Abstract

Background: Populations surveys in the United Kingdom have documented a doubling in the number of men paying for sex over the decade 1990 to 2000. We report the prevalence of this behaviour in men attending a sexual health clinic, and describe their characteristics.

Methods: Retrospective case note review.

Results: Of 2665 men completing a standard health screening questionnaire, 10% (267) reported paid sex. We reviewed case notes of 258 men. The mean age was 34.7 years. The majority reported paying women, with 4.3% paying men for sex. Men reported paying for sex abroad (51%), locally (40%), or elsewhere in the United Kingdom (11%), with only 1.7% paying for sex both in the United Kingdom and abroad. The majority (66%) had paid for sex in the previous 12 months, and 27% were repeated users of prostitutes. Almost half the men (43%) paid for sex while in another relationship. Unprotected vaginal sex was more common in men who had paid for sex abroad. None of the men had HIV infection, but 20% had a sexually transmitted infection (8% chlamydia, 1.3% gonorrhoea, 7% non-gonococcal urethritis, and 1.1% syphilis)

Conclusion: Routine questions about commercial sexual contacts could allow targeted health promotion and harm minimisation for this group of men, protecting their partners—both unsuspecting and commercial.