A study of men who pay for sex, based on the Norwegian national sex surveys.

To estimate the prevalence, time trends and factors associated with paid sex among men. Norwegian Sex Surveys using similar questions in 1992, 1997 and 2002 were analyzed using a cohort analysis and logistic regression. The questionnaires included demographic background, and several aspects of sexual behaviour. The following questions on paid sex were included: ''Have you ever paid for sexual services?'' ''If yes, how many times?'', ''How old were you the first time?'', ''How old were you the last time?'', and ''Did you use a condom the last time?'' Of the 4,545 men who answered this question, 585 (12.9%) reported ever having paid for sex. There was a marked decline overall in reporting from 26.2% in the cohort born in 1927-34, to 5.9% in the cohort born in 1975-84 (p < 0.001). However, there was an increase in the last cohort after the age of around 23 years (p = 0.1). Having paid for sex was significantly associated with being single, being on a disability pension, early sexual debut and having multiple other sex partners; these men were less likely to use condoms when having sex with a cohabiting partner (p < 0.01) and more likely to have had a sexually transmitted infection (p < 0.001). Having paid for sex is associated with high risk sexual behaviour and represents a public health problem. Preventive measures should address men's behaviour across social groups and marital status and explore the trend among younger men.