Charities warn circumcision should not replace condoms in the war on HIV

Nearly 5,000 Ugandan men were recruited for the study. Half were circumcised, half had yet to undergo surgery.

There was little difference between the two groups when they were asked to rate performance and satisfaction, the journal BJU International reports.

Some studies suggest circumcision can cut male HIV infection by up to 50%.

There are several reasons why circumcision may protect against the virus.

Specific cells in the foreskin may be potential targets for HIV infection, while the skin under the foreskin may become less sensitive and less likely to bleed - reducing risk of infection - following circumcision.

Mixed picture

But despite this, it is thought there is some reluctance to be circumcised over fears that it may impact upon sexual experience.

There is a fear that people that have been circumcised will feel they are protected from HIV when they are not

Deborah Jack

National AIDS Trust

Previous studies into circumcision and satisfaction have given a mixed picture.

But researchers from the Johns Hopkins University in the US say the size of their study and demographic profile of their participants made it one of the most reliable to date.

"Our study clearly shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery," said Professor Ronald Gray, who led the study.

"Other studies already show that being able to reassure men that the procedure won't affect sexual satisfaction or performance makes them much more likely to be circumcised."

Mixed armoury

While there were very slight differences in rates of sexual satisfaction between the two groups, these were not felt to be clinically significant.

Some 98.4% of the circumcised men reported satisfaction, compared to 99.9% in the control group.

In terms of ability to penetrate, 98.6% of the circumcised group reported no problem, compared with 99.4 of the non-circumcised group.

However marginally more circumcised men - 99.4% - reported that they had no pain during intercourse, compared with 98.8% of the other group.

But campaigning charities warned against using circumcision as the main weapon against HIV, noting that it was far from 100% effective.

Deborah Jack, chief executive of the National Aids Trust, said: "There is a fear that people that have been circumcised will feel they are protected from HIV when they are not.

"Condoms remain the best way of preventing HIV through sexual intercourse.

"It should be noted that research into HIV and circumcision has been very limited in its scope.

"We still need further research into new prevention methods from circumcision to microbicides and vaccines."