Men should be circumcised to reduce their risk of catching HIV, the virus that causes Aids, the UN recommended today.

The World Health Organisation and UNAIDS, the UN agency that co-ordinates the global fight against Aids, said there was compelling evidence that the operation can reduce infections among heterosexual men by up to 60 per cent.

The recommendation came out of a conference of HIV experts that discussed three recent trials, in Kenya, Uganda and South Africa, that all showed marked reductions in infection rates for circumcised men.

"Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men,” read the joint UNAIDS and WHO statement.

The health agencies were quick to assure that circumcision does not provide complete protection against infection. Instead, it should be used other preventative measures, including male and female condoms, abstinence, delaying the start of sexual activity and reducing the number of sexual partners, said Catherine Hankins, of UNAIDS.

Dr Hankins said it was important to guard against a false sense of security which might lead circumcised men to engage in high-risk behavior that could undermine the partial protection provided by the operation.

She also gave warning that men whose foreskin is removed have a higher risk of being infected with HIV if they resume sex before their circumcision wound has healed, which can take six weeks. Likewise, an HIV-positive man can more easily pass on the disease to his partner if the wound is still unhealed, she said.

More study is needed to ascertain the effects of circumcision on the transmission of the disease to women and among homosexual men, but a WHO doctor said the operation would probably reduce infection rates in those instances too.

“It probably does, but we don’t have sufficient research now to confirm that,” said Dr Teguest Guermo of WHO. “We will be doing some more research on that.”

Today's recommendation, and the large scale studies in Kenya, Uganda and South Africa, come after 20 years of anecdotal evidence, which observed lower rates of infection among circumcised men. The operation provides a measure of protection because the cells in the foreskin of the penis are especially vulnerable to the HIV virus.

The benefits of circumcision are thought to be borne out in the lower HIV rates in Northern and Western African countries where the operation is commonly practised for religious or cultural reasons.

Likewise, the operation is believed to hold the most promise in communities where the main route of HIV infection is among men having sex with women, rather than among homosexual men or drug users. Forecasts have suggested that as many as 5.7 million new cases of HIV infection and 3 million deaths over 20 years could result from more widespread male circumcision in sub-Saharan Africa.

The UN said today that the risks involved in male circumcision are generally low, but can be serious if the operation is performed in unhygienic settings by poorly trained, ill-equipped health workers. With proper training, the operation can be performed safely under local anesthesia by “midlevel" health workers like nurses or clinical officers at a cost of $50-$100 (£25 to £51) per person, WHO officials said.

Priority should be given to providing circumcision to age groups at highest risk of acquiring HIV because it will have the most immediate impact on the disease. But today's statement said that circumcising younger males also will have a public health impact over the longer term.

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