Unsafe behaviour among men over 60 who pay for sex

Washington D.C.: Turns out, older male purchasers of sex are likelier to engage in unsafe sexual practices.

A 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 favourite commercial sex providers.

"There is a nearly universal perception that older men do not pay for, or even engage sexually with regular frequency," said lead author 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.

Using various sex provider review websites and discussion boards, Milrod and University of Portland's Martin Monto 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.

The researchers found that 59.2 percent reported not always using protection with sex workers. 95 percent reported avoiding protection for manual masturbation and 91 percent reported avoiding protection for oral sex.

Moreover, 31.1 percent reported having been diagnosed with a STI at some point during their lifetime. 10.2 percent were once diagnosed with gonorrhea, 10.1 percent with genital warts, 7.8 percent with genital herpes and 5.3 percent with chlamydia.

Men who reported more unprotected sex acts perceived their HIV risk to be higher and were more likely to have been diagnosed with a STI. 77.4 percent reported that they perceived their likelihood of becoming infected with HIV as "low," while only 62 percent reported having been tested for HIV.

29.2 percent reported having an "all-time favourite" sex provider with whom they engage repeatedly. Being more emotionally attached to sex workers was positively related to more unprotected sex.

Of the 60- to 84-year-old men surveyed, advancing age was also positively associated with unprotected sex acts. 57.2 percent reported talking with a doctor about sex since turning 60, though 82.2 percent of these conversations were initiated by the patients, not by their doctors.

To reduce the incidence of STIs among sexually active older men, Milrod and Monto suggest that health care providers ask their older male patients about their sexual partners and discuss protective strategies for avoiding STIs.

The researchers wrote, "Medical and mental health clinicians should not assume that old age is a barrier to paying for sex, particularly among the generations that began engaging in sexual activity prior to the epidemic emergence of the HIV virus." The study is published in the American Journal of Men's Health (a SAGE journal).