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Prevalence of Circumcision Among Men and Boys Aged 14 to 59 Years in the United States, National Health and Nutrition Examination Surveys 2005–2010

Introcaso, Camille E. MD*; Xu, Fujie MD, PhD; Kilmarx, Peter H. MD; Zaidi, Akbar PhD*; Markowitz, Lauri E. MD*

Sexually Transmitted Diseases: July 2013 - Volume 40 - Issue 7 - p 521–525
doi: 10.1097/01.OLQ.0000430797.56499.0d
Original Study

Background: In 2009, an estimated 3590 new heterosexually acquired HIV infections occurred in males in the United States. Three randomized controlled trials demonstrated that male circumcision decreased a man’s risk for HIV acquisition through heterosexual sex. We describe circumcision prevalence in US males and determine circumcision prevalence among males potentially at increased risk for heterosexually acquired HIV infection.

Methods: We estimated circumcision prevalence among men and boys aged 14 to 59 years using data from the National Health and Nutrition Examination Surveys 2005–2010. We defined men and boys with 2 or more female partners in the last year as potentially at increased risk for heterosexually acquired HIV infection.

Results: Estimated circumcision prevalence was 80.5%. Prevalence varied significantly by year of birth, race/ethnicity, health insurance type, and family income. Circumcision prevalence among men and boys reporting 2 or more female partners in the last year was 80.4%, which corresponded to an estimated 3.5 million uncircumcised men and boys potentially at increased risk for heterosexually acquired HIV infection. Of these men and boys, 48.3% lacked health insurance.

Conclusions: Circumcision prevalence in the United States differs by demographic group, and half of uncircumcised men and boys potentially at increased risk for heterosexually acquired HIV are uninsured. These data could inform recommendations and cost analyses concerning circumcision in the United States.

A recent nationally representative study estimated that circumcision prevalence boys and men aged 14 to 59 years is 80.5% and found lower prevalence among those who are younger, nonwhite, poor, or without health insurance.

From the Divisions of *Sexually Transmitted Disease Prevention and †Viral Hepatitis, and ‡Center for Global Health, Centers for Disease Control and Prevention Atlanta, GA

Conflicts of interest: None.

Sources of support: None.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Correspondence: Camille E. Introcaso, MD, Centers for Disease Control and Prevention, Corporate Square Building 10, MS E-02, Atlanta, GA 30329. E-mail: vie4@cdc.gov.

Received for publication January 22, 2013, and accepted March 11, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association