On SAGE Insight: Men over 60 who pay for sex use less protection and purchase more sex as they age

Article title: Condom use, sexual risk, and self-reported STI in a sample of older male clients of heterosexual prostitution in the United States

From American Journal of Men’s Health

This study surveyed American men between the ages of 60 and 84 who pay for sex and found that the older they were, the more frequently they paid for sex and the more likely they were to have experienced unprotected sexual intercourse multiple times with their favorite commercial sex providers. Using various sex provider review websites and discussion boards authors surveyed 208 men between the ages of 60 and 84 who solicited sex workers in order to assess their condom use and sexual risk taking.

“There is a nearly universal perception that older men do not pay for, or even engage sexually with regular frequency,” said lead study author Dr. Christine Milrod. “This view may contribute to a false sense of security for both clients and sex workers during their encounters, and may lead to less protective strategies than with younger purchasers of sex. In addition, the exchange of emotional intimacy during the so-called ‘Girlfriend Experience’ as well as the possibility of being viewed as an elderly low-risk client who engages with only one or a very limited number of providers may contribute to a relaxation of boundaries and a false sense of security in avoiding STIs,” Milrod continued.


While there is evidence of increasing rates of sexually transmitted infections (STIs) among older men in the United States, there has been little research on older male clients of female sex providers. The purpose of the current study was to understand the sexual risk behaviors and psychosocial correlates among older men hiring sex providers through provider review websites and discussion boards. A convenience sample of 208 male clients ages 60 to 84 completed online surveys about their sexual behavior and psychosocial factors. Participants indicated the most common sexual activities with providers in the past 12 months were receiving condomless fellatio (33.7%) and having penile–vaginal intercourse with a condom (31.7%). Although condomless penile–vaginal sex with a provider in the past 12 months was only reported by 2.9%, about half (51%) of the respondents indicated that they had experienced this at least once during their lifetime. This was associated with a preference for providers who do not require condoms, having been previously diagnosed with an STI, and perceiving one’s HIV risk to be higher, as well as advancing age and having more emotional relationships with providers. Findings demonstrate the need for general and sexual health care practitioners to openly discuss protective measures and strategies for avoiding STIs among their older-to-elderly male patients.

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Article details
Christine Milrod and Martin Monto
Condom Use, Sexual Risk, and Self-Reported STI in a Sample of Older Male Clients of Heterosexual Prostitution in the United States
Am J Mens Health 1557988315623990, first published on January 6, 2016 doi:10.1177/1557988315623990



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