Are Men Who Buy Sex Different from Men Who Do Not?: Exploring Sex Life Characteristics Based on a Randomized Population Survey in Sweden

Are Men Who Buy Sex Different from Men Who Do Not?: Exploring Sex Life Characteristics Based on a Randomized Population Survey in Sweden. Charlotte Deogan, Elin Jacobsson, Louise Mannheimer & Charlotte Björkenstam. Archives of Sexual Behavior, Dec 22 2020. https://rd.springer.com/article/10.1007/s10508-020-01843-3

Abstract: The buying and selling of sex is a topic of frequent discussion and a relevant public health issue. Studies of sex workers are available, while studies addressing the demand side of sex are scarce, especially based on robust population data. The current study provides national estimates of the prevalence of and factors associated with having paid for sex among men in Sweden. We used a randomized population-based survey on sexual and reproductive health and rights among ages 16–84 years, linked to nationwide registers. The sample consisted of 6048 men. With a logistic regression, we analyzed what sex life factors were associated with ever having paid for or given other types of compensation for sex. A total of 9.5% of male respondents reported ever having paid for sex. An increased probability of having paid for sex was identified in men who were dissatisfied with their sex life (aOR: 1.72; 95% CI: 1.34–2.22), men reporting having had less sex than they would have liked to (aOR: 2.78; 95% CI: 2.12–3.66), men who had ever looked for or met sex partners online (aOR: 5.07; 95% CI: 3.97–6.46), as well as frequent pornography users (aOR: 3.02; 95% CI: 2.28–3.98) Associations remained statistically significant after adjustment for age, income, and educational attainment. Sex life characteristics such as poor sex life satisfaction, high online sex activity, and frequent pornography use are strongly associated with sex purchase. These findings can help guide and support counselling and prevention activities targeting sex buyers.

Discussion

In this study, we took advantage of unique data from the randomized population-based survey SRHR2017, linked with Sweden’s extensive and high-quality nationwide administrative registers, to identify the proportion of men ever having paid or given other types of compensation for sex in Sweden. Our results confirms that the proportion of men reporting ever having paid for sex in our survey (9.5%) is comparable to previous studies and with other Nordic as well as western European countries (Haavio-Mannila & Rotkirch, 2000; Jones et al., 2015; Schei & Stigum, 2010). The age-group with the highest proportion of men having paid for sex was men above the age of 45 years (11%), and men 30–44 years (10%) reported a similar proportion. The lowest proportion was reported among men 16–29 years of age. It is unclear whether this is due to the question, which provides us with a lifetime prevalence that naturally increases with age, or that sex purchase became illegal in Sweden in 1999.

Our results regarding education and income of buyers also confirm previous studies (BRÅ, 2008; Priebe & Svedin, 2011), that buyers are from different socioeconomic backgrounds and educational level is not associated with having paid for sex. However, having a very low income seem to be associated with having paid for sex, which may indicate underlying vulnerability and deprivation. This contradicts the findings of Priebe and Svedin (2011) and Milrod and Monto (2017) that a higher proportion of buyers had high income. This could potentially be due to differences in the participant characteristics since Priebe and Svedin (2011) was based on an online panel which in Sweden usually tends to hold a larger proportion of males, and individuals that are better educated and have higher incomes than the population in general (Bosnjak et al., 2013).

To our knowledge, no study based on a randomized population based survey has explored the relationship between sex life satisfaction and sex purchase, however it does seem reasonable to assume dissatisfaction drives demand, including having less sex than one would have liked to. In our findings, we see a strong association between having looked for or met sex partners online and sex purchase. Our results confirm previous findings that buyers do use internet and/or mobile apps for sexual activity to a higher extent than non-buyers (Monto & Milrod, 2014; Priebe & Svedin, 2011).

Our results show a strong statistically significant association between frequent pornography use and ever having paid for sex. Swedish research has shown that frequent pornography users also have higher levels of risk taking such as alcohol and drug use as well as higher sexual risk taking such as early sex debut and experiences of selling sex, in comparison with non-frequent pornography users (Mattebo, Tydén, Häggström-Nordin, Nilsson, & Larsson, 2013; Svedin, Akerman, & Priebe, 2010).

In all, sex life dissatisfaction and not having as much sex as one would have preferred, as well as online sexual activity and frequent pornography use are strongly associated with having paid for sex among Swedish men. This tells us that these individuals differ from men not having paid for sex in terms of sex life characteristics. It also gives us an indication that they may differ in terms of other factors related to sex life and sexual risk taking but it remains unclear how. Need for intimacy and social dimensions could also play a role (Birch & Braun-Harvey, 2019; Monto & Milrod, 2014). These insights are of importance in the prevention of disease and promotion of sexual health. The understanding of who pays for sex and why is key to reduce demand of sexual services and is of importance not only for law enforcement but also for public health interventions and support activities targeted toward both people paying for and people receiving money or other compensation for sex.

The strengths of this study include the use of the unique data SRHR2017, enriched with high-quality nationwide register data. In prior research, information on sex life factors such as satisfaction, pornography use and online partners is lacking while in our study the results contribute to the understanding of mechanisms driving demand for sex. Some study limitations needs to be taken into consideration in contextualizing the results. First, while the SRHR2017 is a population based sample, the response rate was 31% (i.e., 14,500 participants). Non-response might have biased our results, because many people resist disclosing information about sensitive topics such as sexual activities and experiences of illegal actions. Hence, our outcome measure is likely to be underreported. The outcome measure was “Have you ever paid or given other compensation for sex?” A total of 9.5% of men reported ever having paid for sex, of which 2.8% (of the 9.5%) reported having paid for sex during the past year. However, the question was unfortunately vaguely formulated, where all options was put together in the same question. Hence, we cannot differ between non-response and a selected “no” response. Only 0.26% of all men reported they had purchased sex within the last 12 months, hence we chose not to use this estimate in our analyses. It is unclear as to what extent this may include online purchases since the question did not define online versus offline. Second, the variable of sex life satisfaction referred to the past year, while the rest of our variables measured lifetime prevalence. This is a limitation that sets back our possibility to identify correlations to recent sex purchase. Thirdly, in our study, we have no information on relationship status, which would have helped us further in the understanding of the results.