Scandinavian Journal of Public Health, 2010; 38: 135–140 ORIGINAL ARTICLE A study of men who pay for sex, based on the Norwegian National Sex Surveys

Aims: To estimate the prevalence, time trends and factors associated with paid sex among men. Methods: 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?’ ’ Results: 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). Conclusions: 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