 0.64 0.02 0 k
(38)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(39)Tj
0 g
(])Tj
1.5137 0 Td
(to)Tj
1.0205 0 Td
(address)Tj
3.2315 0 Td
(the)Tj
1.4683 0 Td
(research)Tj
-31.9122 -1.2982 Td
(questions)Tj
4.0195 0 Td
(of)Tj
1.0147 0 Td
(this)Tj
1.6725 0 Td
(study.)Tj
2.6192 0 Td
(Detailed)Tj
3.5716 0 Td
(description)Tj
4.7338 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(ASM)Tj
2.2733 0 Td
(model)Tj
2.744 0 Td
(and)Tj
1.7348 0 Td
(parameterization,)Tj
7.2679 0 Td
(and)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 411.6472 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Implications)Tj
5.4 0 Td
(of)Tj
1.0417 0 Td
(Circumcis)Tj
4.3158 0 Td
(ing)Tj
1.5236 0 Td
(HIV-Positive)Tj
5.634 0 Td
(Males)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.4748 0 Td
(DOI:10.137)Tj
5.0387 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.0170)Tj
3.5434 0 Td
(641)Tj
2.6362 0 Td
(January)Tj
3.7134 0 Td
(24,)Tj
1.5874 0 Td
(2017)Tj
37.8003 0 Td
(3)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
93 0 obj
<>stream
endstream
endobj
94 0 obj
<>stream
endstream
endobj
95 0 obj
<>stream
endstream
endobj
96 0 obj
<>stream
endstream
endobj
97 0 obj
<>stream
endstream
endobj
98 0 obj
<>stream
endstream
endobj
99 0 obj
<>stream
endstream
endobj
100 0 obj
<>stream
endstream
endobj
101 0 obj
<>stream
endstream
endobj
102 0 obj
<>stream
endstream
endobj
103 0 obj
<>stream
endstream
endobj
104 0 obj
<>stream
endstream
endobj
105 0 obj
<>stream
endstream
endobj
106 0 obj
<>stream
endstream
endobj
107 0 obj
<>stream
endstream
endobj
108 0 obj
<>stream
BT
66.402 0 Td
(20)Tj
ET
Q
endstream
endobj
109 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 12 0 R/Annots 111 0 R/Contents 112 0 R/TrimBox[0 0 612 792]>>
endobj
110 0 obj
<>
endobj
113 0 obj
<>
endobj
114 0 obj
<>stream
%!PS-AdobeFont-1.0
11 dict begin
/FontName /TeX_CM_Roman def
/FontType 1 def
/FontBBox {-31 -250 1000 750} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 8 dict dup begin
/FullName (TeX_CM_Roman) readonly def
/BaseFontName (TeX_CM_Roman) def
end def
/Encoding 256 array
0 1 255 {1 index exch /.notdef put} for
dup 0 /C0 put
dup 1 /C1 put
dup 2 /C2 put
dup 3 /C3 put
dup 4 /C4 put
dup 5 /C5 put
dup 6 /C6 put
dup 7 /C7 put
dup 8 /C8 put
dup 9 /C9 put
dup 10 /C10 put
dup 11 /C11 put
dup 12 /C12 put
dup 13 /C13 put
dup 14 /C14 put
dup 15 /C15 put
dup 16 /C16 put
dup 17 /C17 put
dup 18 /C18 put
dup 19 /C19 put
dup 20 /C20 put
dup 21 /C21 put
dup 22 /C22 put
dup 23 /C23 put
dup 24 /C24 put
dup 25 /C25 put
dup 26 /C26 put
dup 27 /C27 put
dup 28 /C28 put
dup 29 /C29 put
dup 30 /C30 put
dup 31 /C31 put
dup 32 /space put
dup 33 /exclam put
dup 34 /quotedbl put
dup 35 /numbersign put
dup 36 /dollar put
dup 37 /percent put
dup 38 /ampersand put
dup 39 /quoteright put
dup 40 /parenleft put
dup 41 /parenright put
dup 42 /asterisk put
dup 43 /plus put
dup 44 /comma put
dup 45 /hyphen put
dup 46 /period put
dup 47 /slash put
dup 48 /zero put
dup 49 /one put
dup 50 /two put
dup 51 /three put
dup 52 /four put
dup 53 /five put
dup 54 /six put
dup 55 /seven put
dup 56 /eight put
dup 57 /nine put
dup 58 /colon put
dup 59 /semicolon put
dup 60 /less put
dup 61 /equal put
dup 62 /greater put
dup 63 /question put
dup 64 /at put
dup 65 /A put
dup 66 /B put
dup 67 /C put
dup 68 /D put
dup 69 /E put
dup 70 /F put
dup 71 /G put
dup 72 /H put
dup 73 /I put
dup 74 /J put
dup 75 /K put
dup 76 /L put
dup 77 /M put
dup 78 /N put
dup 79 /O put
dup 80 /P put
dup 81 /Q put
dup 82 /R put
dup 83 /S put
dup 84 /T put
dup 85 /U put
dup 86 /V put
dup 87 /W put
dup 88 /X put
dup 89 /Y put
dup 90 /Z put
dup 91 /bracketleft put
dup 92 /backslash put
dup 93 /bracketright put
dup 94 /asciicircum put
dup 95 /underscore put
dup 96 /quoteleft put
dup 97 /a put
dup 98 /b put
dup 99 /c put
dup 100 /d put
dup 101 /e put
dup 102 /f put
dup 103 /g put
dup 104 /h put
dup 105 /i put
dup 106 /j put
dup 107 /k put
dup 108 /l put
dup 109 /m put
dup 110 /n put
dup 111 /o put
dup 112 /p put
dup 113 /q put
dup 114 /r put
dup 115 /s put
dup 116 /t put
dup 117 /u put
dup 118 /v put
dup 119 /w put
dup 120 /x put
dup 121 /y put
dup 122 /z put
dup 123 /braceleft put
dup 124 /bar put
dup 125 /braceright put
dup 126 /asciitilde put
dup 127 /Euro put
readonly def
currentdict end
currentfile eexec
M#1H5 J6o\&rtS(#v\0\V7Fe༙OYx5-cY9^%Y6
(efIOldN"wȰ;)UƽoFg/rvV$JS8_oc@
o9-eGJp}[Do]mN=4*{ܯq=eU^t6¤.vA2*Sr 2@Y0}S/8W}efFz~"7Mԗ3T3#mAE=90}c:o|y$)|DKf{(!✱դs'Xt{r6\C~-x{jFҘ{@]##')\}7l"ۂ8c.)a0KcyZ$FX(uØ!{uh\[l^d*BֿAJyPOM lJvNab?$h:`/A[ 88hxtXX*UT<NoR^@z
!cef WE(3ZmC:A~Y&w$ř/LGjq6Sπ4E0rrdyrx˫3JLqT|heT[?bqv\6Kw0ֻ#[[#Fo碜m w#ojsnlϴ=9 Żԕ)~\]G˧Ž9#iiՋToI.9[ڔl6l_vtK"JfKPč+:
Α/ (kw}
>qoF6EQO8Ql68ůĊɻ֕GNKEvw*70Uz7+*t8w͌`уg;5unV#/-VPoWHY+H%5̶bGPgsPU
v
"h$9;Ap52@\_A-0@i:0&"MW\45@27wRItgtEa5 ew#oH}TȒ)HEY$@W`rTmŽ^xlIC' U:* 3?RCG
hk~sA9+cUɅ;eoYyv@54oR
UeYPΚmu[*՛4z3vIk9UBřR29kӧf4ی4o0H?ǚ<._VhZu*`h>S
ao҄Ã(Kh',9s&/b$fGX==s2:=x?B<Ӂ:ͪbJ*EgDEg|s8, 1 4f&raBڶ]٠}$*U"*/y"7.VgS+'Q6h"3$\އ7U9چۯj1}21WH;=|{pb=x@OѢ^[ngoDU'suIҢ!+VCAb2BsSm
x\=Q,pt響m!.;jX2_f;_$䦐>{ןŌR"=@M
k9٦LnQkջy{yg+_CJ;DU.2qKf ]cj[6$i/@f ^$JnY:4*itKD"_U5Zay";4\.a`a=Bhlru M:%_8Rx=mo9ިӍj&q&dWf?K
$r\;7oU'c{apDT=Zţ!.% c/=3tg|}AGd`#oe )hZ#Č4vQnTERz*uhc}(<T~?ԀlifF!W_Qo0>Tc?gߝv|K{&h{Qza
x
2)3jd@"wSt@![*SZ4\z;,ܵ
❦u@HpΒRMroҜq{z
(`wN
PcT(Sݣ\.]ƿ}/xb)7!P3hQRwYBІd|ՔF ֺw"m%r8= (Ah&x|Fz&E{fup&rxyzNt[AqR9M9N#C1cc9w\GCUN!RaoB$e W-U7ޓweaBoֳD(c6֧droG2tʈmV):ƣDa)r8>HrVm" cu40q?$-@;o,ZUHL6$ {%c#lV_.MBa6[+U3D?rfgv,m,۠8?4}ݏşcVRy5NRP_\Wz囔Zf}&5}Hf
ڗrm@0|NL}B婭$=;Ӻ֚Dȷ;NXf9&SR85+&W]
(
ţ8q ZITrM|bd
s娶 u" ]'Q+>@2Yƭ_vh\goܡn<g$wn_` _u\J!!.5^ ϓ/q
-s#+GzKcggh҇*FAV4cOcBGcf)=Bh(CX\@"8O{J
vXgn8nڧML'D/)(tD~/wF+Ќ:/+=z
EE0\a47 =c]c9H5vEYu{[7_G7>;12ч%V3iw\i ejS}K 74E.bo(/@Q-}]8TIռqw=5ѤrXO96z 96$oXIHLg_FeBP$f`>(R6q]htif N}HjV*dMv^?;[:4HFAe@5$۬x"mS~_wOn['[]a5N1&/8yiw; Dm֣@2Ur>xHDAɵFO\[D(ki=|[2Bo)ʽɢ=ȐU;,Э(W]lC!\OV5, aeI+u