For permission to use where not already granted under a licence please go to http: However, the extent, characteristics and role of MPS in transmission is poorly understood.
Methods We performed complex survey analyses of data from men aged 16—74 years resident in Britain who completed Natsal-3, a probability sample survey undertaken during —, using computer-assisted personal interviewing and computer-assisted self-interview.
Partners of MPS constitute After adjusting for partner numbers, paying for sex remained strongly associated with reporting new foreign partners outside the UK AOR 7. Among men ever paying for sex, They report high numbers of partners, but the minority are paid partners. They are an important core group in STI transmission. Britain's third National Survey of Sexual Attitudes and Lifestyles Natsal-3 by contrast, uses probability sampling of the general population.
We examine variations in the prevalence of paying for sex and the recency of last paid sex by age among men in Britain, and estimate the proportion of paid sex partners among British men's sexual partners. Last, we identify the global geographical regions where men pay for sex. Given that the prevalence of women paying for sex among 16—44 year olds in the past 5 years is 0. Methods Study design and participants Natsal-3 is a stratified probability sample survey of 15 men and women men aged 16—74 years, resident in Britain, undertaken between September and August Details of the sampling methodology and data collection are published elsewhere.
Those who reported they had paid for sex were then asked when they last paid for sex, how many sexual partners they had ever paid, and whether they had ever paid for sex while outside the UK. Men who had paid for sex while outside the UK were asked a further question about the geographical region in which they had paid for sex. Demographic variables include age and relationship status at interview, individual socioeconomic status according to the National Statistics Socio-Economic Classification NS-SEC , 14 and area-level deprivation, using quintiles of the Index of Multiple Deprivation IMD , a multidimensional measure combining income, employment, health, education, access to housing and services, crime and living environment.
Finally, measures of sexual risk behaviour include number of sexual partners, reporting new foreign sexual partner s while outside the UK, 19 same-sex experience, condom use, reporting concurrent partners, and finding sexual partners on the internet. Statistical analysis Prevalence of paying for sex and recency of the occasions of the experience ever, past 5 years, and past year was examined by age group.
Prevalence of same-sex paid sex, 0. The number of paid partners ever reported was added to the number of lifetime partners reported if the participant had indicated that these partners had not been included in their partner counts.
Mean lifetime partner numbers, mean paid partner numbers, and the proportion of paid partners were calculated and examined across sociodemographic, general health, sexual behaviour, and sexual health-related variables for the population and for all MPS. The proportion of paid partners was calculated by dividing total reported paid partners by total lifetime partners for the population and within the categories of each variable. CIs were bootstrapped, as the resulting estimates were calculated from summary statistics and needed to have SEs estimated.
Unadjusted logistic regression models were used to explore associations between reporting paying for sex in the 5 years prior to interview and sociodemographic, general health, and sexual behaviour variables.
Multivariable logistic regressions adjusting for the potentially confounding effect of key sociodemographic variables were used to assess the associations of general health and sexual behaviour variables with the outcome of paying for sex in the past 5 years. Sexual behaviour variables were additionally adjusted for the confounding effect of the reported number of sexual partners in the past 5 years. Additional univariable and multivariable logistic regressions adjusting for sociodemographic variables and number of sexual partners in the past 5 years assessed the associations between paying for sex and key sexual health outcomes.
Finally, we drew comparisons between the geographical regions where men had ever paid for sex when outside the UK, and the geographical origin of unpaid new sex partners while outside the UK, in the past 5 years.
No formal statistical comparison between the regional distributions for paying for sex abroad and having new sex partners abroad are made because of inconsistent time periods and subtle changes in wording in the questions of comparative interest. All analysis used Stata V. The data were first weighted to correct for unequal selection probabilities and then to match the demographic profile of the British population figures, in terms of gender, age and Government Office Region, according to the UK census.
Reporting ever paying for sex was lowest in men aged 16—24 years and three times as high in 25—year-olds. Lifetime prevalence was highest in men aged 55—64 years, while men aged 25—34 years had the highest prevalence in the past 5 years. Paid partners accounted for 4. This percentage ranged from 1.