Aims: To estimate the prevalence, time trends and factors associated with paid sex among men.
Methods: Norwegian Sex Surveys using similar questions in 1992, 1997 and 2002 were analyzed using a cohort analysis and logistic regression. The questionnaires included demographic background, and several aspects of sexual behaviour. The following questions on paid sex were included: ''Have you ever paid for sexual services?'' ''If yes, how many times?'', ''How old were you the first time?'', ''How old were you the last time?'', and ''Did you use a condom the last time?''
Results: Of the 4,545 men who answered this question, 585 (12.9%) reported ever having paid for sex. There was a marked decline overall in reporting from 26.2% in the cohort born in 1927-34, to 5.9% in the cohort born in 1975-84 (p < 0.001). However, there was an increase in the last cohort after the age of around 23 years (p = 0.1). Having paid for sex was significantly associated with being single, being on a disability pension, early sexual debut and having multiple other sex partners; these men were less likely to use condoms when having sex with a cohabiting partner (p < 0.01) and more likely to have had a sexually transmitted infection (p < 0.001).
Conclusions: Having paid for sex is associated with high risk sexual behaviour and represents a public health problem. Preventive measures should address men's behaviour across social groups and marital status and explore the trend among younger men.