How do prostitution customers value health and position health in their discussions? Qualitative analysis of online forums.

Aim: Information on the health values and positioning of health among prostitution customers is limited. The aim is to explore the positioning of health among prostitution customers using data from Internet forums in Finland.

Methods: Qualitative study using a purposive sample of public online forums among prostitution customers in 2002-2012.

Results: Health beliefs in relation to infections and risky sexual behavior were diverse, from correct to false. Although men were aware of health risks in prostitution, it was common to have multiple sexual partners and unprotected sex. Although there were men who warned others about possible health consequences when a condom is not used, typically men were proud not to use a condom with a prostitute and found different explanations for not using a condom. Condom breakage was not an issue discussed in forums. Unexpected findings were beliefs that one fifth of the Nordic population is resistant to HIV, that the possibility of HIV transmission is exaggerated by medical specialists, and that men should control their behavior in order not to degrade prostitutes. Discussions on health service use were few.

Conclusions: Sexual satisfaction and entertainment were the main reasons to post in the analyzed forums health discussion was not common although condom use was reported, attention to health risks was selective information on health service use was limited, which may suggest this topic was not valued among men and should be a topic of future studies.