However, their prevalence and sexual health are unknown in Germany. Methods : We analyzed data from men aged 18β75 years resident in Germany who completed the German Health and Sexuality Survey GeSiD , a population-based probability sample survey undertaken β, using face-to-face interviews participation rate: Results : MPS described their paid sex predominantly as vaginal intercourse in domestic brothels. Regarding sociodemographic characteristics, MPS differed from men not paying for sex MNPS in terms of age, immigration status, and sex education.
Conclusion : The prevalence of MPS suggests physicians should address the topic with their patients to protect and improve the sexual health of MPS and their paid and unpaid partners. Paying for sex is defined as paying money for sexual services e. Direct purchase of sex in a professional sex-work setting or prostitution can be differentiated from indirect purchase e. Paying for sex is a highly gendered activity, as the majority of persons who pay for sex are men and the majority who sell sex are women 3 , 4.
It is also a socially complex 5 , morally and politically contested 6 , and legally regulated 7 activity that is closely linked to general health and especially sexual health 4 , 8 , 9.
MPS are stigmatized and criminalized in a growing number of countries 16 , In , Sweden became the first country to criminalize paying for sex. Since then male clients have been prosecuted, whereas selling sex remains legal to protect female providers from prosecution and make it easier for them to leave the profession To date, however, both buying and selling sex remain legal, in principle, in 21 of 27 European Union member states.
Four countries have wholly or partly criminalized paying for sex Sweden, Finland, France, Ireland. From a public health perspective, criminalization is questionable because it does not quell demand but makes paid sex even more stigmatized, concealed, and unsafe, endangering the health of both buyers and sellers 16 , 17 , The lifetime prevalence of MPS, estimated from population-based sex surveys undertaken in Europe, reflects cultural and legal norms and was 9.
