Prevalence of Circumcision and Herpes Simplex Virus Type 2 Infection in Men in the United States: the National Health and Nutrition Examination Survey (NHANES), 1999-2004

Objectives: To study the prevalence of circumcision in the United States and to examine the association between circumcision and herpes simplex virus Type 2 (HSV-2) infection.

Methods: As part of National Health and Nutrition Examination Surveys from 1999 to 2004, 6174 men were interviewed about circumcision status and sexual behaviors, and were tested for HSV-2 antibodies. Medical artwork was used to aid the reporting of circumcision status.

Results: The overall prevalence of circumcision was 79% and varied by race/ethnicity (88% in non-Hispanic whites, 73% in non-Hispanic blacks, 42% in Mexican Americans, and 50% in others). For men born in the United States from 1940 through 1979, the prevalence of circumcision increased, with larger increases in non-Hispanic blacks and Mexican Americans than in non-Hispanic whites; the prevalence of circumcision decreased significantly in those born in the 1980s (84%) compared to those born in 1970s (91%) (P <0.001). Circumcision status was not associated with sexual behaviors we assessed. In multivariate analyses, circumcision was not associated with HSV-2 infection (P = 0.47).

Conclusions: The prevalence of circumcision apparently peaked in those born in the 1970s and declined in those born in the 1980s. Circumcision was not associated with HSV-2 infection.