Survey questions older men who frequent sex work websites.

Older American male customers of sex workers pay for more sex as they age. These findings are reported in a study which surveyed older American men who frequent sex work websites and discussion boards. It was conducted by Los Angeles-based psychotherapist Christine Milrod and sociologist Martin Monto of the University of Portland in the US and published in Springer's journal Archives of Sexual Behavior.

The participants were 208 men between the ages of 60 and 84 years old from 36 American states who posted or read reviews or comments on female sex work review websites and discussion boards. They were asked 129 questions about their sexual health, behaviors and preferences. More than two-thirds (68.5 percent) were married, and most wanted to keep their activities secret. Over 85 percent of participants held at least a Bachelor's or graduate degree and enjoyed an annual income above that of the average American household. The primary sex partner of about 40 percent of the married or partnered men had a health condition (often sexually related such as being postmenopausal or suffering from vaginal dryness) that limited her engagement in sexual activities.

According to Milrod, there is an almost universal perception that older men do not pay for sex or even regularly engage sexually. "It was therefore extremely surprising to see that the advancing age of the men in our sample was associated with a higher frequency of buying sex," she explains.

Compared with other, more general and inclusive populations of sex buyers, the survey participants were much more active in purchasing sex, with more than half reporting that they had paid for sex between 13 and 24 times during the last 12 months.

Participants most often engaged in fellatio without a condom and penile-vaginal intercourse with a condom, preferably with a White provider aged between 26 and 45 years old. Almost one-third of the men saw one sex provider exclusively, while 44 percent had at some stage become emotionally attached or fallen in love with a provider.

Men were willing to pay for more than just sex. Married men often sought the so-called "girlfriend experience," while other high-income earners with no spouse or partner enjoyed non-sexual activities with a provider, such as dining out, attending cultural events or going on vacation together.

"These encounters appear to be a reliable outlet for sexual contact and physical intimacy sometimes not available in their primary relationships, partly due to a reduced pool of female partners available for sexual experiences," Monto explains.

Over half of the sample reported having talked with their doctor about sex after turning 60, and 80 percent said they initiate the topic. The findings highlight that medical practitioners should not assume that old age is a barrier to paying for sex.

"The uncomplicated and reliable access to willing sexual partners, even if remunerated, seems to ensure that our participants can choose to participate in sexual activities as long as they are physically and financially able," says Milrod.