HIV's Bisexual Bridge to Women
Risk Posed By 'Down Low' Men Still Unknown
July 13, 2004 -- Men who have sex with men and women are
a "significant bridge for HIV to women," the CDC's new data
The findings come in a presentation to the XV International
AIDS Conference in Bangkok by CDC researcher Linda Valleroy, PhD. The CDC's
Young Men's Survey shows that about one in 10 men reporting sex with men also
has sex with women. And more than one in four of these bisexual men has unsafe
sex with both kinds of partners.
"Men who also had sex with women had similar levels of HIV
and STDs [as exclusively homosexual men] and higher levels of many risk
behaviors," Valleroy and colleagues note in their presentation
Another study presented at the AIDS conference -- based on
interviews with nearly 2,500 bisexual men by the San Francisco Department of
Health -- shows that 14% of men who have sex with men also has sex with women.
But the study, led by Willi McFarland, MD, PhD, suggests that these men may
have fewer risk behaviors than exclusively homosexual men.
"In San Francisco a few years back, we detected this rise
in risk behavior in men who have sex with men," McFarland tells WebMD.
"That raises the question of whether this will spill over into the general
population, with the bridge being men who have sex with men and women. Despite
dire predictions, San Francisco does not have a large heterosexual HIV
What's going on? The reality is that nobody really knows.
The Down Low: Not Just Black Men
Black men call it the DL: the down low. Fearing loss of
community support, men living this lifestyle keep their bisexuality -- and
their sexual relationships with other men -- secret from their female
Whether they call it the DL or not, many white and Latino men
also keep their sexual affairs with men secret from their female sex
"Most people believe this is only something happening with
black men," CDC scientist Greg Millet, MPH, tells WebMD. "We see it in
Latino and white men, too. They say they are heterosexual but report sex with
other men in the last three months, in the last year, in the last five years.
Sexual identity is not destiny."
John Peterson, PhD, professor of psychology at Atlanta's
Georgia State University, has studied the issue for a long time.
"The DL is a new name for an old issue," Peterson tells
WebMD. "Bisexual men not telling their female partners about their male
relationships takes place across all races and ethnicities. But what we really
don't know is how these men behave when they have primary male or female
Sex, Risky Sex, and Very Risky Sex
What is known about bisexual men suggests that those who have
long-term relationships with women may have different HIV risks than those who