European gay men more likely to buy or sell sex if they have large numbers of sex partners, are lonely and use drugs

Published: June 25, 2013

Results of a large European internet-based survey show that 8% of gay and other men who have sex with men (MSM) in Europe paid for sex in the previous twelve months, and that 5% were paid for sex during the same period.

A number of characteristics were associated with buying or selling sex, including age, sexual identity and drug use. The investigators stress that buying and selling sex does not automatically involve an increased risk of HIV. Nevertheless, they suggest that individuals with characteristics associated with the purchase or sale of sex should be targeted with health promotion interventions.

Approximately 180,000 participants from 38 European countries completed the European Men-Who-Have-Sex-with-Men Internet Survey (EMIS) in 2010. This is the largest international study of men who have sex with men ever conducted.

The survey gathered a large amount of data on the demographics, sexual behaviour and drug use of MSM. Participants were asked if they had bought or sold sex and, if so, on how many occasions.

Overall, 8% of men had bought sex in the previous year. The countries with the highest proportion of men buying sex were Switzerland (13%), Cyprus (13%), Russia (11%) and Belgium (10%).

Most of the men (60%) who reported buying sex had done so on one or two occasions only, but 10% had paid for sex on more than ten occasions.

Selling sex in the previous year was reported by 5% of men. Countries with the highest proportion of men selling sex were the former Yugoslav Republic of Macedonia (11%), Turkey (8%), Italy (8%) and Moldova (8%).

Over half (52%) of men who had sold sex did so on only one or two occasions.

“Having been paid for sex does not necessarily indicate that a person is a sex worker,” write the authors. “Many men who had sold sex in the last year had done so only once or twice, suggesting that these were opportunistic exchanges.”

Despite this, 10% of men selling sex had had done on ten or more occasions.

A number of factors were associated with having bought sex. Men aged over 40 were almost ten times more likely to have reported buying sex than men aged under 25 (AOR = 9.68; 95% CI, 8.73-10.7).

Identifying as bisexual (AOR = 1.10; 95% 1.03-1.17) was also associated with buying sex, as was being out as gay to only a few people (AOR = 1.28; 95% CI, 1.22-1.35). Men who reported being lonely were also more likely to buy sex (AOR = 1.18; 95% CI, 1.10-1.25).

A large number of sex partners in the previous year (above 50: AOR = 4.50; 95% CI, 5.00-5.06), use of crack or heroin (AOR = 2.08; 95% CI, 1.60-2.70) and recent use of drugs such as Viagra (AOR = 1.56; 95% CI, 1.46-1.66) were associated with the purchase of sex.

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