239119 Male commercial sex clients in the U.S.: Who are they?

Monday, October 31, 2011

Danielle C. Ompad, PhD , Supportive Children's Advocacy Network, c/o HCAP, Harlem Community & Academic Partnership, New York, NY
David L. Bell, MD, MPH , Department of Pediatrics and Mailman School of Public Health's Department of Population and Family Health, Columbia University, New York, NY
Silvia Amesty, MD, MPH, MSEd , Center for Family and Community Medicine, Columbia University, College of Physicians and Surgeons, New York, NY
Eduardo Lazcano-Ponce, MD, MPH, ScD , Center for Population Health Research, National Institute of Public Health (INSP), Mexico, Cuernavaca, Morelos, Mexico
Luisa Villa, PhD , Hospital Alemão Oswaldo Cruz, Ludwig Institute for Cancer Research, São Paulo, Brazil
Anna Giuliano, PhD , Program Leader: Risk Assessment, Detection, and Intervention, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
Most research focused on commercial sex is among sex workers (SWs). Most research among sex clients has been conducted outside the U.S. and/or relies on SW reports of client characteristics and behavior. We describe correlates of ever purchasing sex among 1249 men aged 18-70 without STDs, HIV, or a history of penile or anal cancer recruited in Central Florida. The mean age was 29.0, 72.8% white, 15.6% Hispanic, 17.4% black and 7.8% were MSM. Overall, 4.9% were ever sex clients and 13 (1.0%) were clients in the last 3 months. Clients were significantly older (mean age 42.0 vs. 28.4), married/cohabitating vs. single/divorced/widowed (9.6% vs. 3.8%), had <12 years (15.0%) or ≥17 years of education (13.2%) vs. 12-16 years (3.9%), and had sex with women and men (18.0%) vs. women only (4.6%) or men only (none) as compared to men who never purchased sex. Clients also initiated sex later (mean age 17.9 vs. 16.6, p=0.021) and had more lifetime female sex partners (median 28 vs. 6, p<0.001). Among recent clients, ten paid women, one paid men, and one paid men and women. On average, men paid for sex twice in the last three months. Eleven paid for vaginal sex, seven for oral sex, and none for anal sex. Most (77%) reported always using condoms when they paid for sex. This is one of the first studies to examine purchasing sex among U.S. men. Prevalence appears low, but is likely subject to under-reporting. Additional research is needed to further explore this phenomenon.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Summarize the research describing male commercial sex clients in the U.S. 2. Describe correlates of ever being a commercial sex client.

Keywords: Sexual Behavior, Male Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am an epidemiologist with expertise in sexual behavior and drug use. With my co-authors I designed, conducted, and interpreted the analyses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.