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

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.