Youth paying for sex: what are the associated factors? Findings from a cross-sectional study in Cambodia

Abstract

BackgroundAt-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia.MethodsThis cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16–24 recruited at ‘hotspots’ in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression analysis was used to identify factors associated with transactional sex.ResultsIn total, this study included 405 male youth with a mean age of 21.3 (SD = 2.2). Of the total respondents, 82.5% (n = 334) have ever paid for sex. After controlling for potential confounding, participants who purchased sex in the last 12 months remained significantly more likely to be older than 18 (AOR = 3.60, 95% CI = 1.26–10.62), reside in an urban area (AOR = 2.29, 95% CI = 1.24–4.20), never have been married (AOR = 9.58, 95% CI = 4.34–21.12), spend less than 2.55 USD per day (AOR = 2.22, 95% CI = 1.12–4.40), and have had more than 4.6 sexual partners in the past year (AOR = 16.73, 95% CI = 4.71–59.36).ConclusionsThis study highlights the high proportion of Cambodian male youth who paid for sex and the potential challenges to addressing this issue. While the majority of HIV prevention interventions surrounding sex work are aimed at female sex workers themselves, targeting the demand side of sex work, particularly the local demand, may be an important next step towards a sustainable HIV prevention.

Paid sex among men in sub-Saharan Africa: Analysis of the demographic and health survey

“…Frequency of listening to radio was also categorised as not at all = 1, less than once a week = 2, at least once a week = 3 and almost every day = 4. The choice of these explanatory variables was based on previous studies ( Belza et al, 2008 ; Carael, Slaymaker, Lyerla, & Sarkar, 2006 ; Dizechi et al, 2018 ; Jones et al, 2015 ; Regushevskaya, Haavio-Mannila, & Hemminki, 2013 ; Schei & Stigum, 2010 ).…”

“…Previous studies have revealed that socio-demographic, economic and behavioral factors are associated with paid sex among men. The socio-demographic factors include age ( Girchenko et al, 2015 ; Jewkes et al, 2012 ; Rich et al, 2018 ; Rissel et al, 2017 ), educational level ( Choudhry et al, 2015 ; Dizechi et al, 2018 ; Galvan, Ortiz, Martinez, & Bing, 2009 ; Jewkes et al, 2012 ; Pitts, Smith, Grierson, O'brien, & Misson, 2004 ), place of residence ( Balekang and Dintwa, 2016 , Dizechi et al, 2018 , Pan, Parish, & Huang, 2011 ) marital status ( Belza et al, 2008 ; Rissel et al, 2017 ; Schei & Stigum, 2010 ; Ward et al, 2005 ) and wealth status ( Dizechi et al, 2018 ; Jewkes et al, 2012 ; Jones et al, 2015 ; Rich et al, 2018 ). It has also been found that exposure to mass media (newspapers, magazines, radio and television) are associated with risky sexual practices, which may include paid sex ( Asekun-Olarinmoye, Asekun-Olarinmoye, Adebimpe, & Omisore, 2014 ; Bleakley, Hennessy, Fishbein, & Jordan, 2011 ; Fisher, Hill, Grube & Grube, 2004 ).…”

“…It has also been found that exposure to mass media (newspapers, magazines, radio and television) are associated with risky sexual practices, which may include paid sex ( Asekun-Olarinmoye, Asekun-Olarinmoye, Adebimpe, & Omisore, 2014 ; Bleakley, Hennessy, Fishbein, & Jordan, 2011 ; Fisher, Hill, Grube & Grube, 2004 ). Additionally, there are personal and behavioural reasons that increase the likelihood for men to pay for sex, such as satisfying sexual desire, desire for particular sexual acts or practices that regular partners are unable or unwilling to accommodate ( Mwapu, Hilhorst, Mashanda, Bahananga, & Mugenzi, 2016 ), sexual relief, convenience, entertainment and the belief that people are not meant to be monogamous ( Dizechi et al, 2018 ). Other factors include the influence of alcohol and drugs, and companionship ( Dizechi et al, 2018 ; Pitts et al, 2004 ), travelling issues, problems in households, unavailability of wives and reasons of health (menstruation, pregnancy and disease) ( Dizechi et al, 2018 ; Mwapu et al, 2016 ).…”

Experiences and challenges of Prostitute Women in Iran: A phenomenological qualitative study

“…Physical violence and bodily harm to women, verbal harm, and violence, not paying the agreed money, and even theft of women's money, along with forced sex, involuntary unusual sexual relationship, group sex by force, compulsion not to use protective and prophylactic devices are some aspects of the violence which prostituted women in this study mentioned. Various studies have shown that violence against prostituted women is a common phenomenon [ 25 , 26 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. Farley M et al., 2004 and Scorgie F et al., 2013 showed that violence against prostituted women is a norm and sexual and physical harassment, verbal humiliation, and torturing are forms of this violence [ 14 , 43 ].…”

Male clients of male sex workers in West Africa: A neglected high risk population

“…Despite the vast literature on sex work, most studies to date have focused exclusively on female sex workers (8–12). Although a few studies have focused on MSW and the risk of HIV/STI transmission (13,14,2,15,16), research on male clients of MSW is very scarce (17–20).…”