Male Clients Of Sex Workers Research Articles

Toward a Typology of the Client: A Latent Class Analysis Approach to the Consumption of Sex Work in the United States

ABSTRACT Previous research on male clients of sex workers has emphasized the diversity of purchasing behaviors; however, we know little about how to organize or categorize this diversity quantitatively. I employed latent class analysis with survey data from cisgender male clients of primarily cisgender female sex workers in the United States to organize client consumption patterns by the type of venue used to contact sex workers and the frequency of using each venue. I found that patterns of consumption emerged around the frequency and context in which sex work is negotiated, generating six distinct patterns of buying: generalists, internet-only buyers, brothel-only buyers, experimenters, routinized buyers, and opportunists. I used multinomial logistic regression to identify relationships between latent class membership, known covariates, and self-reported motivations for purchase. Classes had small but significant demographic differences around age, income, marital status, arrest history, and international sex work engagement. Motivational differences were observed across classes, including the importance of emotional connection, practicing sexual skills, and relaxation. Implications for future research are discussed.

Sexually Transmitted Infections and Associated Risk Factors Among Male Clients of Sex Workers: A Cross-Sectional Pilot Project in Antwerp, Belgium.

IntroductionPrevalence of sexually transmitted infections (STIs) is increasing in Belgium in recent years. Clients of sex workers form a key population for acquisition of STIs, due to their sexual relations, with or without a condom, with sex workers. STI testing uptake is low among clients of sex workers, and prevalence of STIs remains to be investigated in Belgium. Therefore, we offered STI-testing to clients of sex workers during outreach sessions in Antwerp.MethodsTime location sampling (TLS) was used to improve representativeness of the sample during ten test sessions in the red light district, Antwerp in May and September 2019 by using a passive approach. Individuals that were interested to get tested for STIs could enter the study. Participants completed an online survey and samples for STI testing were collected. Testing included HIV, syphilis, Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng). Test results were communicated via a cell phone message (for negative test results) or by phone (for positive test results).ResultsIn total, 154 male clients of sex workers with a median age of 38 participated. A total of eight Ct and one Ng infections were detected. TLS analysis revealed a Ct/Ng prevalence of 8.2%. No new HIV nor syphilis infections were detected. Using univariate analysis, testing positive for STI was associated with younger age and anorectal sex with a sex worker. Using multivariate analysis, an STI-positive test result was associated with being younger, having non-Belgian nationality, and being in a relationship.ConclusionOur study found a substantial prevalence of Ct/Ng which highlights the need for sensitization and facilitation of STI testing among clients of sex workers. It is difficult to compare results due to the lack of reference material. Moreover, our relatively small convenience sample limits generalizability of results. However, phone counseling (for positive test results) was accepted, linkage to care was provided, and partner notification was facilitated.

"I Couldn't Afford to Resist": Condom Negotiations Between Male Sex Workers and Male Clients in Mombasa, Kenya.

Male sex workers in Kenya face a disproportionate burden of HIV and often engage in condomless sex with their commercial partners, yet little is known about how condom negotiations between male sex workers and clients take place. We conducted semi-structured interviews with 25 male sex workers and 11 male clients of male sex workers in Mombasa, Kenya, to examine barriers and facilitators to condom use and how condom usenegotiation takes place in these interactions. Participants reported positive attitudes toward condom use and perceived condom use to be a health-promoting behavior. Barriers to condom use included extra-payment for condomless sex, low perceived HIV/STI risk with some sexual partners, perceived reduced pleasure associated with using condoms, alcohol use, and violence against male sex workersby clients. Future interventions should address individual- and structural-level barriers to condom use to promote effective condomuse negotiation between male sex workers and male clients.

Protected Sex with Paid Sexual Partner among Married Men in Indonesia

Background: Married men who are male clients of sex workers play an important role as “bridge population” of HIV infection from the concentrated epidemic population to the general population. This study aimed to investigate the protected sex with last paid sexual partner among currently married men in Indonesia. Method: A nationally representative population-based survey, 2012 Indonesia Demographic and Health Survey (IDHS) which covered 33 provinces in Indonesia was applied in this study. Out of 9,306 currently married men, 510 records of married men who reported for ever paying someone for having sex were eligible for this study. A dependent variable was protected sex (i.e. condom use) at last sex with a paid sexual partner whilst independent variables consisted of socio-demographic factors, spousal communication on HIV prevention, knowledge of HIV prevention, and attitude of condom use. Binary logistic regression was applied for bivariate and multivariate analysis.Results: Prevalence of condom use with a paid sexual partner at last sex among currently married men was 27.86% [95%CI=23.89-32.20]. Based on multivariate analysis, married men were less likely to use a condom with a paid sexual partner if they aged ≥ 40 years old (OR=0.48; 95%CI=0.30-0.76) versus those aged < 40 years old and worked in some sectors: clerical (OR=0.22; 95%CI=0.08-0.61), sales (OR=0.40; 95%CI=0.17-0.95), agricultural/self-employed (0.32; 95%CI=0.13-0.75), skilled manual (OR=0.38; 95%CI=0.18-0.79) compared to those working in professional/technical/engineering sectors. However, those who were from poorer (OR=2.28; 95%CI=1.08-4.82) and richest household (OR=3.08; 95%CI=1.32-7.20) were more likely to perform protected sex compared to the poorest ones. In addition, the likelihood of protected sex also increased when married men had spousal communication on HIV prevention (OR=1.84;95%CI=1.17-2.90), knew that using condoms can reduce HIV infection (OR=2.15; 95%CI=1.14-4.08) and had a positive attitude of using condoms can protect against diseases (OR=3.05; 95%CI=1.14-8.16). Conclusion: Interventional approaches for increasing protected sex among married men as clients of sex workers should be integrated with existing HIV program among other key affected populations (e.g., FSWs) at sex workers’ workplaces setting through providing HIV-related information, ensuring uninterrupted stocks of condoms, and enforcing condom use regulation.

Male clients of male sex workers in West Africa: A neglected high-risk population.

Research on male clients of male sex workers (MCMSW) has been neglected for a long time globally. We aimed to characterize MCMSW and to identify factors associated with their sexual practices using data from the prospective cohort study CohMSM conducted in Burkina Faso, Côte d’Ivoire, Mali and Togo. Our study focused on HIV-negative men who have sex with other men (MSM), recruited between 06/2015 and 01/2018 by a team of trained peer educators. Scheduled study visits at 6, 12 and 18 months included medical examinations, HIV screening, risk-reduction counselling and face-to-face interviews to collect information on their sociodemographic characteristics, sexual behaviours, and HIV risk-reduction strategies (HIV-RRS). Three stigmatization sub-scores were constructed (experienced, perceived and internalized). Mixed-effects logistic regression was used for data analysis. Of the 280 participants recruited at baseline, 238, 211 and 118, respectively, had a follow-up visit at 6, 12 and 18 months. Over a total of 847 visits, 47 transactional sex (TS) encounters were reported by 38 MCMSW (13.6%). Of the latter, only one participant reported systematic TS (2.6%), 18 (47.4%) stopped reporting TS after baseline, while 6 (15.8%) reported TS after baseline. Thirteen participants (34.2%) reported occasional TS. After adjusting for country of study and age, the following self-reported factors were associated with a greater likelihood of being MCMSW: protected anal sex, exclusively insertive anal sex with male sexual partners, avoidance of sex after consuming psychoactive products and experiencing stigmatization (all during the previous 6 months). The majority of MCMSW in this study practiced HIV-RRS with male sexual partners, including engaging in protected anal sex, avoidance of sex when consuming psychoactive products, and practising exclusively insertive anal sex.

Stigma and Risky Behaviors among Male Clients of Sex Workers in the UK

ABSTRACTBuilding on existing theoretical work on sex markets, this study uses data from the 2001 British National Survey of Sexual Attitudes and Lifestyles (Natsal) to replicate the analysis of the demand for paid sex. It formally tests the effects of attitudes, risky behaviors, and personal characteristics of a sample of men on the demand for paid sex. Previous theoretical work argues that stigma plays a fundamental role in determining both demand and risk, and in particular due to the presence of stigma, the demands for unpaid sex and for paid sex are not perfect substitutes. This study finds a positive effect of education (proxy for income), negative effects of professional status (proxies for stigma associated with buying sex), positive and significant effects of all risky behavior variables, and no significant effects of variables that measure the relative degree of conservatism in morals.

Male Clients of Male Sex Workers in China: An Ignored High-Risk Population.

Background:There is a high prevalence of HIV/syphilis among male sex workers, but no formal study has ever been conducted focusing on male clients of male sex workers (MCM). A detailed investigation was thus called for, to determine the burden and sociobehavioral determinants of HIV and syphilis among these MCM in China.Methods:As part of a multicenter cross-sectional study, using respondent-driven and snowball sampling, 2958 consenting adult men who have sex with men (MSM) were recruited, interviewed, and tested for HIV and syphilis between 2008 and 2009. The distributions of sociodemographic characteristics, risk behaviors, and HIV/syphilis prevalence were determined and compared between MCM and other MSM.Results:Among recruited MSM, 5.0% (n = 148) were MCM. HIV prevalences for MCM and other MSM were 7.4% and 7.7%, whereas 18.9% and 14.0% were positive for syphilis, respectively. Condomless anal intercourse (CAI) was reported by 59.5% of MCM and 48.2% of MSM. Multiple logistic regression revealed that compared with other MSM, MCM were more likely to have less education [for ≤elementary level, adjusted odds ratio (aOR) = 3.13, 95% confidence interval (95% CI): 1.42 to 6.90], higher income (for >500 US Dollars per month, aOR = 2.97, 95% CI: 1.53 to 5.77), more often found partners at parks/restrooms (aOR = 4.01, 95% CI: 2.34 to 6.85), reported CAI (aOR = 1.49, 95% CI: 1.05 to 2.10), reported a larger sexual network (for ≥10, aOR = 2.70, 95% CI: 1.44 to 5.07), and higher odds of syphilis (aOR = 1.54, 95% CI: 1.00 to 2.38).Conclusions:The greater frequency of risk behaviors and high prevalence of HIV and syphilis indicated that HIV/syphilis prevention programs in China need to pay special attention to MCM as a distinct subgroup, which was completely ignored until date.

Men’s constructions of masculinity and male sexuality through talk of buying sex

Commercial sex is an everyday occurrence across a range of contexts in South Africa. In this paper we turn our attention to the often-marginalised role of the buyers of sex by drawing on narrative interviews with male clients of female sex workers recruited through online advertisements in order to explore the ways in which heterosexual men construct, negotiate and perform their masculinity and sexuality through talking about their experiences of paying for sex. We highlight parallels between men’s narratives of paying for sex and dominant discourses of gender and heterosexuality. We show how men draw on heteronormative sexual scripts in constructing and making sense of paid sexual encounters and how men are simultaneously able to construct and enact a particular idealised version of masculinity and male sexuality through their talk on paying for sex. Finally, we discuss how online resources could be used more extensively in future research with the male clients of sex workers.

Male Clients of Male Escorts: Satisfaction, Sexual Behavior, and Demographic Characteristics

Few studies have examined male clients who pay for sex with male escorts. In 2012, clients (n = 495) completed an online survey about their most recent hire. Most clients were White/Caucasian (87.7%), HIV negative (89.5%), employed full time (71.1%), single (58.6%), with a mean age of 54. Three-quarters of clients were gay identified, 18% bisexual, and 4% heterosexual. The median rate paid to escorts was $250 per hour with a modal appointment time of 1 to 2 hours (41.6%). Oral sex was common (80% gave, 69% received), 30% reported anal insertive sex, and 34% reported anal receptive sex. In total, few (12%) reported unprotected anal sex. Satisfaction with encounters was high. Receptive unprotected anal intercourse was associated with greater satisfaction in bivariate analyses but not in multivariable analyses. In a multivariable model, having receptive anal sex (whether protected or not) and rating the financial cost of the encounter as “worth it” were significantly associated with greater satisfaction. This study contributes to a scarce literature regarding clients of male sex workers and, in particular, provides information on the characteristics of men hiring men for sexual services, behavioral event-level data about their encounters, and analysis of factors directly associated with client satisfaction.

P3.307 Population Growth Within Regional Pattern of Population Change and Male Clients of Sex Workers in U.S. Metropolitan Areas

BackgroundMale clients of sex workers are at high-risk of HIV and are a key group in the spread of sexually transmitted infections to the general population. Places undergoing population growth...

P3.301 Male Clients of Sex Workers in the United States: Correlates with STI/HIV Risk Behaviors and Urbanization Level

BackgroundMen who have purchased sex from sex workers (“clients”) have been associated with an increased risk of acquiring STIs including HIV and in influencing the spread of infection in the...

Face Value: Information and Signaling in an Illegal Market

Economists argue that rich information environments and formal enforcement of contracts are necessary to prevent market failures when information asymmetries exist. We test for the necessity of formal enforcement to overcome the problems of asymmetric information by estimating the value of information in an illegal market with a particularly rich information structure: the online market for male sex work. We assemble a rich data set from the largest and most comprehensive online male sex worker Web site to estimate the effect of information on pricing. We show how clients of male sex workers informally police the market in a way that makes signaling credible. Using institutional knowledge, we identify the specific signal male sex workers use to communicate quality to clients: face pictures. We find that there is a substantial return to the signal in this market. The findings provide novel evidence on the ability of rich information environments to overcome problems of asymmetric information without formal enforcement mechanisms.

“These girls gave me AIDS. Why should I use condoms?” Clients of Sex Workers in Kamathipura Express Their Attitudes About HIV

Very little research has been conducted that examines the attitudes toward HIV/AIDS from the perspective of clients of sex workers. This study examined 13 male clients of sex workers through in-depth interviews that aimed to explore their understanding of risks associated with unprotected sex, as well as condom use and attitudes about condoms and HIV/AIDS. The findings suggested that clients of sex workers often have incorrect knowledge about HIV/AIDS. Additionally, differences arose around condom use with sex workers versus intimate partners. Finally, participants were found to deceive sex partners and intimate partners about their HIV/AIDS status. These findings emphasize the importance of more effective HIV/AIDS awareness programming aimed at male clients of sex workers.

Understanding the diversity of male clients of sex workers in China and the implications for HIV prevention programmes

Male clients of sex workers have been overlooked in China's HIV prevention efforts. This study aims to examine men's practices and attitudes toward extramarital sexual relationships, motivations for visiting female sex workers (FSWs), perceptions of sexually transmitted infection (STI)/HIV risk and risk prevention strategies used. One hundred and eighty-six clients of FSWs with varying socio-economic statuses were interviewed in different sex work settings. Men described no conflict between their role as a client and a responsible family provider. They described social pressure from peers and business partners to visit FSWs, sexual pleasure and companionship as motivators to seek commercial sex. While some men reported no risks associated with visiting FSWs, others identified risks such as being arrested by the police, robbed by gangs and threatening the health of their families by contracting a STI. This study underscores the diversity of FSW clients and the need to understand the beliefs and behaviours of different client types to develop appropriate HIV prevention programmes. It also demonstrates the feasibility of recruiting different types of male clients, a hard-to-reach population for Chinese HIV prevention efforts.

Concentrated HIV epidemic in Pakistan: An opportunity to prevent generalized epidemic

Concentrated HIV epidemic in Pakistan: An opportunity to prevent generalized epidemic

Bellwether Citizens: The Regulation of Male Clients of Sex Workers

Dangerous and discriminatory new provisions against sex workers' clients have repeatedly been put before parliament in England and Wales. Female ministers keen to punish clients of sex workers eagerly supported the Bill. However, while sex work has become a rights issue it is no longer just about women's rights. Diverse and multiple sexualities and working practices see gay, trans or bisexual workers selling sex to a diverse range of lesbian, gay, trans, and straight clients who may be able‐bodied or disabled. This article critically examines the regulation of clients of sex workers, explores the current legislation against them, and reviews recent research evidence. The ideas that inform policy will be discussed along with the various policy approaches. The latest move to criminalize clients in the Policing and Crime Bill 2009 will be discussed along with the spectre of trafficking, used to scapegoat clients by a government which has undermined civil liberties and the fundamental concepts of a free society. [A]nyone indulging in sexual activity is entitled to a degree of privacy especially if it is on private property and between consenting adults (paid or unpaid) Mr Justice Eady1

Who pays for sex and why? An analysis of social and motivational factors associated with male clients of sex workers.

A total of 1,225 men and women attending a commercial event in the state of Victoria, Australia were surveyed as to whether they had ever paid for sex. Of 612 men surveyed, 143 (23.4%) had paid for sex at least once. Men who had ever paid for sex were compared with male nonclients on 13 demographic and sexual history measures; only four significantly differentiated clients from nonclients. Clients were significantly older, less likely to have been educated beyond high school, less likely to report having a regular partner in the past 6 months, and more likely to report that their most recent sexual encounter was with a casual partner. Clients of sex workers reported the major reason for paying for sex was to satisfy their sexual needs (43.8%), followed by the belief that paying for sex was less trouble (36.4%), and that it would be entertaining (35.5%). A factor analysis of reasons for visiting sex workers identified three factors labelled Ease, Engagement, and Arousal. Together, these factors accounted for 55% of the variance associated with the factor solution of motivations for paying for sex. In a setting where commercial sex is legally available from brothels, it would appear that clients are unremarkable in their social characteristics and are motivated mainly by the ease of the commercial sex encounter, the need for engagement with another, and because they feel in need of sexual "relief."

A profile of clients of male sex workers in Córdoba, Argentina.

This paper provides a profile of clients seen by male sex workers (MSWs) in Córdoba, Argentina. Thirty-two MSWs completed a diary after each paid sexual encounter with a client over a two-week period. The results show that 254 commercial sex encounters were reported. More than half of these encounters were with first time clients. The most common source of recruiting clients was advertisements followed by street contact. The majority of the clients were aged in their 30s or 20s, and identified as 'middle class' and 'bisexual' or 'gay'. In the majority of the encounters, alcohol or drugs were not used by clients, and in about less than half of the cases, the MSWs had some personal tracing information about the client. Most of the clients indicated to the MSW what sexual activity they wanted and unsafe anal sex was requested in a minority (6%) of the encounters. While most workers reported having no or little attraction to the client, most indicated that they would serve the client again. The implications of the results for public health education and further research are discussed.

A profile of the clients of male sex workers in three Australian cities

ObjectiveThis paper describes the profile of clients as reported by 186 male sex workers in three Australian cities. MethodThe data were collected using a diary which was completed after each commercial sexual encounter with a male client over a two-week period. The data reported in this study are based on reports from 2,088 sex encounters and a profile of 1,776 clients. ResultsThe findings reveal, for example, that the most common source used for recruiting clients was advertisements, followed by escort agencies, although there were differences between the three cities; the majority of the clients were in their 40s but clients of street workers were younger; clients were most often classified as ‘middle class’, with differences by source of client recruitment; less than half the clients were identified as being gay and a significant number were identified as bisexual or straight; alcohol and drug use took place in a small percentage of the encounters; most workers had some information about their clients, such as occupation and home number; violence was infrequent; and unsafe sex was requested in a minority of the encounters. ConclusionOverall, the results reveal that clients of male sex workers are a highly heterogeneous group. ImplicationsThe paper highlights a number of issues which can further promote safety and public accountability in male sex work.